Mask-wearing skyrocketed in the early years of the 21st century with the outbreak of SARS and avian influenza. The Japanese government recommended that all sick people wear masks to protect others, while they suggested that healthy people could wear them as a preventative measure.
When H1N1 hit Japan in , it first struck tourists who had returned from Canada. The sick were blamed for failing to wear masks while abroad. In a country that takes etiquette very seriously, wearing masks in Japan has become a form of politeness. Similarly, in China, mask-wearing has a long history. A pneumonic plague epidemic in China in sparked widespread mask-wearing there.
After the Communists came to power in , there was intense fear of germ warfare, leading many to wear masks. In the 21st century, the SARS epidemic intensified mask-wearing, as did the smog that blanketed many Chinese cities. The Chinese government urged its citizens to protect themselves against pollution by wearing masks. During the COVID epidemic, some of the first people in Canada to wear masks were people with ties to Asia , who were already accustomed to the practice of masking.
On the flight back to Canada, she wore a mask. In China there is evidence of similar face coverings dating back to the 13th-century Yuan dynasty. In his travelogue written during this period, the Italian explorer Marco Polo — described servants attending to the Chinese emperor and his entourage wearing silk scarves to cover their mouths and noses to prevent their breath from contaminating the food they prepared.
Another outbreak in the 17th century led to the invention of the beak mask — which came to symbolise the plague — by French doctor Charles de Lorme. Covering the entire face, the mask had glass portals so the wearer could see, and the beak was often filled with spices or aromatics, including mint and camphor, to filter out disease. Artist Leonardo da Vinci — soaked cloth in water and placed it on his face in order to prevent toxic chemicals from paint and plaster from entering his lungs.
People trying to escape a burning building are still advised to use this effective method to protect their lungs from the effects of smoke inhalation. The discovery in of the presence of bacteria in the air by Louis Pasteur made people aware of the dangers of breathing in harmful pathogens. This led doctors to prescribe cotton masks to limit contagion during epidemics.
Fashionable women wore lace veils to protect their lungs from harmful airborne particles. During the early years of the 20th century, Wu Lien-teh , a public-health specialist from Malaya, was investigating a pneumonic plague that had broken out in northern China. He developed a mask from layers of gauze enveloped in cotton, with ties so that it could be hung on the ears. This was the prototype from which the masks currently used in medicine today evolved. In Chicago physician Alice Hamilton published a study about the amount of streptococci bacteria expelled when scarlet fever patients coughed or cried.
She also measured the bacteria from healthy doctors and nurses when they talked or coughed, leading her to recommend masks during surgery. Masks at this stage were closer to gas masks. Hassley applied for the patent in with the patent number , which is still available in the archives in the US. In , French biologist, microbiologist and chemist Louis Pasteur proved the presence of bacteria in the air, which made more people pay attention to the design of modern masks. For example, a French doctor created a mask made of six layers of gauze and sewed it on the collar of a surgical gown in The doctor only needed to flip the collar up when using it.
It gradually evolved into a form that could be freely tied and hung on the ears with a looped strap, thus giving birth to the modern mask. During the late Qing Dynasty , Chinese medical scientist Wu Liande invented a mask made of two layers of gauze called "Wu's mask" in response to a plague in Northeast China.
This mask was highly complimented by experts in different countries as it is simple to manufacture, has a low production cost and the materials are easy to obtain. New design With several outbreaks of infectious diseases and flu, and the rise of smog from modern industry, the materials in masks have continued to evolve to better filter viruses and pollution. In last few months, many communications were brought to the public that face masks are ineffective during a pandemic crisis.
Since April 27, face masks have become mandatory for shopping and in public transportation in Germany. In the Netherlands, it became mandatory only for public transportation, from June 1, onwards. However, in Asian countries people have been wearing masks in public for ages. This fact alone implies a necessary, and a more distinguished view of the normative application of facemasks.
In two manuscripts, we are now describing the use of masks during this viral pandemic. This first review describes the history of facemasks. The second will concentrate on benefits and risks by wearing facemasks in modern times. This is the most recent expression of the use of face masks. However, face masks have been used since the middle ages. There are pictures of medical professionals from the early modern age treating patients suffering from the bubonic plague wearing beak-like masks.
The doctors were dressed in black cloaks and dark hats and were considered the symbol of the deathly epidemic of the Middle Ages. It was proclaimed that spoiled air from the East had caused the epidemic. There are two masks displayed in German museums that are suspected to be forgeries from a younger date. That indicates that the beak-doctors were in retrospect awarded a meaning they apparently did not have in reality [ 3 ].
Colored version of a copper engraving of Doctor Schnabel i. Heroic stories of the introduction of antisepsis by Joseph Lister — and the corresponding preliminary works by Louis Pasteur — or Ignaz Semmelweis — [ 4 ] have inspired movie productions for decades and had an impact on our culture of remembrance. In contrast, the bacteriologic era that influenced the development of surgery has only recently been analyzed for the German area by Schlich et al.
Ever since the works of Lister and Pasteur, the surgical ward and its developing special disciplines were confronted with a trend-setting discourse about wound infections and their prohibition and containment.
The introduction of mouth and nose coverage mouth protection, face veils, face masks, mouth bandages can be followed back to the turn-of-the th -century. At that time, the respiratory system as a transmitter of germs came into focus of research and already mandated instructions to keep distance [ 7 , 9 ].
In here, Mikulicz described a one-layered mask made of gauze [ 10 ]. More studies regarding the germ content in the operating room air followed [ 11 , 12 ]. Until , the application of face covers was not common in surgery and the general hospitals.
Nevertheless, an earlier illustration of a multilayer face mask made of gauze can be found in the surgical operating teachings of the British surgeon B. Moynihan — Fig. Only those afflicted with a catarrh or angina should wear a mouth bandage when operating that is to be sterilised in steam.
The surgical mask was used first in the operating rooms of Germany and the USA in the s. A similar situation applies for the United States. In that country, following the First World War, more and more research addressed facemasks with varying thickness [ 20 , 21 , 22 , 23 ]. Still, masks were not generally accepted, which can be seen in contemporary photographs [ 24 ] or paintings Figs. At this time, it was not common covering the nose with the cloth-made mask.
Christiane Matuschek, daughter of Dr. Ewald Matuschek. In the middle of the s, the research on the role of facemasks was continued in Germany and the USA [ 25 , 26 ].
Only in the s, washable and sterilizable masks gained acceptance in German and international surgery with only the number of gauze layers varying 2—3, 3—4 [ 27 , 28 ]. Beginning in the mids, the use of disposable items made of paper and fleece was introduced all over the world after this was started in the USA. Still in the s, there were only uncertain data available. Therefore, an unresolved discussion was present between surgery and hospital hygiene, if wound infections could be reduced by the use of surgical mouth and nose protection [ 29 , 30 ].
Today, following the recommendations of the RKI German Robert Koch-Institute for hygiene , the available data indicate that surgical facemasks lower the contamination of indoor air [ 31 ].
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