Ajaj et al. Sustainable Environment Researchhttps://doi.org/10.1186/s42834-023-00182-x(2023) 33:20

Sustainable Environment
Research

Open Access

REVIEW

Understanding the environmental impactsof facemasks: a review on the facemask industry
and existing life cycle assessment studies
Rahaf Ajaj1* , Rania Al Dweik1, Shafeeq Ahmed Syed Ali1,2 and Mohammed Hashem Stietiya3

Abstract
The unprecedented COVID-19 pandemic has caused socioeconomic, physical, mental, and environmental upheaval.
Personal protective equipment, such as face masks, was mandatory to curb the spread of the virus. The unexpected
increase in demand for face masks resulted in an alarming increase in plastic waste globally. The non-biodegradable
nature of the raw materials and the potential threat of microplastic pollution amplify the problem. This puts a lotof pressure on policymakers and the global supply chain to develop long-term plans to make face masks less harmful.
By reviewing existing life cycle assessment studies, this study aims to provide an overview on how sustainable facemasks are. Various challenges in the facemask industry such as microplastic pollution and waste management are
discussed. A critical analysis on the various process hotspots is also conducted. Recommendations from this study canmotivate focused research into an important field and enable the transitions towards a sustainable facemask industry.
Keywords COVID-19, Environmental impact, Face masks, Life cycle assessments, Micro-plastic pollution, Waste
management
1 Introduction
In January 2020, the World Health Organization (WHO)confirmed a new coronavirus infection in Wuhan, China.
Over the next two years as SARS-CoV-2 swept the globe,
the world experienced a pandemic comparable to the
Spanish flu of 1918 [1]. As of May 2022, the WHO says
there have been over 521 million confirmed coronavirus
infections and over 6.2 million confirmed deaths due tothe pandemic [2]. The pandemic has caused problems forthe global economy, supply chain systems, public health,and everyday life that have never been seen before.
*Correspondence:
Rahaf Ajaj
rahaf.ajaj@adu.ac.ae
1
Department of Environmental and Public Health, Abu Dhabi University,
Abu Dhabi 59911, United Arab Emirates
2
School of Engineering, Monash University, Subang Jaya 47500, Malaysia
3
Divison of Consultancy, Research & Innovation (CRI), BEEAH Group,
Sharjah 20248, United Arab Emirates

Several precautionary and preventive measures were put
in place at the national and regional levels to stop the
spread of the virus. There were multiple stages of lockdown and legislative changes to ensure social distancing
and adoption of personal protective equipment (PPE).
Social awareness campaigns at the global level werealso undertaken to educate the importance of personal
hygiene.
Demand for protective facemasks had gone throughthe roof during the pandemic. Single-use facemasks provided a convenient way to ensure sufficient protection
from infection. Najmi et al. [3] showed that the adoptionof communal face masking was key to stopping the pandemic. Using face masks by at least 60% of the population was a critical control strategy while opening up the
economy, especially since compliance with face masking
is easier to achieve than social distancing. The demand
for face masks is also clear from the WHO study, whichfound that the US needed nearly 89 million masks to deal

© The Author(s) 2023. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which
permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to theoriginal author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images orother third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line
to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory
regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of thislicence, visit http://​creat​iveco​mmons.​org/​licen​ses/​by/4.​0/.

Ajaj et al. Sustainable Environment Research(2023) 33:20

with the pandemic [4]. Also, the Japanese Ministry for
Finance, Trade, and Industry noted that almost 600 million face masks would be required in April 2020 [5]. The
figures seem consistent compared to China’s production
capacities, which make it a significant supplier of masks
globally. Chinese production of face masks increased to
110 million d­ −1 in 2020 to meet this demand [6].
The impending crisis following the pandemic would
be the management and safe disposal of used protective
facemasks. While countries have laid out regulations andguidelines for plastic waste management, most countries
lack a centralized regulation on the management and disposal of used face mask waste [7]. The primary concerns
about face mask end-of-life options are (i) the ecotoxicological aspect, where the full facemask or micro- andnano-plastics originated due to their degradation disrupts the day-to-day lives of humans, animals, andaquatic organisms. (ii) the energy-intensive processes
and greenhouse gas emissions in the manufacturing offace masks and the additional energy to be spent collecting, sorting, treating, and disposing of used face masks.
(iii) the socioeconomic aspect, where more money andresources are spent to deal with PPE waste [8].
Selvaranjan et al. [7] surveyed 1033 participants from
6 different countries to study the fate of used face masks.
The results showed that nearly 35% of the respondents
just discarded the used face masks with mixed waste, andnearly 20% threw away the masks. This is especially worrying because the polymeric materials in the facemask
will not break down in nature. The study by Knicker andVelasco-Molina [9] conducted a microcosm experiment
to analyze the mean residence time (MRT) associatedwith the microbial activity to degrade the polypropylene(PP) layer of the face masks. It was seen that even withfeasible microbial degradation, the MRT was between
7 and 28 years. This is enough time for the low-tensilestrength spunbond or melt-blown polymeric material to
be degraded into micro- or nano-plastic, which can thencause detrimental impacts to the ecosystem.
Several studies have been undertaken to this effect. A
study by Spennemann [10] conducted field observations
in Albury, New South Wales. It could be seen that mostof the mask debris collected was below 10 ­mm2 in sizeand had been shredded by leaf blowers or lawnmowers.
These tiny microfibre materials can easily evade the traditional waste collection and sorting system and end up
in the soil or aquatic ecosystems. Hasan et al. [11] surveyed 30 ponds in Muktagacha Upazila, Bangladesh, andfound that 76.7% had plastic debris either directly in contact with the water body or within 1 m of it.
In a similar study, Thiel et al. [12] surveyed the tourist beaches in Chile to determine the amount of discarded PPE. The average density of discarded face masks

Page 2 of 19

across Chile was calculated to be 0.006 face masks ­m−2.
The same study found that these values were higher
than beaches in Peru and lower than some beaches in
Kenya. A critical analysis study by Kutralam-Muniasamy
et al. [13] compiled several other surveys conducted inSouth Africa, the Persian Gulf, Chile, Indonesia, Bangladesh, Peru, Canada, Kenya, and Morocco, all of which
reported the presence of PPE litter in the environment.
Akber Abbasi et al. [14] said that Saudi Arabia and Qatar
could be responsible for almost half of the microplastic
pollution in the Arabian Peninsula. Chowdhury et al.
[15] conducted a study across the coastal regions of 46
countries. It is estimated that 0.15 to 0.39 Mt of plastic
debris could end up in the ocean next year. PPE usage
during the pandemic was a significant contributor todriving up the numbers. Cudjoe et al. [16] found that
Asia’s average daily accumulation of single-use face mask
waste accounted for 19.12 kt ­d−1. It is also estimated thatthe world consumes 129 billion single-use face masksmonthly [17]. This shows how important it is to identify
sustainable options to recover and dispose of used facemasks and PPE, backed up by stringent enforcement.
It is then imperative to raise awareness about the harmful effects of facemask waste and to devise effective strategies to manage them. Life Cycle Assessment (LCA) is asustainability tool that comprehensively evaluates a process or product to analyse its environmental impacts ina standardized manner [18]. The results of an LCA study
can identify the “hotspots” in a process that cause significant impacts, which can then be optimized as required or
aid policymakers in making sustainable decisions.
Over the last few years, there has been an increased
focus on pandemic-related research. This is also reflectedin the increased number of studies on the LCA of PPE
and facemask. However, there has been a lack of studies
focusing solely on the environmental impacts of facemasks. This study aims to bridge that knowledge gap byreviewing existing LCA studies to better understand theenvironmental impacts of face masks. This is achieved byproviding an overview of the protective face mask industry, and discussing the challenges due to micro-plastic
pollution and facemask waste management in Sect. 3.
Further, a critical analysis of existing LCA studies on
facemasks is provided in Sect. 4. Recommendations fromthis study can guide future directions and aid in policy
legislation for a sustainable facemask industry.

2 Methodology
Google Scholar and Scopus were the primary sources
for gathering scientific information. Search strings “lifecycle assessment” and “face masks” were used to find
LCA studies. Google Scholar returned 795 results, andAjaj et al. Sustainable Environment Research(2023) 33:20

Scopus returned 94 results. These were then filtered tofind results that were:• Published in a peer-reviewed journal or underwent apeer-review process• Primarily involved in assessing the environmental impact of different types of face masks (studies
involved in assessing the environmental impacts of
PPE without explicitly defining the impacts due toface masks are excluded)• Conducting a LCA study to analyze the environmental impacts• Assessing the global warming potential (GWP)/climate change impact (in a mass of ­CO2eq)• Published in English
The literature review was conducted following theabove steps. A total of 18 studies were found that satisfied the mentioned selection criteria.

