Skip to main content

Main menu

  • Home
  • Current issue
  • ERJ Early View
  • Past issues
  • Authors/reviewers
    • Instructions for authors
    • Submit a manuscript
    • Open access
    • COVID-19 submission information
    • Peer reviewer login
  • Alerts
  • Podcasts
  • Subscriptions
  • ERS Publications
    • European Respiratory Journal
    • ERJ Open Research
    • European Respiratory Review
    • Breathe
    • ERS Books
    • ERS publications home

User menu

  • Log in
  • Subscribe
  • Contact Us
  • My Cart

Search

  • Advanced search
  • ERS Publications
    • European Respiratory Journal
    • ERJ Open Research
    • European Respiratory Review
    • Breathe
    • ERS Books
    • ERS publications home

Login

European Respiratory Society

Advanced Search

  • Home
  • Current issue
  • ERJ Early View
  • Past issues
  • Authors/reviewers
    • Instructions for authors
    • Submit a manuscript
    • Open access
    • COVID-19 submission information
    • Peer reviewer login
  • Alerts
  • Podcasts
  • Subscriptions

“You can leave your mask on”: effects on cardiopulmonary parameters of different airway protective masks at rest and during maximal exercise

Massimo Mapelli, Elisabetta Salvioni, Fabiana De Martino, Irene Mattavelli, Paola Gugliandolo, Carlo Vignati, Stefania Farina, Pietro Palermo, Jeness Campodonico, Riccardo Maragna, Gerardo Lo Russo, Alice Bonomi, Susanna Sciomer, Piergiuseppe Agostoni
European Respiratory Journal 2021 58: 2004473; DOI: 10.1183/13993003.04473-2020
Massimo Mapelli
1Centro Cardiologico Monzino IRCCS, Milan, Italy
2Dept of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy
4Shared first author privilege
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • ORCID record for Massimo Mapelli
Elisabetta Salvioni
1Centro Cardiologico Monzino IRCCS, Milan, Italy
4Shared first author privilege
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • ORCID record for Elisabetta Salvioni
Fabiana De Martino
1Centro Cardiologico Monzino IRCCS, Milan, Italy
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Irene Mattavelli
1Centro Cardiologico Monzino IRCCS, Milan, Italy
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • ORCID record for Irene Mattavelli
Paola Gugliandolo
1Centro Cardiologico Monzino IRCCS, Milan, Italy
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Carlo Vignati
1Centro Cardiologico Monzino IRCCS, Milan, Italy
2Dept of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • ORCID record for Carlo Vignati
Stefania Farina
1Centro Cardiologico Monzino IRCCS, Milan, Italy
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Pietro Palermo
1Centro Cardiologico Monzino IRCCS, Milan, Italy
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • ORCID record for Pietro Palermo
Jeness Campodonico
1Centro Cardiologico Monzino IRCCS, Milan, Italy
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • ORCID record for Jeness Campodonico
Riccardo Maragna
1Centro Cardiologico Monzino IRCCS, Milan, Italy
2Dept of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • ORCID record for Riccardo Maragna
Gerardo Lo Russo
1Centro Cardiologico Monzino IRCCS, Milan, Italy
2Dept of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Alice Bonomi
1Centro Cardiologico Monzino IRCCS, Milan, Italy
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • ORCID record for Alice Bonomi
Susanna Sciomer
3Dipartimento di Scienze Cardiovascolari, Respiratorie, Nefrologiche, Anestesiologiche e Geriatriche, “Sapienza”, Rome University, Rome, Italy
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • ORCID record for Susanna Sciomer
Piergiuseppe Agostoni
1Centro Cardiologico Monzino IRCCS, Milan, Italy
2Dept of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Milan, Italy
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • ORCID record for Piergiuseppe Agostoni
  • For correspondence: piergiuseppe.agostoni@cardiologicomonzino.it
  • Article
  • Figures & Data
  • Info & Metrics
  • PDF
Loading

Abstract

During the COVID-19 pandemic, the use of protective masks has been essential to reduce contagions. However, public opinion is that there is an associated subjective shortness of breath. We evaluated cardiorespiratory parameters at rest and during maximal exertion to highlight any differences with the use of protective masks.

12 healthy subjects performed three identical cardiopulmonary exercise tests, one without wearing a protective mask, one wearing a surgical mask and one with a filtering face piece particles class 2 (FFP2) mask. Dyspnoea was assessed using the Borg scale. Standard pulmonary function tests were also performed.

All the subjects (40.8±12.4 years; six male) completed the protocol with no adverse events. Spirometry showed a progressive reduction of forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) from no mask to surgical to FFP2 (FEV1: 3.94±0.91 L, 3.23±0.81 L, 2.94±0.98 L; FVC: 4.70±1.21 L, 3.77±1.02 L, 3.52±1.21 L; p<0.001). Rest ventilation, O2 uptake (V˙O2) and CO2 production (V˙CO2) were progressively lower, with a reduction in respiratory rate. At peak exercise, subjects had a progressively higher Borg scale when wearing surgical and FFP2 masks. Accordingly, at peak exercise, V˙O2 (31.0±23.4 mL·kg−1·min−1, 27.5±6.9 mL·kg−1·min−1, 28.2±8.8 mL·kg−1·min−1; p=0.001), ventilation (92±26 L, 76±22 L, 72±21 L; p=0.003), respiratory rate (42±8 breaths·min−1, 38±5 breaths·min−1, 37±4 breaths·min−1; p=0.04) and tidal volume (2.28±0.72 L, 2.05±0.60 L, 1.96±0.65 L; p=0.001) were gradually lower. There was no significant difference in oxygen saturation.

Protective masks are associated with significant but modest worsening of spirometry and cardiorespiratory parameters at rest and peak exercise. The effect is driven by a ventilation reduction due to increased airflow resistance. However, because exercise ventilatory limitation is far from being reached, their use is safe even during maximal exercise, with a slight reduction in performance.

Abstract

Protective mask use in healthy subjects is associated with modest respiratory discomfort and a slight reduction in exercise performance, mainly due to an increase in airflow resistance https://bit.ly/3aOCpwB

Footnotes

  • All raw data collected for the study will be made available to others after request. Data will be stored in anonymised form at www.zenodo.org when the paper is published.

  • Conflict of interest: M. Mapelli has nothing to disclose.

  • Conflict of interest: E. Salvioni has nothing to disclose.

  • Conflict of interest: F. De Martino has nothing to disclose.

  • Conflict of interest: I. Mattavelli has nothing to disclose.

  • Conflict of interest: P. Gugliandolo has nothing to disclose.

  • Conflict of interest: C. Vignati has nothing to disclose.

  • Conflict of interest: S. Farina has nothing to disclose.

  • Conflict of interest: P. Palermo has nothing to disclose.

  • Conflict of interest: J. Campodonico has nothing to disclose.

  • Conflict of interest: R. Maragna has nothing to disclose.

  • Conflict of interest: G. Lo Russo has nothing to disclose.

  • Conflict of interest: A. Bonomi has nothing to disclose.

  • Conflict of interest: S. Sciomer has nothing to disclose.

  • Conflict of interest: P. Agostoni reports non-financial support from Menarini, Novartis and Boehringer, grants from Daiichi Sankyo and Bayer, and grants and non-financial support from Actelion, outside the submitted work.

  • Support statement: This work was supported by the Italian Ministry of Health. Funding information for this article has been deposited with the Crossref Funder Registry.

  • Received December 10, 2020.
  • Accepted February 3, 2021.
  • Copyright ©The authors 2021. For reproduction rights and permissions contact permissions{at}ersnet.org
https://www.ersjournals.com/user-licence
View Full Text

ERS Members

myERS - ERS members : log in with your myERS username and password.

INDIVIDUALS

Log in Login as an individual user.

Forgot your username or password?

