Saving the beard. Melbourne hospital studies mask technique fit for the beard

The Singh Thattha technique – Photo: RMH / Journal of Hospital Infection

By Asia Samachar | Australia |

The beard has been coming in the way, or so it is claimed, in the medical profession. This has affected Sikhs who maintain their beard as part of the tenets of their faith, as well as a host of other people who maintain the beard for religious, cultural or medical reasons.

At the height of the Covid-19 pandemic, two Sikh doctor were reported to have shaved their beard to allow them to continue serving on the frontlines.

With the issue in mind, an Aussie hospital has embarked on an investigation to solve the problem. A tecnique developed by some Sikh medical practitioners may be the answer they are looking for.

Researchers at the Royal Melbourne Hospital (RMH) are conducting a 12 month clinical trial to see whether a new mask fit technique is suitable for healthcare workers and students who cannot shave their beards for religious, cultural or medical reasons.

The reasoning behind the study is due to the increasing number of clinical staff required to wear an N95 mask, according to an entry at the RMH website.

Charles Bodas, an occupational hygienist in the RMH Respiratory Protection Program, is exploring a new technique after seeing a number of staff with beards failing their mask fit test.

“An under-mask elastic band beard cover, also known as the Singh Thattha technique, has been identified as a potential option that would enable the use of tight-fitting respirators for those unable to shave,” said Charles.

“We need all hands on deck as healthcare workers at the moment, and we had to come up with a practical solution that did not require a lot of training,” he was quoted in the news update.

The RMH respiratory protection program has been working closely with the Australian Sikh Doctors Association and other religious groups and healthcare organisations to help promote the study to any relevant groups, it added.

The Victorian Department of Health is also supporting the study by encouraging referrals to the RMH and through ongoing collaborations with Worksafe, Safer Care Victoria, health services, universities and state-based infection prevention bodies.


The problem is real and it is already impacting individuals.

A bearded medical student who requested to be known only as Mr Singh is facing a dilemma that threatens his very identity. Like many other Sikh health professionals and nursing students from across Australia, he was told to get “clean-shaven” to meet mask fit requirements, reports SBS Punjabi.

“I have unfortunately been barred from continuing my studies and there is currently no guarantee that there will be any changes next year or any time in the future,” he tells SBS Punjabi.

Singh said he submitted a complaint to the Ombudsman only to receive a reply that the issue lies with his institution, not the Department of Health. “Under the current system, Sikh healthcare workers like myself will not be able to work in a hospital setting if fit testing remains long-term without any accommodations made,” he was quoted in the report.

New South Wales (NSW), Western Australia (WA) and South Australia (SA) have all given the green light to the new Singh Thattha technique, which involves using an under-mask elastic band beard cover for donning respirator masks. However, this technique is not currently endorsed by WorkSafe Victoria for use in passing fit-test protocols, the report added.


A quantitative fit testing has returned promising results, reported the Journal of Hospital Infection.

“The under-mask beard cover technique may be used to achieve a satisfactory seal with tight-fitting P2/N95 respirators in health workers with facial hair that cannot shave,” concluded a report published in May. See here.

Tight-fitting respirators are a critical component of respiratory protection against airborne diseases for health workers. However, they are not recommended for health workers with facial hair. Some health workers are unable to shave for religious or medical reasons. Under-mask beard covers have been proposed as a solution to allow health workers with facial hair to wear tight-fitting respirators. However, studies to date have been limited by their predominant reliance on qualitative rather than quantitative fit testing techniques, the study noted.

Thirty subjects were assessed in the testing. No subject had an adverse reaction to the under-mask beard cover, according to the report.

The Clinical Excellence Commission’s (CEC) Infection Prevention and Control said its team played a key role in research and guidance development to improve the safe use of P2/N95 respirators among health workers in the Sikh community. It noted that the research was of value for health workers with facial hair which cannot be shaved due to cultural, religious or medical reasons.

In an update at its website, CEC Principal Advisor Dr Susan Jain said the pandemic had heightened the entire health system’s awareness of infection prevention and control procedures while also being mindful of cultural diversities.

“At all times we want staff to stop the spread of airborne disease and for staff to be using personal protective equipment which is safe and effective,” Dr Jain said.

“Developing and assessing the effectiveness of procedures like the beard wrapping in this research means a broader cohort of health workers can safely care for patients in challenging circumstances like a pandemic.

“Typically, beards are not allowed for health workers using a respirator because without a ‘seal’ between the skin and respirator there can be a risk of exposure for the workers.

“The research shows beard wrapping may be another effective option for some of these health workers and this has excellent benefits not just for the individual health workers but for the entire system because we have found another way to keep valuable staff working safely in the system.”


On two Sikh doctors shaving their beards (Asia Samachar, 23 May 2020)

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