Fitness Workout

End Tidal Carbon Dioxide Level

Despite the gym closures and the inconsistencies in lockdowns, maintaining a healthy lifestyle is an important strategy in keeping yourself safe during the coronavirus pandemic[1]. While social media chatter and opinion may disagree, the reality doesn’t change: the US Centers for Disease Control and Prevention recommends wearing a mask or cloth face‐covering in public, especially in places where maintaining social distancing is difficult, and mass masking is a low cost, easy way to complement social distancing and other methods of controlling infection rates. Research also shows that gyms are a source of viral transmission[2], like many other public spaces, and that masking should be part of the exercise and workout experience. This is especially true when the activity is aerobic[3].

Researchers at the Rambam Health Care Campus in Haifa, Israel, have looked into the physiological effects of face masks during exercise to assess the impact on the trainee. They found that masking during aerobic training has minimal and statistically inconsistent impact on heart rate, respiratory rate, breathing and oxygen saturation in the blood. However, using an N95 respirator did indicate an increase in EtCO2 (end tidal carbod dioxide) levels, a measure of carbox dioxide production and clearance in breathing. This increase could also be explained by the fact that exhaled air is being rebreathed when wearing a mask. Granted, respiratory exposure to increased levels of carbon dioxide could impact performance, may cause headaches, confusion, stupors and increases in heart rates and breathing rates. Short term exposure and intermittent exposure may also lead to improvements in respiratory muscle development and better performance.

The research doesn’t look at the impact of mask wearing from a psychological point of view and it is not a wide enough study to help draw any specific conclusions about specific populations because it was an all male subject group. So, it’s best not to generalize the results. But, you can just stay out of the slipstream of anyone who is vigorously working out and keep your distance [5]. It used to be called an ounce of prevention which seems like a million years ago today, at a time when people are extremely polarized in their opinions about everything.


1. Epstein, D., Korytny, A., Isenberg, Y., Marcusohn, E., Zukermann, R., Bishop, B., Minha, S., Raz, A., & Miller, A. (2021). Return to training in the COVID-19 era: The physiological effects of face masks during exercise. Scandinavian Journal of Medicine & Science in Sports, 31(1), 70–75.
2. Gontjes, K. J., Gibson, K. E., Lansing, B., Cassone, M., & Mody, L. (2020). Contamination of Common Area and Rehabilitation Gym Environment with Multidrug-Resistant Organisms. Journal of the American Geriatrics Society, 68(3), 478–485. 
3. Leung, N. H. L., Chu, D. K. W., Shiu, E. Y. C., Chan, K.-H., McDevitt, J. J., Hau, B. J. P., Yen, H.-L., Li, Y., Ip, D. K. M., Peiris, J. S. M., Seto, W.-H., Leung, G. M., Milton, D. K., & Cowling, B. J. (2020). Respiratory virus shedding in exhaled breath and efficacy of face masks. Nature Medicine, 26(5), 676–680. 

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