Auto\u0159i: <\/strong>RNDr. Zuzana Kr\u00e1tk\u00e1, Ph.D. a MUDr. Vladim\u00edr \u010c\u00ed\u017eek <\/p>\n\n\n\n Kdy\u017e na n\u00e1s \u010d\u00edh\u00e1 nebezpe\u010d\u00ed, je v\u00fdhodn\u00e9 m\u00edt po ruce n\u011bco, co n\u00e1s aspo\u0148 do ur\u010dit\u00e9 m\u00edry chr\u00e1n\u00ed. Ale je rozumn\u00e9 se tak\u00e9 v\u010das zamyslet, zda ona ochrana je skute\u010dn\u011b kvalitn\u00ed a zda n\u00e1m n\u00e1hodou sou\u010dasn\u011b \u017eivot nekomplikuje. Je t\u0159eba rozumn\u011b posoudit p\u0159\u00ednosy a rizika. <\/p>\n\n\n\n V. \u010c\u00ed\u017eek m\u011bl v posledn\u00ed dob\u011b hned n\u011bkolik p\u0159edn\u00e1\u0161ek na t\u00e9ma \u201erou\u0161ky\u201c . Z jeho p\u0159edn\u00e1\u0161ky na konferenci covidkon 2 vyb\u00edr\u00e1me nejd\u016fle\u017eit\u011bj\u0161\u00ed informace, ale celou si ji m\u016f\u017eete poslechnout na konci \u010dl\u00e1nku.<\/p>\n\n\n\n Prezentace v\u010detn\u011b odkaz\u016f na publikace je k\u00a0dispozici\u00a0zde<\/a>.<\/p>\n\n\n\n Na z\u00e1klad\u011b metaanal\u00fdzy\u00a0Chu et al<\/a>.:\u00a0 Physical distancing, face masks, and eye protection to prevent person-to-person transmission of SARS-CoV-2 and COVID-19: a\u00a0systematic review and meta-analysis<\/strong>\u00a0z\u00a0\u010dervna 2020 doporu\u010duje WHO no\u0161en\u00ed rou\u0161ek a\u00a0respir\u00e1tor\u016f. V\u00a0metaanal\u00fdze bylo zahrnuto 44 studi\u00ed s\u00a0celkem 25 tis\u00edci pacienty s\u00a0onemocn\u011bn\u00edmi covid-19, SARS a\u00a0MERS ze studi\u00ed, kter\u00e9 byly k\u00a0dispozici do kv\u011btna 2020. No\u0161en\u00ed rou\u0161ek dle t\u00e9to studie v\u00fdznamn\u011b sni\u017eovalo riziko infekce (n=2647; a\u00a0OR 0\u00b715, 95% CI 0\u00b707 to 0\u00b734, RD \u221214\u00b73%, \u221215\u00b79 to \u221210\u00b77; low certainty), respir\u00e1tory byly \u00fa\u010dinn\u011bj\u0161\u00ed ne\u017e rou\u0161ky, ale\u00a0auto\u0159i v\u00a0diskusi p\u0159izn\u00e1vaj\u00ed, \u017ee je nezbytn\u011b nutn\u00e9 prov\u00e9st randomizovan\u00e9 studie, kter\u00e9 by ov\u011b\u0159ily skute\u010dn\u00fd efekt no\u0161en\u00ed rou\u0161ek \u010di\u00a0respir\u00e1tor\u016f<\/strong>.\u00a0Tedy jin\u00fdmi slovy \u2013 asi by to m\u011blo fungovat, ale mus\u00edme to pe\u010dliv\u011b ov\u011b\u0159it v\u00a0praxi.<\/p>\n\n\n\n Our findings accord with those of a cluster randomised trial showing a potential benefit of continuous N95 respirator use over medical masks against seasonal viral infections. Further high-quality research, including randomised trials of the optimum physical distance and the effectiveness of different types of masks in the general population and for health-care workers\u2018 protection, is urgently needed. Until such data are available, our findings represent the current best estimates to inform face mask use to reduce infection from COVID-19.