Effectiveness of Masks and Respirators Against Respiratory Infections in Healthcare Workers: A Systematic Review and Meta-Analysis.

Abstract

This systematic review and meta-analysis quantified the protective effect of facemasks and respirators against respiratory infections among healthcare workers. Relevant articles were retrieved from Pubmed, EMBASE, and Web of Science. Meta-analyses were conducted to calculate pooled estimates. Meta-analysis of randomized controlled trials (RCTs) indicated a protective effect of masks and respirators against clinical respiratory illness (CRI) (risk ratio [RR] = 0.59; 95% confidence interval [CI]:0.46-0.77) and influenza-like illness (ILI) (RR = 0.34; 95% CI:0.14-0.82). Compared to masks, N95 respirators conferred superior protection against CRI (RR = 0.47; 95% CI: 0.36-0.62) and laboratory-confirmed bacterial (RR = 0.46; 95% CI: 0.34-0.62), but not viral infections or ILI. Meta-analysis of observational studies provided evidence of a protective effect of masks (OR = 0.13; 95% CI: 0.03-0.62) and respirators (OR = 0.12; 95% CI: 0.06-0.26) against severe acute respiratory syndrome (SARS). This systematic review and meta-analysis supports the use of respiratory protection. However, the existing evidence is sparse and findings are inconsistent within and across studies. Multicentre RCTs with standardized protocols conducted outside epidemic periods would help to clarify the circumstances under which the use of masks or respirators is most warranted.

• Authors: Vittoria Offeddu, Chee Fu Yung, Mabel Sheau Fong Low, Clarence C Tam
• Journal: Clinical infectious diseases : an official publication of the Infectious Diseases Society of America (Clin Infect Dis) Vol. 65 Issue 11 Pg. 1934-1942 (Nov 13 2017) ISSN: 1537-6591 [Electronic] United States
• PMID: 29140516 (Publication Type: Journal Article, Meta-Analysis, Review, Systematic Review)
• Copyright: © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: [email protected].

Topics

• Health Personnel (statistics & numerical data)
• Humans
• Infection Control (statistics & numerical data)
• Influenza, Human (prevention & control)
• Masks
• Observational Studies as Topic
• Occupational Exposure (prevention & control, statistics & numerical data)
• Randomized Controlled Trials as Topic
• Respiratory Protective Devices (statistics & numerical data)
• Respiratory Tract Infections (microbiology, prevention & control, virology)
• Severe Acute Respiratory Syndrome (prevention & control)
• Ventilators, Mechanical
• Virus Diseases (prevention & control)