Supplement titlebanner ENG

The HIVE project research found that agencies often distribute masks in eruption crises and that these are usually loose-fitting surgical (or similar material) masks [4]. Yet, the laboratory studies showed that such masks offer a low level of protection due to poor fit [3]. In an affiliated project, led by Dr Fiona McDonald (QUT, Australia), we developed a framework to assist agency decision making on which type of respiratory protection to recommend/distribute based on ethical principles [12].

Some agencies only recommend public health interventions based on their known efficacy (the ‘principle of effectiveness’) whereas others take a precautionary approach, where any intervention is considered better than no intervention, even when there is a lack of evidence of the intervention’s efficacy or the health risk. Agencies distributing surgical masks take the latter approach. Since the HIVE study was completed, there has been a global shift, towards the precautionary principle, in attitudes on community use of respiratory protection, as a result of the COVID-19 crisis [13].

The project also evaluated whether agencies may have a legal duty of care, arising out of tort law, to provide warnings about the health risks associated with air pollution disasters and/or to recommend facemasks as a protective mechanism for community use to reduce exposure to particulate matter. There is also potential for liability, if a receiver of an inadequate facemask alleges that they have been harmed as a consequence and seeks compensation [14]. Further research is necessary to determine how the negligence framework may work in each jurisdiction.