3 Protective facemasks
Facemasks are an effective control strategy against infectious diseases that are predominantly spread through airborne, droplet, or aerosol transmission [19]. In the caseof COVID-19, many precautions were taken, like limiting
physical contact, social distancing, maintaining hygiene,
and wearing protective facemasks [8]. However, the lackof community compliance limits the absolute benefit offace masks. The following sub-sections provide an overview of how face masks are fabricated and its various
types available on the market. Concerns about the facemask industry, microplastic pollution, and waste management are also raised.
3.1 Fabrication of facemasks

In order to understand the source of the environmental
impacts, it is important to understand the raw materials and production process involved in the fabrication of
facemasks. The basic structure of facemasks includes filtration layers, ear loops, and a nose wire. The ear loops
are generally made of elastic materials like polyester andspandex [20]. The nose wires are made from aluminum,high-density polyethylene, or polyvinyl chloride [21].
Meanwhile, the filtration layers are made from “nonwoven” materials to provide minimal airflow resistance andbetter particle filtration efficiency [8]. These nonwoven
materials are characterized by the entanglement of polymer fibers resulting in web-like structures. Dependingon the type of manufacturing process selected for web
formation, the quality of the web will vary, which in turn
determines the final quality of the face mask [22]. Threewidely used processes include spunbonding, melt-blowing, and electrospinning [23]. The basic idea behind thePage 3 of 19

three processes is that some liquid polymer of choice istransformed into fibers that form web-like structures
within a single step. Depending on the desired specifications, multiple polymers such as PP, polyethylene,
polyesters, polyamides, cellulose acetate, polylactic acid,polytetrafluoroethylene membranes, and polymer composites like nylon six could be used to manufacture facemasks [23].
To improve the filtration efficiency of the face mask or
to impart specific characteristics like antiviral, antibacterial, or self-cleaning, multiple layers of filtration material
produced from different polymer feedstocks or throughdifferent processes could be combined [8]. The typicalsurgical mask consists of a spunbond absorbent PP fabric inner layer, a melt-blown electrically charged PP fabric middle layer and a spunbond hydrophobic PP fabricouter layer. A typical N95 mask has the following combination of filtration layers: spunbond PP outer layer; cellulose/polyester second layer; melt-blown PP third layer;
spunbond PP inner layer. Unlike N95 and surgical masks,
there is no standardized method aiding in the choice ofmaterials, layering, or threads per inch (TPI) in assembling a cloth mask [24]. Ideally, a cloth mask should havea comfortable, absorbent inner layer; a woven or nonwoven middle layer that facilitates filtration (preferablyelectrostatic); and a hydrophobic outer layer that could
be aesthetically designed [8].
3.2 Types of face masks

Depending on the requirements, several face masks areavailable on the market. Pandit et al. [25] group theminto three main types: surgical face mask, respirators, andcloth masks. Surgical masks are typically loose-fitting
and disposable. They protect the wearer from splashesor large airborne particles coming into contact with
their mouth, nose, or respiratory tract. Most of the time,
healthcare workers and patients use these since they
are more likely to get sick. At the same time, respirators
enable their wearer to withstand harsh conditions andinhale a toxic or hazardous atmosphere (such as biological contaminants, gases, mist, dust, or an oxygen-deficient atmosphere). These close-fitting masks are further
categorized based on their type and usage. They generally exhibit an efficacy of 95–99% against the particulatematter of size ranging from 0.01–0.3 µm. The commonlyused N-series, R-series, and P-series masks fall under thesubcategory “disposable air-purifying respirators.” They
are predominantly helpful in multiple industrial settings.
Surgical masks and respirators are regulated using
regional standards and guidelines across the globe. Contrary to this, cloth masks do not conform to guidelines orstandards, making it hard to evaluate their efficacy. They
should be multi-layered (hydrophobic, electrostatic, andAjaj et al. Sustainable Environment Research(2023) 33:20

absorbent) to offer protection. During the COVID-19
pandemic, cloth mask sales went through the roof when
surgical and respirator masks were hard to find [26]. Furthermore, the need for cheap, affordable, and reusable
masks has increased. Figure 1 shows the classification ofvarious types of face masks.
3.3 Micro‑ and nano‑plastic pollution

The exponential increase in facemask usage foreshadows an impending plastic pollution crisis. During the
COVID-19 pandemic, the demand for plastic went up
by 370%, which can be directly linked to medical waste.
Simultaneously, the demand for plastic packaging went
up by 40% [27]. The current waste management system isdesigned to handle the average amount and type of medical waste. The pandemic, on the other hand, pushes thewaste management system past its limits [28]. Pathogens
in used face masks add to the difficulty of dealing with
waste, which is already complicated by the amount ofwaste being made. The uninformed disposal of facemasks
and PPE poses several environmental and health concerns. Studies have shown the presence of active SARSCoV-2 on plastic surfaces after three days [29], whereas,on the outer layer of surgical masks, it was present evenafter six days [30].
When facemasks are exposed to prolonged durations ofultraviolet radiation and visible light, along with fluctuating temperatures, the tensile strength of the PP mask fibers is reduced. This leads to the separation of individual
fibers and fragmentation. Eventually, brittle fracturing
produces micro- and nano-plastic fibers [10]. It could
take 450 years for these microfibres made of medicalgrade PP to break down in nature [31]. They can be easily mistaken for food by both land and aquatic animals

Fig. 1 Classification of facemasks

Page 4 of 19

due to their bright colors. Once eaten, it can’t be broken
down, causing the animal to die of starvation.
Another common problem is that the face mask wastes
wrap around the animal’s body, making it hard for it tobreathe [32]. Marine plastic, on the other hand, pulls
all toxins and other pollutants to its surface, where they
form a layer. This toxic film can poison marine animals,
rendering them weak and vulnerable. Selvaranjan et al.
[7] say that these toxins make it hard for them to reproduce slowing their growth and metabolism. Chemicals
like phthalate, nonylphenol, organotin, triclosan, andpolybrominated biphenyl ether are also released frommicroplastics when they break down chemically or biologically [33].
Multiple studies have been conducted to evaluate
microfibre release from facemasks, which provides abasis to estimate the extent of the resultant microplastic
pollution. The artificial withering experiments by Saliu
et al. [34] showed that up to 173,000 fibers ­d−1 could
be released from face masks submitted to 180 h of UV
irradiation and vigorous stirring in artificial seawater. Ina similar experiment, Chen et al. [35] shook both new
and used facemasks in deionized water for 24 h. Results
showed that new facemasks released fewer microfibres (183 ± 78 particles ­mask−1) than used facemasks(1246 ± 403 particles ­mask−1). A similar mechanical agitation study on different types of single-use facemasks by
Dissanayake et al. [27] showed that the highest microfibre
release was from surgical masks (202 fibers m­ ask−1). This−1
was followed by KF-94 (161 fibers m­ ask ) and FFP1 (160
fibers ­mask−1) masks. Others [36–42] also conductedsimilar studies. All noted-down results depict concerning levels of microplastic release from face masks. Finally,
Shen et al. [43] studied the impact of natural and induced
withering using detergent or alcohol solutions on

Ajaj et al. Sustainable Environment Research(2023) 33:20

facemasks. It was seen that the addition of detergents andalcoholic solutions sped up the degradation process andreleased a higher quantity of microfibres. Subsequently,
the broken fragments had a higher exposure area which
exponentially increased the release of microfibers.
Microplastics and nano plastics are a concern because
they can get through layers of biological barriers andstay in the body of an organism. These occurrences areconcerning as these microplastics can bioaccumulate
in the food chain through tropic transfer and eventually move up to higher organisms. Researchers are stilltrying to figure out the long-term effects of consuming
microplastics, but they have been seen to get into cells.
They accumulate in the bloodstream, brain, and placenta,
posing immunosuppression and psychological burdens[44]. A recent study by Amato-Lourenco et al. [45] foundthe presence of microplastics in human lungs, possibly
inhaled. A study by Cox et al. [46] estimates microplastic ingestion in the US population. In their study, which
evaluated 3600 processed samples representing approximately 15% of Americans’ calorific intake, the annual
microplastic ingestion is estimated between 39,000 and
52,000 particles. Inside the human body, these microplastics can break down and release toxic chemicals

Page 5 of 19

like organophosphate esters, which have been shownto interfere with the way the endocrine, nervous, andreproductive systems work [13]. They are also linked to adrop in the quality of sperm and cause asthma and allergies. Figure 2 provides a summary of the various publichealth impacts due to micro- and nano-plastic pollution
from discarded facemasks. Face masks are essential for
stopping the spread of COVID-19, but they are slowly
becoming a big problem regarding waste management
and the subsequent rise of micro- and nano-plastics. It
then becomes essential to analyze and improve the facemask life cycle to align with the circular economy andresource conservation principles.
3.4 Reuse, reduce & recycle

In situations like the COVID-19 pandemic, there is asudden rise in the demand for facemasks. This demandand other socioeconomic factors put much pressure
on the supply chain, which could cause a shortage andmake face masks more expensive in some markets [47].
Generally, reusing and recycling medical waste such as
syringes and PPE may not be preferred due to concerns
over secondary infections [48]. However, preserving life
takes precedence in trying times when there is physical,

Fig. 2 Various public health impacts due to micro- and nano-plastic pollution from discarded facemasks

Ajaj et al. Sustainable Environment Research(2023) 33:20

mental, and economic turmoil; as such, multiple studies
have been conducted to evaluate the feasibility of various
decontamination strategies and their effectiveness. There
are several tested and available methods for decontamination, such as heat treatment, chemical disinfection,
UV irradiation, microwaving, or washing with detergent.
In their paper, Ogbouji et al. [23] put together a detailed
table of research on decontamination strategies. Whilereusing face masks does provide significant environmental benefits, as discussed in the next section, exercising
caution while decontaminating face masks and adheringto the WHO guidelines is strictly recommended [49].
Even though face masks are unavoidable in times ofcrisis like the COVID-19 pandemic, it is essential to lookfor ways to make them less harmful. One approach could
be to extend the usable lifetime of facemasks so thatfewer facemasks are used up or to substitute sustainable
alternatives for facemasks’ raw materials. Several studies have looked into the possibility of new biomaterials
with similar properties that could be used instead of nonsustainable plastic-based raw materials [50]. A summaryof this research is provided in Table 1. Studies have also
explored materials that impart favorable characteristics
such as antiviral, antibacterial, self-cleaning, self-sanitizing, and superhydrophobicity. These make it easier to
use a face mask and could extend the usable lifetime of
facemasks [51]. A summary of this research is provided
in Table 2.

