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Dear Brains Trust,
We have recently started to see the use of face mask brackets / inserts creep into use in our facility with staff wearing surgical face masks.
We have been unable to find any specific literature but from an infection prevention and control point of view we have a number of concerns including:
* Does it create a gap in the seal between mask and face?
* Does it potentially pose a risk as a pressure causing agent?
* Is removal of the mask in a manner that won’t contaminate still possible with the bracket in place?
* Is the bracket stored in a clean space?
* Is the bracket cleaned after use and before storage?
Does anyone have any references regarding these products or has anyone investigated and / or authorised the use of these products within their facility.
Kind regards,
Fiona De Sousa CICP-E| Nurse Manager | Infection Prevention & Control Unit
Launceston General Hospital, Level 2, Launceston TAS 7250
phone: 6777 6715 | mobile: 0408 487 197 | fax: 6777 5170 | email: fiona.de.sousa@ths.tas.gov.au |
intranet: http://www.dhhs.tas.gov.au/intranet/thon/infection_controlIPCU – ‘By working together we promote a culture of safety to reduce preventable infections and transmission of multi-resistant organisms’
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Hi Fiona,
Interesting!
Are they being used with N95 masks in addition to surgical masks?
If so, have you done any fit testing with the Mask Bracket/Face Mask Inner
Support Frame in situ?Regards
Glenys
Glenys Harrington
Consultant
Infection Control Consultancy (ICC)
P.O. Box 6385
Melbourne
Australia, 3004
M: +61 404816434
Sousa, Fiona M
Dear Brains Trust,
We have recently started to see the use of face mask brackets / inserts
creep into use in our facility with staff wearing surgical face masks.We have been unable to find any specific literature but from an infection
prevention and control point of view we have a number of concerns
including:*Does it create a gap in the seal between mask and face?
*Does it potentially pose a risk as a pressure causing agent?
*Is removal of the mask in a manner that won’t contaminate still
possible with the bracket in place?*Is the bracket stored in a clean space?
*Is the bracket cleaned after use and before storage?
Does anyone have any references regarding these products or has anyone
investigated and / or authorised the use of these products within their
facility.Kind regards,
Fiona De Sousa CICP-E| Nurse Manager | Infection Prevention & Control Unit
Launceston General Hospital, Level 2, Launceston TAS 7250
phone: 6777 6715 | mobile: 0408 487 197 | fax: 6777 5170 | email:
fiona.de.sousa@ths.tas.gov.au |intranet:
http://www.dhhs.tas.gov.au/intranet/thon/infection_controlIPCU – ‘By working together we promote a culture of safety to reduce
preventable infections and transmission of multi-resistant organisms’_____
CONFIDENTIALITY NOTICE AND DISCLAIMER
The information in this transmission may be confidential and/or protected by
legal professional privilege, and is intended only for the person or persons
to whom it is addressed. If you are not such a person, you are warned that
any disclosure, copying or dissemination of the information is unauthorised.
If you have received the transmission in error, please immediately contact
this office by telephone, fax or email, to inform us of the error and to
enable arrangements to be made for the destruction of the transmission, or
its return at our cost. No liability is accepted for any unauthorised use of
the information contained in this transmission.MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO
NOT REPRESENT THE OPINION OF ACIPC.The use of trade/product/commercial brand names through the list is
discouraged by ACIPC. If you wish to discuss specific reference to products
or services by brand or commercial names, please do this outside the list.Archive of all messages are available at http://aicalist.org.au/archives –
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(without the quotes) to listserv@aicalist.org.auMESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.
The use of trade/product/commercial brand names through the list is discouraged by ACIPC. If you wish to discuss specific reference to products or services by brand or commercial names, please do this outside the list.
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Hi Fiona,
Gleny’s is right, this is a very interesting question. I personally have not come across their use in our facility, but I do remember they were all the rage last year on social media, when everyone was coming up with ‘mask hacks’ or ‘DIY mask projects’.
The brackets/frames were then being recommended as a solution, for people who were not used to the daily wearing of face masks and were struggling with all those little nuisances that come with it, such as fogging up of glasses, difficulty breathing e.t.c. Some sellers of the brackets I recall were even saying that the brackets helped “extend mask life” as it kept the mask from having direct contact with your face.
I remember doing a literature search then and only finding news, magazines or blog articles about the products. Which made sense since it was a new product. So studies were yet to be done on how they affect the transmission of infectious agents. Also I couldn’t find any guidelines or even healthcare facilities that had mentioned that their staff were using them.
I had another quick look again after reading your query and again no sign of any scientific literature about them. Just multiple news articles, blogs e.t.c.But back to your query:
Does it create a gap in the seal between mask and face?
The CDC this year in April 2021, published an article about how to “improve the fit and filtration of a mask to reduce the spread of COVID-19” and interestingly enough in that article, there was no mention of face-mask brackets/frame or any recommendations for their use.Their message in that article regarding the masks remained clear, that the mask should “fit snugly against the side of the face and not have any gaps”. Which is contrary to what the face-mask brackets/frames are designed to do, which is to keep the mask away from the face, thus causing the mask to potentially not seal properly to the users face.
