The Effects of N95 Masks on Sinonasal Symptoms and Opinions of Healthcare Workers in Singapore.

Background The use of N95 masks is ubiquitous in the healthcare setting to protect against respiratory tract infections and even more so since the emergence of the SARS-CoV-2 virus (COVID-19) infection. The purpose of this study was to assess the effect of N95 masks on nasal symptoms. Methods We designed a questionnaire to survey nasal symptoms such as rhinorrhoea, obstruction, sneezing, and itching that may be experienced whilst wearing the different models of N95 masks. This was disseminated to staff from departments that had the highest usage of N95 masks, namely, accident and emergency, anaesthesia, and otolaryngology. The completed questionnaires underwent statistical analyses to identify the prevalence and effect of N95 masks on healthcare workers. Results A total of 232 survey responses were obtained. When analysing the responses across four major nasal complaints, 115 (49.6%) experienced nasal itching, 98 (42.2%) had rhinorrhoea, 79 (34.1%) developed a blocked nose, and 44 (19%) users experienced worse sneezing with mask wear. Nasal itch was also more commonly experienced than rhinorrhoea and nasal obstruction. Users with an existing history of allergic rhinitis were more likely to develop nasal symptoms with mask wear. There was no significant association between gender and nasal symptoms except for in the category of sneezing. There was also no significant association between worse symptoms and the three major mask models worn by users participating in our survey. Conclusion The use of N95 masks is associated with significant nasal complaints. This may be due to the formation of a microclimate within the mask's dead space, which may alter the physiological environment of the nasal cavity. Additionally, factors such as a history of allergic rhinitis and exposure to polypropylene materials used in the mask's construction may further contribute to the development of nasal symptoms.