A first-of-its-kind literature review on the adverse effects of face masks, titled "Is a Mask That Covers the Mouth and Nose Free from Undesirable Side Effects in Everyday Use and Free of Potential Hazards?," reveals there are clear, scientifically demonstrable adverse effects for mask wearers, both on psychological, social and physical levels.
Newly published in the International Journal of Environmental Research and Public Health, a team of German researchers acknowledge that theirs is the first comprehensive investigation into the adverse health effects that masks can cause -- a surprising fact considering that many countries around the world introduced universal mask wearing in public spaces for containing SARS-CoV-2 in 2020 as a mandatory health policy without investigating nor communicating to their citizens the true risks of masks, hence violating informed consent.
According to the German research team, their work is designed to "provide a first, rapid, scientific presentation of the risks of general mandatory mask use by focusing on the possible adverse medical effects of masks, especially in certain diagnostic, patient and user groups."
The researchers summarize their study as follows:
"The aim was to find, test, evaluate and compile scientifically proven related side effects of wearing masks. For a quantitative evaluation, 44 mostly experimental studies were referenced, and for a substantive evaluation, 65 publications were found. The literature revealed relevant adverse effects of masks in numerous disciplines. In this paper, we refer to the psychological and physical deterioration as well as multiple symptoms described because of their consistent, recurrent and uniform presentation from different disciplines as a Mask-Induced Exhaustion Syndrome (MIES). We objectified evaluation evidenced changes in respiratory physiology of mask wearers with significant correlation of O2 drop and fatigue (p < 0.05), a clustered co-occurrence of respiratory impairment and O2 drop (67%), N95 mask and CO2 rise (82%), N95 mask and O2 drop (72%), N95 mask and headache (60%), respiratory impairment and temperature rise (88%), but also temperature rise and moisture (100%) under the masks. Extended mask-wearing by the general population could lead to relevant effects and consequences in many medical fields."
The researchers provided the following important context for their work:
"The potential drastic and undesirable effects found in multidisciplinary areas illustrate the general scope of global decisions on masks in general public in the light of combating the pandemic. According to the literature found, there are clear, scientifically recorded adverse effects for the mask wearer, both on a psychological and on a social and physical level. Neither higher level institutions such as the WHO or the European Centre for Disease Prevention and Control (ECDC) nor national ones, such as the Centers for Disease Control and Prevention, GA, USA (CDC) or the German RKI, substantiate with sound scientific data a positive effect of masks in the public (in terms of a reduced rate of spread of COVID-19 in the population) [2,4,5] Contrary to the scientifically established standard of evidence-based medicine, national and international health authorities have issued their theoretical assessments on the masks in public places, even though the compulsory wearing of masks gives a deceptive feeling of safety [5,112,143]."
The authors provided the following summary of the problem with the widely disseminated narrative that masks are a priori "safe and effective."
"From an infection epidemiological point of view, masks in everyday use offer the risk of self-contamination by the wearer from both inside and outside, including via contaminated hands [5,16,88]. In addition, masks are soaked by exhaled air, which potentially accumulates infectious agents from the nasopharynx and also from the ambient air on the outside and inside of the mask. In particular, serious infection-causing bacteria and fungi should be mentioned here [86,88,89], but also viruses . The unusual increase in the detection of rhinoviruses in the sentinel studies of the German RKI from 2020  could be an indication of this phenomenon. Clarification through further investigations would therefore be desirable. Masks, when used by the general public, are considered by scientists to pose a risk of infection because the standardized hygiene rules of hospitals cannot be followed by the general public . On top of that, mask wearers (surgical, N95, fabric masks) exhale relatively smaller particles (size 0.3 to 0.5 μm) than mask-less people and the louder speech under masks further amplifies this increased fine aerosol production by the mask wearer (nebulizer effect) . The history of modern times shows that already in the influenza pandemics of 1918-1919, 1957-58, 1968, 2002, in SARS 2004-2005 as well as with the influenza in 2009, masks in everyday use could not achieve the hoped-for success in the fight against viral infection scenarios [67,144]. The experiences led to scientific studies describing as early as 2009 that masks do not show any significant effect with regard to viruses in an everyday scenario [129,145]. Even later, scientists and institutions rated the masks as unsuitable to protect the user safely from viral respiratory infections [137,146,147]. Even in hospital use, surgical masks lack strong evidence of protection against viruses . Originally born out of the useful knowledge of protecting wounds from surgeons' breath and predominantly bacterial droplet contamination [144,148,149], the mask has been visibly misused with largely incorrect popular everyday use, particularly in Asia in recent years . Significantly, the sociologist Beck described the mask as a cosmetic of risk as early as 1992 . Unfortunately, the mask is inherent in a vicious circle: strictly speaking, it only protects symbolically and at the same time represents the fear of infection. This phenomenon is reinforced by the collective fear mongering, which is constantly nurtured by main stream media . Nowadays, the mask represents a kind of psychological support for the general population during the virus pandemic, promising them additional anxiety-reduced freedom of movement. The recommendation to use masks in the sense of "source control" not out of self-protection but out of "altruism"  is also very popular with the regulators as well as the population of many countries. The WHO's recommendation of the mask in the current pandemic is not only a purely infectiological approach, but is also clear on the possible advantages for healthy people in the general public. In particular, a reduced potential stigmatization of mask wearers, the feeling of a contribution made to preventing the spread of the virus, as well as the reminder to adhere to other measures are mentioned .
Morever, the researchers pointed out that there are recurring patterns of related health issues associated with mask wearing, leading them to coin the term mask-induced exhaustion syndrome (MIES), which encompasses the following pathophysioloical changes and subjective complaints:
Increase in dead space volume [22,24,58,59] (Figure 3, Section 3.1 and Section 3.2)
Increase in breathing resistance [31,35,61,118] (Figure 3, Figure 2: Column 8)
Increase in blood carbon dioxide [13,15,19,21,22,23,24,25,26,27,28] (Figure 2: Column 5)
Decrease in blood oxygen saturation [18,19,21,23,28,29,30,31,32,33,34] (Figure 2: Column 4)
Increase in heart rate [15,19,23,29,30,35] (Figure 2: Column 12)
Decrease in cardiopulmonary capacity  (Section 3.2)
Feeling of exhaustion [15,19,21,29,31,32,33,34,35,69] (Figure 2: Column 14)
Increase in respiratory rate [15,21,23,34] (Figure 2: Column 9)
Difficulty breathing and shortness of breath [15,19,21,23,25,29,31,34,35,71,85,101,133] (Figure 2: Column 13)
Feeling of dampness and heat [15,16,22,29,31,35,85,133] (Figure 2: Column 7)
Drowsiness (qualitative neurological deficits) [19,29,32,36,37] (Figure 2: Column 15)
Impaired skin barrier function with acne, itching and skin lesions [37,72,73] (Figure 2: Column 20-22)