Use of FFP2/N95 Masks feasible and safe while continuing physical education in children

A recent study delving into the effects of wearing FFP2/N95 masks during physical exercise in children has shed light on the potential impact of these masks on cardiorespiratory function. Amid concerns about the repercussions of face mask usage during physical education (PE) lessons, this research aimed to understand the physiological responses of children to wearing FFP2/N95 masks during exercise. This study was published in European Journal Of Pediatrics by Annika Weigelt and colleagues.

The research involved twenty healthy children aged 8–10 years who performed cardiopulmonary exercise tests on a treadmill, once with FFP2 masks and once without, within a two-week interval. The study revealed:

Participants: 20 children (12 boys and 8 girls).

Parameters Measured:

Peak VO2: 42.7 ± 9.5 vs 47.8 ± 12.9 ml/min/kg (p = 0.097).

O2pulse: 7.84 ± 1.9 vs. 6.89 ± 1.8 (p = 0.064).

VE/VCO2slope: 33.4 ± 5.9 vs. 34.0 ± 5.3 (p = 0.689).

RER: 1.01 ± 0.08 vs 0.95 ± 0.08 (p = 0.004).

Gas Exchange Changes: End-tidal CO2 increased and O2 decreased significantly in almost every step while wearing FFP2 masks. However, these values stayed within safe limits, avoiding hypercapnia or hypoxia.

The study observed that children did not encounter adverse events during exercise, even at maximal exertion, with the mean parameters at peak exercise showing no significant differences between the two conditions. Parameters such as peak VO2, O2pulse, and VE/VCO2slope didn’t exhibit notable variations between the mask and non-mask trials.

However, the study did reveal a significant difference in the respiratory exchange rate (RER) between the conditions, indicating a conscious effort by the children to reduce exertion while wearing masks. The end-tidal values for CO2 increased, and for O2 decreased significantly during exercise with masks, yet remained within safe ranges, avoiding hypercapnia or hypoxia.

The study concludes that wearing FFP2/N95 masks during exercise did not lead to discernible differences in cardiorespiratory function at peak exercise in children. Despite alterations in respiratory gases, these changes did not reach levels of concern. Notably, children exercised at a lower intensity while wearing masks, suggesting an innate adjustment to the increased strain.

These findings highlight that the physiological effects of FFP2/N95 masks on children during exercise are minor, affirming the feasibility of continuing physical education without compromising safety significantly. Considering the documented detriments of restricted physical activity during the pandemic, the study advocates for reconsideration of halting PE lessons solely due to the minor physiological effects of wearing these masks.

Reference:

Weigelt, A., Schöffl, I., Rottermann, K., Wällisch, W., Müller, S. K., Dittrich, S., & Hübner, M. J. Sports despite masks: no negative effects of FFP2 face masks on cardiopulmonary exercise capacity in children. European Journal of Pediatrics,2023. https://doi.org/10.1007/s00431-023-05316-2