Totobobo mask is the most comfortable and advanced respirator in the non-certified respirator market. In many respects the patented design is revolutionary. The original design cater to the needs of common users, who do not have access to professional fit-test facility and yet need the assurance of a well fitted respirator.

Preparing Totobobo masks for test

A different approach
To provide assurance of good fit, we made the reusable mask with transparent plastic, so that users can see through it and check the face-seal. We make the mask customizable, so that users can trim it to fit their face. The thin and flexible plastic is highly adaptive and easily follows the contour of the face, require very little force to hold on to the face. The strap is exceptionally flexible and comfortable to use. There is silver ion anti-virus additive in the mask to make reuse more safe. all these sounds great on paper, but how does it perform in real life?

Testing Totobobo mask

Testing the masks
To validate the protection of Totobobo, we sent the masks to the Prince of Wales Hospital in Hong Kong to test the effectiveness by professional fit-test facilities.
A randomized controlled cross over study was carreid out to compare the efficacy of Totobobo with fitted tested N95 masks (1860 or 1860s or 1862, 3M). The test was conducted in 22 healthy volunteers. The key findings are:

- The pass rate (filtration factor >100) of Totobobo mask was over 73%, while majority of (N95) masks fitting less than 40% of the test population
- The average filtration factor of fitted tested N95 masks is higher (193) then Totobobo mask (135).
- In terms of comfort, 65% subjects preferred Totobobo mask over their fitted tested N95 masks

Quote from the report:

“..Using the Totobobo mask in the panel of masks to be tested may reduce the number of masks that need to be tested before an adequate fit is found. This potential advantage, however, will need to be balanced against the time taken to trim the Totobobo mask to size. Furthermore, in situations where there is insufficient time to carry out fit testing use of the Totobobo mask may be a useful stopgap measure. In addition to this, the fact that the Totobobo mask is designed to be reusable may provide significant advantage. This would minimize the problems associated with the need to stockpile disposable masks and the difficulty of obtaining supplies in an epidemic. However, prior to concluding the mask is re-usable it is necessary to test the effect of sterilization processes on the mask. It is conceivable that such processes may make the mask less pliable and the fit less good. Moreover it is important to ensure that the process of changing the HEPA filters does not contaminate the user with infectious particles.

In terms of comfort 65% of subjects preferred the Totobobo mask over the N95 mask (1860, 1860s 3M). While the confidence interval straddles 50% this may be due to our small sample size. Comfort is an important issue when masks need to be worn for long periods of time. Greater comfort may translate into greater compliance with proper use of the mask and hence greater protection in clinical use. The experience of our ICU during SARS suggests that compliance is an important factor in determining the risk of occupational infection.”

The bottom line
If your have access to fit-test facility and have time to conduct fit test, the best option is fit-tested N95 mask. Otherwise, Totobobo mask provides reasonable good protection even if you don’t have access to fit-test facility or there is no time for fit test.

fit-test result from one of the subject

Source:
A randomized controlled pilot study to compare filtration factor of a novel non fit tested HEPA filtering facemask with a fit-tested N95 mask.
by Dr Sylvia S.W. Au, Dr Charles D. Gomersall, Patricia Leung and Dr Peggy T.Y. Li.
Dept of Anaesthesia & Intensive Care, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong.

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London, January 26 (ANI ): Respiratory infections like flu can be guarded against if people use protective facemasks, according to a study led by British and Aussie scientists.

In their study report, the researcher also say that protective facemasks can even be helpful in defending against a pandemic.

Researchers at Imperial College London and the University of New South Wales, however, have also found that persuading people to wear a mask and to fit it properly is a difficult task, which could limit their effectiveness.

In a clinical trial of the effectiveness of masks, the researchers studied 280 adults from 143 families living in Sydney during the winter flu seasons of 2006 and 2007.

When a child in the household was ill with flu, the volunteers were asked either to wear a mask or not, on a random basis.

The researchers observed that people who wore a mask while their children were sick were four times less likely to become infected by their sick children than non-wearers.

Led researcher Neil Ferguson, director of the MRC Centre for Outbreak Analysis and Modelling at Imperial College, said that the findings suggested that masks could be useful in protecting against flu infections, and could be important in a pandemic.

In a severe influenza pandemic, there may be limited availability of vaccines in the first few months. In that context, masks are a potentially important additional weapon, he said.

