RSC Advances View Article Online REVIEW View Journal | View Issue A comprehensive review on antimicrobial face masks: an emerging weapon in fighting pandemics Cite this: RSC Adv.,2021,11,6544 Gayathri Pullangott,†a Uthradevi Kannan,†a Gayathri S.,a Degala Venkata Kiranb and Shihabudheen M. Maliyekkal *a The world has witnessed several incidents of epidemics and pandemics since the beginning of human existence. The gruesome effects of microbial threats create considerable repercussions on the healthcare systems. The continually evolving nature of causative viruses due to mutation or re- assortment sometimes makes existing medicines and vaccines inactive. As a rapid response to such outbreaks, much emphasis has been placed on personal protective equipment (PPE), especially face mask, to prevent infectious diseases from airborne pathogens. Wearing face masks in public reduce disease transmission and creates a sense of community solidarity in collectively fighting the pandemic. However, excessive use of single-use polymer-based face masks can pose a significant challenge to the environment and is increasingly evident in the ongoing COVID-19 pandemic. On the contrary, face Creative Commons Attribution-NonCommercial 3.0 Unported Licence. masks with inherent antimicrobial properties can help in real-time deactivation of microorganisms enabling multiple-use and reduces secondary infections. Given the advantages, several efforts are made incorporating natural and synthetic antimicrobial agents (AMA) to produce face mask with enhanced safety, and the literature about such efforts are summarised. The review also discusses the literature Received 26th November 2020 concerning the current and future market potential and environmental impacts of face masks. Among Accepted 20th January 2021 the AMA tested, metal and metal-oxide based materials are more popular and relatively matured DOI: 10.1039/d0ra10009a technology. However, the repeated use of such a face mask may pose a danger to the user and environment due to leaching/detachment of nanoparticles. So careful consideration is required to select rsc.li/rsc-advances This article is licensed under a aDepartment of Civil and Environmental Engineering, Indian Institute of Technology bDepartment of Mechanical Engineering, Indian Institute of Technology Tirupati, Tirupati, Andhra Pradesh, 517619, India. E-mail: [email protected]; sm. Andhra Pradesh, 517619, India Open Access Article. Published on 08 February 2021. Downloaded 9/25/2021 5:35:33 PM. [email protected]; Fax: +91 877 2503004; Tel: +91 877 2503164 † Equally contributed. Gayathri Pullangott is a Junior Uthradevi Kannan is a Doctoral Research Fellow in Department Research Scholar in Department of Civil and Environmental of Civil and Environmental Engineering, Indian Institute of Engineering, Indian Institute of Technology Tirupati, India. She Technology Tirupati, India. She is currently working on a project is the recipient of DST-INSPIRE titled “Centre for Sustainable fellowship award (IF160288) Treatment, Reuse and Manage- for pursuing PhD by Department ment for Efficient, Affordable of Science and Technology, and Synergistic solutions for Government of India. Her Water” (DST/TM/WTI/WIC/ research work is on developing 2K17/82(C)) by the Department an affordable and reusable, of Science and Technology, point-of-use disinfection system Government of India. The project mainly focuses on developing for drinking water involving an antimicrobial nanoscale material. a point-of-use disinfection system for drinking water involving an She has experience in synthesising and characterising nanoscale antimicrobial nanoscale material. antimicrobial materials. She has authored one international journal, one book chapter and ve international conference papers. She is also a co-inventor in an Indian patent application (IN 345400). 6544 | RSC Adv.,2021,11,6544–6576 © 2021 The Author(s). Published by the Royal Society of Chemistry View Article Online Review RSC Advances AMA and their incorporation methods to reduce their leaching and environmental impacts. Also, systematic studies are required to establish short-term and long-term benefits. 