Abstract
Cloth masks are a tool for controlling community transmission during pandemics, as well as during other outbreak situations. However, cloth masks vary in their designs, and the consequences of this variability for their effectiveness as source control have received little attention, particularly in terms of user discomfort and problematic mask-wearing behaviors. In the present studies, common design parameters of cloth masks were systematically varied to ascertain their effect(s) on the subjective discomfort and frequency of problematic mask-wearing behaviors, which detract from the effectiveness of cloth masks as source control. The type of fabric comprising a mask (flannel or twill made of 100% cotton) and the attachment-style of a mask (i.e., ear loops or fabric ties) were varied in adults (18 to 65 years) and children (ages 6 to 11 years). For adults, ear loops were less comfortable than ties (p = .035) and were associated with greater face- (p = .005) and mask-touching (p = .001). Children, however, found flannel masks to be more breathable than twill masks (p = .007) but touched their masks more frequently when wearing a mask made of flannel than twill (p = .033). Common design parameters of cloth masks not only affect user discomfort and behavior but do so differently in adults and children. To improve the effectiveness of cloth masks as source control, the present studies highlight the importance of measuring the effect(s) of design decisions on user discomfort and behavior in different populations.
Acknowledgments
The authors would like to acknowledge Noah Kaufman for 3D-printing the head forms, Oluwateniola Ayeni for helping to identify measurement instruments, Brad Weaver for performing statistical analyses, Susie Helton for modifying mask designs and creating instructions for the manufacturer, Rachel Regina for coordinating mask manufacturing, Golpar Ghassemian for technical support, and Marilyn Garcia, Ellen Jordan, Anagha Nair, and Talia Crowther for their assistance collecting data and preparing the manuscript.
Data availability
The data that support the findings of this study are available from the corresponding author upon reasonable request.