No, Face Masks Can’t Cause CO2 Poisoning

  • The Centers for Disease Control and Prevention (CDC) has advised using face masks to reduce risk of infection with the new coronavirus, particularly in settings where social or physical distancing is difficult to maintain.
  • Some people have been worried that they can cause carbon dioxide (CO2) poisoning, but experts say that’s not possible.
  • Experts say that masks, even the N95 type used by medical professionals, pose no risk to healthy people.
  • However, the CDC advises that we should use cloth masks to reserve enough N95s for healthcare workers.

We’ve made many changes to our daily lives, and wearing a face mask in public is among the most visible signs of living through a global pandemic.

The Centers for Disease Control and Prevention (CDC) has advised using face masks to reduce risk of infection with the new coronavirus, particularly in settings where social or physical distancing is difficult to maintain.

However, there have been rumors that wearing face masks for an extended time can impair breathing or even poison us with excess carbon dioxide (CO2).

Here’s why you don’t need to worry.

Face mask blamed for car crash

On April 23, a New Jersey driver crashed into a pole after passing out behind the wheel. He told responding police officers that it was wearing an N95 face mask for too long that made him unconscious. Lincoln Park, New Jersey police posted the incident to their Facebook page.

According to the post, “We ‘believed’ the excessive wearing of an N95 mask was a contributing factor to this accident. While we don’t know this with 100% certainty, we do know that the driver had been wearing an N95 mask inside the vehicle for several hours and ultimately passed out while operating the vehicle.”

However, experts confirm that the mask could not have been a factor.

“There is no risk of hypercapnia (CO2 retention) in healthy adults who use face coverings, including medical and cloth face masks, as well as N95s,” Dr. Robert Glatter, an emergency physician at Lenox Hill Hospital, New York, told Healthline. “Carbon dioxide molecules freely diffuse through the masks, allowing normal gas exchange while breathing.”

What to know about N95 masks

The CDC recommends that the general public use cloth face masks. They specify, “The cloth face coverings recommended are not surgical masks or N-95 respirators.”

However, the CDC emphasizes that the reason we shouldn’t be using N95 masks isn’t health-related, but because they “must continue to be reserved for healthcare workers and other medical first responders.”

“Rebreathing tiny amounts of CO2 from wearing either properly fitted N95 respirators or more loosely fitted cloth or surgical masks is of no concern for the vast, vast majority of people,” said Darrell Spurlock Jr., PhD, RN, the director of the Leadership Center for Nursing Education Research at Widener University and a professor in Widener’s PhD in Nursing program.

According to Spurlock, even workers, including medical providers, wearing surgical or cloth masks for a whole shift should have no concerns about retaining CO2 and shouldn’t worry about negative effects from wearing a mask.

“The ‘dose’ of CO2 we might rebreathe while masking is quickly and easily eliminated by both the respiratory and metabolic systems in the body,” he said. “I worry a thousand times more about viral transmission than any negative effects arising from mask wearing per CDC guidelines.”

Only those with lung disease should be concerned

“In persons with sleep apnea or severe lung disease who require oxygen, the masks may pose a risk to normal air entry and gas exchange, making breathing problematic,” said Glatter. He emphasized that these patients should discuss wearing a mask with their physician.

Spurlock explained that someone with severe lung disease, already struggling to maintain oxygenation and balanced CO2 due to lung damage “may be more sensitive to CO2 levels.”

But he clarified, “Even then, higher CO2 levels actually stimulate breathing to blow off the excess CO2 in the blood first.”

This would happen before the negative effects of CO2 exposure would take place.

He added that only those with very specific chronic respiratory disease need to check with their health provider before wearing a face mask, and, “It could be argued that they should avoid exposures to the virus at nearly any cost, regardless, so their need for masks is minimal.”

How to wear a mask

“The cloth or surgical mask should cover both mouth and nasal openings,” said Dr. Sigfredo Aldarondo, a pulmonologist and the chief medical officer of PN Medical.

Aldarondo specified that it should also be large enough to sit flush over the surrounding skin surface to prevent droplets or aerosols from contaminating nearby surfaces or people.

He also recommended that mask wearers “be mindful of their respiratory pattern and consider doing several slow deep ‘healthy’ breathing maneuvers before and after donning the mask. Periodic breaks, when feasible are advisable.”

The bottom line

There have been concerns that face mask use is associated with impaired breathing, but this isn’t true.

Experts say that masks, even the N95 type used by medical professionals, pose no risk to healthy people. However, the CDC advises that we should use cloth masks to reserve enough N95s for healthcare workers.

They also say people with severe lung disease already have impaired breathing and should speak with their healthcare providers before wearing a mask.


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