Totobobo demo in Beijing and Shanghai

Swanport cafe in Soho Galaxy at Chaoyang, Beijing
Swanport cafe in Soho Galaxy at Chaoyang, Beijing
Muren of Totobobo Tmall share a presentation about PM2.5
Muren of Totobobo Tmall share a presentation about PM2.5
Francis shared his story about Totobobo mask
Francis shared his story about Totobobo mask, Robin from Totobobo Tmall is providing realtime translation

2014-09-16 Swanport Cafe, Chaoyang District, Beijing

The demo in Beijing was a great success on a Tuesday evening, thanks to Robin and Muren from Totobobo Beijing and the helpful staff from Swan Port Cafe. The session started off with a brief introduction of PM2.5 by Muren, he explained what PM2.5 is, and how it affects our health. Francis, the designer of Totobobo mask, shared how he came up with the idea of a customizable and reusable respirator mask out of the SARS crisis in 2003. The fit-test demo started after a short tea break.

What is “Fit-test”? Why it is important?

Fit-testing is a procedure to determine if a tight seal can be achieved when the user don a respirator mask. This is important because the quality of the seal affects the overall protection against PM2.5 and other airborne contamination. In fact, the NIOSH N95 standard requires a proper fit-test to be conducted before anyone starts using a respirator for the first time. During the fit-test, a particle counting instrument is used to accurately measure respirator fit by comparing the particle concentration in the surrounding air with the particle concentration inside the respirator. The ratio of these concentrations is called the Fit-factor (FF). For N95 mask, a minimum Fit-factor of 100 is required in order to pass the fit test.

Fit factor formular
Fit factor formular

TSI Portacount is the best fit-testing machine in the world. (US Army recently purchased 65 sets of the same TSI Portacount fit-tester http://itbriefing.net/modules.php?op=modload&name=News&file=article&sid=571559)

The working principle of the PortaCount 8083 is straight forward: there are two flexible tubes coming out of the machine, one is to draw the air and measure the concentration of particles inside the mask. The second tube is open ended and is used to measure the particle concentration in the surrounding area. The PortaCount fit-tester calculates the particle concentration inside and outside of the mask and report the ratio, or the Fit-factor, in realtime. The higher the Fit-factor, the better is the protection effect of the mask. With the Portacount machine, Francis was able to demonstrate quantitatively how the quality of the seal and the filters can have a great impact on the protection effectiveness of a respirator.

Preparing for the test

Francis exchange ideas with the VIPs.
Francis exchange ideas with the VIPs.

Before the fit-test, a “Daily check” on the machine was performed to assure that the ambience air quality is suitable for the test and the machine is in proper operation condition. Amongst the audience, there were members from the China Consumer Association (中国消费者协会), National labor supplies Quality Supervision and Inspection Center (Beijing) 国家劳保用品质量监督检验中心(北京), Austria Embassy, TimeOut Beijing,  Aqicn.org and members of the public to monitor the entire process of the fit-test demo.

Fit test demo with PortaCount professional fit-tester

Faye testing Totobobo mask
Faye testing Totobobo mask
The perfect shape for Faye
The perfect shape for Faye
Fit-factor is only 3.3, the result of the cosmetic cotton pad is not convincing
Fit-factor is only 3.3, the result of the cosmetic cotton pad is not convincing

The first Fit-test of Totobobo mask was performed on Faye, a Chinese lady with a slender face shape. Francis first tested a pair of “fake filters” made of cosmetic cotton pad. The “fake filters” looks nearly the same as the original, but the resulting Fit-Factor is only 3.3 which means on a day with AQI 500, the cotton pad can ideally bring it down to 150, just not good enough. After changing into a pair of F96 filters, the Fit-factor shoot up to 150+. In AQI 500 day, ideally it can bring it down to 4-, better than the air you will get in Switzerland!

The Fit-factor shoot up to 150+ after changing into a pair of F96 filters
The Fit-factor shoot up to 150+ after changing into a pair of F96 filters

The second participant was a young girl (Guo Yao) with a fuller face. Francis first conduct the test with the same Totobobo mask without modification. The water-mark-method shown that the seal was not perfect and the initial result was relatively low (below 50). However, after Reshape the mask with a hair-dryer and after a good water-mark is obtained, the Fit-factor reported by the Portacount machine come up to 200+.

The perfect shape to fit  Guo Yao after ReShaping the mask
The perfect shape to fit Guo Yao after ReShaping the mask
Guo Yao received a new Totobobo mask from Sharon, Managing Director of Totobobo mask.
Guo Yao received a new Totobobo mask from Sharon, Managing Director of Totobobo mask.
Francis using the "Water-mark" method to predict the fitting of the mask
Francis using the “Water-mark” method to predict the fitting of the mask

Francis also demonstrated the effect of good and poor seal, by the “water mark method”. He applied a bit of water around the nose bridge area. When the matt color mask surface touching the wet skin, it changes to transparent (water-mark).

Barbara testing Totobobo mask
Barbara testing Totobobo mask

The third participant was Barbara Grosse from the Austria Embassy. It took Francis few rounds of ReShaping the mask in order to obtain a good water-mark seal. The final Fit-factor was also in the range of 150~200+. All three ladies passed with a clear margin from the minimum requirement of 100 (for N95 mask).

Fit-test demo based on only three users is obviously not statistically sound. However, we have done this nearly a hundred times privately and this is the first time we perform the fit-test in front of a public group.

After Beijing, we went to Shanghai ArtBike to conduct another fit-test demo with their customers. We came to similar observation as in Beijing.

