Executive Summary

The executive summary is utilised to allow a time-deficient person to obtain the gist or précis of a document, within a page or two of text (slightly more in this report). The full text of this section is contained within the rest of this report. To that end, this executive summary is as follows:

Is there a consensus or a majority of medical professionals that have reported/documented or researched the effects of large scale, long- term wearing of masks? This is for the population in general, but this report is focussed on the health effects for children.

Research by Graham F French and other members of The Awareness Foundation has discovered the following:

Face masks are part of non-pharmaceutical interventions providing some breathing barrier to the mouth and nose that have been utilised for reducing the transmission of respiratory pathogens. 

Face masks can be medical and non-medical, with two types of medical masks primarily used by healthcare workers. The first is National Institute for Occupational Safety and Health (NIOSH)-certified N95 mask, a filtering face-piece respirator, and the second is a surgical mask. The third type of face masks are non-medical cloth or fabric masks. The non-medical face masks are made from a variety of woven and non-woven materials such as polypropylene, cotton, polyester, cellulose, gauze, wool and silk.

Wearing a face mask mechanically restricts breathing by increasing the resistance of air movement during both inhalation and exhalation. Carbon dioxide is given off as a by-product of cell metabolism, and is carried by the blood through the venous system (veins) to the lungs. Here it is exhaled. The concentration of CO2 in each breath is ~3.8%, and the “average” person produces approximately two pounds of carbon dioxide each day. More CO2 is given off during strenuous activity. 


COVID-19 – transmission

  • Aerosol-based transmission is the primary mode of COVID-19 transmission. 
  • Social distancing does nothing for airborne or aerosol particles. 
  • Based on empirical evidence, masks are not an effective means for reducing aerosol-based transmission.


Health Effects – Teeth, Gums and Mouth

It appears that most people, when wearing masks, breathe through their mouths as opposed to their noses, and this results in reduced saliva production and dry mouth, which becomes problematic as saliva is protective against tooth decay and gum disease. Dentist Dr. Justin Russo says: “A lot of people are stressed out. I can just tell by people’s mood that they’re stressed out. So, they’re clenching, grinding their teeth. A lot of people are eating on an irregular basis. Some dentists are experiencing a 25 percent rise of bite-related cases and some have stated that they believe the pandemic could be to blame.”


Health Effects – Skin

Clinical teams engaged in all types of the coronavirus care settings are consistently reporting facial skin tears and lesions caused by prolonged use of protective face masks. Loss of facial skin integrity creates a portal for penetration of pathogens, including the coronavirus itself, as well as other hospital-acquired bacterial, viral, or fungal infections. Thus, skin damage can facilitate penetration of coronavirus and other pathogens directly into the blood circulation. The mask materials mechanically indent and damage facial skin, an effect that is further compromised by perspiration (sweat), and moisture, due to the mental stress and workload care teams are experiencing.


Health Effects – Cognitive

When the use of a face mask is maintained for an extended length of time (over eight hours in healthcare professionals) symptoms of hypoxemia (abnormally low level of oxygen in the blood) such as chest discomfort and tachypnoea (respiration rate greater than normal) are presented. These responses could be explained as carbon dioxide (CO2) is a respiratory stimulant and, when is accumulated by the mask use, it does increase lung ventilation and respiratory activity; this fact that would explain the symptoms of confusion, impaired cognition, and disorientation, experienced by nurses.


Health Effects – Immunity

Several studies have indeed found significant problems with wearing such a mask. This can vary from headaches, to increased airway resistance, carbon dioxide accumulation, to hypoxia, all the way to serious life-threatening complications. A drop in oxygen levels (hypoxia) is associated with an impairment in immunity. Studies have shown that hypoxia can inhibit the main immune cells used to fight viral infections. People with cancer, especially if the cancer has spread, will be at a further risk from prolonged hypoxia as the cancer grows best in a micro-environment that is low in oxygen. Low oxygen also promotes inflammation which can promote the growth, invasion, and spread of cancers.