The study, published in the journal Emerging Infectious Diseases, indicates that masks could be an effective extra element of the defence plan, provided that people could be made to wear them consistently.

During the study, fewer than half of those who were asked to wear masks kept them on as directed. (ANI)

link

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Totobobo mask is able to  fit a wide range of  large and small faces. However, it is not possible to claim that it always seal your face perfectly. Sometimes it may reqire adjustment of the strap and the position of the mask to improve the seal. Sometimes trimming down the mask to a smaller size may help.

The purpose of a user-seal-check is to provide a fast and reliable method to evaluate the face seal, without the need of fit-test equipments.

User-seal-check of normal respirator (e.g. N95 mask) involve the steps of cupping the filter area with hands, forcefully inhale and/or exhale to sense if there is air-leak. Such method relys on the user’s ability to feel the air movement around the leak area. Sereverl studies shown such method is not relaible.

The Totobobo Visual-Seal-Check (VSC) method (patent pending) is facilitated by a very fine texture molded on the inside of the transparent mask. In normal condition, the surface is dry and it appear as semi-transparent. The same surface turns transparent if there is water stick on the surface. Even a tiny little water trapped between the mask and the face will make the surface change from semi-transparent to complete transparent.

To do a simple Visual-Seal-Check, you apply a little moisture on your face, than put the mask on. Observe the edge of the mask. Where it is completely transparent, there is a good seal. Where there is semi-transparent, there is no seal. It will be consider as a good overall seal If there is a continuous seal circle around the nose and mouth.

Our user test using a TSI PortaCount system in a hospital, the gold standard of respirator fit test, shows there is a strong correlation (90%+) between the Visual-Seal-Check (VSC) and the standard fit-test results. In other words, it is possible to predict if the mask will pass or fail the gold standard fit-test by performing a TOTOBOBO VSC. This is particular useful for people who don’t have access to a proper fit-test system.

Milky surface indicates the face seal leak location

Transparent surface indicates good face seal of Totobobo mask

Buy Totobobo mask

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“Rohan is glad that the dirt is collected on the filter, not in his lung.”

used filter (200km) vs new

Rohan Kini, an online bicycle shop owner in Bangalore, India, was testing a new pollution mask. After 200 km of bicycling in the city, he was very impressed with the performance of a new mask call TOTOBOBO from Singapore and decided to carry it in his shop.

The air pollution in London is nowhere near Bangalore standards. However, riding in heavy traffic can damage the respiratory system. The question is: How does one know if a pollution mask is needed or not?

The latest TOTOBOBO mask won’t be able to tell that in advance. But you can be pretty sure when it does the job – simply by checking out the color of the filters. The filter will turn into a distinguish dirty gray to signal that it’s time to change the filters.

The mask is ergonomically designed to fit the majority of faces, from adult down to children of age 5! The secret is in a world’s first “customizable” feature which allows you to trim the mask smaller if it is too big for you.

This reusable, flat folding little gadget may just be the right thing to keep in your pocket when you brave the urban traffic.

more:  BumOnTheSaddle

PS. Totobobo filter use special electro-static charge to collect even sub-micron dust.

TOTOBOBO and cycling

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Document title
Predictive value of the user seal check in determining half-face respirator fit

Author(s)

DERRICK J. L. (1) ; CHAN Y. F. (1) ; GOMERSALL C. D. (1) ; LUI S. F. (2) ;

Author(s) Affiliation(s)
(1) Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, HONG-KONG
(2) Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, HONG-KONG
Résumé / Abstract

Guidelines issued by the Centers for Disease Control and Prevention and the World Health Organization state that healthcare workers should wear N95 masks or higher-level protection during all contact with suspected cases of severe acute respiratory syndrome. Before use, the manufacturer recommends performing a user seal check to ensure that the mask is fitted correctly. This study aimed to test the ability of the user seal check to detect poorly fitting masks. This study is a retrospective review of a mask-fitting programme carried out in the intensive care unit of the Prince of Wales Hospital in Hong Kong. In this programme, all staff were tested with two types of N95 mask and one type of N100 mask. The results of the documented user seal check were then compared with the formal fit-test results from a PortaCount. Using a PortaCount reading of 100 as the criterion for a correctly fitted mask, the user seal check wrongly indicated that the mask fitted on 18-31% of occasions, and wrongly indicated that it did not fit on 21-40% of occasions. These data indicate that the user seal check should not be used as a surrogate fit test. Its usefulness as a pre-use test must also be questioned.