Page 6 of 19

The already strained plastic waste economy has been
put under much stress by the sudden increase in PPE
waste. The pandemic increased the number of single-use
plastic products, most of which have a useful life spanof hours or days [26]. Only a fraction of these masks iscollected back at the waste treatment facilities, while
the majority are just thrown away to end up in the soil
or water bodies. Hence, it is critical to investigate innovative end-of-life options for a used face mask to reduce its
impact and, if possible, establish a circular economy [83].
Studies have assessed the feasibility of using shredded mask fibers in concrete material. It was shown that
adding 0.2% [84] to 1% [85] improved the mechanical properties of concrete. Yu et al. [86] investigated thepossibility of recycling used face masks into a carbon
nanotube–nickel hybrid through catalytic conversion to
be used in microwave absorption. The study concluded
it was an environmentally friendly, scalable, and costeffective recycling strategy. Fabiani et al. [87] studied thepossibility of turning used face masks into panels that
could be used for building construction. The novel panels
were seen to have improved both thermal and acoustic
performances. Another study by Pulikkalparambil et al.
[88] recycled face masks as a matrix material to reinforce sisal and hemp fibers used in packaging materials.
The composites exhibited increased tensile strengths of
197 and 305%, respectively. Other creative ideas include
the French company Plaxtil, which turns used face masks

Table 1 A summary of existing and potential biomaterial applications in face masks
Type
Protein

Cellulose

Biomaterial

Application

Reference

Keratin/polyamide 6 nanofiber

Water & Air filtration[52]

Soy protein isolate/polyvinyl alcohol hybrid nanofiber

Air filtration mask

[53]

Gluten nanofiber

Face mask[54]

Electrospun Sericin nanofibrous matsAir filtration mask

[55]

Silk nanofibers

Air filtration mask

[56]

Nanomembrane lyocell fibrous

Surgical face mask

[57]

Fungal hyphae and cellulose fibers (Wood and Hemp)

To substitute synthetic melt
and spun-blown materials[58]

Cellulose acetate (CA) nanofibers

Air filtration mask

[59]

Cellulose non-woven layers

Surgical face mask

[60]

3-ply cotton-PLA-cotton layered

Face mask[61]

Non-woven cellulosic fiber

Face mask[62]

Banana stem fiber

Face mask[63]

3D printed and electrospun polylactic acidFace mask filter[64]

Poly(lactic acid) fibrous membranes

Air filtration mask

[65]

Polyhydroxyalkanoates (PHAs)

Nano fibroustructure

Face mask[66]

ChitosanChitosan nanowhiskers and poly(butylene succinate) -based
microfiber and nanofiber

Face mask filter[67]

Nanofibrous chitosan non-woven

Water & Air filtration[68]

Gelatin/β–cyclodextrin composite nanofiber

Respiratory filter[69]

Polylactic Acid (PLA)

GelatinAjaj et al. Sustainable Environment Research(2023) 33:20

Page 7 of 19

Table 2 Summary of possible face mask modifications to increase their usability
Characteristic Property

Material added

Reference

Antibacterial

Quaternary Ammonium[70]

N-halamines[71]

Metal nanoparticles (eg. Ag)[72]

Electrospun polylactic acid (PLA) membranes[65]

Extracts of Vitex tri- folia, Punica granatum, Allium sativum, Acacia nilotica, Andrographis[19]
paniculata, Sphaeranthus indicus, Strobilanthes cusia, Chromolaena odorata, Aloe barba- densis,
and Azadirachta indica

Antiviral

Self – cleaning,
Self – sanitizing,
Super-hydrophobicity

Graphene & Graphene oxides[73]

Mangosteen extract[74]

Metal & metal oxide nanoparticles (eg. Zn, Cu, Ag)[75]

Sodium chloride[76]

Poly(ethylenimine) (PEI)[77]

Poly-phenol[62]

Ginkgo extract with Sumac[78]

Iodine[79]

Graphene oxide[80]Graphene nanosheet embedded carbon[81]

Laser induced transfer of graphene[73]

Shellac & copper nanoparticles[82]

into plastic visors [89]. The study by Battegazzore et al.
[90] has shown that the mechanical recycling of used facemasks to form materials that are not subjected to shocks
or significant deformations, like furniture, is a cheap andstraightforward solution to managing face mask waste.
Even if the 3 R’s (reuse, reduce, and recycle) are given
the most attention, there has been much waste fromface masks already generated over the years. It is just as
essential to study and understand how to manage thiswaste while minimizing the impact on the environment.
The waste hierarchy places landfilling as the least favorable alternative [91]. Incineration remains the primary
option for eliminating medical waste contamination[48]. But it is also essential to think about how the different emissions from incineration affect the environment.
Zhao et al. [92] did an LCA study to compare the effectsof five medical waste disposal techniques. Results showthat medical waste disposed of after being sterilized in a
microwave is the best for the environment. Conversely,
when energy recovery is prioritized, rotary kiln incineration shows the best performance (38.2%), followed bypyrolysis (33%). After process optimization, these go up
to 63.6% and 55%. The conclusions from the study also
recommended the co-incineration of medical waste withmunicipal solid waste. Under an optimized situation, this
scenario showed > 83.4% energy recovery potential. Since
then, several studies [16, 93] have used the waste-toenergy route to turn face masks into power or fuel. Thermochemical conversion of facemasks using incineration,

pyrolysis, and gasification all show good energy recovery
potential.

4 LCA of protective facemasks
A literature review was conducted according to the steps
mentioned in the methodology. Table 3 provides a summary of all the literature collected as part of this review.
4.1 Trends in literature

All the LCA studies were undertaken within the last
three years, starting with Schmutz et al. [94]. This is likely
because of the pandemic and the subsequent realizationof an environmental impact crisis, which caused more
PPE and facemasks to enter the economy. All eighteen
studies primarily evaluated some form of disposable
single-use surgical or medical masks. In most cases, thiswas compared to the effects of a reusable mask. Thirteen
studies looked at the effects of cloth facemask, whether
hand-made or bought from a store, but only six looked at
the effects of N95 facemask. Other facemasks being evaluated were embedded filtration layer reusable facemask,
3D printed masks with valves, FFP3 masks, and rigid halfmasks. Even though these are all common types of masks,
some commercially available ones, like activated carbon
facemask and polylactic acid facemask, still need to belooked at. Most studies utilized dedicated LCA software
such as SimaPro, GaBi, or OpenLCA. The exceptions of
Schmutz et al. [94] and Bouchet et al. [95] utilized MS
Excel, but their studies were justified as simplified LCA

ExcelSwitzerland

UK

Europe

Italy

Italy

2020 [94]2021 [21]2021 [95]2021 [96]2021 [97]

OpenLCA

SimaPro

Excel

GaBi

SoftwareYear Article Country/
RegionCradle to grave

Cradle to grave

Cradle to grave

Cradle to grave

Cradle to grave

Surgical & reusable

Cloth, Surgical, & FFP2
with & without valves

Disposable single-use,
Cloth & Reusable

Single use & reusablecottonSurgical & 2-layered
cottonType of LCA study Types of face masks

Table 3 Summary of LCA studies evaluating face masks

1 maskFacemask usedin 306 days

Facemask required by 1
person in 1 month

1 yr of facemask use
by UK population

1 person wearing facemask for 1 week

Functional Unit

IPCC-GWP100, CML
baseline

IPCC 2013, GWP 100a,
ReCiPe 2016, IMPACT
2002 +UBP

Environmental Footprint
3.0

IPCC, VDI definition,
AWARE

Method of LCA

0.327

5.36E + 07–1.96E + 8

0.4–1.3

1.47E + 09

0.23–0.24

GWP for Functional
Unit (in kg of ­CO2)• Major hotspot
was the textile production
for facemask• Disposable masks provide
better protection• Cloth masks have 3.39
times lower impact, 85%less wastage and 3.7
times cheaper• Most favourable scenario
is a homemade cotton
mask• Importing disposable masks by plane
was the most impactful
scenario• GWP reduction of 50–90%
can be achieved by switching from single-use
to reusable facemask• Reusing medical maskswith a ‘wait and reuse’strategy is most appropriate as it balances
between protection
achieved and environmental impact• Use of 4 facemasks
in rotation without filters
and machine washed had
the lowest impact• Hot spot analysis showedthat import of facemasks
from China was the major
impact category• Both masks had highimpacts in dependingon the impact category
considered• User behavior determines
the environmental impactof facemask• The production phase
is a hotspot

Main Conclusions

Ajaj et al. Sustainable Environment Research(2023) 33:20
Page 8 of 19

-Singapore

Italy

Netherlands SimaPro 9.1

China

India

Indonesia-

2021 [98]2021 [99]2021 [100]2021 [101]2021 [102]2022 [103]2022 [104]

Cradle to grave

SimaPro 9.2

OpenLCAOpenLCA

SimaPro 9.0

Cradle to grave

Cradle to gate

Cradle to grave

Cradle to grave

Cradle to grave

Single use surgical

Disposable single use

Cotton & Surgical

Combined impact
from surgical and N95

Single use & reusable

3D printed with changeable valve, surgical, FFP2
with and without valves& washable

Surgical & Embedded
filtration layer reusable

Type of LCA study Types of face masks

SimaPro v9.0 Cradle to grave

SoftwareYear Article Country/
RegionTable 3 (continued)

1 single use surgicalfacemask

30 (12-h) days / 30 single
use facemask-

Sum of surgical and N95
facemask producedby China in 2020

1 facemask each used
2-h for 100 health care
workers

Facemask used by Italian
citizen in a month

31 (12-h) days

Functional Unit

ReCiPeReCiPeCML IA baseline, ILCD
2011 Midpoint +IMPACT 2002 + , EDIP
2003

ReCiPeReCiPe, Cumulative
Energy Demand

ReCiPeMethod of LCA

3.49E-02

1.82593

1.92E-2–4.89E-2

2.13E + 09

2.77–6.55

1.5E + 06–5.6E + 07

0.038–0.58

GWP for Functional
Unit (in kg of ­CO2)• Material supply and transport was major impact
hotspot• Sustainable end of life
options have to be developed other than incineration and landfilling• Biodegradable materials
like PLA has to be considered as substitutes• Production line contributed to more than 50%
of emissions• New ear-loop designis proposed to reduce
emissions• Surgical facemask
has higher impact
than cotton facemask• Substituting mask 10 –100% of mask material
with bio alternatives canresult in 4 – 43% reductionof environmental impacts• PP used in production
was the major contributor
to many impact category• 58% lower carbon footprint for masks reused 5
times compared to single
use facemasks• 3D printed and washable
masks were most sustainable• Highest impact in all
category was for FFP2
mask with valve followed
by FFP2 mask without valve• Upstream production
phase was a hotspot• EFL reusable masks
has 30% lesser wastage
and impacts