LIBRARY USERS

Log in through your institution

If your library has a subscription, you may already be logged in via your IP address. Otherwise you may be able to log in via one of the following routes.
You may be able to gain access using your login credentials for your institution. Contact your library if you do not have a username and password.
If your organization uses OpenAthens, you can log in using your OpenAthens username and password. To check if your institution is supported, please see this list. Contact your library for more details.
If you think you should have access, please contact your librarian or email journals@ersnet.org

Purchase access

You may purchase access to this article. This will require you to create an account if you don't already have one.
PreviousNext
Back to top
View this article with LENS
Vol 58 Issue 3 Table of Contents
European Respiratory Journal: 58 (3)
  • Table of Contents
  • Index by author
Email

Thank you for your interest in spreading the word on European Respiratory Society .

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
“You can leave your mask on”: effects on cardiopulmonary parameters of different airway protective masks at rest and during maximal exercise
(Your Name) has sent you a message from European Respiratory Society
(Your Name) thought you would like to see the European Respiratory Society web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Print
Citation Tools
“You can leave your mask on”: effects on cardiopulmonary parameters of different airway protective masks at rest and during maximal exercise
Massimo Mapelli, Elisabetta Salvioni, Fabiana De Martino, Irene Mattavelli, Paola Gugliandolo, Carlo Vignati, Stefania Farina, Pietro Palermo, Jeness Campodonico, Riccardo Maragna, Gerardo Lo Russo, Alice Bonomi, Susanna Sciomer, Piergiuseppe Agostoni
European Respiratory Journal Sep 2021, 58 (3) 2004473; DOI: 10.1183/13993003.04473-2020

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero

Share
“You can leave your mask on”: effects on cardiopulmonary parameters of different airway protective masks at rest and during maximal exercise
Massimo Mapelli, Elisabetta Salvioni, Fabiana De Martino, Irene Mattavelli, Paola Gugliandolo, Carlo Vignati, Stefania Farina, Pietro Palermo, Jeness Campodonico, Riccardo Maragna, Gerardo Lo Russo, Alice Bonomi, Susanna Sciomer, Piergiuseppe Agostoni
European Respiratory Journal Sep 2021, 58 (3) 2004473; DOI: 10.1183/13993003.04473-2020
del.icio.us logo Digg logo Reddit logo Technorati logo Twitter logo CiteULike logo Connotea logo Facebook logo Google logo Mendeley logo
Full Text (PDF)

Jump To

  • Article
    • Abstract
    • Abstract
    • Introduction
    • Methods
    • Results
    • Discussion
    • Shareable PDF
    • Footnotes
    • References
  • Figures & Data
  • Info & Metrics
  • PDF

Subjects

  • Respiratory infections and tuberculosis
  • Respiratory clinical practice
  • Tweet Widget
  • Facebook Like
  • Google Plus One

More in this TOC Section

Original Research Articles

  • Use of singing for lung health in COPD
  • Interferon-inducible signature of airway disease from blood gene expression profiling
  • Development of lung diffusion to adulthood following extremely preterm birth
Show more Original Research Articles

Pulmonary infection

  • Prognostic factors of community-acquired staphylococcal pneumonia
  • COVID-19, pulmonary function and quality of life
Show more Pulmonary infection

Related Articles

Navigate

  • Home
  • Current issue
  • Archive

About the ERJ

  • Journal information
  • Editorial board
  • Reviewers
  • Press
  • Permissions and reprints
  • Advertising

The European Respiratory Society

  • Society home
  • myERS
  • Privacy policy
  • Accessibility

ERS publications

  • European Respiratory Journal
  • ERJ Open Research
  • European Respiratory Review
  • Breathe
  • ERS books online
  • ERS Bookshop

Help

  • Feedback

For authors

  • Instructions for authors
  • Publication ethics and malpractice
  • Submit a manuscript

For readers

  • Alerts
  • Subjects
  • Podcasts
  • RSS

Subscriptions

  • Accessing the ERS publications

Contact us

European Respiratory Society
442 Glossop Road
Sheffield S10 2PX
United Kingdom
Tel: +44 114 2672860
Email: journals@ersnet.org

ISSN

Print ISSN:  0903-1936
Online ISSN: 1399-3003

Copyright © 2022 by the European Respiratory Society