<\/em><\/p>\n\n\n\n Efekt no\u0161en\u00ed rou\u0161ek byl sledov\u00e1n u\u017e d\u0159\u00edve pro \u0161\u00ed\u0159en\u00ed viru ch\u0159ipky, nap\u0159. ve studii Xiao j et al<\/a>. \u2013 Nonpharmaceutical Measures for Pandemic Influenza in Nonhealthcare Settings\u2014Personal Protective and Environmental Measures. <\/strong><\/a>V t\u00e9to metaanal\u00fdze auto\u0159i neprok\u00e1zali pozitivn\u00ed efekt no\u0161en\u00ed rou\u0161ek na \u0161\u00ed\u0159en\u00ed viru ch\u0159ipky. <\/p>\n\n\n\n Existuji dv\u011b randomizovan\u00e9 kontrolovan\u00e9 studie porovn\u00e1vaj\u00edc\u00ed efekt no\u0161en\u00ed masek na \u0161\u00ed\u0159en\u00ed infekce SARS-CoV-2.<\/p>\n\n\n\n D\u00e1nsk\u00e1 studie \u2013 Bundgaard et al, Mar 2021 <\/a>\u2013 Effectiveness of Adding a Mask Recommendation to Other Public Health Measures to Prevent SARS-CoV-2 Infection in Danish Mask Wearers<\/strong><\/p>\n\n\n\n V D\u00e1nsku byl sledov\u00e1n v\u00fdskyt infekce u skupiny v\u00edce jak 3 tis\u00edce osob nos\u00edc\u00ed rou\u0161ky a 3 tis\u00edce osob nenos\u00edc\u00edch rou\u0161ky . Studie prob\u00edhala v dubnu a\u017e kv\u011btnu 2020. Rozd\u00edl ve v\u00fdskytu infekc\u00ed mezi skupinami byl nesignifikantn\u00ed \u2013 infekce byla zji\u0161t\u011bna u 1,8 % osob ve skupin\u011b nos\u00edc\u00ed rou\u0161ky a u 2,1 % u osob nenos\u00edc\u00edch rou\u0161ky.<\/p>\n\n\n\n Banglad\u00e9\u0161sk\u00e1 studie \u2013 Abaluck j. et al, prosinec 2021 \u2013 The Impact of Community Masking on COVID-19: A Cluster-Randomized Trial in Bangladesh<\/strong><\/p>\n\n\n\n Soubor zahrnoval 178 tis\u00edc osob s rou\u0161kami a 164 tis\u00edc osob bez rou\u0161ek. Studie prob\u00edhala od listopadu 2020 do dubna 2021. P\u0159\u00edznaky onemocn\u011bn\u00ed covid-19 byly zji\u0161t\u011bny u 7,63 % osob nos\u00edc\u00edch rou\u0161ky a u 8,6 % osob ve skupin\u011b bez rou\u0161ek. S\u00e9ropozitivn\u00edch osob bylo 0,68 % ve skupin\u011b s rou\u0161kami a 0,76 % ve skupin\u011b bez rou\u0161ek. Vy\u0161\u0161\u00ed efekt byl zji\u0161t\u011bn u lid\u00ed star\u0161\u00edch 60 let.<\/p>\n\n\n\n Sv\u00e9ho \u010dasu byla obl\u00edbenou studie Adjodah et al<\/a>: Decrease in Hospitalizations for COVID-19 after Mask Mandates in 1083 U.S. Counties.