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The Facemask Minefield

The current COVID climate has seen face masks inundate the market. There has been a lot of speculation and conflicting advice as to whether face masks are effective in preventing a person from catching COVID or if they prevent COVID from spreading by their use.

It is important for the clinician to understand what masks are available and how they all differ so that an informed decision can be made as to whether to use a mask and which mask to use. Not all masks are equal and they serve a purpose depending on the setting and what the user aims to achieve.

These are the basic categories of face masks that are simplistically explained;

The most common masks we will come across in the community and in the clinical setting are the regular homemade masks,clinical face masks and respirators. We can see how these differ and when they may be used;

What we can conclude is the following;

  1. Any sort of home made cloth or sponge mask is really not going to offer any protection to either the wearer or to the people in the surrounds.
  2. Surgical face masks are the best option for people in  a clinical setting where patients will be seen but non aerosol procedures are being performed.
  3. Respirators are to be used by health practitioners at the front line where high chances of infection are present such as in aerosol producing procedures.

Within the category of surgical face masks there are big differences in what types of masks are available. The key factors when looking at face masks are;

  1. Fluid resistance- amount of pressure required for fluid to pass through the mask material- the higher the more pressure required.
  2. Filtration efficiency- how efficient is the material at preventing bacterial and viral flow through- higher the better.
  3. Breath ability- how easily does the material breathe.This will prevent build up of moisture in the mask and improve wearbility.

Masks are tested and are rated at a level based on these ratings. In Australia surgical masks are classified under ASTM testing levels, which is the global standard. See below the classification and testing levels;


Face masks that have not been rated really offer little to no protection. Clinicians working in close contact with patients are recommended to wear at least a level 1, if not a level 2, face mask to ensure protection not only from the wearer from their surrounds, but the surrounds from the wearer. The slightly higher fluid resistance of the Level 2 makes it more suitable for close contact in close confines.

The market has been flooded with face masks in the last few weeks and it can be a minefield to a consumer knowing which face mask is of quality and will offer the best result for their needs. Australian Customs and over-seas customs have tightened the screws to ensure that the flood is stemmed and only quality masks are allowed into our country. Unfortunately however millions of masks that have made it into Australia prior to these rule changes leaving millions of masks still in circulation in our community. Many masks are of a poor quality, are not rated to a standard and do not meet Australian Standards.

You can protect yourself as a clinician and a consumer by using a simple checklist;

  1. Does it meet Australian and global standards? The Australian standard for face masks is ASN 4381:2015 and any mask being sold should meet this standard. The ASTM is the american and global standard which is the global standard that masks are tested to.
  2. Is it advertised as being of a certain quality offering a certain level of protection? If face mask advertising doesn’t offer a standard or level of protection then it probably doesn’t have one.
  3. Does it have BFE and PFE? A high quality mask will have both the ability to protect from bacteria (BFE) and viruses (PFE). There are masks now in the market that have Level 2 protection, but are lacking PFE, which means only 30-40% of virus particles will be stopped! These are classified as Level 2R masks, however this is often hidden behind the Level 2 tag. A high PFE eg 98% is imperative if adequate protection is needed.
  4. Is it TGA approved? The Therapeutic Goods Administration (TGA) is the regulatory body for therapeutic goods in Australia. If the product is TGA approved and has a Certificate Number then you can be confident that the product is compliant with all quality standards and medical standards required.
  5. Price is not the measure of quality– The costs of protective equipment (PPE), including face masks, has gone up 6-8 times in the last few weeks due to the excessive global demand and rising raw material costs. This means costs are much higher than they were even 6 weeks ago and the higher quality products are also of a much higher price. If a face mask is cheap then it is unlikely to meet the basic standards. In saying that however, there is a fair amount of profiteering occurring right now meaning inferior products are being sold at over inflated prices. The best way to ensure that you are receiving a quality product that will do the job you require is to run through the checklist above.

The playing field is constantly changing and it’s very hard as a distributor to keep up, let alone as a clinician and consumer. If you have any queries or questions please do not hesitate to contact us to discuss further.

Stay safe and stay well

The APE Team