1. Introduction results in 290 000–650 000 deaths each year.2,3 Also, the rapidly evolving inuenza viruses cause annual epidemics and occa- Outbreaks of communicable diseases are not uncommon and sional pandemics (3 to 4 times per century).4 The fatality rate in have existed since humankind's hunter-gatherer days. However, Ebola is estimated to be as high as 50%.5 AIDS, with no they became more prominent when the world shied towards complete cure, continues to be a signicant global public health settled community life. Pathogenic organisms such as viruses, issue,6 and the present COVID-19 pandemic has already resul- bacteria, protozoa, helminths, and fungi are the major causes of ted in more than 95 million cases worldwide (till 17th January infectious diseases in humans and animals. It is estimated that 2021).7 one-fourth of annual global deaths are due to these pathogenic The emergence of more resistant strains with high infection organisms.1 Mainly, u viruses and non-u viruses like Flavi- potential happens because of mutation or re-assortment of pre- virus, Filoviridae, and human coronavirus are responsible for existing microbial strains, which sometimes makes the vaccines major epidemics and pandemics starting from Russian u-1889 and antibiotics incompetent. Therefore, to control or delay the to the present Coronavirus disease (COVID-19). The four spread of the infection, WHO and the Centers for Disease communicable diseases that rattled the world are Inuenza, Control and Prevention (CDC) suggests various non- Ebola, Acquired immunodeciency syndrome (AIDS), and pharmaceutical interventions such as hand washing, personal COVID-19. According to the World Health Organisation (WHO), protective equipment (PPE), isolation, quarantine, personal the respiratory diseases from annual seasonal inuenza alone hygiene, use of disinfectants, and social distancing. For instance, the use of respiratory protective devices (RPDs) has gained massive impetus during COVID-19. This intervention is Creative Commons Attribution-NonCommercial 3.0 Unported Licence. highly benecial in pandemic situations to reduce exposure to Gayathri S. is a Post Graduate infectious respiratory aerosols and droplets and slow down the student in the Department of spread of the disease.8–12 Realising the fact, most of the coun- Civil and Environmental Engi- tries have enforced or advised its citizen to wear face masks in neering, Indian Institute of public places.13 Technology Tirupati, India. Her However, there are several concerns associated with the use masters' project work is on of conventional face masks such as the survivability of micro- developing an N95 equivalent organisms on the face mask surface,14,15 re-aerosolisation of antimicrobial respirator. She has settled particles,16 safe management and disposal of used face This article is licensed under a co-authored a book chapter dis- masks,17 and fomite transmission.18 Some of these concerns cussing remediation technologies have led to the development of face masks with inherent anti- for arsenic removal in microbial properties to impart surface contact killing/ Open Access Article. Published on 08 February 2021. Downloaded 9/25/2021 5:35:33 PM. groundwater. deactivation property in addition to particle ltration. Dr Degala Venkata Kiran is an Dr Shihabudheen M. Maliyekkal Assistant Professor in the is an Assistant Professor, Department of Mechanical Department of Civil and Envi- Engineering, Indian Institute of ronmental Engineering, Indian Technology Tirupati, India. He Institute of Technology Tirupati earned his PhD from the Indian (IITT), India. He earned his Institute of Technology Bombay masters and PhD from Indian in Manufacturing Specializa- Institute of Technology Madras tion. The main focus of his (IITM) in the area of Environ- research is to develop various mental Engineering. His welding technologies for the research's primary focus is to marine, automotive and aero- address the challenging task of space industries. Dr Kiran also providing clean water through works extensively in Additive Manufacturing for aerospace and nanotechnology. Dr Maliyekkal has authored over 70 articles in medical implants applications. Dr Kiran has authored over 30 reputed journals and conference proceedings. He is an inventor/co- articles in reputed journals and conference proceedings. He has inventor in 14 patents or patent applications. He has secured secured several research grants and is the PI of 5 ongoing spon- several research grants, and he is PI and Co-PI of seven ongoing sored research projects. sponsored research projects. © 2021 The Author(s). Published by the Royal Society of Chemistry RSC Adv.,2021,11,6544–6576 | 6545 View Article Online RSC Advances Review Antimicrobial face masks pave the way for reusability and 2. Major epidemics and pandemics in considerably reduces the surging demand for single-use face masks, especially during outbreaks in highly populated, devel- history oping, and middle-income countries. Moreover, the ongoing The occurrence of pandemics and epidemics have been re- pandemic has further stressed the signi cance of such devel- ported throughout history. It is accepted that pandemics occur opment. Thorough knowledge of suitable antimicrobial agents at unpredictable intervals with no specic occurrence pattern.14 (AMA) and incorporation methods are required to develop The