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Public Health

Assessment of Proficiency of N95 Mask Donning Among the General Public in Singapore

Educational Objective
To understand how to assess the proficiency of N95 Mask usage

1 Credit CME

JAMA Network Open

Published Online: May 20, 2020

Research Letter

Article Information and Disclosures

Wesley Yeung, MBBS^1,2;

Kennedy Ng, MBBS³;

J. M. Nigel Fong, MBBS⁴;

Judy Sng, MBBS⁵;

Bee Choo Tai, PhD⁵;

Sin Eng Chia, MBBS⁵

Author Affiliations

¹University Medicine Cluster, National University Hospital, Singapore
²Laboratory for Computational Physiology, Harvard-MIT Health Sciences and Technology, Massachusetts Institute of Technology, Cambridge
³Division of Medical Oncology, National Cancer Centre Singapore, Singapore
⁴Division of Medicine, Singapore General Hospital, Singapore
⁵Saw Swee Hock School of Public Health, National University of Singapore, Singapore

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With the advent of the coronavirus disease 2019 (COVID-19) pandemic, mask-wearing among the general public has become commonplace, leading to a worldwide shortage.¹ However, there is little data on mask-wearing proficiency in the general public. A single study performed in the US after Hurricane Katrina, when individuals donned masks for mold remediation, found that only 24% of participants demonstrated proper technique.² Incorrectly worn masks may not confer effective protection against COVID-19.

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Article Information

Accepted for Publication: April 25, 2020.

Published: May 20, 2020. doi:10.1001/jamanetworkopen.2020.9670

Open Access: This is an open access article distributed under the terms of the CC-BY License. © 2020 Yeung W et al. JAMA Network Open.

Corresponding Author: Wesley Yeung, MBBS, University Medicine Cluster, National University Hospital, 5 Lower Kent Ridge Rd, Singapore 119074 (wesley_yeung@nuhs.edu.sg).

Author Contributions: Drs Yeung and Ng had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. Drs Yeung, Ng, and Fong contributed equally to this work.

Concept and design: Yeung, Ng, Fong, Sng, Chia.

Acquisition, analysis, or interpretation of data: Yeung, Ng, Fong, Tai.

Drafting of the manuscript: Yeung, Ng, Fong.

Critical revision of the manuscript for important intellectual content: All authors.

Statistical analysis: Yeung, Ng, Tai.

Obtained funding: Yeung.

Administrative, technical, or material support: Yeung, Ng, Chia.

Supervision: Yeung, Sng.

Conflict of Interest Disclosures: Dr Tai reported receiving personal fees from Boehringer Ingelheim and Wiley Blackwell outside the submitted work. No other disclosures were reported.

Funding/Support: 3M Singapore provided 800 3M VFlex 9105 N95 masks for use in the study.

Role of the Funder/Sponsor: 3M Singapore had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

Additional Contributions: Alex Lua, MBBS; Amanda Chin, MBBS; Cheryl Lie, MBBS; Claudia Chong, MBBS; Julia Ann-Lee, MBBS; Liang Sai, MBBS; Xin Qi Look, MBBS; Yun Hao Leong, MBBS, Abigail Lee, MBBS; Alexandra Yung, MBBS; Bing Howe Lee, MBBS; Bochao Jiang, MBBS; Cheryl Lam, MBBS; Deborah Lim, MBBS; Fiona Ng, MBBS; George Tan, MBBS; Jasmine Chang, MBBS; Jiaquan Chaung, MBBS; Jia Long Chua, MBBS; Kai Yun Ang, MBBS; Kevin Lim, MBBS; Kristabella Low, MBBS; Lorraine Yong, MBBS; Lyria Hoa, MBBS; Marcus Tan, MBBS; Marianne Tsang, MBBS; Michael Chee, MBBS; Nicholas Ngiam, MBBS; Nicole Chan, MBBS; Nicole Chew, MBBS; Ren Wei Liu, MBBS; Ryan Lee, MBBS; Shaina Neo, MBBS; and Zhao Kai Low, MBBS; provided help in the conduct of this study. They were not compensated for their contribution.

References

Gunia A . There aren’t enough medical masks to fight coronavirus: here's why it's not going to get better anytime soon. Time. February 27, 2020. Accessed April 28, 2020. https://time.com/5785223/medical-masks-coronavirus-covid-19/

Cummings KJ , Cox-Ganser J , Riggs MA , Edwards N , Kreiss K . Respirator donning in post-hurricane New Orleans. Emerg Infect Dis. 2007;13(5):700-707. doi:10.3201/eid1305.061490 PubMed Google Scholar Crossref

Lin M . Emergency starter kits delivered to all households. The Straits Times. May 14, 2014. Accessed April 28, 2020. https://www.straitstimes.com/singapore/emergency-starter-kits-delivered-to-all-households

3M Singapore. How to wear a 3M VFlex N95 respirator. YouTube; 2014. Accessed April 28, 2020. https://www.youtube.com/watch?v=sIkbyfJ5YRQ

Desai AN , Mehrotra P . Medical masks. JAMA. 2020;323(15):1517-1518. doi:10.1001/jama.2020.2331 PubMed Google Scholar Crossref

Harber P , Boumis RJ , Su J , Barrett S , Alongi G . Comparison of three respirator user training methods. J Occup Environ Med. 2013;55(12):1484-1488. doi:10.1097/JOM.0000000000000010 PubMed Google Scholar Crossref

AMA CME Accreditation Information

Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00  AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:

1.00 Medical Knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program;;
1.00 Self-Assessment points in the American Board of Otolaryngology – Head and Neck Surgery’s (ABOHNS) Continuing Certification program;
1.00 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program;
1.00 Lifelong Learning points in the American Board of Pathology’s (ABPath) Continuing Certification program; and
1.00 CME points in the American Board of Surgery’s (ABS) Continuing Certification program

It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.