Patient Knowhow

High-Filtration (Hi-Fi) Masks

While we wait for vaccines to become available, everyone can benefit from immediate access to high-filtration (hi-fi) masks as discussed by Patient Knowhow with our partners in StatNews. In June, with our partners in Harvard Business Review we highlighted the need for better masks (consumer respirators) for protection from Coronavirus. This includes a high level of filtration and fit, comfort, reusability, and style. At Patient Knowhow we have been on the lookout for better masks with these properties. Below are a short list of off-the-shelf options you can purchase online as well as a number of new mask designs that push the envelope in these dimensions. Which is best? We are not making any recommedations because it seems the right mask for each person is different based on their preferences, but at minimum they need to promise N95 level filtration and have features to form a seal (fit) with the face. Without proper fit, unfiltered air will leak around the edges due to lack of tight contact with the face (in other words "no fit no filtration"). Many good options are available off-the-shelf -- when in doubt NIOSH approved masks are validated by the US government (see below). Please also see notes on testing and valves below. If you know of any masks that should be included here please reach out to me at sri at patientknowhow dot com or @sri_srikrishna on Twitter. For updates please join our email list.

Off-the-shelf Hi-Fi masks (NIOSH approved)

Masks that are N95 (or better) approved from CDC NIOSH means the mask's fit, filtration, breathability, durability, and manufacturing consistency have all been rigorously verified by the US federal government. NIOSH maintains a list of approved masks and counterfeits.

Envomask

Reusable N95 mask, NIOSH-approved, that uses a silcone gel to form a seal around the face written up in Wall Street Journal

One nurse's experience after 7 months using Envomask

Unboxing and Assembly of Envomask

3M Elastomeric

Reusable N95 mask (eN95), NIOSH-approved, with matching P95 filter sold separately.

It was recently adopted by the Fire Department of New York using a higher filtration filter (P100) that is significantly harder to breathe through but offers even greater protection compared to the P95

The woman in the picture of this article appears to be wearing a 3M elastomeric mask but with a fuzzy cover over the filter to make it look a little less industrial and more stylish.

Fire Department of New York's video about the 3M elastomeric mask

Assembly and wearing a 3M 6000 series elastomeric mask

Softseal

Disposable N95 mask, NIOSH-approved, that builds on the traditional N95 design by using silicone to form a seal with the face.

Their video does a good job of explaining why in addition to the filter material a proper seal is important.

Moldex

Disposable N95 mask, NIOSH-approved, that builds on the traditional N95 design by using foam to create a seal with the face.

Comes in N95 and N100 varieties

Their video explains how to fit the respirator to the face.

N95 (disposable)

The N95 mask (NIOSH approved) is one of the best known high-filtration masks. Disposable N95 masks have been largely reserved for healthcare workers because they have been in short supply during the pandemic (although some manufacturers say that demand from the general public is beneficial to even out the ebbs and flows of demand from hospitals).

With some exceptions like the models above, most disposable N95 masks do not have special technology other than the filter material from which it is made to improve the fit to the face. Professionals use disposable N95 after training and a “fit-test” that assures proper fit to the wearer, something that would not be easy for most people.

Some N95 models are also available from Amazon, Costco and Office Depot.

eN95 (reusable, elastomeric)

A reusable, NIOSH-approved N95 type of mask that is not in short supply is an elastomeric N95 (eN95) mask made by several manufacturers including 3M, Honeywell, MSA, etc.

According to the CDC, elastomeric models have sealing surfaces and adjustable straps that can accommodate a better fit, and the replaceable filters in some models could be used for one year as long as the filter cartridges remain in good condition.

We wrote about eN95 with our partners in August for the California State Firefighters Association, in October for Harvard Business Review, and in December for the International Assocation for Police Chiefs.


Off-the-shelf Hi-Fi masks (either pending or not seeking NIOSH approval)

O2 Curve

Consumer mask, not NIOSH-approved, but has test results

Unboxing and Assembly of O2 Curve

O2 Tactical

Military grade mask by makers of O2 mask above, not NIOSH-approved, but tested for use with special operations forces to help prevent poisoning from aerosolized lead

Design of the TR2 by O2's chief innovation officer

Airgami

Uses a folding design based on origami principles to achieve a tighter fit with the face

Winner of a competition run by Johnson & Johnson and BARDA and recently written up in National Geographic.

Although not yet NIOSH approved they are working towards approval.

Fix The Mask

A brace or harness to improve the fit of commonly used surgical masks.

Although not yet NIOSH approved they are working towards approval.

Their video explains how to fix the face seal of loose-fitting surgical masks.

How to wear the brace (EMB) with a surgical mask.

Maskforce1

An elastomeric mask in use by first responders made by a Wisconsin auto-parts manufcturer that uses a symmetric, flat-filter design (so no exhalation valve).

Although not yet NIOSH approved they are working towards approval.

Can be purchased through a non-profit here.

Open Standard Industries

An elastomeric mask that uses a symmetric, flat-filter design (so no exhalation valve).

Although not yet NIOSH approved they are working towards approval with test results.

Canopy

Clear face mask with high-performance filter for better view of facial expressions

Has test results and although not yet NIOSH approved they are working towards approval.

Leaf

Clear face mask with HEPA filter for better view of facial expressions

KF94 (disposable)

Another commonly used hi-fi alternative to disposable N95 is KF94 from South Korea. Aaron Collins has done some testing of various KF94 masks.

KN95 (disposable)

Many people use an alternative to disposable N95 called KN95 which is a Chinese standard for hi-fi masks. However there have been reports of inconsistent filtration performance so we are unable to make any conclusion about them at this time.

Valves: To protect others many N95 models with a valve require a workaround to cover their exhalation valve, although the CDC recently reported the maximum particle emissions through the valve are similar to or better than surgical masks or unregulated face coverings. Some manufacturers now address this by completely plugging the valve (e.g. Envomask and MSA). Additionally, valveless elastomerics and bidirectional high-fi masks designed for public use are also becoming available.

Testing: Places such as Nelson Labs do testing, and NIOSH has a certification process. Watch the video below by Minute Physics and read these recent papers (1, 2, 3) to learn why it matters.

Disclaimer: These links to resources on masks, peer-reviewed videos, and comments by researchers (the “Content”) are for informational purposes only and should not be construed as professional advice. The Content is intended to complement, not substitute, the advice of your doctor. You should seek independent professional advice from a person who is licensed and/or qualified in the applicable area. No action should be taken based upon any information contained in this website. Use of the website is at your own risk. Patient Knowhow, Inc. takes no responsibility and assumes no liability for any Content made available over this website.

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