Unit 4: Health Misinformation - Prolonged Mask Use Can Increase CO2 Levels to Toxic Levels

The proliferation of information technology and social media platforms in the last two decades has facilitated the broadcasting of health misinformation at a global level (Suárez-Lledó & Álvarez‐Gálvez, 2021). “Health misinformation is a serious threat to public health. It can cause confusion, sow mistrust, harm people’s health, and undermine public health efforts” (Murthy, n.d.). With myths such as drinking bleach to protect against the COVID-19 virus, credited to President Trump, to other misinformation such as cancer causes, and cures, the body of misinformation is endless. Deciphering evidence-based health information from the sea of misinformation is one way to combat the negative consequences of the existing body of misinformation.

Among the many myths that emerged throughout the COVID-19 pandemic, one was about CO2 intoxication linked to prolonged mask use (WHO, 2022). While the WHO (2022) refuted the myth, acknowledging that while prolonged dawning of medical masks can be uncomfortable, it does not cause CO2 intoxication or oxygen deprivation, I searched the literature to find out if any evidence supports either claim.

In an earlier publication, Rhee et al. (2021) investigated the impact of wearing medical masks on CO2 levels with 11 healthy volunteers, including men and women ranging from 16 to 54 years of age. The authors used the National Institute for Occupational Safety and Health (NIOSH) limits as toxicity threshold. Rhee et al. (2021) reported a significant increase in CO2 concentrations with routine face masks; however, the observed values remain below the NIOSH toxicity limits for short-term use. The study was inconclusive on the long-term use of masks and suggests further investigation to determine the long-term impact of mask use on CO2 levels (Rhee et al., 2021).

In a recent study, Kisielinski et al. (2023) investigated the correlation between prolonged mask use and CO2 buildup and took it a step further to determine the implications on early life. The results were shocking and appear to undermine the WHO (2022) claims that the masks do not affect CO2 levels and do not increase the risk of hypercapnia-related complications. Kisielinski et al. (2023) reported that wearing masks for more than five minutes can increase CO2 levels to 1.41% to 3.2% of inhaled air, significantly higher than the 0.04% CO2 in fresh air. The authors agree with the WHO (2022) claims that the detected CO2 levels are safe in the short term; however, they reported long-term exposures at more than 0.3% CO2 levels as toxic (Kisielinski et a., 2023). Mammal experimental data shows an increased risk of stillbirths, irreversible neuron damage in the offspring, and “reduced spatial learning caused by brainstem neuron apoptosis and reduced circulating levels of the insulin-like growth factor-1” (Kisielinski et al., 2023). Additionally, the authors reported on data that suggests neuron destruction leading to less activity, increased anxiety, impaired learning and memory, and testicular toxicity in adolescent mammals.

Considering the above evidence, the claims regarding CO2 toxicity linked to mask use have some merit and are not a myth. This shows evidence can evolve to support or refute previously reported claims, even from credible organizations such as the WHO. Given the emergence of circumstantial evidence correlating prolonged mask use with possible CO2 toxicity leading to increased prevalence of stillbirths, reduced verbal motor, and overall cognitive performance (Kisielinski et al., 2023), a need exists to reconsider mask mandates as suggested by Kisielinski et al. (2023)

References

Kisielinski, K., Wagner, S., Hirsch, O., Klosterhalfen, B., & Prescher, A. (2023). Possible toxicity of chronic carbon dioxide exposure associated with face mask use, particularly in pregnant women, children and adolescents – A scoping review. Heliyon, 9(4), e14117. https://doi.org/10.1016/j.heliyon.2023.e14117

Murthy, V. H. (n.d.). Health Misinformation. Current Priorities of the U.S. Surgeon General. Retrieved October 20, 2023, from https://www.hhs.gov/surgeongeneral/priorities/health-misinformation/index.html

Rhee, M. S. M., Lindquist, C. D., Silvestrini, M. T., Chan, A. C., Ong, J., & Sharma, V. K. (2021). Carbon dioxide increases with face masks but remains below short-term NIOSH limits. BMC Infectious Diseases, 21(1). https://doi.org/10.1186/s12879-021-06056-0

Suárez-Lledó, V., & Álvarez‐Gálvez, J. (2021). Prevalence of health Misinformation on social media: Systematic review. Journal of Medical Internet Research, 23(1), e17187. https://doi.org/10.2196/17187

World Health Organization (WHO). (2022, January 19). COVID-19 Myth Busters. World Health Organization. Retrieved October 20, 2023, from https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public/myth-busters#oxygen