<\/strong> Studie byla publikov\u00e1na pouze jako preprint a byla sta\u017eena pot\u00e9, co se po\u010det infekc\u00ed v \u201ezarou\u0161kovan\u00fdch\u201c st\u00e1tech zv\u00fd\u0161il. Nyn\u00ed se o n\u00ed do\u010dtete pouze: \u201e<\/strong>The authors have withdrawn this manuscript because there are increased rates of SARS- CoV-2 cases in the areas that we originally analyzed in this study. New analyses in the context of the third surge in the United States are therefore needed and will be undertaken directly in conjunction with the creators of the publicly-available databases on cases, hospitalizations, testing rates etc.<\/em>\u201e<\/p>\n\n\n\n Velmi dobrou publikac\u00ed, kter\u00e1 p\u0159ehledn\u011b shrnuje informace o negativn\u00edch \u00fa\u010dinc\u00edch o no\u0161en\u00ed rou\u0161ek a respir\u00e1tor\u016f je nap\u0159. review Kisielinski et al.<\/a> Is a mask that covers the mouth and nose free from undesirable side effects in everyday use and free of potential hazards?<\/strong><\/p>\n\n\n\n Hlavn\u00edm probl\u00e9mem p\u0159i pou\u017e\u00edv\u00e1n\u00ed rou\u0161ek je ni\u017e\u0161\u00ed koncentrace kysl\u00edku ve vdechovan\u00e9m vzduchu a vy\u0161\u0161\u00ed koncentrace CO2 v mrtv\u00e9m prostoru (tedy v t\u00e9 \u010d\u00e1sti objemu vzduchu, kter\u00fd se ne\u00fa\u010dastn\u00ed v\u00fdm\u011bny plyn\u016f v plicn\u00edch skl\u00edpc\u00edch). To vede k celkov\u00e9mu sn\u00ed\u017een\u00ed saturace kysl\u00edkem, a zv\u00fd\u0161en\u00ed hladiny oxidu uhli\u010dit\u00e9ho v krvi nositele. Doch\u00e1z\u00ed proto ke zv\u00fd\u0161en\u00ed srde\u010dn\u00ed frekvence a tak\u00e9 zv\u00fd\u0161en\u00ed dechov\u00e9 frekvence. V d\u016fsledku nedostate\u010dn\u00e9ho okysli\u010den\u00ed organismu se rozv\u00edj\u00ed \u201esyndrom vy\u010derp\u00e1n\u00ed vyvolan\u00fd maskou\u201c (MIES Mask-Induced Exhaustion Syndrome).<\/p>\n\n\n\n No\u0161en\u00ed rou\u0161ek vede ke zv\u00fd\u0161en\u00e9 \u00fanav\u011b, bolesti hlavy, dezorientaci. Vede k n\u00e1r\u016fstu du\u0161nosti a k p\u0159eh\u0159\u00e1t\u00ed. Mezi dal\u0161\u00ed probl\u00e9my pat\u0159\u00ed n\u00e1r\u016fst vlhkosti pod rou\u0161kou, co\u017e p\u0159isp\u00edv\u00e1 k rozvoji dermatologick\u00fdch probl\u00e9m\u016f (vyr\u00e1\u017eky, akn\u00e9, sv\u011bd\u011bn\u00ed), z\u00e1n\u011bt\u016f v dutin\u011b \u00fastn\u00ed (z\u00e1n\u011bt d\u00e1sn\u00ed, koutk\u016f \u00fast, z\u00e1pach z \u00fast), vzniku chronick\u00e9 r\u00fdmy. No\u0161en\u00ed rou\u0161ek zhor\u0161uje perifern\u00ed vid\u011bn\u00ed a zp\u016fsobuje zaml\u017een\u00ed br\u00fdl\u00ed, co\u017e zhor\u0161uje orientaci v prostoru.<\/p>\n\n\n\n Dal\u0161\u00edm probl\u00e9mem je nam\u00e1h\u00e1n\u00ed hlasivek p\u0159i nutnosti komunikace p\u0159es rou\u0161ku nap\u0159. u u\u010ditel\u016f \u010di l\u00e9ka\u0159\u016f. No\u0161en\u00ed rou\u0161ky m\u016f\u017ee vyvolat psychick\u00e9 probl\u00e9my, sni\u017euje schopnost reagovat na podn\u011bty, sni\u017euje kognitivn\u00ed v\u00fdkonost.