Respirators are playing an increasingly larger role in protecting our health.  Respirators have traditionally been used professionally to protect workers against toxic, dangerous substances or pathogens.  For example, healthcare workers commonly use respirators when interacting with patients to protect themselves from communicative diseases.  Respirators, especially N95 masks, have been shown to have a protective effect against clinical respiratory illness and influenza-like illness (Offeddu, Yung, Low, & Tam, 2017).  For healthcare workers in China, the use of N95 respirators has been shown to be a cost-effective intervention over simple medical masks for the prevention of serious pathogens (Mukerji et al., 2017).  However, environmental hazards, like air pollution, have suggested a beneficial application of respirators for everyone.  Air pollution is a major worsening public health concern.  The World Health Organization estimates that, in 2012, ambient air pollution was responsible for nearly seven million deaths, worldwide (WHO, 2014).  In particular, China has haze pollution, a particularly serious form of air pollution, due to the high concentration of environmental pollutants like carbon monoxide, ozone, and particulate matter (Gao et al., 2017; Giles & Koehle, 2014).

“Traditional respirators also suffer from accumulation of carbon dioxide in the microenvironment, leading to increased carbon dioxide levels, called hypercapnia.”

Air pollutants have acute and chronic effects on human health.  Effects can range from simple respiratory irritation to chronic bronchitis, acute respiratory infections, pulmonary fibrosis, and lung cancer.  Pollution can also seriously worsen pre-existing cardiorespiratory diseases, including chronic obstructive pulmonary disease (COPD), emphysema, and congestive heart failure (Kampa & Castanas, 2008; Requia et al., 2018).  There is a correlation between air pollution and the incidence of childhood asthma (Khreis et al., 2017).  The mechanisms by which both indoor and outdoor pollutants cause health problems include carcinogenicity, genetic toxicity, inflammation, and oxidative stress (Li, Wen, & Zhang, 2017).  The significant health effects of air pollution, especially in those with existing cardiorespiratory disease, cannot be simply avoided and stresses the importance a respirator can have in the overall health of both adults and children.

“TO2M respirator mask addresses this problem through a proprietary oxygenation material that is present within a plastic capsule that is bonded directly onto the mask. ”

Traditional respirators protect through a filtration material through which a person breathes that blocks toxins and pathogens, commonly based on size.  However, traditional respirators have problems that stem from how the wearer breathes.  When you exhale, your breath contains a quarter of the oxygen, over 100 times the amount of carbon dioxide and 30 times as much moisture.  Traditional respirators and masks trap this air between your mouth and the outer surface of the mask, creating an uncomfortable and unhealthy microenvironment.  Breathing this air can have both acute and chronic negative effects on health due to a (1) decrease in oxygenation (hypoxia), (2) retention of carbon dioxide (hypercapnia), and (3) discomfort from excessive moisture which leads to breaks in the seal and non-compliance with the mask.  The TO2M respirator mask is an improvement over traditional respirator masks because it addresses each of these problems.

Oxygen plays important roles in overall health and disease.  Insufficient oxygenation, or hypoxia, can have negative effects on behavior and cognitive functioning, such as irritability, hostility, and impairments in vision, mental acuity, and memory (Bahrke & Shukitt-Hale, 1993).  Studies have shown that high intensity interval training, which increases peak oxygen uptake, can improve some cardiometabolic risk factors in those who are overweight/obese (Batacan, Duncan, Dalbo, Tucker, & Fenning, 2017).  Oxygen is also important for the proper functioning of our immune system.  Many of our immune cells kill pathogens through the production of superoxide, which is an oxygen-dependent process (Guo & DiPietro, 2010).  Oxygen plays a vital role in wound healing.  It prevents infection, stimulates cell growth and differentiation, and promotes collagen synthesis and wound contraction (Guo & DiPietro, 2010).

Oxygen has many therapeutic uses, as well.  Hyperoxia, or increased oxygen content, forms the basis of hyperbaric oxygen therapy, which has been shown to reduce the incidence of surgical site infection (Hopf & Holm, 2008; Qadan, Akça, Mahid, Hornung, & Polk, 2009) and protect the myocardium from ischemic damage.  In addition, hyperoxia reduces the incidence and longevity of gas micro-emboli during cardiopulmonary bypass (Young, 2012).  Oxygen is also important in fighting the effects of aging.  Chronic exposure to ozone (O3), a common air pollutant, has been shown to cause premature aging of the lungs (Lippmann, 1989).  Many of the negative effects of aging are caused, in part, by the production of free radicals, called oxidative stress.  Oxygen is needed for the proper function of the enzymes that protect us from the effects of free radicals.  Hyperoxia is neuroprotective in acute ischemic stroke, likely mediated by a reduction in oxidative stress (Yuan, Pan, Liu, & Liu, 2014).

This suggests that the hypoxic state induced by traditional respirators can have potentially significant health effects, especially during chronic use.  TO2M respirator mask addresses this problem through a proprietary oxygenation material that is present within a plastic capsule that is bonded directly onto the mask.  This releases pure oxygen into the microenvironment between your face and the mask and thereby increasing the oxygen content of the air inhaled while wearing the mask and reversing the hypoxia that plagues traditional respirators.

