COVID-19: Research Unmasks the Environmental Impact of PPE

The Occupational Safety and Health Administration (OSHA) notes that PPE can help prevent illness and injury. People will use different types of PPE based on the situation and need for protection.

The Food and Drug Administration (FDA)Trusted Source helps regulate how manufacturers make PPE to ensure it works correctly. PPE can help prevent infectious materials from getting on a person’s skin, eyes, and nose. When people correctly use PPE, it can help reduce the risk of spreading an illness from one person to another.

Examples of PPE include masks, gloves, face shields, goggles and protective clothing, such as gowns.

The Centers for Disease Control and Prevention (CDC)Trusted Source currently recommends that healthcare professionals treating people with COVID-19 wear N-95 masks, gowns, gloves, and eye protection such as face shields or goggles.

The CDC also has general recommendations related to mask use by the general public. Currently, it recommends that all people over the age of 2 wear masks in indoor public spaces.

While the CDC’s main focus has been on vaccination, it still promotes activities such as mask-wearing. For example, in a recent Facebook post, the CDC discusses a study demonstrating vaccine effectiveness. The agency advocates the following:

“Protect yourself and your community by becoming fully vaccinated, receiving your booster dose when recommended, and engaging in recommended prevention steps (like wearing masks or physical distancing in indoor public places where spread is high or substantial).”

Other countries have developed similar recommendations regarding masks throughout the pandemic.

COVID-19, PPE, and the environment

The study’s researchers looked at the changes in litter levels regarding recommendations and announcements from the World Health Organization (WHO) and the policies and legislation adopted by 11 countries.

Researchers collected data from France, Germany, Belgium, Netherlands, Spain, the United Kingdom, Sweden, the United States, Canada, Australia, and New Zealand about litter levels from September 2019 through October 2020.

They used the “Litterati” app to collect their data, specifically measuring the level of litter from masks, gloves, and wipes.

Since the WHO declared COVID-19 a pandemic on January 30, 2020, the researchers observed an increase in litter related to all types of PPE.

The amount of waste related to gloves recorded an initial spike and then a decline to about double pre-pandemic levels.

There was also a gradual increase in litter from wipes from March through August. The amount then declined to about double pre-pandemic levels.

The primary point of interest was the increase in litter from face masks. The litter from masks increased 84 times compared to pre-pandemic levels.

Before the pandemic, there was almost no litter related to masks.

Study author Dr. Keiron P. Roberts explained to Medical News Today:

“For the 11 countries studied from September 2019 to October 2020, we reported [an over] 80-fold increase in the proportion of masks as collected litter. This represents an almost [8,400%] increase.”

Researchers were then able to look at the adoption of specific COVID-19 policies in different countries and how these policies correlated with the increases in PPE litter.

One resource was the Oxford University Coronavirus Government Response Tracker. They specifically looked at countries’ policies related to mask-wearing and travel restrictions related to lockdowns.

They found the litter from masks increased after the introduction of mask legislation.

“Where mask legislation was present, we observed a significant increase in the proportion of mask litter. The report helps to support the anecdotal accounts we saw all too often last year and gives some justification as to why these items began to be more visible,” Dr. Roberts told MNT.

Reusable PPE and correct disposal will be key

Overall, the study provides evidence that the use of PPE can impact the environment, infrastructure, and people, particularly when people do not dispose of used PPE correctly.

This could lead to the following consequences:littered PPE could spread SARS-CoV-2 to others shortly after removal; it can clog sewage systems and pollute areas, such as streams and rivers; it can serve as a choking hazard or entanglement issue for animals; it can help spread pathogens and pollution.

The researchers acknowledge that their study risks observational bias and other possible errors, such as the lack of a standard method for collecting litter items. But their findings overall show an increase in litter related to COVID-19 and PPE use.

As the use of masks will likely continue, the risk for mask litter will remain, the study points out.

For that reason, the researchers encourage the adoption of policies and behaviors that can help reduce litter from PPE.

For example, agencies and governments can encourage reusable items where possible and provide appropriate disposal bins in areas where single-use masks are required.

Dr. Roberts offered the following recommendation:

“Moving forward, and in light of tightening restrictions and mask requirements across the world, we need to ensure continued mask use while preventing them from becoming litter. This is a dual responsibility of governments and the public. With governments providing strong messaging and education on disposing masks and other items, as well as supporting businesses to help customers and patrons bin their masks after use, [they will essentially help] to provide the facilities in the right place to do the right thing.”

However, Dr. Roberts ultimately noted that the responsibility lies with people making smart choices and choosing not to litter.