Severe hypoxemia may also provoke cardiopulmonary and neurological complications, and is considered an important clinical sign in cardiopulmonary medicine. Low oxygen content in the arterial blood can cause myocardial ischemia (blockage of heart arteries), serious arrhythmias, right or left ventricular dysfunction, dizziness, hypotension (low blood pressure), syncope (loss of conscious), and pulmonary hypertension (high blood pressure). Chronic low-grade hypoxemia and hypercapnia as result of using face masks can exacerbate  existing cardiopulmonary, metabolic, vascular, and neurological conditions.

Re-breathing contaminated air with high bacterial and toxic particle concentrations along with low O2 and high CO2 levels continuously challenge the body homeostasis, causing self-toxicity and immunosuppression.


Health Effects – Psychological

Psychologically, wearing face masks have negative effects on the wearer and those nearby. Basic human-to-human connectivity through facial expression is compromised, and self-identity is eliminated. These dehumanising movements delete the uniqueness and individuality of the person wearing the face mask, as well as the those in proximity. Social connections and relationships are basic human needs, which are inherited in all people, whereas reduced human-to-human connections are associated with poor mental and physical health.

Poor social connections are closely related to isolation and loneliness, these are considered significant health-related risk factors. A meta-analysis of 91 studies of approximately 400,000 people, showed a 13% increased morality risk among people with low compared to high contact frequency. Another meta-analysis of 148 prospective studies (308,849 participants) found that poor social relationships were associated with 50% increased mortality risk. People who were socially isolated or felt lonely had 45% and 40% increased mortality risk, respectively. 


Long-term health consequences

Long-term practice of wearing face masks has a strong potential for devastating health consequences. Prolonged hypoxic and/or hypercapnic state compromises normal physiological and psychological balance, deteriorating health, and promotes the developing and progression of existing chronic diseases. For instance, ischemic heart disease caused by hypoxic damage to the myocardium is the most common form of cardiovascular disease and is a number one cause of death worldwide (44% of all non-communicable diseases) with 17.9 million deaths occurred in 2016. Chronic stress, along with hypoxic and hypercapnic conditions, knocks the body out of balance, and can cause headaches, fatigue, stomach issues, muscle tension, mood disturbances, insomnia, and accelerated ageing. 


Face mask and physiology alteration during exercise

Exercising with customised tight face masks induces a hypercapnic hypoxia environment (inadequate oxygen (O2) and carbon dioxide (CO2) exchange). This acidic environment, both at the alveolar and blood vessels level, induces numerous physiological alterations when exercising with face masks. Studies of obstructive sleep apnoea provide irrefutable evidence of hypercapnic hypoxemia affecting the postural stability, proprioception, altered gait velocities, and falls. Exercising with face masks might increase pathophysiological risks of underlying chronic disease, especially cardiovascular and metabolic risks. 


Toxic Masks

Professor Michael Braungart, director at the Hamburg Environmental Institute and co-founder of the world-renowned Cradle to Cradle environmental standard, has told Ecotextile News that mask wearers unwittingly run the risk of breathing in carcinogens, allergens and tiny synthetic microfibres by wearing both textile and non-woven surgical masks for long periods of time.

“What we are breathing through our mouth and nose is actually hazardous waste,” said Professor Braungart, who ran preliminary tests on used surgical masks that found traces of chemicals such as the known carcinogen aniline as well as formaldehyde and optical brighteners – both heavily restricted on consumer goods by European and US authorities to minute parts per million concentrations.

Initial analytical tests by experts have now thrown into doubt the wisdom of whether people should be wearing certain types of masks for hours on end. Particularly schoolchildren, factory workers, and long-haul flyers who may be at a greater risk from the long-term damage to lungs through exposure to both restricted chemistry and micro-plastics. There is a potential risk of ‘future’ inflammatory/fibrotic lung diseases because we have been inhaling these materials in the masks for over a year, with no end in sight. These substances might also be highly carcinogenic, not just for us as adults; we must be very concerned about the risks especially to our children since they depend on us as mentors and guides for their decision-making. It is our children that we are very concerned for. 


Microbial contamination 

Bacteria are, on average, ten times the size of viruses, particularly coronaviruses, and have less penetration through masks. Therefore, at least part of the re-circulated flow of bacteria in aerosolised and droplet exhalation does not escape the vicinity of the oral and nasal environment. Bacteria and other microbes are not only retained in this space, but masks themselves are warm, moist repositories of these microbes. Laboratory testing of used masks from 20 train commuters revealed that 11 of the 20 masks tested contained over 100,000 bacterial colonies. Moulds and yeasts were also found. Three of the masks contained more than one million bacterial colonies.

