Effects on communication due to face mask use: an integrative review.
Jonathan Grassi, Isabel Barreto de Oliveira, Laura Franco Chiriboga and 3 others
PMID 37820148WHAT IT FOUND
Face masks made speech harder to understand and increased vocal effort, especially with N95 masks, face shields and background noise.
SLPs should expect communication barriers and use clear speech, quiet rooms, subtitles or transparent masks.
Key findings
01In people with self-reported hearing loss, mean word recognition scores reached 46% with an N95 mask, compared with 79% in people who reported normal hearing.
02Personal protective equipment use significantly impaired speech perception among healthcare workers, with a mean 12.4 dB increase in speech reception threshold and a mean 7% decrease in speech discrimination score.
03The surgical mask had less impact than the KN95 mask on analyzed vocal aspects and was preferred when spoken communication was a priority alongside respiratory protection.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
Many included studies were cross-sectional, so they cannot show that masks caused the communication effects. The studies used different mask types, designs, populations and outcome measures, so the findings are not directly comparable. Many studies used speech parameters from languages mainly English, which may not apply to Brazilian Portuguese. The review did not include qualitative studies, so it may miss how patients and clinicians experience these communication barriers.
The easy way to misread this
Do not conclude that masks do not affect communication because some acoustic voice measures were unchanged. Other included studies reported reduced word recognition, higher voice handicap scores and greater listening effort.