As most of you are aware, yesterday, CDC recommended Americans wear facial coverings made of cloth while out in public to help stop the spread of the Coronavirus.  Although this is purely voluntary, Dr. (Col, USA, retired) Deborah Birx is warning the Public not to develop a false sense of security by wearing any form of mask and, to not stop adhering to the COVID-19 Mitigation recommendations. 


Historically, respirators were specifically developed in order to reduce exposure of healthcare workers to infectious droplet and airborne transmission.  CDC guidelines recommends the use of only a NIOSH-certified N95 filtering facepiece respirators.  N95 respirators are intended to block the invasion of particles such as pathogens or droplets with diameters greater than 0.3 microns and filter over 95% of these fine particles.


It has been generally accepted to give an assigned protection factor (APF) number of 10 to disposable respirators. When a quantitative Fit Test is conducted to verify that the mask can attain a good seal around the face, the wearer of the mask is assigned a “fit factor” that is based upon the APF of the mask being tested X (times) a safety factor of 10.   Consequently, a N95 mask is supposes to have a “fit factor” of 100, but, in reality, it is more often 90 - 95.


Bowen published in the Journal of Association Biosafety and Biosecurity International in 2010 a study reporting an APF of 33.3%, 11.3%, and 6.1% for the surgical mask, bandana, and simple dust masks, respectively. 


In response to a mask shortage during the prior SARS Epidemic, Dato published in the Journal of Emerging Infectious Diseases in 2006 about her home-made mask - a 8-ply mask (see attachment) made from a heavy weight Hanes Pre-shrunk cotton men’s T-shirt.  It had a Fit Factor of 67 (which means an APF of 6.7 and the ability to filter the air so that the inside the mask is 67 X cleaner than the outside air).   Actually, that’s pretty good!  


The bottom line is, use a home-made mask if you want on the street or in necessary in the hospital (see below), but continue to wash your hands frequently, don’t touch your face, and stay six feet away from people in the street.  


Come to think about it, perhaps that why Dr. Birx is always wearing those colorful scarfs at the Press Conferences? 😊   


Stay Safe and Healthy!



Michael A. Sauri, MD, MPH&TM, FACP,


Medical Director

Occupational Health Consultants

2301 Research Blvd, Suite #125

Rockville, MD 20850

Tel 301-738-6420

Fax 301-990-3534


From: MCOH-EH <> On Behalf Of Freeley, Marlene
Sent: Saturday, April 4, 2020 7:55 AM
To: MCOH-EH <>
Subject: Re: [MCOH-EH] Nontraditional Mask Use


Thanks, Marlene

On Apr 3, 2020, at 4:32 PM, Nancy Clover <> wrote:

        External Email - Use Caution        

ANNOUNCEMENT: Joint Commission Statement on Use of Face Masks Brought From Home


The Joint Commission supports allowing staff to bring their own standard face masks or respirators to wear at work when their healthcare organizations cannot routinely provide access to protective equipment that is commensurate with the risk to which they are exposed.  In taking this position, The Joint Commission recognizes:

1. Hospitals must conserve personal protective equipment (PPE) when these items are in short supply to protect staff who perform high-risk procedures. 2. The degree to which privately-owned masks and respirators will increase the protection of healthcare workers is uncertain, but the balance of evidence suggests that it is positive. 3. No Joint Commission standards or other requirements prohibit staff from using PPE brought from home. 4. Homemade masks are an extreme measure and should be used only when standard PPE of proven protective value is unavailable. 

The evidence assessment and policy analysis that is the foundation of this statement on this link:

Be well,

Nancy Clover RN, COHN-S, FAAOHN

Occupational Health Connections

PO Box 2106   Methuen, MA 01844

Tel:  978-686-9739

Fax: 978-258-2682




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From: MCOH-EH <> On Behalf Of Galaid Edward I
Sent: Friday, April 3, 2020 2:37 PM
Subject: [MCOH-EH] Nontraditional Mask Use


Cross posted to OEM-L and MCOH…4 Questions…


Are you using non-traditional masks; 

Do you provide direction as to how they are use;

What they should be made of; 

How they should be laundered or inspected for continued use or disposal/disinfection?


Thanks. Will share results.




Edward I. Galaid, MD, MPH, FACOEM


Medical Director, Roper St. Francis Physician Partners Occupational Medicine

Charleston, SC

Member, ACOEM Task Group,  Guidance for the Medical Evaluation of Law Enforcement Officers

Special Expert, NFPA Fire Service Occupational Safety & Health (FIX-AAA) Committee

(O) 843-402-5053



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