Transmission of communicable respiratory infections and facemasks

Yi LI, Yue Ping GUO, Kwok Ching Thomas WONG, Wai Yee Joanne CHUNG, Mayur Danny Indulal GOHEL, Hang Mei Polly LEUNG

Research output: Contribution to journalArticle

5 Citations (Scopus)


Background: Respiratory protection efficiency of facemasks is critically important in the battle against communicable respiratory infections such as influenza and severe acute respiratory syndrome (SARS). We studied the spatial distributions of simulated virus-laden respiratory droplets when human subjects wore facemasks and were exposed to regulatory viral droplets by conducting in vivo experiments in facemask use.

Methods: Transmission pathway of aerosols of Fluorescein-KCl solution through facemasks and protective efficiency of facemasks were examined by using normal surgical facemasks and two facemasks with exhaust valves (Facemask A) and exhaust holes (Facemask B) covered with the same surgical filters situated at the back of the facemasks. Fluorescein-KCl solution was sprayed onto the faces of participants wearing the facemasks and performing intermittent exercises on a treadmill in a climatic chamber.

Results: Experimental results showed that when droplets spread onto a person face-to-face over short distances, 92.3% to 99.5% of droplets were blocked by the front surface of the facemask, whereas only 0.5% to 7.7% of droplets reached the back of the facemask. Both facemasks A and B had near or over 99% protection efficiency, compared with that of 95.5% to 97% of surgical facemasks. Using the same filters as normal surgical masks, facemasks A and B provided more effective respiratory protection against communicable respiratory infections such as influenza and SARS by the location of the breathing pathway to the back of the facemasks.

Conclusions: Separating the breathing pathway from the virus-contaminated area in facemasks can provide more effective protection against communicable respiratory infections such as influenza and SARS. Copyright © 2008 Li et al, publisher and licensee Dove Medical Press Ltd.
Original languageEnglish
Pages (from-to)17-27
JournalJournal of Multidisciplinary Healthcare
Publication statusPublished - 2008


Severe Acute Respiratory Syndrome
Respiratory Tract Infections
Human Influenza


Li, Y., Guo, Y. P., Wong, K. C. T., Chung, W. Y. J., Gohel, M. D. I., & Leung, H. M. P. (2008). Transmission of communicable respiratory infections and facemasks. Journal of Multidisciplinary Healthcare, 2008, 17-27. doi: 10.2147/JMDH.S3019


  • Transmission
  • Communicable respiratory infections
  • Separating the breathing pathway
  • The virus-contaminated area
  • Facemasks with valves/holes
  • Protective efficiency