Effectiveness of manufactured surgical masks, respirators, and home-made masks in prevention of respiratory infection due to airborne microorganisms

Stephen Rossettie BA, Cody Perry BS, Mohammed Pourghaed BS, Mimi Zumwalt, MD


According to a Centers for Disease Control (CDC) estimate, the health sector would require about 1.5 billion face masks plus 90 million respirators, and the public would need around 1.1 billion masks for a six-week influenza pandemic.1 As the current COVID-19 pandemic unfolds, concerns have been raised over depletion of medical supplies, including face masks. This has led to recommendations for healthcare personnel (HCP) to apply extended use and limited re-use strategies with face masks.2 In addition, the general population’s response is mounting with persons making their own face masks for self-protection. This article aims to provide more detailed scientific information regarding the effectiveness and reusability of medical/surgical masks, respirators, and homemade masks.

Data have been collected from various journals and different studies listed in PubMed and the Cochrane Library. The CDC and the World Health Organization’s (WHO) guidelines were also used extensively, as well as broader web searches of the English literature for up to date information.

Several investigators have shown that respirators are effective for reducing HCP exposure to airborne viruses and bacteria.3–6 Although some studies indicate no difference between the effectiveness of surgical masks and respirators, evidence does exist showing that respirators should be used instead of surgical masks when performing aerosol-generating procedures, since a respirator’s tight seal and regulator are better equipped for minimizing airborne transmission.6,7 However, surgical masks are still considered an effective form of PPE since they provide some respiratory protection and can prevent the transmission of contagious respiratory droplets by infected individuals. As for the effectiveness of cloth homemade masks, this is difficult to determine since limited randomized controlled trials (RCTs) exist involving the use of these masks.8 However, studies conducted in some laboratory settings and one clinical investigation indicate that they provide minimal respiratory protection.9–11 It is important to continue further inquiries about the efficacy and reusability of surgical masks, respirators, and homemade masks, so that both healthcare providers and the public can collaborate to help reduce the destructive impact of SARS-CoV-2 and work toward improving the prevention of this highly infectious, potentially deadly transmissible disease.

Keywords: COVID-19, SARS-CoV-2, surgical masks, N95 respirator, cloth masks, effectiveness, reuse

Article citation: Rossettie S, Perry C, Mohammed Pourghaed M, Mimi Zumwalt M. Effectiveness of manufactured surgical masks, respirators, and home-made masks in prevention of respiratory infection due to airborne microorganisms. The Southwest Respiratory and Critical Care Chronicles 2020;8(34):11–26
From: The Department of Orthopedics (MZ) and the School of Medicine (SR, CP, MP), Texas Tech University Health Sciences Center, Lubbock, Texas
Submitted: 4/1/2020
Accepted: 4/5/2020
Reviewer: Kenneth Nugent MD
Conflicts of interest: none
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