<\/p>\n\n\n\n Nevhodn\u00e9 je no\u0161en\u00ed rou\u0161ek u lid\u00ed se schizofreni\u00ed, demenc\u00ed, \u00fazkostmi, klaustrofobi\u00ed, panikou, ale t\u00e9\u017e u epileptik\u016f. U t\u011bchto osob v\u00fdznamn\u011b naru\u0161uje psychiku. Nevhodn\u00e9 je no\u0161en\u00ed rou\u0161ek p\u0159i sportovn\u00ed z\u00e1t\u011b\u017ei. No\u0161en\u00ed rou\u0161ek t\u011bhotn\u00fdmi \u017eenami m\u016f\u017ee negativn\u011b ovlivnit saturaci kysl\u00edkem u plodu.<\/p>\n\n\n\n Odborn\u00edci upozor\u0148uj\u00ed, \u017ee masky naru\u0161uj\u00ed z\u00e1klady lidsk\u00e9 komunikace<\/a> (verb\u00e1ln\u00ed i neverb\u00e1ln\u00ed). Omezen\u00e9 rozpozn\u00e1n\u00ed obli\u010deje zakryt\u00e9ho rou\u0161kou vede k potla\u010den\u00ed emocion\u00e1ln\u00edch sign\u00e1l\u016f. Rou\u0161ky naru\u0161uj\u00ed soci\u00e1ln\u00ed interakce, pot\u00edraj\u00ed pozitivn\u00ed vliv \u00fasm\u011bvu a sm\u00edchu, ale z\u00e1rove\u0148 zna\u010dn\u011b zvy\u0161uj\u00ed pravd\u011bpodobnost nedorozum\u011bn\u00ed, proto\u017ee negativn\u00ed emoce jsou pod rou\u0161kami tak\u00e9 m\u00e9n\u011b patrn\u00e9.<\/p>\n\n\n\n Naru\u0161en\u00ed neverb\u00e1ln\u00ed komunikace v d\u016fsledku ztr\u00e1ty rozpozn\u00e1n\u00ed v\u00fdrazu obli\u010deje pod rou\u0161kou m\u016f\u017ee zv\u00fd\u0161it pocity nejistoty, skl\u00ed\u010denosti, co\u017e m\u016f\u017ee b\u00fdt zejm\u00e9na pro d\u011bti, a pro ment\u00e1ln\u011b a sluchov\u011b posti\u017een\u00e9 osoby, extr\u00e9mn\u011b stresuj\u00edc\u00ed.<\/p>\n\n\n\n U d\u011bt\u00ed vyvol\u00e1v\u00e1 no\u0161en\u00ed rou\u0161ek \u010dast\u00e9 bolesti hlavy, pot\u00ed\u017ee se soust\u0159ed\u011bn\u00edm, smutek, pot\u00ed\u017ee s u\u010den\u00edm, \u00fanavu \u00fazkost a dokonce no\u010dn\u00ed m\u016fry.<\/p>\n\n\n\n Velk\u00fdm rizikem pou\u017e\u00edv\u00e1n\u00ed rou\u0161ek je vytvo\u0159en\u00ed fale\u0161n\u00e9ho pocitu bezpe\u010d\u00ed<\/a>, \u017ee jdevo stoprocentn\u00ed ochranu p\u0159ed virov\u00fdmi infekcemi. Viry SARS-CoV-2 maj\u00ed velikost 0,06 a\u017e 0,14 \u03bcm, viry ch\u0159ipky s 0,08 a\u017e 0,12 \u03bcm. Aerosolov\u00e9 kapi\u010dky maj\u00ed pr\u016fm\u011br 0,09 a\u017e 3 \u03bcm. V p\u0159\u00edpad\u011b respir\u00e1toru N95 ozna\u010den\u00ed N znamen\u00e1 National Institute for Occupational Safety and Health of the United States (NIOSH) a \u010d\u00edslo 95 ozna\u010duje 95% filtra\u010dn\u00ed kapacitu pro jemn\u00e9 \u010d\u00e1stice do velikosti alespo\u0148 0,3 \u03bcm. Tedy tento respir\u00e1tor zastav\u00ed pr\u016fchod kap\u00e9nek, ale ne samotn\u00fdch virov\u00fdch \u010d\u00e1stic.