The second interesting thing I noted in this CDC article, was the mention about the use of a “mask fitter’ or brace” which unlike the face-mask bracket/frame which is designed to sit under your mask, this one is designed to sit on the outer part of the mask. Here is the article link to read more: https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/mask-fit-and-filtration.html#mask-fitters-braces
From CDC: Image Link:https://www.cdc.gov/coronavirus/2019-ncov/images/your-health/masks/COVID-19_Masks_and_Beards_disposable_fitter-small-200px.png
The CDC is recommending that these ‘Mask Fitters or Brace” can be used with surgical masks or cloth masks but NOT with tight fitting respirators (P2/N95).
There have also been a few studies that have have been done to support the hypothesis that modifications like the ones mentioned above by the CDC can enhance the effectiveness of filtering.See below 2 studies I quickly managed to find:
1. There is this study that was published last year in December 2020 by Phillip Clapp called ‘Evaluation of cloth masks and modified procedure masks as personal protective equipment for the public during the CoVID-19 pandemic’. Link: Evaluation of Cloth Masks and Modified Procedure Masks as Personal Protective Equipment
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Evaluation of Cloth Masks and Modified Procedure Masks as Personal Prote…This comparative study examines the fitted filtration efficiency of 7 consumer-grade face masks and 5 medical pr…
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2. And this one by David Rothamer that was posted this year in January 2021 and looked at strategies to ‘minimise SARS-CoV-2 transmission in classroom settings: Combined impacts of ventilation and mask effective filtration efficiency’. Strategies to minimize SARS-CoV-2 transmission in classroom settings: Combined impacts of ventilation and mask effective filtration efficiency
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Strategies to minimize SARS-CoV-2 transmission in classroom settings: Co…The impact of the COVID-19 pandemic continues to be significant and global. As the global community learns more …
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Additional Light reading resource: There was a WebMD article on the blog page that was written by a Registered nurse in January 2021, discussing the use of the brackets and she talks about the flaw these items have. Here is the link: https://blogs.webmd.com/public-health/20210126/is-it-okay-to-use-a-mask-bracket
– Does it potentially pose a risk as a pressure causing agent?
I guess that might depend on the material and the sizing of the brackets, but the concerns I have seen raised regarding this issue has been about the risk of skin irritation from the plastic or silicone which can cause skin breakouts. The article was published last year in August, 2020. See article:Infectious Disease Experts Warn Against Face Mask Brackets, Which Are Rising in Popularity
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Infectious Disease Experts Warn Against Face Mask Brackets, Which Are Ri…People are buying them thinking they’ll make their mask more comfortable, but they could make your mask less eff…
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– Is removal of the mask in a manner that wont contaminate still possible with the bracket in place?
This will depend on the design of the bracket as looking online I can see there are various designs with some that attach or hook into the mask to some 3D printed ones that have ear loops on them. So I guess it will all come down to the manufacturers recommendation on how the user can donn the item and safely doff it without contaminating themselves.
– Is the bracket stored in a clean space?
As per the manufacturers recommendation on how to store the item
– Is the bracket cleaned after use and before storage?
Again this will be as per the manufacturers recommendation about how to clean or sterilize the item before storage.
To conclude, it is hard to endorse and support their use at the moment Fiona, because as we both have found from the research, there have been no studies or trials done so far that show proof of their efficacy. There is also no peer reviewed journals or literature that advocate their use.
In addition, since their introduction to the mask accessory market last year, both the CDC and the WHO have remained silent about them and have not issued any guidelines or statements about them.
But this is just my humble opinion on the matter , I too will wait to see what the rest of the brain trust stance is on this as am sure it will be a query we will all come across soon.
Kind Regards,
Farida KavataRegistered Nurse | Infection Prevention and Control Unit | MRO SurveillanceCanberra Health Services | ACT Government
Canberra Hospital |Infection Prevention and Control Unit| Building 15 Level 1| Yamba Drive, Garran, ACT 2606
Reliable | Progressive | Respectful | Kind
“We are seeing your face turn towards the sky again and again..”
On Thursday, 9 September 2021, 05:12:53 pm AEST, Glenys Harrington wrote:
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Hi Fiona,Interesting!
Are they being used with N95 masks in addition to surgical masks?
If so, have you done any fit testing with the MaskBracket/Face MaskInner Support Frame in situ?
Regards
Glenys
Glenys Harrington
Consultant
Infection Control Consultancy (ICC)
P.O. Box 6385
Melbourne
Australia, 3004
M: +61 404816434
Dear Brains Trust,
We have recently started to see the use of face mask brackets / inserts creep into use in our facility with staff wearing surgical face masks.
We have been unable to find any specific literature but from an infection prevention and control point of view we have a number of concerns including:
– Does it create a gap in the seal between mask and face?
– Does it potentially pose a risk as a pressure causing agent?
– Is removal of the mask in a manner that wont contaminate still possible with the bracket in place?
– Is the bracket stored in a clean space?
– Is the bracket cleaned after use and before storage?
Does anyone have any references regarding these products or has anyone investigated and / or authorised the use of these products within their facility.
