Adverse Health Effects of Face Mask Usage Among Nurses During the COVID-19 Pandemic
Keywords:
COVID-19, Face mask, Adverse health effectsAbstract
Nurses’ use of face masks during the COVID-19 pandemic has had adverse effects on nurses' health. This descriptive correlational research aims to determine the relationship between using face masks and the adverse health effects of using face masks among nurses during COVID-19. The participants were 421 nurses working in tertiary hospitals under the Ministry of Public Health in northern Thailand who were selected using multi-stage random sampling. The research instrument was a questionnaire, developed from the literature review, with a content validity index (CVI) of 1.0 and reliability level of .81. The data were analyzed using descriptive statistics and chi-square.
The results show that the types of face masks used among nurses included surgical face masks (97.62%) and N95 face masks (73.89%). Participants who wore N95 face masks and surgical face masks experienced adverse physical health effects at 92.93% and 81.02%, respectively. The most adverse physical health effects of both types were pressure injuries (90.35% and 71.29%, respectively). Participants who wore N95 face masks and surgical face masks experienced adverse mental health effects at 57.56% and 41.12%, respectively. The most common adverse mental health effects for both types were uncomfortable feelings (56.59% and 39.90%, respectively). The age, length of nursing service, and the number of working hours per day had a statistically significant relationship with adverse physical health effects (p < .05), and the number of working hours per day and the frequency of changing face masks had a statistically significant relationship with adverse mental health effects (p < .05).
The study's findings suggest that occupational health nurses and other pertinent staff should give priority to following guidelines in order to prevent the negative health effects of face mask use. This can be achieved by ensuring that nurses have the right number of working hours and quantity of face masks, which will enhance their quality of work.
References
Abiakam, N., Worsley, P., Jayabal, H., Mitchell, K., Jones, M., Fletcher, J., Spratt, F., & Bader, D. (2021). Personal protective equipment related skin reactions in healthcare professionals during COVID-19. International Wound Journal, 18(3), 312–322. https://doi.org/10.1111/iwj.13534
American Academy of Dermatology. (n.d.). 10 ways to prevent face mask skin problems. https://www.aad.org/public/everyday-care/skin-care-secrets/face/prevent-face-mask-skin-problems
Badillo-Goicoechea, E., Chang, T. H., Kim, E., LaRocca, S., Morris, K., Deng, X., Chiu, S., Bradford, A., Garcia, A., Kern, C., Cobb, C., Kreuter, F., & Stuart, E. A. (2021). Global trends and predictors of face mask usage during the COVID-19 pandemic. BMC Public Health, 21, 2099. https://doi.org/10.1186/s12889-021-12175-9
Bansal, K., Saji, S., Mathur, V. P., Rahul, M., & Tewari, N. (2021). A survey of self-perceived physical discomforts and health behaviors related to personal protective equipment of Indian dental professionals during covid-19 pandemic. International Journal of Clinical Pediatric Dentistry, 14(6), 784–789. https://doi.org/10.5005/jp-journals-10005-2061
Bowornsathitchai, N. (2021). Wear a mask or hygienic mask. So why does acne appear? https://www.medparkhospital.com/content/acne-from-mask (in Thai)
Chaichalothorn, M. (2020). N95 Respirator during COVID-19 Pandemic. Thai Journal of Anesthesiology, 46(3), 95-102. (in Thai)
Choudhury, A., Singh, M., Khurana, D. K., Mustafi, S. M., Ganapathy, U., Kumar, A., & Sharma, S. (2020). Physiological effects of n95 FFP and PPE in healthcare workers in covid intensive care unit: A prospective cohort study. Indian Journal of Critical Care Medicine, 24(12), 1169–1173. https://doi.org/10.5005/jp-journals-10071-23671
