Face Mask Usage and Disposal Practices among Adults at Selected Market  Places in Gampaha District, during COVID-19 Pandemic 

Dr. C. C. Magedaragamage



Background- Face mask wearing is one of the most successful strategy to curtail SARS-COV-2  both in hospital and community setting. They provide a protective barrier for droplet transmission  when correctly worn. Almost all countries across the globe have favored the use of masks in public.  However, with the excessive usage of face masks clinical waste generation and potential  environmental hazard has emerged. Therefore, adherence to correct facemask usage and disposal  practices are mandatory to effectively control COVID-19 as well as to minimize the environmental  pollution.  

Objectives- To assess face masks usage and disposal practices among adults at selected market  places in Gampaha district during COVID-19 pandemic. 

Methods- A descriptive cross-sectional study was carried out in three selected market places in  Gampaha district. Both vendors and consumers more than 18 years were included and non probability sampling method using a convenient sample was applied until required sample was  achieved. A pre-tested IAQ and an observational checklist were used to obtain data about face  mask usage, re-usage, technique of wearing and disposal practices. The associated factors for  facemask usage and disposal were analyzed using SPSS. 

Results- Response rate was 91.5% (183/200). Majority of adults at market places in Gampaha  district were females (N=96, 52.5%), Sinhalese (N=197, 92.9%), educated up to passing O/L or  below (N=129, 70.5%), had a monthly income of less than LKR 70,000/= (N=138, 75.4%) and  within 18 years to 50 years of age (N=94, 51.4%). Approximately similar number of employed  (N=48, 49.5%) and unemployed (N=49, 50.5%) consumers were found. 

Commonly used face masks types were fabric masks (N=86, 47%, 95% CI 39.3-54.1%) and  surgical masks (N=78, 42.6%, 95% CI 35.5-50.3) while N95/KN95 (N=18, 9.8%, 95% CI 6-14.2)  and FFP (N=1, 0.6%, 95% CI 0-1.6) were used in low percentages by the study population. Four  types of masks were worn by study participants at market places as observed using the check list;  fabric masks (N=86, 47%, 95% CI 39.3-54.1%), surgical (N=74, 40.4%, 95% CI 33.9-47.5),  N95/KN95 (N=22, 12%, 95% CI 7.1-16.9) and FFP (N=1, 0.6%, 95% CI 0-1.6). Collectively,  disposable mask usage was higher (N=97, 53%, 95% CI 45.9-60.1) compared to reusable masks.  Among disposable masks users, 39.2% re-used N95/KN95 masks (N=38, 95% CI 29.1-49.5), 1%  re-used FFP masks (N=1, 95% CI 0-3.5) and 21.6% re-used surgical masks (N=21, 95% CI 14- 30.1).  

Based on the IAQ, following practices were revealed among participants; never performed hand  hygiene before wearing (N=19, 10.3%, 95% CI 6-14.8) and never performed hand hygiene after  removing (N=25, 13.7%, 95%CI 9.3-18.6). Based on observation of participants during encounter  following were noted; wore wet masks (N=11, 6%,95% CI 2.7-9.8), masks were dirty (13.1%,  95%CI 8.7-18), masks were torn (N=14, 7.7%, 95% CI 4.4-11.5), did not completely cover nose,  mouth and chin with the mask (N=43, 23.5%, 95% CI 17.5-29.5), participants pulled down masks  to talk (N=18, 9.8%, 95% CI 6-14.7), touched masks during encounter (N=66, 36.1%, 95% CI 29- 43.2). Among surgical mask wearing participants, equal number of participants wore white side  out (N=1, 1.4%). and metal piece on chin (N=1, 1.4%). Total usage practice was analyzed based  on observational check list and majority were adherent to wrong usage practices (N=106, 57.9%,  95% CI 50.3-65.6). 

Majority of disposable face mask users did not dispose face masks to bin with a lid while away  from residence (N=61, 62.9%, 95% CI 52.8-72.8). Common methods of disposal simultaneously  practiced in households were handing over to a garbage collecting vehicle (N=97, 100%) and burn  (N=63, 65%). Among the participants who handed over to garbage collecting vehicle at household  level, majority did not collect used masks in separate bags (N=72, 74.2% 95% CI 65.9-82.8). 

There was a statistically significant association (P=0.023) of gender with face mask usage practices  with higher percentage of males having wrong usage practices (N=58, 54.7%). Higher percentage  of wrong usage practices (N=86, 81.1%) were manifested by participants who had lower income  LKR <70,000/= compared to those who had higher income (N=20, 18.9%), giving a statistically  significant association with p value <0.05. 

There was a statistically significant association (p=0.042) of face mask disposing practice to a bin  with a lid with income level with higher percentage of low-income families having wrong practices  (57.4%). 

Conclusion – Majority of adults at market places have wrong face mask usage and disposal  practices. These results of the study clearly highlight the importance of educating vendors and  consumers at market places using a behavioural change communication approach. It recommended  to develop and publish a national policy to Sri Lanka on correct face mask usage and disposal  practices.  

Key words-Face masks, usage, disposal, COVID-19, market places