ReviewAnnals of the American Thoracic Society2021
Face Masks and the Cardiorespiratory Response to Physical Activity in Health and Disease.
Review in Annals of the American Thoracic Society, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 82 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
82 citing papers in PubMed, 4 syntheses or guidelines pooled it, 192 citations in OpenAlex.
- Effects of the inhaled dose of air pollution on health: a systematic review.European respiratory review : an official journal of the European Respiratory Society · 2025Pooled it
- Masks and respirators for prevention of respiratory infections: a state of the science review.Clinical microbiology reviews · 2024Pooled it
- Facial mask acute effects on affective/psychological and exercise performance responses during exercise: A meta-analytical review.Frontiers in physiology · 2022Pooled it
- Pooled it
- The pandemic legacy face mask: hidden barrier or insignificant factor in exercise performance?: A randomized crossover trial.Medicine · 2026Trial
- Physiological impact of surgical masks and N95 masks on obese operating room staff.Scientific reports · 2025Trial
- Effect of face masks on dyspnea perception, cardiopulmonary parameters, and facial temperature in healthy adults.Narra J · 2024Trial
- Surgical masks and filtering facepiece class 2 respirators (FFP2) have no major physiological effects at rest and during moderate exercise at 3000-m altitude: a randomised controlled trial.Journal of travel medicine · 2023Trial
- Evaluation of Mask-Induced Cardiopulmonary Stress: A Randomized Crossover Trial.JAMA network open · 2023Trial
- Influence of face masks on the subjective impairment at different physical workloads.Scientific reports · 2023Trial
- Effects of wearing different face masks on cardiopulmonary performance at rest and exercise in a partially double-blinded randomized cross-over study.Scientific reports · 2023Trial
- Effects of surgical masks on the responses to constant work-rate cycling performed at different intensity domains.Clinical physiology and functional imaging · 2022Trial
- Effects of Using the Surgical Mask and FFP2 during the 6-Min Walking Test. A Randomized Controlled Trial.International journal of environmental research and public health · 2021Trial
- Effects of surgical and cloth facemasks during a submaximal exercise test in healthy adults.Respiratory medicine · 2021Trial
- Associations between adhering to 24-hour movement guidelines and anxiety among adolescents across intersectional identities: KYRBS 2020-2022.BMC public health · 2025Article
- The effects of acute exercise intensity on memory: Controlling for state-dependence.Memory & cognition · 2025Article
- Assessing the impact of different types of masks on COPD patients: a randomised controlled trial.ERJ open research · 2025Article
- The Effect of a KN95 Mask on High-Intensity Interval Training Performance, Physiological Response, and Perception.International journal of exercise science · 2025Article
- The mask paradox between perception of discomfort and reality of physiological effects in healthy college students in China: a panel study.BMC public health · 2024Article
- Ibrutinib and atrial fibrillation: An in-depth review of clinical implications and management strategies.World journal of cardiology · 2024Review
22 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors at 7 institutions in 2 countries.
Funding
Abstract
To minimize transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the novel coronavirus responsible for coronavirus disease (COVID-19), the U.S. Centers for Disease Control and Prevention and the World Health Organization recommend wearing face masks in public. Some have expressed concern that these may affect the cardiopulmonary system by increasing the work of breathing, altering pulmonary gas exchange and increasing dyspnea, especially during physical activity. These concerns have been derived largely from studies evaluating devices intentionally designed to severely affect respiratory mechanics and gas exchange. We review the literature on the effects of various face masks and respirators on the respiratory system during physical activity using data from several models: cloth face coverings and surgical masks, N95 respirators, industrial respirators, and applied highly resistive or high-dead space respiratory loads. Overall, the available data suggest that although dyspnea may be increased and alter perceived effort with activity, the effects on work of breathing, blood gases, and other physiological parameters imposed by face masks during physical activity are small, often too small to be detected, even during very heavy exercise. There is no current evidence to support sex-based or age-based differences in the physiological responses to exercise while wearing a face mask. Although the available data suggest that negative effects of using cloth or surgical face masks during physical activity in healthy individuals are negligible and unlikely to impact exercise tolerance significantly, for some individuals with severe cardiopulmonary disease, any added resistance and/or minor changes in blood gases may evoke considerably more dyspnea and, thus, affect exercise capacity.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.