Main Conclusions

Ajaj et al. Sustainable Environment Research(2023) 33:20
Page 9 of 19

SimaPro

BrazilItaly

TurkeyUK2022 [105]2022 [106]2022 [107]2022 [108]Cradle to grave

GaBi

GaBi v10.5

Cradle to grave

Cradle to grave

Surgical, Cloth, FFP3 &Rigid half mask

Single use

Single use & Type IIR
reusableSingle use & handmade
cottonType of LCA study Types of face masks

SimaPro v8.2 Cradle to grave

SoftwareYear Article Country/
RegionTable 3 (continued)

1 year of mask use
by health care professional

1 3-layer single use facemask with nose wire

Total number of facemask used by Italian
population in 2020

90 h (1 reusable cotton
mask or 30 single use
masks)

Functional Unit

Environmental Footprint
3.0

CML 2001

ReCiPeReCiPe 2016, IMPACT
world +

Method of LCA• Handmade cotton masks
perform better environmentally than single use
facemask• 60% of impacts werefrom manufacturing phasefor single use facemask• After a single use the final
disposal of cotton maskspose 5 times impact compared to single use masks.
However with each reuse
this value is compensatedand finally after the recommended maximum
reuse of 30 uses, single use
masks have 6 times higher
impact compared to reusable facemask

Main Conclusions

1.7–120

0.02E-02• Reusable alternatives generate 80–90%
less waste than single use
facemask• Reusable alternatives
possess 3–11 times lower
climate change impacts• Sourcing masks locally(purchasing from Turkey)
or manufacturing in UK
itself had less environmental impact• Raw material supply(40.5%) and packaging(30%) were hotspots
for GWP

1.47E + 08–9.04E + 08 • Reusable facemask showed
less impacts for 14/18
impact categories• The ‘use phase’ for reusable masks, comprisingof energy and washingrequirements made 1/3of the total impacts• Incineration of facemask
always had a higher
environmental impact
than landfilling

6.05E-01–3.76E + 00

GWP for Functional
Unit (in kg of ­CO2)

Ajaj et al. Sustainable Environment Research(2023) 33:20
Page 10 of 19

SimaPro 9.2

UK

China

2022 [20]2023 [109]Cradle to grave

Cradle to grave

1 year of mask usedby a person

Functional Unit

Reusable cotton, Dispos- Facemask used by 100
able medical, Disposable individuals over one
surgical & KN95 respirator monthSingle-use, EFL reusable& Reusable wool mask

Type of LCA study Types of face masks-

GWP for Functional
Unit (in kg of ­CO2)

Carbon footprint calcula- 1.29E3
tion model

Environmental Footprint
3.0

Method of LCA• Cotton facemask will
break even and become
an environmentally friendly
alternative after 17 washes• In low-risk settings,
reusable cotton facemask
and disposable facemask
are better options• In high-risk settings, surgical facemask and KN95
respirators are better• Reusable woollen
facemask had 46% lower
environmental impacts• The annual expenses
of using woollen facemask
is expected to be 54%
lower than conventional
PP facemask

Main Conclusions

IPCC International Panel on Climate Change, VDI definition Verein Deutscher Ingenieure/Association of German Engineers, AWARE Available Water Remaining, UBP Umweltbelastungspunkte/Environmental Impact Points,
EDIP Environmental Design of Industrial Product programme, ILCD International Reference Life Cycle Data System-

SoftwareYear Article Country/
RegionTable 3 (continued)

Ajaj et al. Sustainable Environment Research(2023) 33:20
Page 11 of 19

Ajaj et al. Sustainable Environment Research(2023) 33:20

evaluations or preliminary studies. Another exception is
Luo et al. [109], who did not specify the use of any software. The carbon footprint calculation and evaluation
model from ISO 14067:2018 was used in their study.
4.2 Functional unit and system boundary

In an LCA study, the functional unit is the necessary
product or process within the system to which all other
input and output flows are scaled. The idea behind theuse of functional units is to represent the performance
characteristic of the system, and they are chosen on acase-by-case basis that is specific to each study (e.g., producing x amount of product or consuming y amount of
product in y amount of time). When comparing the life
cycle of multiple products, it is essential to make surethat all of the product’s life cycle characteristics are taken
into account without any bias. This is more useful whencomparing a single-use product to one that can be used
repeatedly. This is why a time frame is chosen instead ofa specific number as the functional unit, like the numberof face masks used in a year, month, or week. This enables, the LCA practitioner to account for the use phase of
reusable facemask and the potential savings from its life
cycle. From the literature, the functional unit was mostly
specified as a time frame. The exceptions are Giungato
et al. [97] who compared the impacts of one single surgical facemask to a single reusable facemask, and Barbanera et al. [104] and Atilgan Turkmen [107] who studied
the impact of a single surgical facemask.
The system boundary defines the limits of various input
and output flows to be considered as part of the study.
This is often shown as a diagram in the section of thestudy called “Goals and Scope.” In the current list of studies, almost everyone followed a cradle-to-grave systemboundary, except for Alfarisi et al. [103]. Even when all
studies use a cradle-to-grave system boundary, it is hard
to compare them as there is a vast disparity in the life
cycle inventory due to assumptions and data gaps. While
the results of the LCA study are still valid, these differences stand in the way of an adequate comparison. It is in
the best interest of interested parties like LCA practitioners, manufacturers, policymakers, and consumers that
the LCA studies evaluate similar or the same productwith comparable functional units and system boundaries.
This allows for easy translation of the results and avoids
speculation.
4.3 Life cycle inventory

Data quality in an LCA is essential, as it determines
the accuracy of the obtained results. Considering thatmany policy reformations and supply chain optimizations could be done based on the results, it becomes
imperative that due diligence be practiced during thePage 12 of 19

data collection and validation steps. During an LCA
study, two main types of data are collected: foregrounddata, which is collected directly from the source orindustry through surveys or direct communication, andbackground data, which comes from databases in LCA
software or from existing literature. But collecting background data can be challenging if you do not have theright connections in the industry. It can also be hard if
you need more time or money. This leads to data gaps inthe life cycle inventory, which are then substituted withbackground data, or valid assumptions for simplification.
In the current list of studies, most of them use a combination of primary and background data. The primarydata included things like the mass of the facemasks, while
the background data was mainly used to fill in gaps about
energy use and manufacturing. The 2021 study by Allison
et al. [21] had one of the complete life cycle inventories,
with good explanations of assumptions and correct citations of data sources. This is probably why studies by Do
Thi et al. [96] and Luo et al. [109] used their inventory
as a background data source. Studies by van Straten et al.
[100], Morone et al. [106], and Atilgan Turkmen [107]were able to gather and use industry data. Lee et al. [98]were able to gather information from the researchers at
the Singapore Institute of Manufacturing Technology. In
the case of Alfarisi et al. [103], it was seen that the collected primary data were all grouped together and not
differentiated by different life cycle stages (raw material
production, assembly, packaging, etc.). Transportation
was not considered in any of the studies by Schmutz et al.
[94], Do Thi et al. [96], and Boix Rodriguez et al. [99].
The packaging has a significant impact on the life cycleof face masks. However, only ten out of eighteen studies considered the impacts due to packaging. All of theabove-mentioned data gaps and the subsequent assumptions being made can skew the results. This also voids any
direct comparisons between the results of different LCA
studies.
4.4 Decontamination strategies

An essential part of the face mask’s life cycle is the usephase and how it is decontaminated after each use. Thissection briefly explains the various decontamination
strategies in literature and their environmental performance. Other than the 18 LCA studies on face masks,
information from other LCA studies and sources wasadded to this section to make it more complete.
Thermal treatment is considered the primary choice
for mask decontamination as the heating equipment isreadily available. Ogbouji et al. [23] looked at the effectsof heat treatment on N95, surgical masks, FFPs, KN95,
and KP94. The studies were modeled to include a multitude of aerosols such as SARS-CoV-2, Staphylococcus

Ajaj et al. Sustainable Environment Research(2023) 33:20

aureus, Escherichia coli, Human Adenovirus Type 2,
Tulane virus, etc. Results show that the filtration performance was retained at the optimal level for several
decontamination cycles (~ 10). Heating blocks, steamer
cookers, water baths, steam, drying ovens, and autoclaving were all used as heat sources. All cases showedsignificant inactivation of microbial activity. Soares
et al. [110] conducted an LCA on healthcare waste
management. They discovered that autoclaving had amore significant impact on climate change (48 parts per
thousand) and was more expensive (US$ 1.1 ­kg−1) than
microwaving and lime disinfection. The hotspot was
identified as the electricity requirement for operating
the equipment. In their study, van Straten et al. [100]saw similar trends and found that the energy needed
for steam sterilization was a hotspot. Also, Allison et al.
[21] showed that the heating required to prepare thewater bath was a hot spot in disinfecting cloth masks.
Chemical disinfection is a standard method of choice
for sterilizing various materials. Hence the potential ofcertain alcohols and peroxides to decontaminate facemasks was also tested [23]. Studies have been modeled using E. coli, Bacillus subtilis, SARS-CoV-2, Porcine respiratory coronavirus, etc., as aerosol on surgicalmasks, N95, KN95, and FFP. While the results show
microbial inactivation, the filtration performance wassignificantly reduced. The chemical treatment also
impacted the mask morphology and surface potentials. This is a significant drawback in the utilization ofchemical disinfection. Chemical disinfection affects theenvironment and the economy less than other methods, primarily because it uses less energy. The hotspot
in chemical disinfection would be the chemical production process [111].
UV irradiation, short-wave UV light, has been used tokill microorganisms [23]. It works by stopping the organism’s DNA from copying itself. However, UV light can
only kill microorganisms when exposed to it. Multiple
studies were modeled with E. coli, B. subtilis, S. aureus,
Porcine respiratory coronavirus, etc., as aerosol on surgical masks, N95, KN95, and FFP. The results of UV irradiation show that microbial activity is greatly reduced
while filtration performance stays the same.
Microwaving is another promising non-chemical
method of choice in face mask decontamination, as it canbe potentially done at home. Studies were modeled using
E. coli, B. subtilis, and NaCl as aerosols for surgical masks,
N95, KN95, and FFP [23]. A reduction in microbial activity is observed while filtration performance is retained.
However, microwaving does affect the mask morphology
over long periods, and in some cases, it melts the filter
layer and makes holes visible. Soares et al. [110] showedthat microwaving had a lower environmental impact (12Page 13 of 19

points) and cost less (US$ 0.12 ­kg−1) in waste treatment
when compared to autoclaving.
Detergent laundering is not a preferred decontamination method for surgical or respiratory masks. Ogbouji
et al. [23] found that using laundry detergent to clean
surgical masks, N95, and KN95 did not reduce microbial activity and decreased filtration performanceafter the first cycle. Yet this is still a practical methodof disinfection for cloth masks at the household level.
However, studies have identified the detergent manufacturing process as a hotspot that closely follows waterrequirements [106].
4.5 Significant observations

