WHN Joins in the Chorus: Throughout the COVID-19 pandemic, confusion has persisted among public health and medical leaders regarding which masks offer true protection against airborne diseases such as SARS-CoV-2. Early shortages of respirator masks (like N95s) and a widespread misunderstanding that the virus spread primarily through droplets rather than aerosols led to the widespread recommendation of medical masks for both the public and healthcare workers (HCWs).
Although global supplies of respirators have long recovered, a critical problem remains: many HCWs are still advised to use medical masks instead of respirators, despite mounting scientific and regulatory evidence showing that medical masks are not personal protective equipment (PPE).
Two prominent organizations — the British Occupational Hygiene Society (BOHS) and the Canadian Standards Association (CSA) — have recently issued firm statements clarifying this distinction, reinforcing that only respirators qualify as true PPE for airborne protection.
British Occupational Hygiene Society: Clarifying the Legal Definition of PPE
In August 2025, the BOHS released its statement titled “Guidance for Healthcare Employers and Workers on the Use of Fluid-Resistant Surgical Masks and Respirators To Comply with the Requirements of the Control of Substances Hazardous to Health Regulations (COSHH) 2022 (England)”.
The document makes an unambiguous claim:
“It is a breach of Health and Safety law for employers to suggest that medical masks (MMs) could be used by healthcare workers to protect themselves from inhaled hazards.”
BOHS emphasizes that medical masks were never designed, tested, or certified as PPE, and that manufacturers themselves do not recommend their use as protective equipment. Respirators, on the other hand, are specifically engineered to protect users from airborne hazards. The BOHS urges healthcare employers to comply with occupational safety laws and provide respirators to all at-risk healthcare workers.
Canadian Standards Association: Continuous Respirator Use Recommended
The Canadian Standards Association (CSA), responsible for setting national equipment and safety standards, updated its Z94.4 “Selection, Use and Care of Respirators” draft to include a new section — Chapter 9: Respirator Selection for Health Care Workplaces.
This chapter acknowledges asymptomatic transmission of SARS-CoV-2 and continued infections among healthcare workers and patients. It concludes that continuous respirator use is necessary in all healthcare settings.
The CSA further defines limited “respirator-exempt zones” (e.g., cafeterias, administrative offices), where equivalent protective engineering controls must be implemented. Critically, it states:
“Surgical masks are not considered respirators and shall not be used as respiratory protection by healthcare workers.”
Global Consensus: Medical Masks Are for Source Control, Not Personal Protection
The WHN, BOHS, and CSA positions are consistent with long-standing international standards:
- U.S. FDA: “Face masks are for use as source control and are not PPE; they are not a substitute for N95 respirators.”
- CDC Infection Control Guidance (2024): Recommends only respirators for protection against airborne pathogens.
- EU Standard EN14683:2025: “This document is not applicable to face masks intended exclusively for the personal protection of staff.”
- Canadian Centre for Occupational Health and Safety (CCOHS): Recognizes only respirator masks as PPE, stating medical masks are for source control only.
Together, these statements confirm a decades-old scientific and regulatory understanding — that medical masks are not designed to protect the wearer from inhaling airborne particles.
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Why Experts Differentiate Medical Masks from Respirators
To understand this distinction, it’s essential to revisit the origin and purpose of medical masks.
Medical Masks: Designed for Splash Protection
Medical masks (MMs) were developed to prevent surgical staff from contaminating a sterile field with saliva or nasal secretions and to protect them from splashes of bodily fluids. They serve as source control devices, preventing the wearer from spreading droplets to others.
However, because medical masks are loose-fitting, air easily escapes or enters through gaps at the sides — allowing bioaerosols (tiny airborne particles) to bypass the filter entirely. While more comfortable for long use, they cannot protect against inhaled infectious aerosols.
Respirators: Designed for Airborne Hazard Protection
Respirators — such as N95, KN95, FFP2, FFP3, or KF94 — were originally developed for industrial use, protecting workers from inhaling toxic dust, smoke, or fine particles.
They feature tight-fitting seals, high-efficiency electrostatic filters, and are subject to fit testing to ensure all inhaled air passes through the filter. These design principles make respirators the only effective PPE for airborne hazards, including viruses and bacteria.
Moreover, respirators outperform medical masks even in source control, since they prevent exhaled air from escaping through gaps.
Comparison: Medical Mask vs. Respirator
| Feature | Medical Mask (Surgical/Procedure Mask) | Respirator (e.g., N95, FFP2, KF94) |
|---|---|---|
| Main Purpose | Protects others from sprays and droplets | Protects wearer and others from airborne particles |
| Fit | Loose-fitting | Tight-fitting seal to face |
| Filtration | Basic barrier; limited particle filtration | High-efficiency filtration (down to ~0.075 µm) |
| Certification | Tested for droplet protection (ASTM, EN14683) | Certified for particulate protection (NIOSH, CSA, EU EN149) |
| Attachments | Ear loops or ties | Head straps (ensuring tighter seal) |
| Use Type | Droplet protection, source control | Airborne protection, aerosol source control |
| Fluid Resistance | Required (3 levels) | Optional |
| Occupational Safety Status | Not PPE for airborne hazards | Certified PPE for airborne hazards |
As occupational hygienists summarize: using a medical mask instead of a respirator is like using the heel of your shoe instead of a hammer — only one is fit for the job.
Conclusion
The World Health Network (WHN), along with the BOHS and CSA, reinforces a crucial message: medical masks are not personal protective equipment.
Despite decades of evidence and clear global standards, many healthcare institutions continue to rely on medical masks as PPE for airborne pathogens. This practice not only violates occupational safety standards but also puts healthcare workers and patients at unnecessary risk.
Respirators — whether N95, FFP2, or equivalent — are the only proven, legal, and scientifically supported form of PPE for protection against airborne diseases like COVID-19. Ensuring universal access, training, and compliance with respirator use is not just best practice — it’s a legal and moral obligation to protect healthcare workers and the public alike.
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FAQs
1. Are medical masks considered PPE?
No. Medical masks are designed for source control and splash protection, not for personal protection from airborne hazards.
2. What qualifies as PPE for airborne protection?
Only respirator masks (e.g., N95, KN95, FFP2, FFP3, KF94) are certified as PPE against airborne hazards.
3. Why are respirators more effective than medical masks?
Respirators provide a tight facial seal and multi-layer electrostatic filtration, blocking >95% of tiny airborne particles, unlike loose-fitting medical masks.
4. What do safety authorities like BOHS and CSA recommend?
Both recommend continuous respirator use for healthcare workers in all medical settings, citing legal and safety compliance.
5. Should healthcare facilities still allow medical masks?
Medical masks may still be used for source control or in low-risk administrative areas, but not as PPE in clinical or patient-care environments.