Department of Medical Services. (2020). Personal protective equipment, PPE. https://shorturl.asia/sI7c4 (in Thai)
Department of Medical Services. (2021). Guidelines for practice for medical and public health personnel who came into contact with a confirmed COVID-19 patient. https://covid19.dms.go.th/backend///Content//Content_File/Covid_Health/Attach/25641008093025AM_COVID_HCW_n_20211004.3.pdf (in Thai)
Division of Occupational and Environmental Diseases. (2021). Medical and public health operations manual in the case of dust particles no larger than 2.5 microns (PM2.5) 2021. https://url.in.th/HqibH (in Thai)
Etgu, F., & Onder, S. (2021). Skin problems related to personal protective equipment among healthcare workers during the covid-19 pandemic (online research). Cutaneous and Ocular Toxicology, 40(3), 207–213. https://doi.org/10.1080/15569527.2021.1902340
Falodun, O., Medugu, N., Sabir, L., Jibril, I., Oyakhire, N., & Adekeye, A. (2022). An epidemiological study on face masks and acne in a Nigerian population. PLOS ONE 17(5), e0268224. https://doi.org/10.1371/journal.pone.0268224
Fischer, R. J., Morris, D. H., van Doremalen, N., Sarchette, S., Matson, M. J., Bushmaker, T., Yinda, C. K., Seifert, S. N., Gamble, A., Williamson, B. N., Judson, S. D., de Wit, E., Lloyd-Smith, J. O., & Munster, V. J. (2020). Effectiveness of N95 respirator decontamination and reuse against SARS-CoV-2 Virus. Emerging Infectious Diseases, 26(9), 2253-2255. https://doi.org/10.3201/eid2609.201524
Galanis, P., Vraka, I., Fragkou, D., Bilali, A., & Kaitelidou, D. (2021). Impact of personal protective equipment use on health care workers' physical health during the covid-19 pandemic: A systematic review and meta-analysis. American Journal of Infection Control, 49(10), 1305–1315. https://doi.org/10.1016/j.ajic.2021.04.084
Huang, L., Lin, G., Tang, L., Yu, L., & Zhou, Z. (2020). Special attention to nurses’ protection during the COVID-19 epidemic. Critical Care, 24(1), 120. https://doi.org/10.1186/s13054-020-2841-7
Institute of Occupational and Environmental Medicine Nopparat Rajathani Hospital, Department of Medical Services. (2020). Program to protect personnel from the COVID-19 outbreak situation for public health facilities. DMS. (in Thai)
Jackson, D., Bradbury-Jones, C., Baptiste, D., Gelling, L., Morin, K., Neville, S., & Smith, G. D. (2020). Life in the pandemic: Some reflections on nursing in the context of COVID?19. Journal of Clinical Nursing, 29(13–14), 2041–2043. https://doi.org/10.1111/jocn.15257
Jiang, Q., Liu, Y., Song, S., Wei, W., & Bai, Y. (2021). Association between n95 respirator wearing and device-related pressure injury in the fight against covid-19: A multicentre cross-sectional survey in china. BMJ Open, 11(2), 041880. https://doi.org/10.1136/bmjopen-2020-041880
Jiang, Q., Song, S., Zhou, J., Liu, Y., Chen, A., Bai, Y., Wang, J., Jiang, Z., Zhang, Y., Liu, H., Hua, J., Guo, J., Han, Q., Tang, Y., & Xue, J. (2020). The prevalence, characteristics, and prevention status of skin injury caused by personal protective equipment among medical staff in fighting covid-19: A multicenter, cross-sectional study. Advances in Wound Care, 9(7), 357–364. https://doi.org/10.1089/wound.2020.1212
Jose, S., Cyriac, M. C., & Dhandapani, M. (2021). Health problems and skin damages caused by personal protective equipment: Experience of frontline nurses caring for critical covid-19 patients in intensive care units. Indian Journal of Critical Care Medicine, 25(2), 134–139. https://doi.org/10.5005/jp-journals-10071-23713
Kısacık, Ö. G., & Özyürek, P. (2022). Skin-related problems associated with the use of personal protective equipment among health care workers during the covid-19 pandemic: A online survey study. Journal of Tissue Viability, 31(1), 112–118. https://doi.org/10.1016/j.jtv.2022.01.003
Krejcie, R. V., & Morgan, D. W. (1970). “Determining sample size for research activities”. Educational and Psychological Measurement, 30(3), 607-610.
