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HomeMy WebLinkAbout2023_04_26 SSchumacher_Face mask toxicityFrom:Stephen Schumacher To:jbuhler@jeffersonhealthcare.org; mready@jeffersonhealthcare.org; mdressler@jeffersonhealthcare.org; KeesKolff; bmccomas@jeffersonhealthcare.org; Board of Health Subject:New study: face mask CO2 toxicity may increase stupidity, sterility, and stillbirths Date:Wednesday, April 26, 2023 12:52:29 PM ________________________________ ALERT: BE CAUTIOUS This email originated outside the organization. Do not open attachments or click on links if you are not expecting them. ________________________________ https://www.cell.com/heliyon/fulltext/S2405-8440(23)01324-5 Possible toxicity of chronic carbon dioxide exposure associated with face mask use, particularly in pregnant women, children and adolescents - A scoping review Heliyon 2023 Apr;9(4):e14117. doi: 10.1016/j.heliyon.2023.e14117. Epub 2023 Mar 3. A Cell Press journal | Volume 9, ISSUE 4, e14117, April 2023 Abstract Introduction: During the SARS-CoV-2-pandemic, face masks have become one of the most important ubiquitous factors affecting human breathing. It increases the resistance and dead space volume leading to a re-breathing of CO2. So far, this phenomenon and possible implications on early life has not been evaluated in depth. Method: As part of a scoping review, literature was systematically reviewed regarding CO2 exposure and facemask use. Results: Fresh air has around 0.04% CO2, while wearing masks more than 5 min bears a possible chronic exposure to carbon dioxide of 1.41% to 3.2% of the inhaled air. Although the buildup is usually within the short-term exposure limits, long-term exceedances and consequences must be considered due to experimental data. US Navy toxicity experts set the exposure limits for submarines carrying a female crew to 0.8% CO2 based on animal studies which indicated an increased risk for stillbirths. Additionally, mammals who were chronically exposed to 0.3% CO2 the experimental data demonstrate a teratogenicity with irreversible neuron damage in the offspring, reduced spatial learning caused by brainstem neuron apoptosis and reduced circulating levels of the insulin-like growth factor-1. With significant impact on three readout parameters (morphological, functional, marker) this chronic 0.3% CO2 exposure has to be defined as being toxic. Additional data exists on the exposure of chronic 0.3% CO2 in adolescent mammals causing neuron destruction, which includes less activity, increased anxiety andimpaired learning and memory. There is also dataindicating testicular toxicity in adolescents atCO2 inhalation concentrations above 0.5%. Discussion: There is a possible negative impactrisk by imposing extended mask mandatesespecially for vulnerable subgroups.Circumstantial evidence exists that extended maskuse may be related to current observations ofstillbirths and to reduced verbal motor andoverall cognitive performance in children bornduring the pandemic. A need exists to reconsider mask mandates. Consequences for pregnant women and early life (unborn) For pregnant women there is a metabolic need fora foetal-maternal CO2 gradient. The mother'sblood carbon dioxide level should always be lowerthan that of the unborn child. This is necessaryto ensure the diffusion of CO2 from the foetalblood into the maternal circulation via theplacenta. Therefore, the hypercapnic gas shiftspromoted by masks could, even with subliminalcarbon dioxide increases, act as an interferencevariable of the foetal-maternal CO2 gradient andincrease over time of exposure. ... May there be a link between an increasedmask-related (pandemic) global carbon dioxidere-breathing since 2020 and the current reporteddisturbing 28% rise in stillbirths worldwide? ...May there be also a link between the pandemicdriven excessive mask-use and the fact that 42%of female USA surgeons surveyed between November2020 and February 2021 lost a pregnancy according to a recent study? During a pandemic, surgeons are likely to havethe heaviest mask exposure compared to thegeneral population. Data from Italy show athree-fold increase with statistical significancein stillbirths in the general population duringlockdown period (March-April-May) 2020 comparedto the same period in 2019 . A recent rapidreview and meta-analysis gives clues about theseverity of the indirect influence of COVID-19lockdown implementations.The authors found thatlockdown measures were associated with asignificant risk of stillbirth with RR = 1.33(95% CI 1.04, 1.69) when compared to beforelockdown period. It is well known that lockdownmeasures include mask mandates as well. Among the few countries that do not require the wearing of masks in public is Sweden. Interestingly, despite similar pandemic measures and SARS-CoV-2 presence in the media and in thereal world, no increased risk of stillbirths wasobserved in Sweden. A Swedish nationwide study"did not find any associations between being bornduring a period when many public healthinterventions aimed at mitigating the spread ofCOVID-19 were enforced and the risk for any ofthe preterm birth categories or stillbirth(adjusted OR 