Reusable cloth masks in operating theatre.

Abstract

The significant rise and release into the atmosphere of carbon emissions related to modern human activities are the predominant causes of global warming1. Global net-zero carbon dioxide emissions must be reached before 2050 to ensure that global warming is limited to 1.5°C by 21002. Carbon emissions from healthcare account for approximately 5.5 per cent of the total carbon footprint3. Surgery substantially contributes to this, with a single surgical procedure being estimated to be responsible for the production of 6–814 kg carbon dioxide equivalents4. Notably, disposable surgical masks (SMs) in the operating room (OR) contribute to waste production that could be reduced by switching to reusable cloth masks (CMs). The environmental benefit of reusable CMs over SMs was recently studied in depth, including manufacture, transport, washing, and waste processing5. The conclusion was that such transition would reduce the carbon footprint by 50–90 per cent, the variation depending mostly on the distance the masks need to travel between manufacturer and user. However, OR masks must protect both patients and surgeons. As the filtration capacity of a 100 per cent cotton three-layer accredited CM is similar to that of a standard SM (98.9 versus 98.5 per cent for nanoparticles with a diameter of 100 nm respectively), the major residual concern relates to breath leakage around the mask6.