Face the Facts: What You Need To Know About Medical Face Masks In Healthcare Settings

Q&A with Kathleen Stoessel

RN, BSN, MS, Senior Manager, Clinical Education & Accreditation, Halyard Health

Why do I need a fluid-resistant mask?

If your mask is not fluid resistant, you are not adequately protected when performing procedures such as endotracheal suctioning, bronchoscopy, and invasive surgery that generate splashes or sprays of blood, body fluids, secretions, or excretions. Wearing a fluid-resistant mask helps to protect the wearer from mucosal contact and inhalation of these potentially infectious splashes and sprays.1

Is there a meaningful difference between a mask that offers a 95% BFE versus 99.7% BFE?

A higher percentage indicates higher filtration efficiency; e.g., 95% BFE indicates 5% of the aerosolized bacteria used in testing passed through the mask material, while 99.7% BFE indicates only 0.3% passed through.

What are the primary purposes for wearing masks in the healthcare setting? Masks have 3 primary purposes1. They are:

  1. Worn by healthcare personnel to protect them from contact with infectious splashes and sprays.
  2. Worn by healthcare personnel to protect patients from exposure to infectious agents carried in a healthcare worker’s mouth or nose; and
  3. Worn by patients to limit potential dissemination of infectious respiratory secretions from the patient to others (protect others).

What is a surgical mask?

In the United States, surgical masks are cleared for marketing by the U.S. Food and Drug Administration (FDA). According to the FDA, surgical masks may be labeled as surgical, laser, isolation, dental or medical procedure masks.2

What is ASTM?

ASTM International is one of the world’s largest standards developing organizations.

What performance characteristics are tested using criteria specified by ASTM F2100-11 and why are these characteristics important?

  • BFE and PFE:
    Describe mask performance for bacteria filtration efficiency (BFE) and particle filtration efficiency (PFE). The higher the percentage, the more the mask prevents the passage of bacteria or particles.3
  • Fluid Resistance:
    Face masks are challenged with synthetic blood at various levels of pressure (80, 120, 160mm Hg). The higher the pressure withstood, the greater the fluid spray and splash resistance.
  • Delta P/Differential Pressure:
    Measures the effort it takes to force air through the mask material…the lower the Delta P, the more breathable and comfortable the mask.
  • Flammability:
    The mask material is subjected to flame. The rate at which the material burns determines the level of flammability.

How do I know if my current face mask is providing adequate protection?

Look at the package! The new ASTM F2100-11 standard requires a graphic display on the packaging stating the mask performance level. The new standard also changed mask classifications from performance class (low, medium, high) to levels (1,2,3). This rating level is determined based on the test results of the material performance categories listed above.3

Related Article


  1. Siegel JD, Rhinehart E, Jackson M, Chiarello L. 2007 Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Health Care Settings. Am. J. Infect. Control. Dec 2007;35(10 Suppl 2):S65-164.
  2. Center for Devices and Radiological Health. Guidance for Industry and FDA Staff. Surgical Masks – Premarket notification [510(k)] submissions 2004.
  3. ASTM International. Standard Specification for Performance of Materials Used in Medical Face Masks. Vol ASTM F2100-11. West Conshohocken, PA: ASTM International; 2011.


Face Masks  PPE