Ministry of Public Health. (2020). Infopersonal. http://gishealth.moph.go.th/healthmap/gmap.php#result (in Thai)
National Health Service. (2020). FFP3 fit testing. https://www.england.nhs.uk/coronavirus/secondary-care/infection-control/ppe/ffp3-fit-testing/
Nga Saman, K. (2020). The magic mask strap. The Office of Disease Prevention and Control 11th Nakhon Si Thammarat, 20(1), 2. https://ddc.moph.go.th/uploads/publish/1117720210310034717.pdf (in Thai)
Tabah, A., Ramanan, M., Laupland, K. B., Buetti, N., Cortegiani, A., Mellinghoff, J., Conway Morris, A., Camporota, L., Zappella, N., Elhadi, M., Povoa, P., Amrein, K., Vidal, G., Derde, L., Bassetti, M., Francois, G., Ssi Yan Kai, N., & De Waele, J. J. (2020). Personal protective equipment and intensive care unit healthcare worker safety in the covid-19 era (ppe-safe): An international survey. Journal of Critical Care, 59, 70–75. https://doi.org/10.1016/j.jcrc.2020.06.005
Tam, V. C. W., Tam, S. Y., Khaw, M. L., Law, H. K. W., Chan, C. P. L., & Lee, S. W. Y. (2021). Behavioural insights and attitudes on community masking during the initial spread of COVID-19 in Hong Kong. Hong Kong Medical Journal, 27(2), 106-112. https://doi.org/10.12809/hkmj209015
Thailand Institute of Occupational Safety and Health (Public Organization). (2021). Types and effectiveness of face masks for health protection. https://www.tosh.or.th/index.php/media-relations/vdo/item/904-2021-06-07-08-59-30 (in Thai)
Wismans, A., van der Zwan, P., Wennberg, K., Franken, I., Mukerjee, J., Baptista, R., Marín, J. B., Burke, A., Dejardin, M., Janssen, F., Letina, S., Millán, J. M., Santarelli, E., Torrès, O., & Thurik, R. (2022). Face mask use during the COVID-19 pandemic: How risk perception, experience with COVID-19, and attitude towards government interact with country-wide policy stringency. BMC Public Health, 22,1622, https://doi.org/10.1186/s12889-022-13632-9
World Health Organization. (2020). covid-19-what-we-know. Face Book. https://shorturl.asia/6Sjf9
Zhao, Y., Liang, W., Luo, Y., Chen, Y., Liang, P., Zhong, R., Chen, A., & He, J. (2020). Personal protective equipment protecting healthcare workers in the Chinese epicentre of COVID-19. Clinical Microbiology and Infection, 26(12), 1716-1718. https://doi.org/10.1016/j.cmi.2020.07.029
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Nursing Journal CMU

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
บทความที่ได้รับการตีพิมพ์เป็นลิขสิทธิ์ของวารสารพยาบาลสาร
ข้อความที่ปรากฏในบทความแต่ละเรื่องในวารสารวิชาการเล่มนี้เป็นความคิดเห็นส่วนตัวของผู้เขียนแต่ละท่านไม่เกี่ยวข้องกับมหาวิทยาลัยเชียงใหม่ และคณาจารย์ท่านอื่นๆในมหาวิทยาลัยฯ แต่อย่างใด ความรับผิดชอบองค์ประกอบทั้งหมดของบทความแต่ละเรื่องเป็นของผู้เขียนแต่ละท่าน หากมีความผิดพลาดใด ๆ ผู้เขียนแต่ละท่านจะรับผิดชอบบทความของตนเองแต่ผู้เดียว