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Editorials

Face masks can be devastating for people with hearing loss

BMJ 2020; 370 doi: https://doi.org/10.1136/bmj.m2683 (Published 09 July 2020) Cite this as: BMJ 2020;370:m2683

Linked Opinion

The communication needs of D/deaf healthcare workers and patients are being forgotten

Linked Opinion

D/deafness and solidarity in the covid-19 pandemic

Rapid Response:

Re: Face masks can be devastating for people with hearing loss

Dear Editor

Chodosh et al[1] and Grote et al[2] highlight an important issue but overlook the use of face shields, hoods and other clear barriers that decrease disease transmission, facilitate lip reading, and reduce muffling. Face shields are also easier to manufacture, clean and reuse[3]. They protect the user’s eyes and are more acceptable than masks in a paediatric setting[4].

The suggestion to adopt masks with clear windows is premature given the lack of evidence that they are more effective than face shields. Using a laser particle counter, we found that facemasks and Perspex barriers had similar efficacy in reducing airborne and droplet transmission across a slit lamp[5].

When a higher level of protection is required, clear ventilated hoods can be used and these have been successfully trialled with a view to widespread adoption[6]. The authors have identified a salient problem to which cost effective and viable solutions are available and can be readily applied.

References

1 Chodosh J, Weinstein BE, Blustein J. Face masks can be devastating for people with hearing loss. BMJ 2020;370. doi:10.1136/bmj.m2683
2 Grote H, Izagaren F. Covid-19: The communication needs of D/deaf healthcare workers and patients are being forgotten. BMJ 2020;369. doi:10.1136/bmj.m2372
3 Perencevich EN, Diekema DJ, Edmond MB. Moving Personal Protective Equipment Into the Community: Face Shields and Containment of COVID-19. JAMA 2020;323:2252–3. doi:10.1001/jama.2020.7477
4 Forgie SE, Reitsma J, Spady D, et al. The “Fear Factor” for Surgical Masks and Face Shields, as Perceived by Children and Their Parents. Pediatrics 2009;124:e777–81. doi:10.1542/peds.2008-3709
5 Poostchi A, Kuet M-L, Pegg K, et al. Efficacy of slit lamp breath shields. Eye (Lond) 2020;34:1185–6. doi:10.1038/s41433-020-0940-y
6 Elkington P, Morgan H. Personal respirators for population level control of the COVID19 pandemic. Journal of Infection 2020;81:318–56. doi:10.1016/j.jinf.2020.04.025

Competing interests: No competing interests

27 July 2020
Ali Poostchi
Ophthalmology Registrar
Mong-Loon Kuet, registrar, Patrick S Richardson, consultant, Moneesh K Patel, consultant
University Hospitals of Derby and Burton NHS Trust
Royal Derby Hospital, Uttoxeter Road, Derby