The mechanism of pathology originating from masks is likely as follows: microbe-carrying droplets, trapped in masks, stay damp while the mask is worn; whereas without a mask, exhaled droplets and aerosol are known to dry quickly. In the continually damp environment of the mask, bacteria start to proliferate, are re-inhaled and then transferred throughout the body. Bacteria are exhaled through masks at an increasing rate over the time of use. Outward penetration of masks by bacteria is made worse by the plosive force of coughing, sneezing, and talking loudly. Scatter mechanics from the mesh of the mask and the resulting chaotic collisions of aerosolised droplets in turn produce a wider contaminated airspace outside the masked mouth than outside the unmasked mouth. Wearers of cloth masks had significantly higher influenza-like illnesses when compared to unmasked. 

When oral bacteria gain access to blood and deep tissues, they may cause pneumonia, abscesses in lung tissue, subacute bacterial endocarditis (life-threatening inflammation of the inner lining of your heart’s chambers and valves), sepsis and meningitis. It is important to consider that endocarditis can be a lifelong infection. Streptococcus pyogenes (Strep) bacteria has been observed for decades to cause irreversible fibrosis in heart tissue long after the bacteria were no longer found. This bacteria is known by many as “flesh- eating strep”. Former Streptococcus infections that had seemingly resolved a long time ago may still be positive in an Antistreptolysin O test. For years afterwards, flares of toxins can be released in the body at times of stress or secondary infection, and cause debilitating symptoms. 


Face Masks on Children

The results of the first German study on children and teenagers wearing mouth and nose coverings reveal 68% complain of wearing a mask. The average length of time the mask was worn varies greatly with age; it averaged 4.5 hours per day, and was much higher, especially among youth (13-18 years), averaging six hours. In 16,913 children (65.2%) it was reported that fabric masks were worn, followed by surgical masks.

Most common issues were:

  • Irritability (60%),
  • Headaches (53%),
  • Difficulties concentrating (50%),
  • Sadness (49%),
  • Reluctance to attend school (44%),
  • Malaise (42%),
  • Impaired learning (38%),
  • Fatigue and drowsiness (37%).

Other physical symptoms included rashes and allergies around the mouth, syncope – temporary loss of consciousness usually related to insufficient blood flow to the brain (20%), nausea (16.6%), hyperventilation (12%) fainting spells (2.2%).

In addition, 25% of the children had developed anxieties. Regarding the question as to whether children themselves complain about impairments caused by wearing the mask, 67.7% of the respondents answered yes for their children; 26% answered no. The question as to whether the respondents themselves observed an impairment of the child by wearing the mask was answered yes in 66.1%.


Children’s Emotional Development

We’ve known for decades that children’s emotional well-being depends in part on neurological development, which comes from watching faces and recognising emotions. How all this works isn’t entirely clear, but as Catherine Herba and Mary Phillips at the London Institute of Psychiatry have explained, there is enough evidence to suggest that normal child development needs children to see people expressing their emotions.

With widespread masking, we may unintentionally be disadvantaging younger children from developing the necessary skills to discern emotions and the neurological changes that make it possible to distinguish one face from another.

For adults, the need to wear a mask can be inconvenient. For children it could be more serious. Masks disguise key cues in our expressions, making it harder to read someone’s face, and there is growing evidence that this could be affecting child development. Child carers who wear masks while at work say it is difficult to establish a relationship of trust with children, because they have to conceal their mouths.

Elementary schools in Japan are reporting that masks are having adverse effects on their students, including more unruly behaviour as masks disrupt communication. Professor Masako Myowa says children between four and ten years old are developing the ability to empathise, to imagine what others think, and how to respond. Children normally have ample chances at school to put themselves in someone else’s shoes, but masks in classrooms mean the opportunities are much scarcer now.

Changes in face recognition performance and alteration along the processing style of partially occluded faces could have significant effects on children’s social interactions with their peers and their ability to form important relationships with educators. Previous research in adults has already demonstrated the detrimental effect of reduced face perception abilities on one’s level of social confidence and quality of life. 

This concludes the Executive Summary section of this report.