0.78, CI 0.57 to 1.06)" Although society was not completely closed,Swedish authorities enforced many policies tomitigate the spread of COVID-19, such aspromotion of general hygiene measures and socialdistancing (including remote working), ban ofnon-essential travel, prohibition of gatheringsof more than 50 people and the closure of uppersecondary schools and universities Consequences for children and adolescents The problem of prolonged mask use in children andin schools needs to be discussed as well. One hasto consider that children are not just smalladults. This means that exposure criteria shouldbe based on information relevant to predictingrisks to children and should account for suchtoxicokinetic differences occurring withdevelopment. In this context, it is crucial todiscuss the toxicological impact of prolongedmask wearing and the concomitant elevation inre-breathed carbon dioxide ... In 2014 Uysalcould demonstrate with his experiments that amere 0.3% CO2 exposure to adolescent brainneurons can cause destruction in the gyrusdentatus and the prefrontal cortex with decreasedIGF-1 levels resulting in less activity,increased anxiety and impaired learning and memory Already in 1972 Vandemark revealed - only after a4-h low level CO2 exposure - a carbon dioxidedependent destruction of spermatid and Sertolicells in testes, streaking & vacuolization of thetubular components with no maturation ofspermatids ... The damaging mechanism of CO2affecting testicular tissues is based on theconditions of oxidative stress and acidosis withincreased inflammation and apoptosis as describedabove. Testes metabolism and cell respirationhave been shown to be inhibited increasingly byrising levels of CO2. It has to be pointed outthat this data on the toxicity of carbon dioxideon reproduction has been known for 60 years.Exposure limits have therefore typically been set at 0.5% CO2 in working environments, e.g. according to a Safety Data Sheet by the Linde Company on Exposure Limits ... Looking at thepotential damage to the reproduction function bysubacute or chronic carbon dioxide exposureproven in animal experiments makes it very clear why these limits exist. ... Indeed, if the potential adverse effects andpossible long-term consequences of masks aretaken into account doubts arise regarding masksas a harmless means of combating SARS-CoV-2 inwidespread use, especially regarding ourreferenced data with possible deleterious effectsfor children, adolescents and pregnant women. ...If wrong decisions are made in the selection ofpreventive measures in healthy people or if theyare improperly applied, the consequences areusually much more severe and liability claims areoften unavoidable. In view of the possibletoxicological mask effects of re-breathed carbondioxide in pregnant women, children andadolescents, and in view of the limitedscientific evidence for masks as an effectivepandemic measure, there is need to re-evaluateand reconsider mask mandates especially for these vulnerable subgroups. ... In this review we only focused on CO2, however,other noxious agents in the masks contribute totoxicological long-term effects like theinhalation of synthetic microfibers, carcinogeniccompounds and volatile organic compounds couldalso play a role regarding our research question 6. Conclusions A significant rise in carbon dioxide occurringwhile wearing a mask is scientifically proven inmany studies, especially for N95-masks due totheir higher deadspace and breathing resistance. Fresh air has around 0.04% CO2 while masks bear apossible chronic exposure to low level carbondioxide of 1.41-3.2% CO2 of the inhaled air in reliable human experiments. Animal experimental data shows deleterious proveneffects of elevated CO2 of inhaled air in thelong term with threshold values of above 0.3%,0.5% and 0.8% (Neuron destruction, impairedmemory and learning, increased anxiety,destruction of cells in testes, stillbirth, andbirth defects) . The risk for children's mentaldevelopment starts at levels of above 0.3%, toadolescent male sexual development at levels ofabove 0.5%, as well as to unborn life at levelsof above 0.8% resulting in reduced cognitiveperformance, reduced fertility and stillbirths.There is circumstantial evidence that popular mask use may be related to current observations of a significant rise of 28% to 33%in stillbirths worldwide and a reduced verbal,motor, and overall cognitive performance of twofull standard deviations in scores in children born during the pandemic. According to the data found, wearing face masksalso has the potential to exceed acute (3% CO2for 15 min) and chronic (0.5% CO2 for 8 h) NIOSHlimits for CO2 respiration. ... Instead of onlyworrying about the potential risks of a futureharmful long-term CO2 increase in the atmospherewith impact on human health, the focus ofresearch should also be on the currentmask-related CO2 increase in breathing air withits numerous effects. Face mask experiments withappropriately long (and variable) exposure timesand measurements of e.g., electrolyte, acid-baseand renal excretion haemostasis are needed toinvestigate toxicological risks of carbon dioxiderebreathing for the most vulnerable groups.