Wearing a mask increased the harmful effects of smoking on the body

(ORDO NEWS) —  Smoking while wearing a surgical mask was associated with a two-fold increase in exhaled CO and markers of cardiovascular disease.

Greek and Italian scientists from the Attikon University Hospital of the Kapodistrian National University of Athens School of Medicine, the University of Thessaly and the University of Rome La Sapienza tested how long-term wearing of a surgical protective mask affects the level of exhaled carbon monoxide (CO) and vascular function in smokers. The study was published in the European Journal of Preventive Cardiology.

Exposure to carbon monoxide, a colorless, odorless compound produced by any type of fire, has been linked to poor health in smokers. When CO is breathed into the lungs, it binds to hemoglobin in red blood cells to form carboxyhemoglobin (COHb), which is then transported into the bloodstream.

Once this happens, the oxygen-carrying capacity of the blood is reduced, which in the worst case can lead to death. And although carbon monoxide quickly combines with red blood cells, it is excreted from the body slowly.

The normal level of COHb in the bloodstream when exposed to CO from the environment is less than 1%. For smokers, this figure is much higher: for someone who smokes a pack of cigarettes a day – from 3% to 6%, two packs – from 6% to 10%.

Saturation of blood with carbon monoxide above 1% threatens with such consequences as increased heart rate, decreased stamina, headache.

The lack of oxygen, in turn, makes the heart work harder. All this makes the level of CO one of the main factors in cardiovascular diseases, among which are heart failure and myocardial infarction.

The experiment, which lasted a month, involved 120 health workers (average age – 45 years, 28.3% – men): the first group smoked regular cigarettes, the second used tobacco heating systems (in this case, it heats up to an average of 250-350 degrees, in resulting in an aerosol containing nicotine), the third was a non-smoker.

Electronic cigarettes, or vapes, were not included in the study. People with hypertension, diabetes, dyslipidemia, chronic kidney disease, and atrial fibrillation were also excluded from the sample.

To begin with, the scientists measured the level of carbon monoxide exhaled by all subjects using a special device, as well as the pulse wave velocity in the aorta (a predictor of future cardiovascular diseases), the index of aortic augmentation adjusted for heart rate and central systolic blood pressure.

All these procedures were performed early in the morning on weekends, after a good sleep and without prolonged wearing of surgical masks.

Similar readings were then taken, first, at the end of the eight-hour morning shift at the hospital, when participants are required to wear masks; secondly, after the same eight hours, but outside the walls of the medical facility and without masks.

Volunteers were asked not to smoke for at least an hour before the measurements, but otherwise they did not change their habits.

According to the results, health care workers who smoked “traditional” cigarettes had their exhaled CO levels jump from 8.00 ppm at baseline to 12.15 ppm without a mask and 17.45 ppm when they wore a mask.

Meanwhile, participants who preferred tobacco heating systems increased from 1.15 ppm at baseline to 1.43 ppm without a mask and 2.20 ppm with a mask. For non-smokers, such a relationship was not revealed: the content of carbon monoxide in the air they exhaled remained the same and did not depend on wearing a mask.

The levels of markers of cardiovascular disease in smokers were also higher if they spent eight hours wearing masks.

“Our study showed that smoking while wearing a surgical mask was associated with a two-fold increase in exhaled CO2 levels and concomitant arterial laxity. This may be caused by rebreathing of exhaled CO and/or nicotine-rich vapors.

Non-smokers, on the other hand, were not affected by wearing masks. Thus, people should refrain from smoking when they wear masks, and the refusal of conventional cigarettes and tobacco heating systems is a prerequisite for improving health in a pandemic, ”the authors of the work emphasized.

They noted that the study also had weaknesses, primarily due to the small sample size. It also cannot be excluded how the results could be affected by workplace stress, environmental pollution, eating or sleep disturbances.

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