Wearing a Face Mask During Intense Exercise Is Safe for Healthy People

A new study found that wearing a protective face mask has only a modest effect on the ability of healthy people to perform vigorous exercise, according to results published in the European Respiratory Journal.

A team of researchers carried out detailed testing on breathing, heart activity, and exercise performance in a group of 12 people while they were using an exercise bike with and without a mask, according to the study authors.

There were differences found in some measurements between wearing a mask and not wearing a mask, but the researchers mentioned that none of their results indicate any risk to health. These findings suggest that masks could be worn safely during intense exercise, for example, to reduce COVID-19 transmission between people visiting an indoor gym, according to the study authors.

"We know that the main route of transmission for coronavirus is via droplets in the breath and it's possible that breathing harder during exercise could facilitate transmission, especially indoors,” said researcher Elisabetta Salvioni, MD, in a press release. “Research suggests that wearing a mask may help prevent the spread of the disease, but there is no clear evidence on whether masks are safe to wear during vigorous exercise."

The researchers worked with a group of healthy volunteers made up of 6 women and 6 men with an average age of 40 years. Each person took part in 3 rounds of exercise tests: once while not wearing a face mask, once wearing a surgical mask (blue, single-use mask), and once wearing a filtering face piece 2 or FFP2 mask (white, single-use mask believed to offer slightly better protection than a surgical mask), according to the study authors.

The participants used an exercise bike, during which the researchers measured their breathing, heart rate, blood pressure, and the levels of oxygen in their blood. Results of the tests showed that wearing a face mask had a small effect on the volunteers. For example, there was an average reduction of approximately 10% in their ability to perform aerobic exercise.

The results further indicate that this reduction was most likely caused by it being slightly harder for the volunteers to breathe in and out through the masks, according to the study authors.

"This reduction is modest and, crucially, it does not suggest a risk to healthy people doing exercise in a face mask, even when they are working to their highest capacity,” said researcher Massimo Mapelli, MD, in a press release. “While we wait for more people to be vaccinated against COIVD-19, this finding could have practical implications in daily life, for example potentially making it safer to open indoor gyms.”

Mapelli added that people should not assume the same is true for people with a heart or lung condition, as more research needs to be done to investigate this scenario. The researchers are continuing with this study to analyze the impact of wearing a face mask while carrying out daily activities, such as climbing the stairs or housework, in healthy people and those with heart or lung conditions.

"COVID-19 has hit our region and our hospital so hard, with devastating effects at a personal, professional and organizational level. Despite that, this was one of many studies carried out with enthusiasm by our young researchers,” said researcher and professor Piergiuseppe Agostoni in a press release. "We are particularly proud of this work because it began spontaneously during our free time in the otherwise depressing period of the current pandemic and our findings demonstrate the necessity of clinical research, even during an emergency."

Professor Sam Bayat, chair of the European Respiratory Society Clinical Respiratory Physiology, Exercise, and Functional Imaging Group, was not involved in the research but added that there are still gaps of knowledge as to how to limit the spread of COVID-19, but face masks have a major role to play.

"Although these results are preliminary and need to be confirmed with larger groups of people, they seem to suggest that face masks can also be worn safely for indoor sports and fitness activities, with a tolerable impact on performance,” Bayat added in a press release.