Dear Subscriber,
The wearing of masks has been a contentious issue. As most of you know, I did not think highly of it from the start. I recently got a message from a reader telling me he felt the N95 mask is an exception and should be considered. I am posting this respectfully in response. This report comes from Germany. I happen to trust the compulsive Germans in matters like this more than Americans. I have copied and pasted relevant sections of the article. It raises the health risks of the N95 masks which carry significant resistance to breathing. Please read the information and feel free to comment back. You will see that N95 mask wearing can contribute to significant pathology (brain deoxygenation). The information mirrors my concerns and comments about masks from day 1.
To Your Excellent Health,
Robert Jay Rowen, MD
from: https://www.frontiersin.org/articles/10.3389/fpubh.2023.1125150/full
N95 mask compared to surgical mask
In line with recent findings by Kisielinski et al. (14) and Sukul et al. (26), the present results clearly show that N95 masks lead to significantly more pronounced and unfavorable biochemical, physiological and psychological effects (Figure 7) than surgical masks. Altogether, the results in blood oxygenation, discomfort, heart rate, CO2, exertion, humidity, blood pressure, VE, temperature, dyspnea, and itching etc. can be attributed to the larger (almost doubled) dead space and higher breathing resistance of the N95 mask (14). Compared to the surgical mask upon the short-term effects, N95 masks could impose elevated health risks under extended use. Interestingly, recent data from a large multi-country RCT study show no significant differences between the two mask types in terms of SARS-CoV-2 infection rates (150). Nevertheless, there was long enforcement of N95 masks in e.g., Austria and Germany (9). Physio-metabolic and clinical consequences of wearing face masks—Systematic review with meta-analysis and comprehensive evaluation
Physical burden of masks: Humidity and skin temperature
Together with the immune-inhibiting mechanisms mentioned above, we found some other possible deleterious mask effects that impede healthy natural breathing. The most prominent and extreme effect was found in the increase of air humidity and skin temperature within the dead space of the mask (Figures 5, 9B). Increased humidity and temperature can increase droplet and aerosol generation, which facilitate liquid penetration through the mask mesh. This not only increases the chance of microorganism (fungal and bacterial pathogens) growth on and in masks (134–136) causing increased risk for accumulation of fungal and bacterial pathogens (134, 136) including mucormycosis (137), but also leading to re-breathing of viruses that may be trapped and enriched within the moisturized mask meshwork. Therefore, these conditions within masks are favorable for pathogenic growth and are unfavorable for good/systemic microbiota i.e., individual specific. As a result, the isolation of people with masks for extended periods can attain conditions for new and individual specific strains formations/mutations of pathogens—to which other people in the environment will be susceptible and/or not immune. Additionally, the high concentration of microbiome in masks can be a potential source of infection for the population. The findings of Fögen (11) using data from the USA which shows that mask use correlates with an increased mortality (case fatality rate of COVID-19) could be due to these processes. This phenomenon could also explain the similar figures found by Spira (16) in the EU.
Possible sub-threshold impact of masks—The low-dose long-term effect on health
In contrast to our study, most of the recent systematic reviews (27–31) have only analyzed a few outcome threshold values without considering comprehensive effects, exposure time and the susceptibility of the exposed organisms and tissues. Therefore, their recommendations e.g., masks are harmless and safe for everybody etc. appears to be superficial, non-medical, non-holistic, and misleading.
In accordance with conclusions of Sukul et al., Fikenzer et al., and Zhang et al. (26, 53, 62), we have found hints to deleterious effects even without exceeding physiological threshold values and we have interpreted these data as a risk for individuals with suppressed compensatory mechanisms such as in older individuals and sick subjects with cardiorespiratory diseases, infection, diabetes, cancer, and other comorbidities. Sukul et al. (26) were able to show that the unfavorable effects are more pronounced in the older adults (aged: 60–80 years). Moreover, they could provide evidence for toxic effects of face masks including oxidative stress, immunosuppression, deoxygenation and hypercarbia induced vasoconstriction and altered systemic microbial activity.
Even with CO2 and SpO2 levels that do not exceed the limits, many clinical researchers have also found troubling results in face mask wearers.