<\/p>\n\n\n\n Nav\u00edc je nutn\u00e9 pom\u016fcky spr\u00e1vn\u011b pou\u017e\u00edvat. Bylo zji\u0161t\u011bno, \u017ee 65 % zdravotnick\u00fdch pracovn\u00edk\u016f a a\u017e 78 % b\u011b\u017en\u00e9 populace pou\u017e\u00edv\u00e1 rou\u0161ky nespr\u00e1vn\u011b. Zdroj infekce mohou p\u0159edstavovat i pou\u017eit\u00e9 rou\u0161ky nespr\u00e1vn\u011b likvidovan\u00e9.<\/p>\n\n\n\n Rou\u0161ky mohou obsahovat celou \u0159adu potenci\u00e1ln\u011b nebezpe\u010dn\u00fdch l\u00e1tek (kancerogenn\u00ed anilin, formaldehyd, optick\u00e9 zjas\u0148ova\u010de, kancerogenn\u00ed diisokyan\u00e1ty, acetyldehyd, t\u011b\u017ek\u00e9 kovy<\/a> a dal\u0161\u00ed). Evropsk\u00fd syst\u00e9m RAPEX ji\u017e navrhl sta\u017een\u00ed 308 typ\u016f rou\u0161ek. \u017d\u00e1dn\u00fd z platn\u00fdch standard\u016f FDA nereguluje mno\u017estv\u00ed mikroplast\u016f a nanoplast\u016f uvol\u0148ovan\u00fdch z rou\u0161ek. S\u00daKL upozor\u0148uje na nutnost preklinick\u00fdch a klinick\u00fdch test\u016f <\/a>u ka\u017ed\u00e9ho typu rou\u0161ky, ale tyto testy se v praxi ned\u011blaj\u00ed. Pro d\u011btsk\u00e9 respir\u00e1tory<\/a> neexistuje \u017e\u00e1dn\u00e1 norma.<\/p>\n\n\n\n \u010cesk\u00e1 obchodn\u00ed inspekce provedla kontrolu kvality respir\u00e1tor\u016f. Ve sv\u00e9 zpr\u00e1v\u011b <\/a>mimo jin\u00e9 uvedla, \u017ee \u201ev r\u00e1mci kontroln\u00ed akce byl proveden odb\u011br 74 vzork\u016f v\u00fdrobk\u016f. Do zku\u0161ebn\u00ed laborato\u0159e bylo odesl\u00e1no 19 vytipovan\u00fdch vzork\u016f v\u00fdrobk\u016f. Z t\u011bchto vzork\u016f nevyhov\u011blo po\u017eadavk\u016fm \u010dl. 7.9.1 Celkov\u00fd pr\u016fnik, nebo \u010dl. 7.9.2 Pr\u016fnik filtra\u010dn\u00edm materi\u00e1lem \u010di \u010dl. 7.16 D\u00fdchac\u00ed odpor normy \u010cSN EN 149:2002+A1:2009 celkem 17 v\u00fdrobk\u016f. U 1 vzorku v\u00fdrobku nad\u00e1le pokra\u010duje ov\u011b\u0159ov\u00e1n\u00ed stanoven\u00fdch po\u017eadavk\u016f.<\/p>\n\n\n\nNa z\u00e1klad\u011b \u010deho je doporu\u010deno no\u0161en\u00ed rou\u0161ek \/ respir\u00e1tor\u016f a je ochrana p\u0159ed infekc\u00ed SARS-COV-2 skute\u010dn\u011b efektivn\u00ed?<\/h2>\n\n\n\n
Jak\u00e9 negativn\u00ed \u00fa\u010dinky m\u00e1 no\u0161en\u00ed rou\u0161ek na na\u0161e zdrav\u00ed?<\/h2>\n\n\n\n
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<\/a><\/figure>\n\n\n\nJak no\u0161en\u00ed masek zhor\u0161uje lidskou komunikaci?<\/h2>\n\n\n\n
Jak \u00fa\u010dinn\u00e1 je ochrana osob pou\u017e\u00edvaj\u00edc\u00ed rou\u0161ky \/ respir\u00e1tory p\u0159ed infekc\u00ed?<\/h2>\n\n\n\n
Jak\u00e1 je bezpe\u010dnost rou\u0161ek a respir\u00e1tor\u016f?<\/h2>\n\n\n\n