Kind regards,
Fiona De Sousa CICP-E| Nurse Manager | Infection Prevention & Control Unit
Launceston General Hospital, Level 2, Launceston TAS 7250
phone: 6777 6715| mobile: 0408 487 197 | fax: 6777 5170|email: fiona.de.sousa@ths.tas.gov.au|
intranet: http://www.dhhs.tas.gov.au/intranet/thon/infection_control
IPCU By working together we promote a culture of safety to reduce preventable infections and transmission of multi-resistant organisms
CONFIDENTIALITY NOTICE AND DISCLAIMER
The information in this transmission may be confidential and/or protected by legal professional privilege, and is intended only for the person or persons to whom it is addressed. If you are not such a person, you are warned that any disclosure, copying or dissemination of the information is unauthorised. If you have received the transmission in error, please immediately contact this office by telephone, fax or email, to inform us of the error and to enable arrangements to be made for the destruction of the transmission, or its return at our cost. No liability is accepted for any unauthorised use of the information contained in this transmission.MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.
The use of trade/product/commercial brand names through the list is discouraged by ACIPC. If you wish to discuss specific reference to products or services by brand or commercial names, please do this outside the list.
Archive of all messages are available at http://aicalist.org.au/archives – registration and login required.
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The use of trade/product/commercial brand names through the list is discouraged by ACIPC. If you wish to discuss specific reference to products or services by brand or commercial names, please do this outside the list.
Archive of all messages are available at http://aicalist.org.au/archives – registration and login required.
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Hi Glenys,
No one is using them with N95 masks, just the surgical mask.
Kind regards,
Fiona De Sousa CICP-E| Nurse Manager | Infection Prevention & Control Unit
Launceston General Hospital, Level 2, Launceston TAS 7250
phone: 6777 6715 | mobile: 0408 487 197 | fax: 6777 5170 | email: fiona.de.sousa@ths.tas.gov.au |
intranet: http://www.dhhs.tas.gov.au/intranet/thon/infection_controlIPCU – ‘By working together we promote a culture of safety to reduce preventable infections and transmission of multi-resistant organisms’
Hi Fiona,
Interesting!
Are they being used with N95 masks in addition to surgical masks?
If so, have you done any fit testing with the Mask Bracket/Face Mask Inner Support Frame in situ?
Regards
Glenys
Glenys Harrington
Consultant
Infection Control Consultancy (ICC)
P.O. Box 6385
Melbourne
Australia, 3004
M: +61 404816434
E: infexion@ozemail.com.au
[Description: ICC Diagram ICCversion]Dear Brains Trust,
We have recently started to see the use of face mask brackets / inserts creep into use in our facility with staff wearing surgical face masks.
We have been unable to find any specific literature but from an infection prevention and control point of view we have a number of concerns including:
* Does it create a gap in the seal between mask and face?
* Does it potentially pose a risk as a pressure causing agent?
* Is removal of the mask in a manner that won’t contaminate still possible with the bracket in place?
* Is the bracket stored in a clean space?
* Is the bracket cleaned after use and before storage?
Does anyone have any references regarding these products or has anyone investigated and / or authorised the use of these products within their facility.
Kind regards,
Fiona De Sousa CICP-E| Nurse Manager | Infection Prevention & Control Unit
Launceston General Hospital, Level 2, Launceston TAS 7250
phone: 6777 6715 | mobile: 0408 487 197 | fax: 6777 5170 | email: fiona.de.sousa@ths.tas.gov.au |
intranet: http://www.dhhs.tas.gov.au/intranet/thon/infection_controlIPCU – ‘By working together we promote a culture of safety to reduce preventable infections and transmission of multi-resistant organisms’
________________________________
CONFIDENTIALITY NOTICE AND DISCLAIMER
The information in this transmission may be confidential and/or protected by legal professional privilege, and is intended only for the person or persons to whom it is addressed. If you are not such a person, you are warned that any disclosure, copying or dissemination of the information is unauthorised. If you have received the transmission in error, please immediately contact this office by telephone, fax or email, to inform us of the error and to enable arrangements to be made for the destruction of the transmission, or its return at our cost. No liability is accepted for any unauthorised use of the information contained in this transmission.
MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.The use of trade/product/commercial brand names through the list is discouraged by ACIPC. If you wish to discuss specific reference to products or services by brand or commercial names, please do this outside the list.
Archive of all messages are available at http://aicalist.org.au/archives – registration and login required.
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________________________________
CONFIDENTIALITY NOTICE AND DISCLAIMER
The information in this transmission may be confidential and/or protected by legal professional privilege, and is intended only for the person or persons to whom it is addressed. If you are not such a person, you are warned that any disclosure, copying or dissemination of the information is unauthorised. If you have received the transmission in error, please immediately contact this office by telephone, fax or email, to inform us of the error and to enable arrangements to be made for the destruction of the transmission, or its return at our cost. No liability is accepted for any unauthorised use of the information contained in this transmission.MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.
The use of trade/product/commercial brand names through the list is discouraged by ACIPC. If you wish to discuss specific reference to products or services by brand or commercial names, please do this outside the list.
Archive of all messages are available at http://aicalist.org.au/archives – registration and login required.
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