Dr Josephine Tan, Co-Lead of Airway SIG, shares the evolution of face masks through the decades.
Wearing face masks to protect ourselves from disease is not a new practice. People have worn masks for hundreds of years in an attempt to halt the spread of pandemic. Through the years, we have come to better understand the science behind protective material. Today, the face mask has become a simple but powerful tool in the combat against airborne diseases.
23-79 AD
Pliny the elder, a roman philosopher and naturalist, used loose animal bladder skins to filter dust from crushing cinnabar, a toxic mineral used as pigments in decorations.
1254-1324
Marco Polo in his travelogue described 13 century Yuan dynasty servants wearing silk masks to prevent contaminating the food they prepared for the emperor.
14th century
The Black Death, europe’s largest plague epidemic prompted the widespread use of facial coverings. Another deadly outbreak in the 17th century led to the invention of the beak mask by French doctor Charles de lorme. The mask covered the entire face and the beak was filled with a mixture of spices and aromatics to block the odors of the dead and dying, neutralize the “miasma” in the air, thought to be the cause of disease.
Figure 1: Masks in the earlier days.
1861
A French microbiologist and chemist, Louis Pastuer, described the presence of bacteria and made people aware of the dangers of breathing in harmful pathogens. Doctors started wearing cotton masks to limit spread of contagious material during epidemics.
20th century
Wu Lien Teh, a public health specialist from Malaya, while investigating a pneumonic plague in china, developed a mask made from layers of cotton with ties to hang from the ears. This became the prototype for the masks currently used in medicine.
Figure 2: First prototype of the current mask we use are these masks made from layers of cotton with ties to hang from ears.
In 1905 Chicago physician Alice Hamilton proposed that scarlet fever was transmitted via droplets and published a study showing streptococci bacteria expelled from patients with scarlet fever during coughing.. Her findings led to the widespread use of protective masks for surgeons and nurses.
During the global flu pandemic of 1918, which killed more people than WW1, both medical staff and members of the public wore protective masks.
The testing of surgical face masks began in earnest in the 1950s, setting the standards for our present day practices.
Respirator type masks that protect the wearer from inhaling pathogens have become highly recommended for the medical staff today during the COVID-19 pandemic. These respirators were originally developed in the mining industry.
In 1972, the first single use N95 respirator was approved, The designation of “N95” is a government efficiency rating that means the mask blocks about 95 per- cent of particles that are 0.3 microns in size or larger.
References:
1oo years respiratory protection history. NIOSH
Through plagues and pandemics: The evolution of medical face masks. KPan, A Goel, LRAkin, SRPatel.Rhode Island Medical Journal. Dec 2020
A history of medical masks. Lizzie Enfield. Wellcome collection. July 2020