In order to determine the effectiveness of different forms of respiratory protection for community exposures to fine particles, it is necessary to not only investigate the efficacy of the masks themselves but also to determine whether there is a measurable health benefit from wearing protection.

Yet, even if it is shown that wearing certain masks can improve health outcomes, there will be many people who will refuse to wear the recommended masks and it is critical to determine the motivations that influence these decisions, whether they be environmental, cultural or simply related to comfort and fashion.

As many agencies distribute light-weight 'surgical-style' masks, it is also crucial that we consider whether these masks are effective at blocking fine particles. Communities suffer great anxiety when ash is in the air as there is little advice available to say whether breathing in the ash is safe. If these light-weight masks reduce anxiety, yet are not effective, it is very important that agencies are aware of this, in order that they stop providing interventions that provide a false sense of security.

Many people use their own interventions to protect themselves. They may be a bandana tied over the mouth or nose, a veil, handkerchief or t-shirt held over the face, a mask designed for motor scooter wearers or even a 'fashion' mask commonly warn by scooter passengers in Indonesia. The HIVE Consortium will also investigate whether these forms of protection are effective. Perhaps they may even be more effective than other light-weight options.

The HIVE Consortium is taking a three-stage, interdisciplinary, multi-location approach to provide a comprehensive evidence base addressing effectiveness, health impact and factors relating to use of respiratory protection.