Traditional respirators also suffer from accumulation of carbon dioxide in the microenvironment, leading to increased carbon dioxide levels, called hypercapnia.  Hypercapnia can also have negative health effects.  Hypercapnia has been shown to increase regional blood flow, blood pressure, and pulse (Gitelman, Prohovnik, & Tatemichi, 1991), which can cause or worsen existing hypertension.  Even short-term hypercapnia is associated with mental disturbances, such as confusion, delirium, and drowsiness (Austen, Carmichael, & Adams, 1957).  Hypercapnia is also associated with an increase in anxiety, frequency of panic attacks, and cortisol levels (Woods, Charney, Goodman, & Heninger, 1988).  Chronic hypercapnia, such as seen in chronic obstructive pulmonary disease (COPD), is linked to nutritional problems, weight loss, skeletal muscle dysfunction, systemic inflammation, and cardiorespiratory disease (Agustí et al., 2003).  Many negative health effects of smoking has been linked to increased carbon dioxide and carbon monoxide content causing a failure in the normal regulation of cerebrovascular blood flow, which may explain the higher incidence of cerebrovascular disease in smokers (Silvestrini, Troisi, Matteis, Cupini, & Bernardi, 1996).  In addition to hypoxia, hypercapnia associated with traditional respirator use can have significant negative health effects.  Similar to the problem with hypoxia, the TO2M respirator mask has a proprietary material within the bonded plastic capsule on the mask that directly absorbs the carbon dioxide, thus lowering the carbon dioxide levels in the microenvironment.  This prevents the hypercapnia induced by traditional respirators.

Finally, traditional respirators also suffer from the accumulation of moisture due to the increased humidity of the microenvironmental.  This leads to discomfort and breaks in the seal of the mask on the face, which is critical for ensuring proper protection against pathogens, allergens, and pollutants.  Studies have shown the importance of a proper fit of an N95 mask to prevent the transmission of pathogens (Offeddu et al., 2017).  In addition, discomfort is a major cause of improper fit and non-compliance with N95 respirators and medical masks (Sim, Moey, & Tan, 2014).  The TO2M respirator addresses this problem through a proprietary moisture-absorbent material within the plastic capsule bonded to the mask.  This reduces the moisture and humidity of the microenvironment, leading to a more comfortable fit and greater compliance.

One further advantage is the versatility of the TO2M respirator mask compared to traditional respirators.  Traditional N95 masks offer protection by blocking materials based on a single size alone.  The TO2M respirator is fully customizable to have any criteria desired, such as N95 or FFP3, through modification of the bonded plastic capsule.  In addition, anionic materials can be added to the plastic capsule as well to further increase the amount of oxygen produced and act as an additional filtration barrier.  By working with TO2M, you can create a respirator that is both comfortable to wear and precisely designed to serve your particular protective purpose.

In summary, the TO2M respirator is a fully customizable protective mask that addresses the problems that plague traditional respirators.  In a time when environmental factors are having an increasingly greater impact on our health, the TO2M respirator represents a landmark improvement over existing technology that can have a dramatic effect on health and well-being. 

 

References   

Agustí, A. G. N., Noguera, A., Sauleda, J., Sala, E., Pons, J., & Busquets, X. (2003). Systemic effects of chronic obstructive pulmonary disease. European Respiratory Journal, 21(2), 347–360. https://doi.org/10.1183/09031936.03.00405703

Austen, F. K., Carmichael, M. W., & Adams, R. D. (1957). Neurologic Manifestations of Chronic Pulmonary Insufficiency. New England Journal of Medicine, 257(13), 579–590. https://doi.org/10.1056/NEJM195709262571301

Bahrke, M. S., & Shukitt-Hale, B. (1993). Effects of Altitude on Mood, Behaviour and Cognitive Functioning. Sports Medicine, 16(2), 97–125. https://doi.org/10.2165/00007256-199316020-00003

Batacan, R. B., Duncan, M. J., Dalbo, V. J., Tucker, P. S., & Fenning, A. S. (2017). Effects of high-intensity interval training on cardiometabolic health: A systematic review and meta-analysis of intervention studies. British Journal of Sports Medicine, 51(6), 494–503. https://doi.org/10.1136/bjsports-2015-095841

Gao, J., Woodward, A., Vardoulakis, S., Kovats, S., Wilkinson, P., Li, L., … Liu, Q. (2017). Haze, public health and mitigation measures in China: A review of the current evidence for further policy response. Science of The Total Environment, 578, 148–157. https://doi.org/10.1016/j.scitotenv.2016.10.231

Giles, L. V., & Koehle, M. S. (2014). The Health Effects of Exercising in Air Pollution. Sports Medicine, 44(2), 223–249. https://doi.org/10.1007/s40279-013-0108-z

