Do facemasks cause CO2 poisoning?

Question

I came across this video on BitChute purporting to test the CO₂ levels of what appears to be a KN95 (a Non-NIOSH Approved Respirator) whilst the mask is in use.

The video shows a device displaying CO₂ levels rising, next to an image depicting symptoms of given CO₂ PPM (parts per million) levels.

The PPM list appears to be legitimate, so does the real-time recording, however I also know that surgeons and medical professionals have worn masks for hours with no adverse effects.

Do these facemasks cause CO₂ poisoning?

Comments are not for extended discussion; this conversation has been [moved to chat](https://chat.stackexchange.com/rooms/110498/discussion-on-question-by-ssight3-do-facemasks-cause-co2-poisoning). — Oddthinking, Jul 11 '20 at 17:12
This question is very confusing because there are two totally separate, completely unrelated, issues: (A) do facemasks cause CO2 poisioning, (B) is the method seen in the photo (that device, etc) sensible or nonsensical for testing the issue? — Fattie, Jul 14 '20 at 11:31
@Fattie I took the question as being the first part and the second part as being an example of a notable claim of the first part (which is required for the question to be on-topic on Skeptics.) — reirab, Jul 14 '20 at 14:57
@reirab - the whole thing is just WAY to unclear for skeptics. The whole question is apparently about the VIDEO linked. BUT the title is a general question utterly unrelated to the video. — Fattie, Jul 14 '20 at 15:56
Note that this is a production by antivax kook Del Bigtree (who, unsurprisingly, is also anti-mask), and while who is the creator isn't dispositive, anything he does should be looked at, well, skeptically. — Andrew Lazarus, Jul 15 '20 at 06:13
@Fattie how are those "totally separate, completely unrelated"? If the testing was appropriate and correct and toxicity is 5000 ppm, then the answer to the question is "yes." If it wasn't, the answer could be either yes or no. These attempts at pedantry are getting out of hand. — Paul Draper, Jul 15 '20 at 07:50
I believe that technically, CO2 is an asphyxiate, not a poison. — Acccumulation, Jul 25 '20 at 02:31
I want to point out that pCO2 is unlikely related to Oxygen level, or marginally related to it, except if one breaths that CO2. In other words the way they choose to suggest that mask might be detrimental makes no sense. Lack of oxygen does not mean higher pCO2, and whatever simple mask reducing O2 in/out, so does for CO2. — Alchimista, Jul 27 '20 at 10:04
Moreover exhaled air is certainly rich in CO2, mask or no mask. — Alchimista, Jul 27 '20 at 10:09

score 227 · Accepted Answer · edited Jul 15 '20 at 00:58

227

This is the meter used in the video:

Note that the sensor is situated at the top, pointing upward. When the person in the video breathes out, the exhaled air will be directed into the sensor, but when the person inhales air will flow around the sensor with no strong tendency to enter it.

This creates a strong bias for measuring exhaled air vs inhaled air, and likely measurements would not be radically different if the same experiment were conducted with no mask present.

More unbiased:

In one small study published in Respiratory Physiology and Neurobiology, twenty subjects wearing surgical masks walked on treadmills for one hour. Scientists measured their blood oxygen and carbon dioxide concentrations, respiratory and heart rates, and core temperatures. After that hour, the scientists found no significant change in these measurements.

With N95 masks, it’s a slightly different story. There is some evidence that these masks, which tend to fit more tightly over the wearers face, can decrease oxygen levels and increase carbon dioxide levels. A small study of ten healthcare workers found that the oxygen and carbon dioxide concentrations within N95 masks fell below workplace standards set by the Occupational Safety and Health Administration. Still, when the scientists compared the subjects’ blood oxygen levels after one hour on the treadmill in an N95 mask versus an hour without, they found no difference. Another study published in the American Journal of Infection Control found similar results with pregnant study subjects — after an hour of walking in N95 masks, the blood oxygen levels of pregnant women and non-pregnant women alike hadn’t changed. The masks also had no apparent effect on the fetuses, whose heart rate didn’t change throughout the study.

