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New study debunks 1 of the biggest concerns about wearing a mask

Recent research updates guidance for Covid-19 and exercise.

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Exercise is key to a healthy life. During a pandemic, the same is true for wearing a mask.

However, since the start of Covid-19, there’s been debate over how safe it is to wear a mask while exercising — for both the person working out and the people near them. In December, the World Health Organization recommended people “not wear masks during vigorous” physical activity. The CDC, meanwhile, urges people to wear masks when exercising — even during a high-intensity workout.

Now, a new study offers additional guidance. Scientists report in the European Respiratory Journal there are no adverse health effects associated with mask-wearing while exercising — although wearing a mask can slightly impair performance.

Is it safe to exercise with a mask on?

It may not be a good idea to run to your nearest open gym. Studies suggest gyms and other enclosed spaces are areas of increased spread of Covid-19.

However, when it comes to safety associated with mask-wearing specifically — not where you are wearing the mask — the answer appears to be yes.

During the European Respiratory Journal study, researchers ran a test on twelve healthy, middle-aged non-athletes to compare their performance resting and exercising. Each participant tried out three different masks: a surgical mask, a FFP2 mask (similar to a KN95 mask), or a “sham mask.” The “sham mask” was a surgical mask with a hole cut out.

The results suggested exercise capacity did decrease by 10 percent, thanks to increased “airflow resistance” from the mask. But the mask posed no danger for participants even during vigorous exercise and their ability to exercise was not greatly changed.

Piergiuseppe Agostoni is the senior author of the study and a professor of cardiology at the University of Milan. He tells Inverse this analysis “clearly” demonstrates people can successfully workout while wearing a mask, even if there is some “limitation due to the presence of the protective mask.”

Researchers tested cardiorespiratory parameters by hiding three mask options inside a mouthpiece used for typical exercise tests. European Respiratory Journal/Mapelli, et. al

While the participants worked out on a stationary bike in three different mask scenarios, Agostoni and his colleagues tested various markers of respiratory and cardiovascular function, including:

  • Ventilation
  • Oxygen intake
  • Carbon dioxide production
  • How difficult or labored breathing was

While mask-wearing participants did feel shorter of breath compared to others, they actually adjusted to ventilation — the volume of gases leaving the respiratory tract — and had no adverse effects from wearing a mask.

Does it matter what type of mask you wear when exercising?

The study suggests both surgical masks and KN95 masks are completely safe to exercise in.

To test the effects of wearing different masks compared to wearing no mask, the study used standard surgical masks, a FFP2 mask, and a “sham mask” hidden under a standard silicone mouthpiece standard for CPET tests or exercise tests in a lab setting.

None of the participants or their testers knew which mask they had on while conducting the trials so they wouldn’t be influenced by the kind of mask they were wearing. The mouthpiece hid the mask, and itself does not impede airflow, according to Agostini.

The study suggests surgical masks, FFP2 masks, and (the very similar) KN95 masks are completely safe to exercise in. Fabian Strauch/picture alliance via Getty Images

There were no adverse effects associated with either of the masks they tested, but participants did experience a slight progressive increase in shortness of breath from no mask to a surgical mask to the KN95 mask scenario.

Still, “we cannot use the presence of the mask as a way to say ‘well, you know, I cannot wear the mask because I need to do the exercise,’” Agostini says. “It's a bunch of people who use this as an excuse for not doing things properly.”

Their results counter false claims about mask-wearing some have used to leverage their stance against masks, like mask-wearing leading to a buildup of CO2 in a mask and hypercapnia (too much carbon dioxide in the bloodstream).

Is it safe to go to the gym during Covid-19?

This study found masks are safe to wear for the user when exercising and suggests people who exercise can and should wear a mask to reduce the risk of spread, even when engaging in intense physical activity. The study, however, does not address the safety of exercise settings.

“What we have learned from other settings is that layered mitigation is key.”

Sarah K. Kemble is the Hawaii Department of Health’s deputy state epidemiologist, and worked on an early case study on community spread of SARS-CoV-2 in three gyms in Hawaii. She says it’s difficult to say how likely gym workouts are to contribute to disease spread. “We don’t really know,” Kemble tells Inverse.

“What we have learned from other settings is that layered mitigation is key,” Kemble explains. “If several safety measures are taken at once, then if any one of them fails, transmission can still be reduced through the other measures that were successfully implemented.”

The CDC recommends reducing risk in the gym from multiple angles: maintaining six feet of separation, masking up, looking for well-ventilated facilities, washing hands, sanitizing surfaces, and avoiding peak hours. Notably, they also recommend taking high-intensity workouts outside.

So, if your nearby gym has great ventilation, requires mask-wearing, and enforces social distancing, for example, the risk of exposure to SARS-CoV-2 might be less compared to a gym without windows or a mask mandate.

Why is it important to exercise during Covid-19?

Long story short, exercise is one of the best things to do during the pandemic for both physical and mental health. A review of literature on Covid-19 and exercise found physical activity actually strengthens the immune response to viral diseases. Those authors recommend regular exercise as an “auxiliary tool in strengthening and preparing the immune system for COVID-19.”

And Hippocrates once said, “If you are in a bad mood go for a walk. If you are still in a bad mood go for another walk.” It may come as a no-brainer for some, but physical activity can offset some of the less-fun side effects of all that sitting around at home.

More than ever, people are leading a more sedentary life. In many cases, exercising less can lead to weight gain, aches and pains from sitting all day, and associated negative changes in mood.

Exercise has a host of benefits that are well established: It can keep pandemic blues at bay, prolong life, help with sleep, and strengthen the body to prevent injuries associated with sitting, among other effects.

And according to an updated report from the WHO on physical activity, adults between the ages of 18 and 64 should be getting the equivalent of 75 to 150 minutes of vigorous activity a week: running, swimming, shoveling, even carrying heavy things.

One review cited a study that found that people who exercised two to three times a week “experienced significantly less depression, anger, stress, and cynical distrust” than those who exercised less. Even 30 minutes a day of any kind of physical activity is associated with lower mortality risk.

That’s a ringing endorsement for doubling down on pandemic pushups — mask on, please.

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