Gitelman, D. R., Prohovnik, I., & Tatemichi, T. K. (1991). Safety of Hypercapnic Challenge: Cardiovascular and Neurologic Considerations. Journal of Cerebral Blood Flow & Metabolism, 11(6), 1036–1040. https://doi.org/10.1038/jcbfm.1991.172

Guo, S., & DiPietro, L. A. (2010). Factors Affecting Wound Healing. Journal of Dental Research, 89(3), 219–229. https://doi.org/10.1177/0022034509359125

Hopf, H. W., & Holm, J. (2008). Hyperoxia and infection. Best Practice & Research Clinical Anaesthesiology, 22(3), 553–569. https://doi.org/10.1016/J.BPA.2008.06.001

Kampa, M., & Castanas, E. (2008). Human health effects of air pollution. Environmental Pollution, 151(2), 362–367. https://doi.org/10.1016/J.ENVPOL.2007.06.012

Khreis, H., Kelly, C., Tate, J., Parslow, R., Lucas, K., & Nieuwenhuijsen, M. (2017). Exposure to traffic-related air pollution and risk of development of childhood asthma: A systematic review and meta-analysis. Environment International, 100, 1–31. https://doi.org/10.1016/J.ENVINT.2016.11.012

Li, Z., Wen, Q., & Zhang, R. (2017). Sources, health effects and control strategies of indoor fine particulate matter (PM2.5): A review. Science of The Total Environment, 586, 610–622. https://doi.org/10.1016/J.SCITOTENV.2017.02.029

Lippmann, M. (1989). HEALTH EFFECTS OF OZONE A Critical Review. JAPCA, 39(5), 672–695. https://doi.org/10.1080/08940630.1989.10466554

Mukerji, S., MacIntyre, C. R., Seale, H., Wang, Q., Yang, P., Wang, X., & Newall, A. T. (2017). Cost-effectiveness analysis of N95 respirators and medical masks to protect healthcare workers in China from respiratory infections. BMC Infectious Diseases, 17(1), 464. https://doi.org/10.1186/s12879-017-2564-9

Offeddu, V., Yung, C. F., Low, M. S. F., & Tam, C. C. (2017). Effectiveness of Masks and Respirators Against Respiratory Infections in Healthcare Workers: A Systematic Review and Meta-Analysis. Clinical Infectious Diseases, 65(11), 1934–1942. https://doi.org/10.1093/cid/cix681

Qadan, M., Akça, O., Mahid, S. S., Hornung, C. A., & Polk, H. C. (2009). Perioperative Supplemental Oxygen Therapy and Surgical Site Infection. Archives of Surgery, 144(4), 359. https://doi.org/10.1001/archsurg.2009.1

Requia, W. J., Adams, M. D., Arain, A., Papatheodorou, S., Koutrakis, P., & Mahmoud, M. (2018). Global Association of Air Pollution and Cardiorespiratory Diseases: A Systematic Review, Meta-Analysis, and Investigation of Modifier Variables. American Journal of Public Health, 108(S2), S123–S130. https://doi.org/10.2105/AJPH.2017.303839

Silvestrini, M., Troisi, E., Matteis, M., Cupini, L. M., & Bernardi, G. (1996). Effect of Smoking on Cerebrovascular Reactivity. Journal of Cerebral Blood Flow & Metabolism, 16(4), 746–749. https://doi.org/10.1097/00004647-199607000-00027

Sim, S. W., Moey, K. S. P., & Tan, N. C. (2014). The use of facemasks to prevent respiratory infection: a literature review in the context of the Health Belief Model. Singapore Medical Journal, 55(3), 160–167. https://doi.org/10.11622/SMEDJ.2014037

WHO. (2014). 7 million deaths annually linked to air pollution. Cent. Eur. J. Public Health, 22, 53–39.

Woods, S. W., Charney, D. S., Goodman, W. K., & Heninger, G. R. (1988). Carbon Dioxide—Induced Anxiety. Archives of General Psychiatry, 45(1), 43. https://doi.org/10.1001/archpsyc.1988.01800250051007

Young, R. W. (2012). Hyperoxia: a review of the risks and benefits in adult cardiac surgery. The Journal of Extra-Corporeal Technology, 44(4), 241–249. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/23441567

Yuan, Z., Pan, R., Liu, W., & Liu, K. (2014). Extended normobaric hyperoxia therapy yields greater neuroprotection for focal transient ischemia-reperfusion in rats. Medical Gas Research, 4(1), 14. https://doi.org/10.1186/2045-9912-4-14

Nathan Hageman, MD, Ph.D

Nathan Hageman received his bachelors in chemistry, biology and physics from Johns Hopkins University (Baltimore, Maryland) and an MD and a Ph.D in neuroscience from the University of California Los Angeles (UCLA) School of Medicine (Los Angeles, California). He’s had many years of experience writing/editing academic research articles and public government and private research grants, both during his doctorate and as a post-doctoral fellow. He have published numerous academic research papers in peer-reviewed medical journals and have written and been awarded several major scientific National Institutes of Health (NIH) research grants. Nearly all of his research articles are available online via Google Scholar or PubMed.