Aya ISSA, Ghaith WEDEH, Sali DAGHIR, Solaiman DOBA, Moatasem AL-JANABI
Turkish Journal of Public Health - 2026;24(1):372-379
Objective: Face masks remain a central component of respiratory infection control strategies;however, concerns persist regarding their physiological effects and user comfort during prolonged wear. This study aimed to compare the physiological and subjective effects of surgical, cloth, and FFP2 masks in healthy young adults. Methods: This repeated-measures crossover study included 80 healthy participants, each of whom tested surgical, cloth, and FFP2 masks on separate days for at least two hours, allowing within-subject comparison of physiological and subjective responses. Peripheral oxygen saturation (SpO?), heart rate (HR), and self-reported symptoms were assessed before and after mask use. Results: Cloth masks were associated with small but statistically significant reductions in SpO? and HR (p<0.05), although all values remained within normal physiological ranges. No significant physiological changes were observed with surgical or FFP2 masks. However, mask type was significantly associated with breathing difficulty (p=0.009) and dry mouth (p=0.024);breathing difficulty was most frequently reported with FFP2 masks, whereas dry mouth was most frequently reported with cloth masks. No significant associations were found between mask type and itching, sweating, or headache occurrence, including among smokers. Conclusion: Physiological alterations were minimal across all mask types. Differences were primarily related to subjective comfort, suggesting that mask selection for prolonged use should balance protective efficiency with user tolerability.
