Here we are again talking of the upcoming flu season. As always we do not know what the virus combination is, therefore I would like to remind you that you take the following precautions. Now that school is in session always have your mask and hand sanitizer with you at all times, avoid crowds, stay away from sneezing coughing people. Wear your mask and sanitize often. These precautions will help normal people as well as we "fragile" people.

I would like to relate to you some of the questions I have received since my last blog.
The first was about a person who is a lung transplant who is involved in grounds keeping. Their question was what masks should they wear? My recommendation was to use a N-95 vented exhaust mask when work around active dust and grass clippings. If they are not actively creating particles and the air is clear you could possible get by with a dust mask. The curve ball came when they spray, first STAY AWAY, second you should protect yourself with a P-95 mask which is made to handle droplets.

The second was a lung transplant who rode a motorcycle and had problems with his mask staying on his face, my solution was two fold. The first was to use his full face helmet and I gave him some N-95 vented masks which I used while racing. The helmet protects the mask from violent wind, but provides a nice air flow to the mask.

The third situation kind of came out of the blue, regarding dirt track racers. The situation there is dust and dirt everywhere. My suggestion was to try different masks on the drivers until they found one that comfortable for them to race with. We need to protect young lungs as well as old one, there will be resistance to the mask by driver until they can see the value. I have had a few catty comments made about my wearing of a mask not only to race but in paddock area also, I race on solid surfaces where there is very little dust. But, dust is everywhere the wind blows so be prepared.

I hope these little tidbits will allow you to understand that transplant and immosupressed patients as well as normal healthy people can all benefit from one another ideas how we can live normal lives and better care for our bodies.

God Bless You All
wil
e-mail: mynewlung@gmail.com

I have just finished my second year of being a lung transplant recipient! WOW, it has been great I live like a normal old man. I go where I want to go and do what I want to do all the time wearing a filter mask.
Every time I have to go back to the Hospital for what I call testing (labs, x-ray, echocardiogram, and the respiratory testing with blood gases) I get nervous. I always worry that something may be going wrong within my body. Am I starting to reject or is there an infection? Are the drugs affecting my liver or kidneys? It’s worry time, because above every thing else you want to continue to live your life as a productive human being.
Well we did it, my lung and I, we passed with good results, and the best part there was no broch. That was the start of a great day to follow, as I was invited to speak to the Heart-Lung Support Group at the hospital. It was great to be able to once again speak about one of my favorite subjects, masks. I was greatly inspired to speak to new and old (years since transplant) recipients, and hear their stories.
Please remember you must keep Faith, don’t lose your Humor, and wear your Mask.
God Bless You
wil

Hi again. It has been some time since I last entered any information on my blog site. Now that the flu scare has passed and hopefully no one got the flu, but continued to be a good mask wearer. Now we are in the pollen season and here in the southeast pollen has been very very bad this year, we have had yellow cars for over a month, it is now starting to recede and with a few more rains the air should be back to normal.

You cannot let your guard down because the weather is getting nicer. There will still be pollen, dust, bacteria and fungi blowing in the wind. I would like to stress that you continue to use a mask when you are outside or in gatherings of people. And you continue to stay away from people who may be or are becoming ill. Remember immunosuppression doesn’t give you the reserve you need to fight a big infection. Be Careful and watch your surroundings.

OK more about masks: Well, I think I have exhausted the various masks in the market place. Now I have my favorites (I use different masks for different activities and environments) my job is to reduce or eliminate particulate matter from entering my new lung. I cannot believe the number of retail outlets that have masks available, and they range from the simple dust mask all the way to a P-100 respirator. I have now been able to find various types of masks at different drug stores, hardware stores, on-line and home supply stores (try the paint department). Two years ago as I looked for different types of masks, with no avail I had to go to the safety stores on the internet, but now I can go to a local retailer. Prices seem to be very standard between the different retailers, just be sure to see what the mask rating is (dust mask, N-95, N-99, P-100, etc.). Make sure the mask is rated; otherwise there is no assurance of its filter capacity.

My opinion at this time about the use of a face mask is simple “something is better that nothing” and compliance is of the utmost importance to your long life. Now that I said that, find the face mask that fits you and is comfortable to wear for a long period of time (I may wear a mask for up to 15 hours a day). If your mask is comfortable then you will be willing to wear it more, thus filtering out more particulate matter from the air.

Now that the flu season is upon us I felt it was time to add a new comment to my mask blog. As you have probably heard the CDC is recommending the N-95 masks for healthcare workers involved in patient care. As was noted in my discussion of masks I dealt with "vented" N-95 masks. When a mask user is in contact with patients or people who may show signs of flu (both seasonal of H1N1), the recommended mask is a "unvented" N-95. The unvented N-95 mask provides protection to both the wearer and those around them, therefore, reducing the risk of receiving or transmitting germs.

During the flu season masks are only one part of your protection. Remember you will still need to wash or sanitize (with alcohol based sanitizer) your hands frequently, stay away from crowds, and get your flu shot

N-95 EXHAUST MASKS vs DUST MASKS

This study was designed to help people to be more compliant in their use of masks to protect their immunocomprized lives. Having already tested masks ranging from the Dust to a P-100 respirator, and knowing the down side of these masks I have embarked on this study to look at 3 masks which are N-95 exhaust vented to determine which masks would provide the wearer with the greatest comfort. At this point I would like to back up a little and review why the use of a mask is an issue. Masks are you protection from inhaled particles like bacteria, fungi, and viruses. As you are aware disease is transmitted in 3 ways: 1. by touch, 2. Inhaled air born particles, and 3. Inhaled droplets, thus you must be aware of you surrounding. You must be prepared to protect yourself from environmental surroundings such as door handles, phones, TV remotes, coughing, sneezing, children, wind and dust, pollen, smoke, and so on.
At this time I would like to provide you some basic information regarding the rating of the different masks. This date is thanks to OSHA.

