Objectives: The increased use of respiratory protective equipment (RPE) during and since the COVID-19 pandemic has highlighted its adverse impact on communication, particularly in high-stakes environments such as anesthesia and surgery, where clear verbal exchange is essential. This study examines how different types and combinations of RPE—including surgical masks, FFP-3 masks, and powered air-purifying respirators (PAPRs)—affect speech intelligibility in the anesthetic setting. Methods: Twenty-one NHS theater staff participated in speech intelligibility testing conducted in a standard anesthetic room. Performance was assessed using single-word, consonant-nucleus-consonant (CNC) tests under various RPE conditions, including combinations of masks and PAPRs. Results: Significant reductions in word recognition accuracy were observed when speakers wore RPE, with FFP-3 masks producing a more pronounced reduction than surgical masks. Communication was further impaired when listeners used PAPRs, particularly when speakers simultaneously wore FFP-3 masks. In contrast, intelligibility was not significantly affected when speakers used PAPRs alone. Conclusions: RPE, principally devices that obscure the mouth, substantially impairs verbal communication in the anesthetic environment, with FFP-3 masks causing the greatest reduction in speech clarity. PAPRs introduce additional barriers, especially for listeners. To mitigate these effects, health care professionals should select RPE that balances protection with communication needs. Additional strategies, such as reducing background noise, enhancing RPE design, and implementing alternative communication methods may further improve verbal exchanges in critical care settings.
Armson et al. (2026) studied this question.