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Mask Use in Audiology: Pandemic Use and Current Opinions

The 2023 survey summarizes audiologists' mask usage during the pandemic, highlighting the communication challenges with masks, the perceived value of masks, and the overall impact on patient interactions and perceptions in clinical settings.
Mask Use Audiology

An audiologist uses a clear mask in practice.

Earlier this year, HearingTracker worked with Safe'N'Clear to conduct a short survey with audiologists to understand in-clinic mask use during the pandemic—and to gauge current attitudes about mask use. We are following up to provide some stats on what was learned in that survey. Our thanks to the 75 of HearingTracker subscribers who participated in the recent survey on Mask Use in Audiology. Below is a summary of the results and observations.

The respondents

Eighty-five percent of the respondents were female while approximately more than 13 percent identified as male.  The age range was from 25 to 70 years. Most of the respondents were located in the United States (USA) with three respondents outside the USA. Respondents’ experience working in audiology ranged from brand-new to 44 years. Approximately 43 percent work in private practice, nearly 19 percent work in hospital settings, another 19 percent work in ENT settings, and the remaining serve in K12, college, government, and military facilities which indicated breadth across industry locations.

Mask use in practice by the numbers

The survey sought to ascertain how many audiologists and clinicians were using masks in their practices and how these masks were impacting communication with patients as well as patient and provider perceptions of mask use.

During the COVID-19 pandemic, nearly 35 percent of respondents said they often wore a clear-window mask while 35 percent said they never wore a clear-window mask. Nearly one in five (20 percent) said they rarely wore a clear-window mask.  When asked about traditional (covered) mask use in the workplace, more than 62 percent indicated they always wore a traditional (covered) mask while nearly 23 percent often wore the traditional (covered) mask.  Interestingly, 29 percent of audiologists indicated that their patients saw them as more credible and concerned for their well-being when they incorporated mask use in the visit; and 33.3 percent said maybe their patients perceived them as more credible.

Justifying costs

Sixty percent responding to the survey said that the expense of masks was well worth their cost when taking into consideration the “soft costs” of not wearing a mask, such as getting sick, closing office, co-pays for medical visits and prescriptions, etc. More than seventeen percent said maybe the expense of masks was worthwhile and more than 22 percent opined that no, the mask expenses were not warranted.

Communication challenges and clear masks

Diving deeper, respondents shared feedback on whether the use of traditional (covered) or clear-window masks impacted their communication with patients. Several providers agreed saying, “Yes, difficult for patients to get visual cues” or “There were a few patients that I could not wear a mask for as they needed to lipread” or “Yes, patients with hearing loss need visual cues. Masking obscures this [feature] and reduces the volume and clarity of speech, making it challenging to communicate.” Some respondents shared creative workarounds if wearing covered masks such as “transcription on monitors and cell phones.”

As you can imagine, mask use deeply impacted people with hearing loss. Some patients would make requests for no masks. Reported by one, “Often my CI [cochlear implant] patients would ask for me to take it [mask] off.” Said another provider trying to balance protection and patient wishes, “I removed my mask and scooted my chair back about three more feet.”

Challenges of mask use

In regard, specifically to clear-window masks or clear shields, some of the following challenges were reported: “clear masks distorted speech” or were difficult to use because “they fogged up.” Some reported “clear masks are definitely harder to hear through but obviously easier to see through.” Not all clear-window masks are created equally; one respondent stated, “they were so wet and gross nobody wanted the lipreading benefit of three sentences and preferred regular masks.” Citing positive aspects of clear masks, the following comments were noted: “Yes it makes it easier for patients to understand my speech” and “I used a clear mask and patients appreciated it.”

Obtaining clear-window masks during the height of the pandemic was challenging. “We eventually bought some when Oaktree started selling them.” When asked which type of mask (clear-window vs tradition) is more beneficial in an audiology clinical setting, respondents shared: “if the clear masks did not fog, they would be better,” “Traditional, because it’s more effective at protecting from transmission of diseases.” Some responded “difficult to say- clear [mask] distorted speech while traditional [mask] attenuated.  Noted by several respondents to the effect that clear-window masks look “disgusting and repulsive with saliva and fog.”

Misunderstandings expressed

Some respondents shared “facts” that are not accurate such as “traditional masks protect better” or “no clear masks are FDA approved for medical setting.” Fact: There are clear-window masks on the market that meet the same stringent requirements as traditional masks and have FDA approval.

Hopefully, this quick review provides awareness to audiologists that they do not have to compromise clear communication in exchange for protection that mask usage provides. Doing research, audiologists can determine the best form of PPE that meets the needs of their patients and their office staff.  Here is what is known about the following clear-window masks from the company’s respective websites:

  • Safe’N’Clear markets two levels of The Communicator surgical mask with clear window. The ASTM Level 1 and Level 3 are both FDA approved and can be used in the OR. The Communicator mask does not fog because the film itself is a no-fog film. Made in USA.
  • BendShape is ASTM Level 3 and, of this writing, is not FDA-cleared. Made in USA.
  • Clear Mask is ASTM Level 1 and FDA-cleared. Their clear film uses no-fog technology. Manufacturing location is not identified.
  • FaceView Mask is KN95 Certified. Manufacturing location is not identified.

As of this writing, 24 hospitals across the US, including Cleveland Clinic, Robert Wood Johnson Barnabas Health, Cincinnati Children’s Hospital, Cambridge (Mass.) Health Alliance, University of Chicago Medicine Center, Kaiser Permanente Santa Rosa Medical Center have reinstituted their masking policies. As we head into cold, flu, COVID, and RSV seasons, providers are better equipped to see what types of protections they can offer their staff as they work closely (no social distancing when helping patients with audiological testing, hearing aid or cochlear implant services) to minimize transmission of viral pathogens.

Anne Mc

Guest Author

Dr. Anne McIntosh leads Safe’N’Clear as its President and CEO, introducing The Communicator™, the first FDA-approved transparent surgical mask, enhancing communication for the deaf and hard of hearing. With a strong academic foundation in communication sciences, her work emphasizes the importance of clear and safe interactions in healthcare. Dr. McIntosh also engages in advocacy and education, furthering discussions on accessibility and inclusion.