Combined Effects of Masking and Distance on Aerosol Exposure Potential

Objective: To quantify the efficacy of masking and “social distancing” on the transmission of airborne particles from a phantom aerosol source (simulating an infected individual) to a nearby target (simulating a healthy bystander) in a well-controlled setting. Methods: An aerosol was created using monodisperse polystyrene latex beads in place of infectious respiratory secretions. Detection was by aerodynamic particle spectrometry. Both reusable cloth masks and disposable paper masks were studied. Transmission was simulated indoors during a 3-minute interval to eliminate the effect of variable ventilation rate on aerosol exposure. The study commenced on September 16, 2020, and concluded on December 15, 2020. Results: Compared with a baseline of 1-foot separation with no masks employed, particle count was reduced by 84% at 3 feet of separation and 97% at 6 feet. A modest decrease in particle count was observed when only the receiver was masked. The most substantial exposure reduction occurred when the aerosol source was masked (or both parties were masked). When both the source and target were masked, particle count was reduced by more than 99.5% of baseline, regardless of separation distance or which type of mask was employed. Conclusion: These results support the principle of layered protection to mitigate transmission of SARS-CoV-2, the virus causing COVID-19, and other respiratory viruses and emphasize the importance of controlling the spread of aerosol at its source. The combination of masking and distancing reduced the exposure to exhaled particulates more than any individual measure. Combined measures remain the most effective way to combat the spread of respiratory infection.