All studies show that single-use face masks have ahigher carbon footprint and harm the environment thanreusable face masks. It was observed that a 50%–90%
reduction in GWP in kg C
­ O2 eq could be achieved byswitching from a single-use face mask to a reusable facemask [95]. The major contributors were the impacts due
to raw material acquisition and production lines. Maceno
et al. [105] showed that the impacts of using single-use
masks disposed of in landfills were five times higher thanthose of reusable mask that is landfilled. The impact is
ten times higher if the reusable mask is recycled. Anothermotivation to consider reusable face masks would be thematerial flow analysis study by Allison et al. [21], whichshowed that the annual waste accumulation of singleuse face masks in the UK amounts to 124 kt. This can be
reduced by > 50% if reusable masks with single-use filters
are used and reduced to > 85% if reusable masks are used.
However, the actual benefits of using reusable facemasks heavily depend on user behaviour [94]. For example, Maceno et al. [105] found that the total environmental impact of reusable face masks is five times higher thanthat of face masks that are used once. This is mainly fromthe cotton used in the fabric materials that require large
amounts of water, fertilizer, and pesticides to grow [21].
But each time the face mask is used again, the net impact
is reduced. After the recommended 30 uses, a reusable
face mask will have six times less impact on the environment than a single-use face mask [105]. Similarly, anothercritical user behavior is the preferred means of washingor disinfection. Two readily available options are handwashing with or without detergent and machine washing. The increased water consumption and use of detergents make hand washing unsustainable. Studies show a
50–66% reduction in GWP impacts when machine washing is preferred [21, 98]. The benefits of washing clothes
in a machine again depend on how often and how muchyou wash since that decides the water and energy consumption. Thirdly, the user’s perception and understanding of masking also influence the environmental benefits.

Ajaj et al. Sustainable Environment Research(2023) 33:20

Suppose they dispose of a reusable mask after a few uses,
much fewer than the recommended number of uses, or
openly dispose of the mask without complying with any
disposal guidelines. In that case, it may offset the potential environmental benefits. Among commercially available face masks, studies show that a single-use FFP2 maskwith an exhalation valve had the highest environmental
impact over its life cycle. Simultaneously, 3D-printed
masks with FFP2 filters had the highest GWP impact
considering the production phase; however, this was offset with each reuse [99].
Studies have looked at how the design of masks, thesupply chain, and possible ways to sterilize them could
be changed to make them less harmful to the environment. Even so, only a tiny number of LCA studies havelooked at how their proposal affects the environment. A
modified ear loop design has been proposed by Alfarisi
et al. [103], which lowers the fraction of polyurethane
raw material to 20% and combines the ear loop bonding
and nose clip loading process. This modification resulted
in an 8–34% reduction in environmental impacts for 7
out of 8 impact categories. Further, a GWP reduction of
25% can be achieved by substituting plastic packaging
with cardboard boxes [107]. This is due to the low energy
and material consumption in processing paper boxes. van
Straten et al. [100] looked at 88 different brands of FFP2
masks and how well they worked after steam sterilization.
They found that the reprocessed masks retained their filtration capacity and structural integrity, and fit for up to
five cycles. New FFP2 masks had 58% more impact than
reprocessed FFP2 masks sterilized with steam. While
the sterilization process has a significant share in total
impact contributions, it substantially reduces the impact
contributions due to the production phase by 73%, transportation by 63%, and end-of-life by 62%.
Sensitivity analysis by Lee et al. [98] showed that theclimate change impacts and waste generation from single-use face masks were highly sensitive to the quantityof spun-bond PP material used. In the case of reusable
face masks, climate change impacts were highly sensitive
to a reduction in emissions from the detergent manufacturing process (modification in its supply chain), andwaste generation was susceptible to the quantity of polyester material used.
Finally, landfilling has a lower environmental impact
than other end-of-life scenarios, but it needs to be moresustainable. Lee et al. [98] conducted a scenario analysis,comparing a base case against hypothetical situations.
Their results show that direct landfilling of single-use
face masks offered an 8% reduction in climate change
impacts compared to incineration followed by landfilling.
However, it exponentially increased waste generation by
3885%.

Page 14 of 19

Environmental impacts can be reduced further by offsetting negative impacts through value addition, even at
the end-of-life stage. For example, when the masks areburned to make electricity, the total impact on freshwater
eutrophication from the rest of the mask’s life cycle is lessthan what the electricity production makes up for [98].
Hence, there was a net positive impact in this particularscenario.
4.6 Hotspot identification

All the research that was reviewed showed that the mostimpactful part of manufacturing single-use face masks is
the production phase, which includes sourcing the raw
materials, processing, and energy requirement. On finer
inspection, it can be seen that PP accounts for almost
33–90% of significant mid-point impact categories, followed by aluminum in nose clips with 42–95% in different mid-point impact categories [101]. In the case of bothmaterials, the major impacts are from the raw material
production process. The same study showed that PP was
the single most damaging element in the face mask life
cycle, with a 47% impact on human health, a 50% impact
on climate change, and a 76% impact on resource depletion. Hence, it becomes imperative to explore the potential for reducing the quantity of raw materials or othersustainable alternatives with a lower carbon footprint.
Transportation was also a big problem, especially whenlong-distance exporting is involved in sourcing the facemasks or their raw materials. Even though transportation impacts are applicable for both single-use and reusable face masks, they are more amplified in the case of
single-use facemasks due to the exponentially higher
numbers [21]. Transportation impacts are also the resultof a skewed supply chain system, which is prioritizing
cost savings over environmental savings. Facemasks asa whole or its individual components may be mass-produced in some place like China where it is available fora fraction of the cost. This promotes manufacturers tojust import the materials in bulk even when the importprocess adds to the environmental impacts. In suchcases, supply chain optimizations have to be undertakensuch that a middle ground is reached between cost andenvironmental savings. In the studies where end-of-lifescenarios were considered, it had a significant impact
closely following the manufacturing and transportation
phases [97, 99, 104, 107]. Barbanera et al. [104] foundthat marine eutrophication and GWP were the two maintypes of end-of-life effects.
In the case of reusable face masks, the hotspots were
found to be the cotton fabrics and the use phase. Cotton
has heavy water requirements during its cultivation andcommercial production. It also involves using pesticides
and fertilizers, increasing environmental impacts [112].

Ajaj et al. Sustainable Environment Research(2023) 33:20

Page 15 of 19

The usage phase becomes a hotspot due to the waterand detergent used to wash face masks. In cases where
hot water is used, 70% of the climate change impacts arefrom the heating required for the tap water [21]. When asteam sterilization process was thought of, the sterilization process became the process hotspot [100].

was designed. Most of the current studies are for Italy,
followed by the UK as shown in Fig. 3. Given the importance of the topic under consideration, there are very few
LCA studies, which is not enough to reflect and assess
the global situation.

4.7 Geographical distribution of selected regions

As for the future direction in this field, three major areas
could be developed further. This includes increased
knowledge sharing, focused research on sustainable materials and designs, and policy changes. This is
explained in depth as follows:

Two possible limitations of an LCA study are the geographical scope and time frame of the study. This isbecause the primary data collected will be specific tothat process and region, and the background data fromdatabases would have been modified to suit the requirement. For example, China is a leading producer andglobal exporter of facemasks, an LCA study for facemasks in China might find the facemask material of the
production process to be a hotspot. Whereas some countries importing facemasks from China using air cargomight find long-distance air transport as the hotspot.
Simultaneously, in LCA software like SimaPro there isan option to input country/region-specific data for electricity mix, fuel mix, and processes, which is being usedin most studies. In each of these instances, any processoptimization or recommendations made will mostly be
specific to that case in that region and may not be valid
when extrapolated. This can be seen from the studies by[21, 95] who found long-distance transportation from
China to be the major hotspot, whereas other studies had
other process hotspots. In the literature review, of the
18 studies, 17 mentioned a region where the LCA study

Fig. 3 Pictorial representation of locations selected for existing LCA studies

4.8 Future recommendations• From inspecting the datasets used in existing LCA
studies, it can be seen that quite a lot of data are
based on assumptions rather than solid industrial
information. This creates discrepancies in the life
cycle inventory calculations. As discussed earlier,the assumptions made include oversimplifying somedata or neglecting some important impact sources(transportation, packaging, certain manufacturing
processes, etc.). This means that the direct comparison of an LCA that accounted for transportationor packaging and one that did not consider thesesources would be impractical. There must be more
open data sharing among the researchers and theirindustry counterparts, such that more accurate data
is available for the studies. This will be reflected as
valuable results that reflect real-time problems andtheir solutions.

Ajaj et al. Sustainable Environment Research(2023) 33:20• Based on the hotspot analyses from existing LCA
studies, it can be inferred that it is important tofocus research on alternative sustainable raw materials (ideally, locally sourced), reducing transportation
impacts, increasing the usable lifetime of facemasks,
and sustainable collection and disposal methods.
• The potential benefits of partially/entirely substituting virgin mask materials with recycled or bio-basedmaterials must be evaluated further. Tabatabaei et al.
[101] already showed that substituting 10–100% ofmask material with bio alternatives can result in a
4–43% reduction in environmental impacts.
• Analytic Hierarchy Process (AHP) techniques canhelp select a suitable mask material. It is generally
used in a complex environment to select the bestalternative when numerous variables are involved.
Hartanto et al. [113] used AHP to show that quilt andcotton 600 TPI were the best options for non-medical face masks, offering good breathability and filtration efficiency and having the lowest impact among
26 other materials. However, it is yet to be adopted
in the industry. Similar studies can be conducted forselecting a sustainable medical facemask material
and design.
• Adopting design for environment principles in facemask manufacturing. This includes designing facemasks to consume fewer raw materials while retaining their functionality can significantly benefit theenvironment. Simultaneously, metal–organic framework such as Zeolitic imidazolate framework-8 [114]and nanofiber membranes, are potential materials
that can be integrated into the mask design. This has
been shown to improve the functionality of facemasks. Also, the potential of 3D printing utilizing
sustainable materials could be explored further [64].
• From the existing studies, it can be seen that only a
few evaluated the impacts due to facemask packaging materials. Often times there may be up to four orfive layers of packaging, the requirement of which isquestionable. As such, sustainable packaging solutions involving recycled materials (like paper) canbe evaluated. At the same time, future LCA studies
should explicitly evaluate the environmental impacts
due to packaging.
• Sustainable waste management and value-addition
strategies for used facemasks should be explored. The
co-incineration of facemasks and PPE waste could be
adopted at the municipal level as it shows the highest
energy recovery potential. However, more sustainable options should be studied in the long term. Valorization techniques such as pyrolysis, carbonization,
catalytic deformation, or high-solid anaerobic defor-

Page 16 of 19

mation could be utilized to produce building materials, fuel-range hydrocarbons, value-added aromatics,
soil stabilizers, cathodes, adsorbent dye carriers, oranode electrodes [84, 115, 116].
• As the environmental benefits of a reusable maskheavily depend on user behavior, it is important to
conduct awareness campaigns and provide clear
guidance on mask usage to the public.
• Support and invest in research relating to bio-plastic
and alternative materials that can replace conventional mask materials. Also, subsidizing bio-plastics
in the medical industry through tax incentives or
grants could provide extra motivation.

5 Conclusions
Because of the COVID-19 pandemic, there was moredemand for PPE like facemasks, which hurt the environment. While there are proper regulatory guidelines
relating to the standards and specifications of all medical facemasks, there must be more guidelines on how
facemask waste should be managed. This could involve
consumer awareness campaigns, revamping waste management infrastructure, or legislative intervention. This
paper evaluated the studies involved in the LCA of facemasks. All LCA studies show that a reusable face mask
is better than a one-time-use face mask. The major process hotspots were the raw material acquisition andmanufacturing processes. In cases where international
import–export was involved, transportation was a crucial
hotspot.
Furthermore, the usage phase of reusable face masks
had significant environmental impacts due to the highwater and energy requirements for disinfecting the facemasks. However, several socioeconomic factors suchas facemasks’ availability, cost, and personal preferences, influence the wearer’s choice in selecting a facemask. Despite the obvious, the environmental impactof face masks is ultimately a function of user behavior. Even though reusable cotton masks are better forthe environment, they cannot protect you as well as
surgical face masks or respirators. At times like the
COVID-19 pandemic user discretion is highly advised
in selecting a suitable facemask for themselves. Thisshows how important it is to do more focused researchon waste management and alternative materials likepolylactic acid that are biodegradable. It is also crucial
to ensure that the biodegradability of such alternative
face masks is widely applicable across existing end-oflife options and not under a constrained environment.
Literature references have been used to suggest researchand policymaking in this field.

Ajaj et al. Sustainable Environment Research(2023) 33:20

Even though the topic was significant, there were only
18 LCA studies for the selected regions. More researchis needed worldwide to understand better how facemasks work in different places and to help make policy.
This paper will likely motivate future research in such animportant field.

Page 17 of 19

13.

14.

Acknowledgements
Not applicable.

15.

Authors’ contributions
Conceptualization, R.A., R.A.D., and S.A.S.A.; methodology, R.A., and S.A.S.A.,
investigation, R.A., S.A.S.A., data curation, R.A., S.A.S.A.; writing—original draft
preparation, R.A., S.A.S.A.; writing—review and editing, R.A., R.A.D., and M.H.S.;
supervision, R.A.; project administration, R.A., R.A.D., and M.H.S.; funding
acquisition, R.A., R.A.D., and M.H.S. All authors have read and agreed to the
published version of the manuscript.

16.

Funding
This research was funded by Abu Dhabi University, grant number 19300646,
and The APC was funded by 19300646.
Availability of data and materials
Data sharing is not applicable to this article as no datasets were generated oranalysed during the current study.

17.
18.
19.
20.
21.

Declarations
Competing interests
The authors declare they have no competing interests.
Received: 23 March 2023 Accepted: 27 June 2023

22.
23.
24.

References
1. Pitlik SD. COVID-19 Compared to other pandemic diseases. Rambam
Maimonides Med J. 2020;11:e0027.
2. WHO. WHO Coronavirus (COVID-19) Dashboard. Geneva: World HealthOrganization. https://​covid​19.​who.​int/. Accessed 19 Jun 2023.
3. Najmi A, Nazari S, Safarighouzhdi F, MacIntyre CR, Miller EJ, Rashidi TH.
Facemask and social distancing, pillars of opening up economies. Plosone. 2021;16:e0249677.
4. WHO. Shortage of personal protective equipment endangering healthworkers worldwide. Geneva: World Health Organization; 2020.
5. Fadare OO, Okoffo ED. Covid-19 face masks: A potential source of microplastic fibers in the environment. Sci Total Environ. 2020;737:140279.
6. XinhuaNet. China’s daily mask output exceeds 110 million units. Beijing:
Xinhua News Agency; 2020
7. Selvaranjan K, Navaratnam S, Rajeev P, Ravintherakumaran N. Environmental challenges induced by extensive use of face masks during
COVID-19: A review and potential solutions. Environmental Challenges.
2021;3:100039
8. Rahman MZ, Hoque ME, Alam MR, Rouf MA, Khan SI, Xu H, et al. Facemasks to combat coronavirus (COVID-19)–processing, roles, requirements, efficacy, risk and sustainability. Polymers. 2022;14:1296.
9. Knicker H, Velasco-Molina M. Biodegradability of disposable surgicalface masks littered into soil systems during the COVID 19 pandemic–a
first approach using microcosms. Soil Syst. 2022;6:39.
10. Spennemann DHR. COVID-19 Face masks as a long-term source of
microplastics in recycled urban green waste. Sustainability. 2022;14:207.
11. Hasan NA, Heal RD, Bashar A, Haque MM. Face masks: protecting thewearer but neglecting the aquatic environment? - A perspective from
Bangladesh. Environmental Challenges. 2021;4:100126.
12. Thiel M, de Veer D, Espinoza-Fuenzalida NL, Espinoza C, Gallardo C,
Hinojosa IA, et al. COVID lessons from the global south – Face masks

25.
26.
27.
28.
29.
30.

31.
32.
33.
34.
35.

invading tourist beaches and recommendations for the outdoor seasons. Sci Total Environ. 2021;786:147486.
Kutralam-Muniasamy G, Perez-Guevara F, Shruti VC. A critical synthesisof current peer-reviewed literature on the environmental and humanhealth impacts of COVID-19 PPE litter: New findings and next steps. J
Hazard Mater. 2022;422:126945.
Akber Abbasi S, Khalil AB, Arslan M. Extensive use of face masks during
COVID-19 pandemic: (micro-)plastic pollution and potential healthconcerns in the Arabian Peninsula. Saudi J Biol Sci. 2020;27:3181–6.
Chowdhury H, Chowdhury T, Sait SM. Estimating marine plastic pollution from COVID-19 face masks in coastal regions. Mar Pollut Bull.
2021;168:112419.
Cudjoe D, Wang H, zhu B. Thermochemical treatment of daily COVID-19
single-use facemask waste: Power generation potential and environmental impact analysis. Energy. 2022;249:123707.
Prata JC, Silva ALP, Duarte AC, Rocha-Santos T. Disposable over reusable
face masks: public safety or environmental disaster? Environments.
2021;8:31.
Klopffer W. Life cycle assessment: From the beginning to the current
state. Environmental science and pollution research international.
1997;4:223–8.
Pullangott G, Kannan U, Gayathri S, Kiran DV, Maliyekkal SM. A comprehensive review on antimicrobial face masks: an emerging weapon infighting pandemics. RSC Adv. 2021;11:6544–76.
Angelis-Dimakis A, Whitehouse A, Vyrkou A, Hebden A, Rana S, Goswami P. Life cycle environmental impact and economic assessment ofBritish Wool face masks. Cleaner Environ Syst. 2022;6:100084.
Allison AL, Ambrose-Dempster E, Bawn M, Arredondo MC, Chau C,
Chandler K, et al. The impact and effectiveness of the general public
wearing masks to reduce the spread of pandemics in the UK: a multidisciplinary comparison of single-use masks versus reusable face masks.
UCL Open Environ. 2021;3:e022.
Tebyetekerwa M, Xu Z, Yang S, Ramakrishna S. Electrospun nanofibersbased face masks. Adv Fiber Mater. 2020;2:161–6.
Ogbuoji EA, Zaky AM, Escobar IC. Advanced research and developmentof face masks and respirators pre and post the coronavirus disease 2019
(COVID-19) pandemic: a critical review. Polymers. 2021;13:1998.
Ju JTJ, Boisvert LN, Zuo YY. Face masks against COVID-19: Standards,
efficacy, testing and decontamination methods. Adv Colloid Interfac.
2021;292:102435.
Pandit P, Maity S, Singha K, Annu, Uzun M, Shekh M, et al. Potential
biodegradable face mask to counter environmental impact of Covid-19.
Cleaner Eng Technol. 2021;4:100218.
OECD. The face mask global value chain in the COVID-19 outbreak:evidence and policy lessons. Paris: Organisation for Economic Cooperation and Development; 2020.
Dissanayake J, Torres-Quiroz C, Mahato J, Park J. Facemasks: a looming
microplastic crisis. Int J Environ Res Public Health. 2021;18:7068.
Dharmaraj S, Ashokkumar V, Hariharan S, Manibharathi A, Show PL,
Chong CT, et al. The COVID-19 pandemic face mask waste: A blooming
threat to the marine environment. Chemosphere. 2021;272:129601.
Prata JC, Silva ALP, Walker TR, Duarte AC, Rocha-Santos T. COVID-19 pandemic repercussions on the use and management of plastics. Environ
Sci Technol. 2020;54:7760–5.
Vanapalli KR, Sharma HB, Ranjan VP, Samal B, Bhattacharya J, Dubey
BK, et al. Challenges and strategies for effective plastic waste management during and post COVID-19 pandemic. Sci Total Environ.
2021;750:141514.
Rathinamoorthy R, Raja Balasaraswathi S. Impact of coronavirus
pandemic litters on microfiber pollution-effect of personal protective
equipment and disposable face masks. Int J Environ Sci Technol. 2022.
de Sousa FDB. Pros and cons of plastic during the COVID-19 pandemic.
Recycling. 2020;5:27.
Aragaw TA. Surgical face masks as a potential source for microplastic
pollution in the COVID-19 scenario. Mar Pollut Bull. 2020;159:111517.
Saliu F, Veronelli M, Raguso C, Barana D, Galli P, Lasagni M. The releaseprocess of microfibers: from surgical face masks into the marine environment. Environ Adv. 2021;4:100042.
Chen X, Chen X, Liu Q, Zhao Q, Xiong X, Wu C. Used disposable facemasks are significant sources of microplastics to environment. Environ
Pollut. 2021;285:117485.

Ajaj et al. Sustainable Environment Research(2023) 33:20

36. Ma J, Chen F, Xu H, Jiang H, Liu J, Li P, et al. Face masks as a source of
nanoplastics and microplastics in the environment: Quantification,
characterization, and potential for bioaccumulation. Environ Pollut.
2021;288:117748.
37. Wang Z, An C, Chen X, Lee K, Zhang B, Feng Q. Disposable masks
release microplastics to the aqueous environment with exacerbation
by natural weathering. J Hazard Mater. 2021;417:126036.
38. Sun J, Yang S, Zhou G-J, Zhang K, Lu Y, Jin Q, et al. Release of microplastics from discarded surgical masks and their adverse impacts
on the marine copepod Tigriopus japonicus. Environ Sci Tech Let.
2021;8:1065–70.
39. Wu P, Li J, Lu X, Tang Y, Cai Z. Release of tens of thousands of microfibers
from discarded face masks under simulated environmental conditions.
Sci Total Environ. 2022;806:150458.
40. Morgana S, Casentini B, Amalfitano S. Uncovering the release of micro/
nanoplastics from disposable face masks at times of COVID-19. J Hazard
Mater. 2021;419:126507.
41. Liao M, Liu H, Wang X, Hu X, Huang Y, Liu X, et al. A technical review offace mask wearing in preventing respiratory COVID-19 transmission.
Curr Opin Colloid In. 2021;52:101417.
42. Sullivan GL, Delgado-Gallardo J, Watson TM, Sarp S. An investigation
into the leaching of micro and nano particles and chemical pollutantsfrom disposable face masks - linked to the COVID-19 pandemic. Water
Res. 2021;196:117033.
43. Shen M, Zeng Z, Song B, Yi H, Hu T, Zhang Y, et al. Neglected microplastics pollution in global COVID-19: Disposable surgical masks. Sci Total
Environ. 2021;790:148130.
44. Wright SL, Kelly FJ. Plastic and Human Health: A Micro Issue? Environ Sci
Technol. 2017;51:6634–47.
45. Amato-Lourenco LF, Carvalho-Oliveira R, Júnior GR, dos Santos Galvao
L, Ando RA, Mauad T. Presence of airborne microplastics in human lungtissue. J Hazard Mater. 2021;416:126124.
46. Cox KD, Covernton GA, Davies HL, Dower JF, Juanes F, Dudas
SE. Human consumption of microplastics. Environ Sci Technol.
2019;53:7068–74.
47. Singh SK, Khawale RP, Chen H, Zhang H, Rai R. Personal protective
equipments (PPEs) for COVID-19: a product lifecycle perspective. Int J
Prod Res. 2022;60:3282–303.
48. Deepak A, Sharma V, Kumar D. Life cycle assessment of biomedical
waste management for reduced environmental impacts. J Clean Prod.
2022;349:131376.
49. WHO. Coronavirus disease (COVID19) advice for public: When and how
to use masks. Geneva: World Health Organization; 2021.
50. Babaahmadi V, Amid H, Naeimirad M, Ramakrishna S. Biodegradable
and multifunctional surgical face masks: A brief review on demands
during COVID-19 pandemic, recent developments, and future perspectives. Sci Total Environ. 2021;798:149233.
51. O’Dowd K, Nair KM, Forouzandeh P, Mathew S, Grant J, Moran R, et al.
Face masks and respirators in the fight against the COVID-19 pandemic:
a review of current materials, advances and future perspectives. Materials. 2020;13:3363.
52. Aluigi A, Vineis C, Tonin C, Tonetti C, Varesano A, Mazzuchetti G. Wool
keratin-based nanofibres for active filtration of air and water. J Biobased
Mater Bio. 2009;3:311–9.
53. Fang Q, Zhu M, Yu S, Sui G, Yang X. Studies on soy protein isolate/polyvinyl alcohol hybrid nanofiber membranes as multi-functional ecofriendly filtration materials. Mat Sci Eng B-Solid. 2016;214:1–10.
54. Das O, Neisiany RE, Capezza AJ, Hedenqvist MS, Forsth M, Xu Q, et al.
The need for fully bio-based facemasks to counter coronavirus outbreaks: A perspective. Sci Total Environ. 2020;736:139611.
55. Purwar R, Sai Goutham K, Srivastava CM. Electrospun Sericin/PVA/
Clay nanofibrous mats for antimicrobial air filtration mask. Fiber Polym.
2016;17:1206–16.
56. Wang C, Wu S, Jian M, Xie J, Xu L, Yang X, et al. Silk nanofibers as highefficient and lightweight air filter. Nano Res. 2016;9:2590–7.
57. Pragadheeswari R, Arunkumar KV, Rajakumar R, Sangeetha K. Nano
membrane fibrous on lyocell non-woven fabric for bacterial filitration
efficiency in surgical face mask. J Nanosci Nanotechnol. 2014;2:598–9.
58. Filipova I, Irbe I, Spade M, Skute M, Dabolina I, Baltina I, et al. Mechanical and air permeability performance of novel biobased materials fromfungal hyphae and cellulose fibers. Materials. 2021;14:136.

Page 18 of 19

59. de Almeida DS, Martins LD, Muniz EC, Rudke AP, Squizzato R, Beal A,
et al. Biodegradable CA/CPB electrospun nanofibers for efficient retention of airborne nanoparticles. Process Saf Environ. 2020;144:177–85.
60. Tiliket G, Sage DL, Moules V, Rosa-Calatrava M, Lina B, Valleton
JM, et al. A new material for airborne virus filtration. Chem Eng J.
2011;173:341–51.
61. Patil NA, Gore PM, Jaya Prakash N, Govindaraj P, Yadav R, Verma V, et al.
Needleless electrospun phytochemicals encapsulated nanofibre based
3-ply biodegradable mask for combating COVID-19 pandemic. Chem
Eng J. 2021;416:129152.
62. Catel-Ferreira M, Tnani H, Hellio C, Cosette P, Lebrun L. Antiviral effects
of polyphenols: Development of bio-based cleaning wipes and filters. J
Virol Methods. 2015;212:1–7.
63. Sen B, Paul S, Bhowmik KK, Pradhan SN, Ali SI. Development of novel
respiratory face masks prepared from banana stem fiber against
bio-aerosols: an eco-friendly approach. Lett Appl NanoBioSci.
2021;10:1993–2002.
64. He H, Gao M, Illes B, Molnar K. 3D printed and electrospun, transparent, hierarchical polylactic acid mask nanoporous filter. Int J Bioprint.
2020;6:278.
65. Wang Z, Pan Z, Wang J, Zhao R. A novel hierarchical structuredpoly(lactic acid)/titania fibrous membrane with excellent antibacterial
activity and air filtration performance. J Nanomater. 2016;2016:6272983.
66. Al-Hazeem N. Manufacture of fibroustructure facemask to protect against
coronavirus using electrospinning. Med Res Chronicles. 2021;8:103–10.
67. Choi S, Jeon H, Jang M, Kim H, Shin G, Koo JM, et al. Biodegradable, efficient, and breathable multi-use face mask filter. Adv Sci.
2021;8:2003155.
68. Desai K, Kit K, Li J, Michael Davidson P, Zivanovic S, Meyer H. Nanofibrous chitosan non-wovens for filtration applications. Polymer.
2009;50:3661–9.
69. Kadam V, Truong YB, Schutz J, Kyratzis IL, Padhye R, Wang L. Gelatin/β–
cyclodextrin bio–nanofibers as respiratory filter media for filtration ofaerosols and volatile organic compounds at low air resistance. J Hazard
Mater. 2021;403:123841.
70. Tseng CC, Pan ZM, Chang CH. Application of a quaternary ammonium
agent on surgical face masks before use for pre-decontaminationof nosocomial infection-related bioaerosols. Aerosol Sci Tech.
2016;50:199–210.
71. Huang C, Liu Y, Li Z, Li R, Ren X, Huang TS. N-halamine antibacterial
nanofibrous mats based on polyacrylonitrile and N-halamine for protective face masks. J Eng Fiber Fabr. 2019;14:1558925019843222.
72. Li Y, Leung P, Yao L, Song QW, Newton E. Antimicrobial effect of surgicalmasks coated with nanoparticles. J Hosp Infect. 2006;62:58–63.
73. Zhong H, Zhu Z, Lin J, Cheung CF, Lu VL, Yan F, et al. Reusable andrecyclable graphene masks with outstanding superhydrophobic andphotothermal performances. ACS Nano. 2020;14:6213–21.
74. Ekabutr P, Chuysinuan P, Suksamrarn S, Sukhumsirichart W, Hongmanee
P, Supaphol P. Development of antituberculosis melt-blown polypropylene filters coated with mangosteen extracts for medical face mask
applications. Polym Bull. 2019;76:1985–2004.
75. Borkow G, Zhou SS, Page T, Gabbay J. A novel anti-influenza copperoxide containing respiratory face mask. PLoS One. 2010;5:e11295.
76. Quan JH, Kang BH, Yang JB, Rhee YE, Noh HT, Choi IW, et al. Trichomonas
vaginalis induces SiHa cell apoptosis by NF-κB inactivation via reactive
oxygen species. Biomed Res Int. 2017;2017:3904870.
77. Lin J, Qiu S, Lewis K, Klibanov AM. Mechanism of bactericidal and fungicidal activities of textiles covalently modified with alkylated polyethylenimine. Biotechnol Bioeng. 2003;83:168–72.
78. Kim HJ, Park CJ. Composition for prevention of influenza viral infection
comprising sumac extract, air filter comprising the same and air cleaning device comprising the filter. Patent US20110086118A1. Alexandria:
United States Patent and Trademark Office; 2011.
79. Fujimorie Y, Nakayama T, Sato T. Antiviral Agent. Patent EP2786760A1.
Munich: European Patent Office; 2014.
80. Bhattacharjee S, Joshi R, Chughtai AA, Macintyre CR. Graphene modified multifunctional personal protective clothing. Adv Mater Interfaces.
2019;6:1900622.
81. Lin Z, Wang Z, Zhang X, Diao D. Superhydrophobic, photo-sterilize,
and reusable mask based on graphene nanosheet-embedded carbon(GNEC) film. Nano Res. 2021;14:1110–5.