Source

edited Jul 15 '20 at 00:58

answered Jul 11 '20 at 18:43

Daniel R Hicks

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Is there any reference to support your assessment of the meter, or is it original research? – Dmitry Grigoryev Jul 12 '20 at 11:11
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Whilst I like Asmael's answer on the product, this answer contains a study which gets to the heart of the query - 'do facemasks cause CO2 poisoning?'. Even if we surmise the product isn't suitable or the testing methodology is flawed, it would still leave the question unanswered, which I'm asking on behalf of others who may be thinking such a question. – SE Does Not Like Dissent Jul 12 '20 at 13:32
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The study is useful. I am disappointed about the excitement about the opening paragraphs, which is unsubstantiated speculation. See chat. – Oddthinking Jul 12 '20 at 13:33
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Here are the original publications, [the one with the ten health workers](https://pubmed.ncbi.nlm.nih.gov/20420727/) and [the one with pregnant women](https://aricjournal.biomedcentral.com/articles/10.1186/s13756-015-0086-z). Sadly, the latter study did not report an arterial blood gas analysis (BGA), which is the gold-standard to look at carbon dioxide uptake. The first study did so and found levels of **40.7** SD 3.5 for no mask, **40.1** SD 2.7 for mask with valve and **39.9** SD 2.8 for mask without valve [mmHg each]. The reference range for pCO2 is 35 up to 45mmHg. – Narusan Jul 12 '20 at 14:48
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One would expect [higher values of pCO2 (so higher than 45) in carbon dioxide poisoning (Hypercapnia)](https://www.ncbi.nlm.nih.gov/books/NBK500012/). If twenty adults on treadmills for an hour do not have elevated pCO2 levels at all, I strongly doubt wearing the KN95 would have a significant effect regarding Hypercapnia in the youth. That said, I can't tell you what the methodological error was in this case; for this we would need access to the data and the statistical evaluation of the experiment ;) – Narusan Jul 12 '20 at 14:54
I think you should move the parts that critique the method and tool used in the claim video to the bottom of your post. The answer is in the quote you give. The other stuff is okay as an *adjunct*. I've bolded relevant portions of the quote, since that's really the answer here. – Jul 15 '20 at 00:55
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Seems like this answer could use a big bold **No** at the top – spacetyper Jul 15 '20 at 02:02
Comments are not for extended discussion; this conversation has been [moved to chat](https://chat.stackexchange.com/rooms/110670/discussion-on-answer-by-daniel-r-hicks-do-facemasks-cause-co2-poisoning). There were a few comments leading into the speculation about this particular meter, whether and how to use it for this case, etc. Please make further comments along those lines in chat. The remaining comments seem to be suggesting improvements for this answer specifically, so they remain. – Jul 15 '20 at 21:38

Fizz · Answer 2 · 2021-05-20T08:47:12.477

Regarding the first issue, whether the measurement method shown in the video is sensible (as this was challenged by mods as being unsourced speculation in the accepted answer), there are actually press articles in which the manufacturers of some such devices say that it isn't sensible...

The France 24 Observers team contacted MSA, the company that manufactures the "ALTAIR 5X Gas Detector", which is the machine used in some of these anti-mask videos. We asked a representative from the company if this machine can actually measure the level of CO2 in a mask. They responded without hesitation:

This machine is a portable gas detector that should be used to evaluate if the air is dangerous or combustible in a room or a confined space – so we are talking about much larger areas than the interior of a mask.

When you place the machine behind your mask, then the person wearing it will breathe out and displace the oxygen. This sets off the alarm. The same thing would happen if a person breathed out directly into the tube.

Because of the sensitivity of the sensors, combined with the lack of space behind the mask, there isn’t enough time for the meter to drop back down to zero before the next breath, which means the alarm just continues going off.

Another expert commented on such videos:

Kirsten Koehler, an associate professor of environmental health and engineering at Johns Hopkins Bloomberg School of Public Health, offered similar observations based on her viewing of the video. [...]

“You can also tell that the sensors don’t immediately respond to the change in concentration because they keep alarming after he takes the tube out of the mask.”

(This refers to a different video by Jeff Neff though, using the MSA detector. In Del Bigtree's video, he's adroit enough not to show what happens after the detector is removed from under the mask.)

Using more suitable equipment, i.e. a transcutaneous CO2 meter that does measure CO2 in the body as opposed to in the exhaled air, a UC San Diego video showed no clinically significant impact of mask wearing, even with 7 layered masks, albeit in a fairly short time span that the video lasts.

Now there are some NIOSH papers that discuss what effects may be seen at >2% [20,000ppm] CO2 (atmospheric) concentration, but it would take several hours for physiological effects to be noticed, according to that paper. The NIOSH indeed sets their 8-hour exposure to just 5,000 ppm, but this is quite conservative as they also set their STEL (15-minutes exposure) to 30,000 ppm (3%)--this is apparently based on submarine data. According to a 2005 review, the UK-equivalent authority had proposed only half the concentration for the latter (15,000 ppm for 15 minutes.)

Do facemasks cause CO2 poisoning?

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