Fit-test at ArtBike, Shanghai
Fit-test at ArtBike, Shanghai

 

Some interesting facts we can draw from all the fit-tests:

1. Totobobo mask can be ReShaped to fit a wide range of face shapes.

  • The same Totobobo mask was used through out the fitting on all three ladies, with significantly different face shapes and all managed to obtain high Fit-factors above 150.
  • Many more fit-tests on different users shows the ReShape function can be applied to a wide range of users.

2. The “Water mark” method is reliable to help ensure face fit and protection.

  • There was a strong correlation between the water-mark-method and the PortaCount results
  • When the water-mark method showed the seal was not perfect, the corresponding Fit-factor dropped  to below 50 and sometimes down to single digit value.
  • When a clear water mark was formed around the nose bridge and the face, the corresponding Fit-factor shot up to 150+

3. Overall protection against PM2.5 require good quality filter AND a good face-mask seal

  • When cosmetic cotton pad is used in place of the Totobobo filters, the Fit-factor dropped to only 3.3.
  • When the water-mark shows there is a leak between the mask and the face, the Fit-factor dropped to below 50 and sometime single digit.
  • The resulting Fit-factor is consistently good (150+) when Totobobo filter is used and the water mark result is positive.

Above points 1&2 are the strengths and the weaknesses of Totobobo mask, ReShape (and cutting) makes Totobobo mask the most versatile solution to fit a wide range of users, including children and adult. But ReShaping and cutting the mask is more complicated than bending a metal nose clip. With the “Water mark” fit-test method, you can be sure that when the water mark seal up your nose and mouth, the mask is giving you high level of protection. In contrary, ensuring face-seal is much more tricky for many popular masks on the market, as a detail research concluded by Tongji Medical College (Huazhong University of Science and Technology, Wuhan, China) suggested: Fitting Characteristics of N95 Filtering-Facepiece Respirators Used Widely in China . 8 out of 10 popular mask can only fit less than 10% of the 54 Chinese test subjects.

On the other hand, these two features are the limiting factors for Totobobo mask to gain certification approval. It is confirmed that the current testing protocol does not allow  mask samples to be reshaped,  cut, or perform a water-mark check before the fit. These may well be the reasons why Totobobo mask did not perform well in the published review of 37 masks by Chinese Consumer Association earlier this year. Obtaining the certification is an important step for marketing purposes, but for now we put our focus on the practical protection that can be measured by the professional fit-testing machine (PortaCount 8083).

 

Related links:

Beijing TimeOut

Totobobo Fit-test demo on Weibo (1)

Totobobo Fit-test demo on Weibo (2)

Testing Totobobo mask with Portacount 8083 (video of entire process)

How to ReShape Totobobo mask?

 

Totobobo demo in Beijing and Shanghai

Next week Tuesday (2014/09/16 to 18) I will be conducting life demo of customizing the Totobobo mask to fit individual users in Beijing and Shanghai. Here is a quick preview of what I intended to share:

The essential factors to determine protection against PM2.5 is:

  • (1) if a tight fit can be achieved between the respirator mask and the user’s face (mask-to-face seal)
  • (2) the quality of the filter
  • – Quality of filter can be achieved by technology and tested in laboratory
    – Quality of mask-to-face seal is the biggest issue for ensuring the protection for individual, because each individual is different

  • Fit-testing is a process to determine the quality of the face-to-mask seal for individual. This is essential because the protection against PM 2.5 is hugely affected by the quality of the seal.
  • Totobobo special approach: (1) ReShape or trim to fit most people, (2) Easy fit-check through the transparent mask
  • To validate our approach, we sent Totobobo mask to Prince of Wales Hospital in Hong Kong for fit-test. The resulting Fit-Factor is 135, which is better than the minimum requirement for N95 mask.
  • For normal N95 mask, a proper fit-test is necessary during the first use by a new user. This is to determine if a good seal is achievable.
  • – if a good seal is not achievable, the user has to choose a different mask
    – In case of Totobobo, if a good seal is not achievable (by see-through method), the mask can be ReShape or cut smaller to get a better fit

    All those who participated in the demo fit-test will get a free, customized Totobobo mask!
    email us as totobobomask(at)gmail.com if you are interested to join.

    How to perform a Visual-Seal-Check (VSC)?

    New user seal check of TOTOBOBO mask predicts fit-test success rate

    Totobobo masks are able to fit a wide range of large and small faces. However, it is not possible to claim that it will always seal your face perfectly. Sometimes it may require 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 Visual-Seal-Check is to provide a fast and reliable method to evaluate the face seal, without the need of fit-test equipment.

    User-seal-check of a normal respirator (e.g. N95 mask) involves the steps of cupping the filter area with hands, forcefully inhaling and/or exhaling to sense if there is air-leak. Such method relies on the user’s ability to feel the air movement around the leak area. Several studies have shown that this method is not reliable.

    The Totobobo Visual-Seal-Check (VSC) method (patented) is facilitated by a very fine texture moulded on the inside of the transparent mask. In normal condition, the surface is dry and it appears as semi-transparent. The same surface turns transparent if there is water stuck on the surface. Even a tiny amount of 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 it is semi-transparent, there is no seal. It is considered as a good overall seal if there is a continuous transparent band 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

    Milky surface indicates the face seal leak location

    Transparent surface indicates good face seal of Totobobo mask

    Transparent surface indicates good face seal of Totobobo mask

    Predictive value of the user seal check (of normal N95/N99 mask)

    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
    Rsum / 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: