Abstract

Chronic Obstructive Pulmonary Disease( COPD) is a progressive respiratory illness significantly affected by environmental factors, especially air pollution. The  part of  particular defensive equipment  similar as face masks has garnered attention post-COVID-19. This study aims to compare the effectiveness of N95 masks versus surgical masks in preventing COPD exacerbations in metropolitan populations exposed to high degrees of air pollution. A prospective cohort design was adopted involving 200 diagnosed COPD cases over a period of 12 months. Results indicated a statistically significant reduction in the frequency and severity of exacerbations among users of N95 masks compared to surgical mask users. Findings suggest that N95 masks offer superior protection and could be integrated into long- term  control strategies for COPD patients living in  weakened civic settings.

Keywords : COPD, surgical masks, N95 Mask, air pollution, pollution, pollutants, public health, respiratory diseases

Introduction

Chronic Obstructive Pulmonary Disease( COPD) is currently very severe respiratory condition in which patient experiences severe respiratory symptoms like airflow limitation in the patients suffering from COPD which are generally caused by environmental pollutants, which significantly contribute to the progression of the disease and also the rate of hospitalization is increased due to it and it is one of the leading cause of mortality in urban modern population.

Air pollution — especially in densely colonized civic regions is a well- established risk factor for exacerbations( Gupta et al., 2014; Liu et al., 2017). With urbanization and artificial growth, pollutants  similar as particulate matter( PM 2.5, PM10), nitrogen dioxide( NO2), and ozone( O3) have  boosted, negatively affecting respiratory health( World Health Organization( WHO), 2021).

Post-COVID-19, the use of face masks has come a common and socially accepted intervention for respiratory protection. Among the most accessible types are N95 respirators and surgical masks. Although both are effective in filtering airborne particles to some extent, their  relative efficacy in preventing COPD exacerbations remains under- investigated.

 This study explores the hypothesis that N95 masks  give better protection against air pollution- induced COPD exacerbations than surgical masks in civic settings.

Methods

 Study Design and Participants A prospective cohort study was conducted in two metropolitan tertiary hospitals in India( New Delhi and Mumbai) over 12 months. The inclusion criteria were age> 40 years,  verified  opinion of COPD grounded on GOLD criteria, abiding in civic areas with an Air Quality Index( AQI)  constantly> 150, and consent to  share. Patients with other comorbid respiratory  ailments, including asthma and bronchiectasis, were excluded.

 A aggregate of 200 participants were enrolled and stratified into two groups

 • Group A 100 patients using N95 masks

 • Group B 100 patients using surgical masks

Collection Baseline data on demographics, smoking history, COPD Assessment Test( CAT) scores, Modified Medical Research Council( mMRC) dyspnea scale, spirometry( FEV1/ FVC), and exacerbation history in the  once year were collected.

 Patients were trained in the correct use of masks and followed yearly via teleconsultation or in- person. Exacerbations were defined grounded on Anthonisen criteria( increased dyspnea, sputum volume, and purulence)( Anthonisen et al., 1987). Exacerbation severity was classified as mild( managed at home), moderate( required antibiotics steroids), and severe(  needed hospitalization).

 Air Quality Monitoring Daily AQI data were  attained from the Central Pollution Control Board( CPCB) database and  identified with participant exposure levels.

 Statistical Analysis Descriptive statistics were used for baseline characteristics. Chi-square tests were applied for categorical variables, and independent t- tests were used for  nonstop variables. Poisson regression was conducted to compare the exacerbation rates between groups.  

Discussion

This study  indeed demonstrates that beings with COPD who  constantly practice N95 masks  had significantly smaller and less severe exacerbations  likened to those who  leaned on surgical masks in  weakened metropolitan  surroundings. These findings are not entirely  shocking  given away the known superior filtration capabilities of N95 respirators. By  program, N95 masks can filter out at least 95 of airborne particles larger than 0.3 microns,  involving adverse pollutants generally found in metropolitan air  similar as PM 2.5 and PM10( CDC, 2020; Lee et al., 2008).

 Urban air quality, especially in heavily industrialized or  marketplace- congested  metropolises, presents a major  hazard to respiratory health.  previous  exploration has established a robust link between high ambient  situations of PM 2.5 and  sharp COPD exacerbations( Song et al., 2014; Dominici et al., 2006).  still and all, while the environmental  risks are well  proved, the  part of  particular defensive strategies especially simple, community- level interventions like face masks has remained less explored in the  environment of chronic respiratory  complaint prevention.

Our study sheds light on this gap. The  bettered  issues seen in the N95 group can be attributed to several critical factors

 Enhanced Filtration and access Unlike surgical masks, which are looser and primarily aimed to  help droplet transmission, N95 respirators are engineered to form a close facial seal. This tight  case allows them to efficiently block both coarse and fine  granules, significantly reducing the inhalation of  contaminants that can  drive or worsen COPD symptoms.

 Reduced Exposure  threat  numerous participants reported feeling more secure when outdoors while  wearing out N95 masks. This perceived and  effective  security likely allowed them to  involve in necessary  out-of-door   exercise without the same  position of exposure  threat, potentially improving  internal well- being and day-to-day function.

 Behavioral  mounting The use of N95 masks may reflect a  further  visionary health mindset. These patients may also have been more active in following medical  guidance,  sticking to  specifics, and avoiding given exacerbation triggers. nevertheless, it's important to recognize the  terminations of universal N95 use.  extended use of these masks can be uncomfortable, especially for elderly or  late- stage COPD cases who  ahead struggle with breathlessness. Cost is another barrier — N95 masks are  hugely more expensive than surgical masks, making long- term use challenging for  smaller-  profit  individualities.  also, the study was limited to metropolitan areas, where exposure histories and healthcare access may differ significantly from rural or peri-urban settings.

Future  study should explore how to make high- filtration masks more accessible and comfortable, while also  imposing the implicit advantages of combining mask use with other defensive measures like inside air cleansers and digital AQI  warnings.

Conclusion

 This study provides evidence that N95 masks offer superior protection against pollution- induced COPD exacerbations compared to surgical masks in civic populations. With accelerating air pollution levels universally, especially in low- and middle- income countries, integrating N95 mask use into routine COPD management could reduce  ailment burden.

 Future studies should explore cost- effectiveness, patient compliance, and the  part of combined interventions  similar as home air purifiers and digital air quality alerts.

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