Surgical mask (blue) 95% efficient to 3 microns
Surgical mask (pink) 99% " to 0.1 microns
Dust Mask 80% " to <1.8-3 micron
Mask rated N,P,R 95 95% " to 0.3 microns
Mask N-99 99.1% " to 0.3 microns
Mask P-100 99.97% " to 0.3 microns

There are 3 designations for the masks:
N not resistant to oil mist
P resistant to oil mist with time limit
R resistant to oil mist for 8 hour shift

Remember: Masks are designed to protect you, but YOU have to use good sense. Compliance is a very important issue as well as having the right mask for the job you are performing. You need the proper fit to obtain the maximum filtration of the air you will also need to avoid facial hair, getting the mask wet, and above all DO NOT SHARE MASKS.
Another piece of information I though would be of interest is the size of some very common particles.

Eye of a needle 1230 microns
Pollens 10-1000 "
Beach sand 100-10000 "
Mold spores 10-30 "
Mold 3-12 "
Face Powder 0.1-30 "
Talcum powder 0.5-50 "
Liquid droplets 0.5-5 "
Dust 1-100 "
Bacteria (average) 4 "
Tobacco smoke 0.01-4 "

The most common masks I have seen patients using are the blue surgical masks available at the doors of hospitals and some use of the dust mask available at the drug store or hardware store. In my review of the litature I found that almost any mask is better than nothing in reducing the amount of particles that will get into your lungs. I have found through trial and error that the dust mask works very well for normal situations like church, shopping, driving, and exercising.
I decided to compare the N-95 exhaust vent masks against the common Dust mask for comfort and wear ability. I undertook this study because of the unknowns in the flu season which will be up coming. The Centers for Disease Control (CDC) has recommended the N-95 mask for the prevention of inhaled flu virus, thus I selected the N-95 exhaust vent masks. I have advocated the use of the dust mask as the cheap everyday mask of choice, so I chose it to compare to the N-95’s. Through the experience I have had using the non vented N-95 masks, I felt it would create a great compliance problem, because of the difficulty in breathing and the amount of heat build up in the mask.

Having already tested masks ranging from the Dust to a P-100 respirator, and knowing the down side of these masks I have embarked on this study to look at 3 masks which are N-95 exhaust vented to determine which masks would provide the wearer with the greatest comfort and the greatest compliance for their protection.

STUDY:

The study was designed to take place in heat, with exercise, work manual, work brain, and in public. The tested masks were worn for a hour up to 12-15 hours at a time. The temperature was mainly in middle 80’s to the middle 90’s with the exception of testing in central Ohio where we encountered the middle 70’s. 90% of the testing was done under exercise and physical work. I employed several other persons to compare the 3 different masks and I incorporated their opinions in the results.

RESULTS:

Mask #1 was a 3M 8511. This mask has a nice soft lining, looks to be very comfortable. This mask does fit under a Bell full face crash helmet, but the exhaust valve gets pressed toward your face. It does work. It fogged the glasses even with a nose clip. Has a lot of moisture build up so that your face and the mask are damp, the rest of your body was sweating also. Very difficult to nose breathe, had to purse breathe. Periodically it was necessary to blow the exhaust valve to free it from sticking.

Mask #2 was a Moldex 2300. This mask has an external skeleton that looks like a fiberglass cast. It is molded to a predetermined shape with a inner liner to bridge the nose. We had one of our testers who had a broken nose and the mask would not seal for that person. Here again we had moister build up inside the mask. The mask did not fog the glasses, although nasal breathing was difficult so you had to purse breathe. Periodically it was necessary to blow hard enough to free the exhaust valve, they tend to stick. This mask does fit under a Bell full face crash helmet and works well.

Mask #3 was a Gerson Aspire 1740. This mask is well molded having adequate room to breathe. This mask routinely did not fog glassed. It does fit under a Bell full face crash helmet and works well. Pursed breathing needed to keep valve from sticking. The head bands stretch out, but will keep the mask in place; it was used for several days to see if it would work. Still lots of moisture build up in the mask under heavy exercise.

Mask #4 was a Dust Mask. It was also hot and fogged you glasses and was at least as uncomfortable as the other masks. This mask will fit under a Bell full face crash helmet but tends to ride up if air flow get under the helmet, but it will work for you.
Footnote: All of these masks were uncomfortable when the heat and humidity were up, with lower temperatures the masks became more comfortable.

CONCLUSION:

From our experience in this study it came down to 2 masks we felt the best about. It is a tie between the Moldex 2300 and the Gerson Aspire 1740. The both provide the protection that you want and the comfort you want if it fits your face. Fitting is very important, because the more unfiltered air you receive the greater your chance of a contaminate being introduced to you. We can evaluate the different masks, but it still comes down to an individual preference as to what comfort is to the wearer. If the mask is not worn then it can’t do it job.
While doing research on the use of masks vs disease I came across an article from Australia where they did a non-blinded study comparing 2 different masks against a control. They found there as statistically no difference between the 3 study arms. The reason, they concluded was the compliance of the mask wearers was 46%. Therefore, if we are going to protect the immunocomprized we must provide them with a product that they can wear with comfort and have a high compliance rate. With the great unknown about the up coming flu season, not knowing which strains, will the H1N1 component be correct, etc. it just makes sense that comprised patients take no chances and wear their masks any time they leave their homes.