Neurologists observed changes in MRI brain signal baseline level due to face mask use (15). Wearing a surgical mask for merely 9 min increased end-tidal CO2 causing mild hypercapnia. This was responsible for a compensatory increase in cerebral blood flow with morphological changes similar to that of a CO2 gas challenge or holding your breath. In patients with aneurysms or brain tumors this phenomenon could be deleterious. Another study showed a pathologic and altered brain metabolism while wearing a N95 mask for 6 h (17). The MRI imaging revealed a significant drop in brain oxygenation. A more than 50% drop in oxygenation in the cingulate gyrus (cognition circuit) after 6 h of mask use was associated with clinical symptoms of a confused state in 80% of the subjects above 35 years. The authors even concluded that the general population should not wear a N95 mask. This phenomenon of brain deoxygenation could be dangerous for people with altered brain functions when on medication, after a transient ischemic attack (TIA) or stroke, respectively.
Ophthalmological studies indicated risk of retinal damage from long-term use of masks. N95 masks reduced the vascular density in the vascular plexus even under resting conditions as early as after 60 min (151). Here, the drop in SpO2 and increase in blood pressure were significant but within the normal physiological range. Another study reported a significant mask-induced increase in intraocular pressure (IOP) after ~5 min of wearing (12). Thus, wearing masks may counteract the therapy aiming to reduce the IOP and can exacerbate irreversible long-term vision problems in individuals with glaucoma. Numerous other studies have shown that the long-term effects, leading to deleterious clinical outcome may result from prolonged mask wearing (15, 17, 151, 152). Such effects are comparable to sick building syndrome (SBS) (153), cigarette smoking and other chronic, slightly toxic influences relevant to the general population.
In accordance with our present analysis and precedent scoping review (14), mask-related changes in leaning toward pathological values can lead to illness and clinical consequences, just like chronically, repeated subliminal harmful environmental events. Occupational diseases defined by the International Labor Organization (ILO) and that are in accordance with the worker's compensation act in Germany illustrates the potential harm caused by chronic exposure to subthreshold environmental factors (154). Numerous examples of these principles can be found in the literature concerning pharmacology, toxicology, clinical and occupational medicine and even in psychology (155–164). Many other toxicological and environmental health examples are presented in the recent scoping review by Kisielinski et al. (14), which refers to MIES (Mask-Induced Exhaustion Syndrome). Such subliminal chronical changes and harmful effects in the long run are comparable to the sick building syndrome (SBS) (153), cigarette smoking (165), salty diet (166), aluminum environmental pollution (167), low-level lead exposure (168), organochlorine pesticides and polychlorinated biphenyl exposure (169), or even the so-called climate change exposure (170).
Altogether, even the subliminal changes due to face mask use can become clinically relevant.
From the above facts, we conclude that a mask requirement must be reconsidered in a strictly scientific way without any political interference as well as from a humanitarian and ethical point of view. There is an urgent need to balance adverse mask effects with their anticipated efficacy against viral transmission. In the absence of strong empirical evidence of mask effectiveness, mask wearing should not be mandated let alone enforced by law.[emphasis added]
Here is one of their referenced articles:
Abstract
Many countries introduced the requirement to wear masks in public spaces for containing SARS-CoV-2 making it commonplace in 2020. Up until now, there has been no comprehensive investigation as to the adverse health effects masks can cause. The aim was to find, test, evaluate and compile scientifically proven related side effects of wearing masks. For a quantitative evaluation, 44 mostly experimental studies were referenced, and for a substantive evaluation, 65 publications were found. The literature revealed relevant adverse effects of masks in numerous disciplines. In this paper, we refer to the psychological and physical deterioration as well as multiple symptoms described because of their consistent, recurrent and uniform presentation from different disciplines as a Mask-Induced Exhaustion Syndrome (MIES). We objectified evaluation evidenced changes in respiratory physiology of mask wearers with significant correlation of O2 drop and fatigue (p < 0.05), a clustered co-occurrence of respiratory impairment and O2 drop (67%), N95 mask and CO2 rise (82%), N95 mask and O2 drop (72%), N95 mask and headache (60%), respiratory impairment and temperature rise (88%), but also temperature rise and moisture (100%) under the masks. Extended mask-wearing by the general population could lead to relevant effects and consequences in many medical fields.
Keywords: MIES syndrome; N95 face mask; adverse effects; contraindications; dyspnea; headache; health risk assessment; hypercapnia; hypoxia; long-term adverse effects; masks; personal protective equipment; physical exertion; risk; surgical mask.
https://pubmed.ncbi.nlm.nih.gov/33923935/
I covered that long ago. It is a real danger.
Thank you for your focused and important contribution to what’s really going on in “healthcare”, Dr Rowen. So happy you’re back home!