Sertaç Yakal1, Esin Nur Taşdemir2, Şensu Dinçer1, Sergen Devran1, Mehmet Güven Günver3, Türker Şahinkaya1, Mustafa Erelel4, Mehmet Altan5, Gökhan Metin1

1Department of Sports Medicine, İstanbul University Faculty of Medicine, İstanbul, Türkiye
2Clinic of Sports Medicine, Başakşehir Çam ve Sakura City Hospital, İstanbul, Türkiye
3Department of Public Health, İstanbul University Faculty of Medicine, İstanbul, Türkiye
4Department of Pulmonary Medicine, İstanbul University Faculty of Medicine, İstanbul, Türkiye
5Department of Physiology, İstanbul University-Cerrahpaşa, İstanbul, Türkiye

Keywords: Mask; oxygen consumption; exercise; athlete


Introduction: Upper respiratory tract infections (URTI) are common medical problems in athletes. Many athletes with URTI continue to train at high-levels and even compete. Using a mask as an additional measure may be beneficial to prevent the spreading of infection among teammates. However, there are many concerns about the effects of mask use on exercise safety and performance. Although some studies have investigated the effects of masks on performance in healthy individuals, studies in athletes are even more limited. Thus, we aimed to evaluate the impact of surgical masks on performance and safety during a cardiorespiratory exercise test (CPET) test applied to both athletes and non-athletes.

Patients and Methods: A cross-over, non-randomized study was designed. The study was conducted in two phases. In phase 1, the CPET was performed without using a surgical mask. In phase 2, CPET was performed with a surgical mask in addition to the spiro mask 48 hours after the first test. Thirty participants aged 18-35 were included in the study. They were further divided as athletes (n= 17) and non-athletes (n= 13) subgroups.

Results: Significant decreases were observed in some parameters of submaximal exercise [VEan, BFan, VE/ VO2 , VE/VCO2 (p< 0.001)] and in maximal exercise [VEmax, BFmax, TVmax, VE/VO2 , VE/VCO2 (p< 0.001)]. There were also significant decreases in VO2 levels (VO2 an, VO2 max) when compared with and without a surgical mask in both submaximal and maximal exercise (p< 0.001). Additionally, PETO2 decreased, and PETCO2 increased in maximum exercise (p< 0.001), whereas no significant changes were detected at the submaximal level. In subgroup analysis, VEan, VEmax, VO2 an, VO2 max parameters were decreased in athletes compared to non-athletes in surgical masked tests.

Conclusion: Surgical masks for athletes and non-athletes decrease performance but have no detrimental effect on cardiorespiratory parameters. Athletes should be aware of this negative effect when high-level performance is demanded.

Cite this article as: Yakal S, Taşdemir EN, Dinçer Ş, Devran S, Günver MG, Şahinkaya T, et al. Exercising with a surgical mask is safe but decreases performance in both athletic and non-athletic individuals. Koşuyolu Heart J 2023;26(3):107-114.

Ethics Committee Approval

This study was approved by the İstanbul University Faculty of Medicine Ethics Committee (Decision no: E-29624016-050.99-196051, Date: 03.05.2021).

Peer Review

Externally peer-reviewed.

Author Contributions

Concept/Design - SY, MA; Analysis/Interpretation - SD, GM; Data Collection - ENT, ŞD; Writing - ŞD, ENT; Critical Revision - GM, ME; Final Approval - TŞ, SY; Statistical Analysis -ŞD, MGG; Overall Responsibility - SY.

Conflict of Interest

The authors have no conflicts of interest to declare.

Financial Disclosure

The authors declare that this study has received no financial support.