posted on 07/08/2022 06:00
(credit: KHALIL MAZRAAWI)
Considered strategic in controlling the spread of the new coronavirus, face masks can have another effect among users that demands attention. In this case, however, these are harmful consequences. These personal protective equipment also enhance the effects of smoking on the human body, warn European researchers in an article published in the latest issue of the European Journal of Preventive Cardiology.
After evaluating medical data from 160 volunteers, the scientists concluded that the use of a surgical mask increases the amount of exhaled carbon monoxide by twice and compromises blood vessel functions, considering periods without the mask. The hypothesis raised by the group is that, at least in part, staying in personal protective equipment for a long time leads to greater rebreathing of carbon monoxide and/or nicotine-rich vapor, substances harmful to health.
The risks of the condition are great, from compromised cardiovascular function to death, according to Ignatios Ikonomidis, a professor at the National and Kapodistrian University of Athens, Greece, and one of the authors of the study. “Research suggests that smoking any tobacco product has become even more dangerous during the Covid-19 pandemic due to the need to wear a mask for long hours. Previous research has shown that impaired vascular function is linked to heart problems and premature death.” , details.
The study focused on traditional (fuel) cigarettes and non-combustible cigarettes, also called heated tobacco — they contain tobacco, but the product is electronically heated to a lower temperature than in a traditional cigarette, releasing an inhalable aerosol containing nicotine. The popular e-cigarettes, also called vaping, were not used in the experiment.
The study included 40 smokers of conventional cigarettes, 40 users of non-burning exclusive cigarettes and 40 non-smokers. The average age of participants was 45 years and 72% were women. They were part of the medical staff of a university hospital. Subjects with known cardiovascular disease, hypertension, diabetes, dyslipidemia, chronic kidney disease, or atrial fibrillation were excluded from the trial, as these conditions can affect vascular function. A similar amount of combustible and non-combustible cigarettes was smoked during the analysis periods.
The researchers investigated exhaled carbon monoxide levels in smokers while wearing a mask during working hours and compared them to carbon monoxide levels during off-mask days. They also investigated whether the change in carbon monoxide exposure was accompanied by impaired blood vessel function. To do this, they measured exhaled gas after a deep breath, as well as markers of vascular function — pulse wave velocity, rate of rise, and central systolic blood pressure — at three time points.
The first assessment took place early in the morning — to assess the condition of the volunteer after a long period without smoking and without using the mask, considering that he was sleeping. This information served as a reference for analysis. Eight hours later, a new analysis was carried out with the volunteers whether or not they used the protective mask — the condition was chosen at random. A third measurement took place eight hours later. Participants were instructed not to smoke at least one hour before measurements to avoid any acute effects of smoking and not to use any other face shields.
The results showed that, among those who smoked the traditional cigarette, exhaled carbon monoxide increased from 8 parts per million (ppm) in the baseline condition to 12.15ppm without a mask and 17.45ppm with a mask. In non-combustible cigarette smokers, the numbers were 1.15ppm, 1.43ppm, and 2.20ppm, respectively. There was no change in the group formed by non-smokers.
Regarding blood vessel function, the impairments were greater in the two groups of smokers comparing the periods with and without the mask. The impairment of arterial elasticity was one of the effects observed, which can impair the supply of oxygen to vital organs, such as the heart. Again, no changes were seen among non-smokers. “Compared to traditional cigarette smokers, non-combustible cigarette users had lower carbon monoxide levels and smaller increases in vascular damage while wearing a mask,” Ikonomidis said.
Despite the difference, the scientist emphasizes that any regular contact with these products combined with the use of a mask is very dangerous. “The results show that (this situation) can further impair blood vessel function compared to periods without a mask (…) Our work provides even more encouragement for all smokers to quit.”
In the article, the authors also point out the need for a follow-up period to detect whether the changes observed during the use of the mask are related to a higher incidence of cardiovascular diseases. According to them, other factors, such as stress during work, environmental pollution, type of diet and quality of sleep, may also influence the markers examined.