Revue / Journal Title
The Journal of hospital infection ISSN 0195-6701

Source:

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    Totobobo mask was spotted in NIOSH NO-FIT-TEST workshop page

I was surpriced when my friend show me this page in CDC site. NIOSH, the National Institute of Occupational Safety and Health under CDC, is the US organization who certify the well known N95 mask. What made TOTOBOBO, a little known Singapore invention of respirator mask, appears in this heavy weight website?

No, TOTOBOBO is not certified by NIOSH, at least not yet. The picture of an early version of TOTOBOBO mask found in the NIOSH website is to serve as an inspirational example for a “No Fit Test” filtering facepiece respirator workshop. The workshop will be conducted in Nov. 6 later this year and the objective is:

“To better understand the interdisciplinary research needs and challenges in developing and certifying a universal “no-fit-test” filtering-facepiece respirator”

I think this is totally appropriate and it shows NIOSH recgonize the need to improve the current procedure in order to motivate manufacturers to innovate toward the direction of “No fit test” respirator. 

Why is this big fuss about “No fit Test”?

If you read carefully the fine text of your respirator instruction, you will notice a statement similar to this:

“Before use of this respirator, a written respiratory protection program must be implemented meeting all the requirements of OSHA 29 CFR 1910,134 such as training, fit testing, medical evaluation, and applicable OSHA substance specific standards.” 

The simple fact is, the rated protection value will be drastically reduced if the mask does not fit your face, and there is no other ways to tell except by doing a fit-test. Buying a mask is easy, but getting a mask fit-tested on each individual is a challenge. In emergency situation like flu pandemic or haze outbreak, it is simply not possible to get everyone a fit tested at once. 

One can start to sense the “pain of fit test” and how touchy this issue is from the following comment in one of the NIOSH science blog :

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Hopeful to see Fit-Test to be lifted- Edward Hernandez, City of Hialeah, Fire Rescue says:- Thank you for proposing a study as this. For a while now this OSHA (Fit-test) requirement  has been a burden to our Fire/EMS service.

Hopeful to see Fit Test to be simplified-Peggie Reinhardt, RN BSN, says:

I would be interested in this study, we currently fit test our employees annually. If this process could be shortened or redesigned so that it was easier to do would help tremendously.

Fighting to keep Fit-Test in organization- Sgt. Julie Love says:

I would be interested in being part of this study on the law enforcement side. We fit test our officers annually but many departments do not. Law Enforcment traditionally has fallen down in this area as many agencies just give their officers their masks without any fit testing. We also fight the battle with our management with what is mandated.

Worry that No-Fit-Test= Not Safe-Kevin MacDonald says:

 I am concerned that changing the fit test frequency while cost effective may defeat its overall purpose. when fit testing went from every 6 months to one year as a requirement of OSHA it was a step back.

Confused and concern-Kelly Russell says:

I am glad this study is being done. Respiratory fit testing is expensive for employers and it will be good to have a current answer when asked why we have to do the testing so often….or maybe not so often as the case may be.

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No matter what, the setting up of this workshop itself is already a breakthrough, and we are definitively happy to be associate with the solution side of the problem. We hope the result of the workshop will bring more practical innovation into the design and certification of respirator, especially taking people like housewife and children who don’t have access to fit-test equipment but also deserved to have good protection when situation come.

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If you burn incense at home regularly, aside from the potential for a nightmare conversation with your home insurance provider should a fire start, you may be putting your children at a risk of developing cancer or lung problems.

TOTOBOBO mask may be the only practical solution for children who cannot avoid exposed to the harmful incense smoke in many Asian cities.

Smoke particles from burning incense were found to cause cancer of the upper respiratory track. A 12 years long “Singapore Chinese Health Study” of more than 61,000 ethnic Chinese adults living in Singapore discovered ‘Among non-smokers who used incense during the day or at all times, the increased cancer risk was three times that of smokers.’ said Prof Koh Woon Puay of National University of Singapore.

The best way to avoid such risk is not to burn any joss-stick. However, incense has a significant meaning in the minds of many Asian cultures such as Hindu, Buddhist or Taoist. Mr Chung Kwang Tong, secretary-general of the Taoist Federation Youth Group in Singapore, explained that for Taoists, the smoke from incense is a way of communicating with the deities. Even for those who don’t practice any of these religions, may have inhaled incense smoke involuntary. Children are particularly at risk, there is mounting evidence that exposure to air pollution has long-term effects on lung development in children.