Ajaj et al. Sustainable Environment Research(2023) 33:20

82. Kumar A, Bhattacharjee B, Sangeetha D, Subramanian V, Venkatraman B. Evaluation of filtration effectiveness of various types offacemasks following with different sterilization methods. J Ind Text.
2022;51:3430S–65S.
83. Sharma HB, Vanapalli KR, Samal B, Cheela VRS, Dubey BK, Bhattacharya
J. Circular economy approach in solid waste management system toachieve UN-SDGs: Solutions for post-COVID recovery. Sci Total Environ.
2021;800:149605.
84. Kilmartin-Lynch S, Saberian M, Li J, Roychand R, Zhang G. Preliminary
evaluation of the feasibility of using polypropylene fibres from COVID19 single-use face masks to improve the mechanical properties ofconcrete. J Clean Prod. 2021;296:126460.
85. Idrees M, Akbar A, Mohamed AM, Fathi D, Saeed F. Recycling of waste
facial masks as a construction material, a step towards sustainability.
Materials. 2022;15:1810.
86. Yu R, Wen X, Liu J, Wang Y, Chen X, Wenelska K, et al. A green and highyield route to recycle waste masks into CNTs/Ni hybrids via catalytic
carbonization and their application for superior microwave absorption.
Appl Catal B-Environ. 2021;298:120544.
87. Fabiani C, Cavagnoli S, Chiatti C, Pisello AL. Management of disposable
surgical masks for tackling pandemic-generated pollution: Thermoacoustic investigations and life cycle assessment of novel recycledbuilding panels. Resour Conserv Recycl. 2022;186:106509.
88. Pulikkalparambil H, Nandi D, Rangappa SM, Prasanth S, Siengchin S.
Polymer composites from natural fibers and recycled waste surgicalmasks during COVID-19 pandemic. Polym Composite. 2022;43:3944–50.
89. Tesfaldet YT, Ndeh NT. Assessing face masks in the environment bymeans of the DPSIR framework. Sci Total Environ. 2022;814:152859.
90. Battegazzore D, Cravero F, Frache A. Is it possible to mechanical recycle
the materials of the disposable filtering masks? Polymers. 2020;12:2726.
91. Ajaj R, Abu Jadayil W, Anver H, Aqil E. A revision for the different reusesof polyethylene terephthalate (PET) water bottles. Sustainability.
2022;14:4583.
92. Zhao HL, Wang L, Liu F, Liu HQ, Zhang N, Zhu YW. Energy, environment
and economy assessment of medical waste disposal technologies in
China. Sci Total Environ. 2021;796:148964.
93. Skrzyniarz M, Sajdak M, Zajemska M, Iwaszko J, Biniek-Poskart A, Skibinski A, et al. Plastic waste management towards energy recovery during
the COVID-19 pandemic: The example of protective face mask pyrolysis.
Energies. 2022;15:2629.
94. Schmutz M, Hischier R, Batt T, Wick P, Nowack B, Wager P, et al. Cottonand surgical masks—what ecological factors are relevant for theirsustainability? Sustainability. 2020;12:10245.
95. Bouchet A, Boucher J, Schutzbach K, Senn N, Genton B, Vernez D. Whichstrategy for using medical and community masks? A prospective analysis of their environmental impact. BMJ Open. 2021;11:e049690.
96. Do Thi HT, Mizsey P, Toth AJ. Applicability of membranes in protective
face masks and comparison of reusable and disposable face masks withlife cycle assessment. Sustainability. 2021;13:12574.
97. Giungato P, Rana RL, Nitti N, Cavallari C, Tricase C. Carbon footprintof surgical masks made in taranto to prevent SARS-CoV-2 diffusion: apreliminary assessment. Sustainability. 2021;13:6296.
98. Lee AWL, Neo ERK, Khoo ZY, Yeo Z, Tan YS, Chng S, et al. Life cycle
assessment of single-use surgical and embedded filtration layer (EFL)
reusable face mask. Resour Conserv Recy. 2021;170:105580.
99. Boix Rodriguez N, Formentini G, Favi C, Marconi M. Engineering design
process of face masks based on circularity and life cycle assessment in
the constraint of the COVID-19 pandemic. Sustainability. 2021;13:4948.
100. van Straten B, Ligtelijn S, Droog L, Putman E, Dankelman J, Weiland
NHS, et al. A life cycle assessment of reprocessing face masks during
the Covid-19 pandemic. Sci Rep-Uk. 2021;11:17680.
101. Tabatabaei M, Hosseinzadeh-Bandbafha H, Yang Y, Aghbashlo M, Lam
SS, Montgomery H, et al. Exergy intensity and environmental consequences of the medical face masks curtailing the COVID-19 pandemic:
Malign bodyguard? J Clean Prod. 2021;313:127880.
102. Nimmy CJ, Remya R, Anjali S, Arathi KU, Devika V. Life cycle assessmentof cotton vs surgical face mask using open-lca software. Int Res J Eng
Technol. 2021;8:572.
103. Alfarisi S, Sholihah Ma, Mitake Y, Tsutsui Y, Wang H, Shimomura Y. A
sustainable approach towards disposable face mask production amidst
pandemic outbreaks. Sustainability. 2022;14:3849.

Page 19 of 19104. Barbanera M, Marconi M, Peruzzi A, Dinarelli S. Environmental assessment and eco-design of a surgical face mask. Proc CIRP. 2022;105:61–6.
105. Maceno MMC, Joao S, Voltolini DR, Zattar IC. Life cycle assessment
and circularity evaluation of the non-medical masks in the Covid-19
pandemic: a Brazilian case. Environ Dev Sustain. 2022.
106. Morone P, Yilan G, Imbert E, Becchetti L. Reconciling human health withthe environment while struggling against the COVID-19 pandemic
through improved face mask eco-design. Sci Rep-Uk. 2022;12:2445.
107. Atılgan Turkmen B. Life cycle environmental impacts of disposable
medical masks. Environ Sci Pollut R. 2022;29:25496–506.
108. Chau C, Paulillo A, Ho J, Bowen R, La Porta A, Lettieri P. The environmental impacts of different mask options for healthcare settings in the UK.
Sustain Prod Consump. 2022;33:271–82.
109. Luo Y, Yu M, Wu X, Ding X, Wang L. Carbon footprint assessment of facemasks in the context of the COVID-19 pandemic: Based on different protective performance and applicable scenarios. J Clean Prod.
2023;387:135854.
110. Soares SR, Finotti AR, Prudencio da Silva V, Alvarenga RAF. Applicationsof life cycle assessment and cost analysis in health care waste management. Waste Manage. 2013;33:175–83.
111. Hong J, Zhan S, Yu Z, Hong J, Qi C. Life-cycle environmental andeconomic assessment of medical waste treatment. J Clean Prod.
2018;174:65–73.
112. Nwadike C, Joshua VI, Doka PJS, Ajaj R, Abubakar Hashidu U, GwaryModa S, et al. Occupational safety knowledge, attitude, and practiceamong farmers in Northern Nigeria during pesticide application—acase study. Sustainability. 2021;13:10107.
113. Hartanto BW, Mayasari DS. Environmentally friendly non-medical mask:
An attempt to reduce the environmental impact from used masks during COVID 19 pandemic. Sci Total Environ. 2021;760:144143.
114. Hao Z, Wu J, Wang C, Liu J. Electrospun polyimide/metal-organic
framework nanofibrous membrane with superior thermal stability for
efficient ­PM2.5 capture. Acs Appl Mater Inter. 2019;11:11904–9.
115. Rehman ZU, Khalid U. Reuse of COVID-19 face mask for the amelioration of mechanical properties of fat clay: A novel solution to an emerging waste problem. Sci Total Environ. 2021;794:148746.
116. Asim N, Badiei M, Sopian K. Review of the valorization options for theproper disposal of face masks during the COVID-19 pandemic. Environ
Technol Inno. 2021;23:101797.

Publisher’s NoteSpringer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Ready to submit your research ? Choose BMC and benefit from:• fast, convenient online submission• thorough peer review by experienced researchers in your field• rapid publication on acceptance• support for research data, including large and complex data types• gold Open Access which fosters wider collaboration and increased citations• maximum visibility for your research: over 100M website views per year
At BMC, research is always in progress.
Learn more biomedcentral.com/submissions