People with cystic fibrosis (CF) generate Pseudomonas aeruginosa in droplet nuclei during coughing. The use of surgical masks has been recommended in healthcare settings to minimise pathogen transmission between CF patients.
To determine if face masks and cough etiquette reduce viable P. aeruginosa aerosolised during cough.
Twenty-five adults with CF and chronic P. aeruginosa infection were recruited. Participants performed six talking and coughing maneuvers, with or without face masks (surgical and N95) and hand covering the mouth when coughing (cough etiquette) in an aerosol-sampling device. An Andersen Impactor sampled the aerosol at 2-meters from each participant. Quantitative sputum and aerosol bacterial cultures were performed and participants rated the mask comfort levels during the cough maneuvers.
During uncovered coughing (reference maneuver), 19/25 (76%) participants produced aerosols containing P. aeruginosa, with a positive correlation found between sputum P. aeruginosa concentration (CFU/mL) and aerosol P. aeruginosa CFUs. There was a reduction in aerosol P. aeruginosa load during coughing with surgical mask, coughing with N95 mask and cough etiquette compared with uncovered coughing (p<0.001). A similar reduction in total CFUs was observed for both masks during coughing, yet participants rated surgical masks more comfortable (p=0.013). Cough etiquette provided approximately half the reduction of viable aerosols of the mask interventions during voluntary cough. Talking was a low viable aerosol producing activity.
Face masks reduce cough generated P. aeruginosa aerosols, with the surgical mask providing enhanced comfort. Cough etiquette was less effective at reducing viable aerosols.
This research output has an Altmetric Attention Score of 18. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 17 January 2026.
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#2,676,669
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Outputs from American Journal of Respiratory & Critical Care Medicine
#2,589
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Outputs of similar age from American Journal of Respiratory & Critical Care Medicine
#38
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Altmetric has tracked 34,411,289 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 92nd percentile: it's in the top 10% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 15,143 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 16.0. This one has done well, scoring higher than 82% of its peers.
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We're also able to compare this research output to 149 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 74% of its contemporaries.
