Health effects of filtering facepiece respirators: Systematic review of pulmonary and cardiovascular effects.

Filtering facepiece respirators (FFRs) were introduced to protect the wearer by removing small particles from inspired air. FFRs are now also used to reduce spread of transmissible agents from the wearer and used outside traditional healthcare and other workplaces. The COVID-19 pandemic increased concerns about potential adverse effects on wearers.


METHOD
A PUBMED query retrieved papers through June 2022. Abstracts and selected full text papers were systematically reviewed by the authors. This paper focuses upon cardiopulmonary physiologic effects (e.g., ventilation, CO2 elimination, oxygen uptake, and respiratory control) with emphasis upon current and potential research methods as well as summarizing results.


RESULTS
1985 records were identified, of which only 26% were published prior to 2020.


CONCLUSIONS
Effects on CO2 elimination appear more likely to be potentially significant than effects on oxygenation or cardiovascular function. While FFRs appear well tolerated by healthy persons, more research is needed for those with pulmonary or cardiac disorders and for children. Many traditional pulmonary exercise study methods require special care when applied to filtering facepiece respirators. Studying additional parameters may explain the paradox of many subjective discomfort reports despite very limited physiologic effects. This article is protected by copyright. All rights reserved.