If stop burning incense is not an option, then protecting the vulnerable children with a face mask should be the second best option, right? To filter out the harmful smoke effectively, a face mask must produce two conditions simultaneously. First it needs to seal the user’s nose and mouth snugly. Second the filter material must be able to filter out those fine smoke particles. The use of simple surgical mask doesn’t help, as air-leaks are all around the face and smoke can easily by-pass the mask to enter the lung. Upgrade to an N95 respirator can help, only if you have access to a fit-test setup to ensure the mask is making a proper fit. Otherwise, if air-gaps exist in an N95 mask, it makes very little difference from using a cheap surgical mask. Buying an N95 mask is easy, but getting it fit-tested is not. Much to disappointment, there is no N95 mask available for children.

TOTOBOBO mask can be cut to fit children (and adults), and parents can now fit-check the mask without the need of expensive fit-test equipments. The name TOTOBOBO (totobobo.com) suggests the solutions in Chinese: TOTO (transparent) BOBO (protection for baby). Parents can see through the transparent mask to examine the seal on the children face. We compared the visual fit-check method with a high-end fit-test setup call Porta-Count in hospital. The result shows strong correlation between the visual-check method and the official fit-test. “User seal-check has never been able to reach such accuracy. It is possible to ensure protection by simply looking through the mask.

It looks like TOTOBOBO mask is going to provide the much needed alternative to surgical masks or disposable N95 mask, especially for children suffering from incense smoke or other air pollution.

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The protective function of a respirator mask is based on two functions;
(1) the filter media must let in air but stop harmful and unwanted particles from entering the breathing zone.
(2) the mask must fit the user’s face and form a complete seal so that no air bypasses the filter media and enters the breathing zone directly.

Filter + Face seal = good protection

Modern technology has produced highly efficient filter media that can achieve up to an incredible 99.9% filtration efficiency. Ensuring a secure mask-to-face fit, however, is not nearly as simple. Rarely do users achieve a professional-grade fit, and they are surprised when they do.

Fit-testing is a task that requires a trained professional, special equipment, knowledge and skills, and considerable time. There is QUALITATIVE fit test based on subjective senses of the user, and there is QUANTITATIVE fit test based on objective measurement which compares the particle counts inside and outside of a mask. The National Institute of Occupational Safety and Health (NIOSH) recommends that such a fit-test be conducted yearly for each user so as to ensure proper usage. Fit testing can determine if a mask fits the user during the test, but can not tell for sure if the mask still fits the user days or months afterwards. These fit-testing procedures are limited to occupational users and not commonly available. The general public has neither the equipment, nor training, nor expertise, nor regular access to professionals who do in order to conduct professional-grade testing on their protective respiratory masks when they need it.

In a recent study “Respiratory Donning in Post-Hurricane New Orleans” (published on the US CDCwebsite in May 2007), researchers found 76% participants were not able to demonstrate proper donning, resulting in the compromising of their protection. This study group should know a thing or two about proper protective mask use considering the ordeal they went through during the post-Katrina clean-up of New Orleans. Imagine in an emergency situation, what would happen if the public needed to wear respirators to protect themselves? How many of these people will be able to fit their mask properly? Less than 24%, perhaps? CDC has been reluctant to recommend N95 masks for the public use because for 3 out of 4 people the poorly fitted respirator may provide a fault sense of security and encourage risky behavior.
The Prince of Wales Hospital of Hong Kong conducted a study where subjects who had previously passed a fit test were asked to properly don a N95 mask and then check for adequate sealing. These same subjects were then given a TOTOBOBO mask which they have not previous experience and conducted the same test. The results found that although the TOTOBOBO mask performed slightly less than the N95 mask, most test subjects did achieve the appropriate fit and pass the test. How did the non-fit tested Totobobo match the fit-tested N95 mask for this group of users?

Transparent surface indicates good face seal of Totobobo mask

The TOTOBOBO mask solves the uncertainty about proper fit in a simple but extremely effective way. The transparent mask makes fit checking an easy task. Check around the perimeter of the mask and you can immediately decide if the face seal is good or not. This simplicity, combined with a soft material that comfortably fits your face, makes fitting a lot more intuitive and reliable. Now you can perform a more reliable face-fit check every time before entering a contaminated area. This is certainly more reassuring than relying on once a year fit test.

Reference:
ESICM Annual Congress-Totobobo-mask-1044

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