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Protecting healthcare workers from pandemic influenza: N95 or surgical masks?

Identifieur interne : 001411 ( PascalFrancis/Corpus ); précédent : 001410; suivant : 001412

Protecting healthcare workers from pandemic influenza: N95 or surgical masks?

Auteurs : Jan Gralton ; Mary-Louise Mclaws

Source :

RBID : Pascal:10-0159611

Descripteurs français

English descriptors

Abstract

Objective: The successful management of an influenza pandemic will be reliant on the expertise of healthcare workers at high risk for occupationally acquired influenza. Recommended infection control measures for healthcare workers include surgical masks to protect against droplet-spread respiratory transmissible infections and N95 masks to protect against aerosol-spread infections. A literature review was undertaken for evidence of superior protective value of N95 masks or surgical masks for healthcare workers against influenza and extraneous factors influencing conferred protection. Methods: Four scientific search engines using 12 search sequences identified 21 mask studies in healthcare settings for the prevention of transmission of respiratory syncytial virus, Bordetella pertussis, and severe acute respiratory syndrome. Each was critically assessed in accordance with Australian National Health Medical Research Council guidelines. An additional 25 laboratory-based publications were also reviewed. Results: All studies reviewed used medium or lower level evidence study design. In the majority of studies, important con-founders included the unrecognized impact of concurrent bundling of other infection control measures, mask compliance, contamination from improper doffing of masks, and ocular inoculation. Only three studies directly compared the protective value of surgical masks with N95 masks. The majority of laboratory studies identified both mask types as having a range of filtration efficiency, yet N95 masks afford superior protection against particles of a similar size to influenza. Conclusions: World Health Organization guidelines recommend surgical masks for all patient care with the exception of N95 masks for aerosol generating procedures. Because of the paucity of high-quality studies in the healthcare setting, the advocacy of mask types is not entirely evidence-based. Evidence from laboratory studies of potential airborne spread of influenza from shedding patients indicate that guidelines related to the current 1-meter respiratory zone may need to be extended to a larger respiratory zone and include protection from ocular inoculation.

Notice en format standard (ISO 2709)

Pour connaître la documentation sur le format Inist Standard.

pA  
A01 01  1    @0 0090-3493
A02 01      @0 CCMDC7
A03   1    @0 Crit. care med.
A05       @2 38
A06       @2 2
A08 01  1  ENG  @1 Protecting healthcare workers from pandemic influenza: N95 or surgical masks?
A11 01  1    @1 GRALTON (Jan)
A11 02  1    @1 MCLAWS (Mary-Louise)
A14 01      @1 School of Public Health & Community Medicine, The University of New South Wales @2 Sydney NSW @3 AUS @Z 1 aut. @Z 2 aut.
A20       @1 657-667
A21       @1 2010
A23 01      @0 ENG
A43 01      @1 INIST @2 17751 @5 354000181829320390
A44       @0 0000 @1 © 2010 INIST-CNRS. All rights reserved.
A45       @0 97 ref.
A47 01  1    @0 10-0159611
A60       @1 P
A61       @0 A
A64 01  1    @0 Critical care medicine
A66 01      @0 USA
C01 01    ENG  @0 Objective: The successful management of an influenza pandemic will be reliant on the expertise of healthcare workers at high risk for occupationally acquired influenza. Recommended infection control measures for healthcare workers include surgical masks to protect against droplet-spread respiratory transmissible infections and N95 masks to protect against aerosol-spread infections. A literature review was undertaken for evidence of superior protective value of N95 masks or surgical masks for healthcare workers against influenza and extraneous factors influencing conferred protection. Methods: Four scientific search engines using 12 search sequences identified 21 mask studies in healthcare settings for the prevention of transmission of respiratory syncytial virus, Bordetella pertussis, and severe acute respiratory syndrome. Each was critically assessed in accordance with Australian National Health Medical Research Council guidelines. An additional 25 laboratory-based publications were also reviewed. Results: All studies reviewed used medium or lower level evidence study design. In the majority of studies, important con-founders included the unrecognized impact of concurrent bundling of other infection control measures, mask compliance, contamination from improper doffing of masks, and ocular inoculation. Only three studies directly compared the protective value of surgical masks with N95 masks. The majority of laboratory studies identified both mask types as having a range of filtration efficiency, yet N95 masks afford superior protection against particles of a similar size to influenza. Conclusions: World Health Organization guidelines recommend surgical masks for all patient care with the exception of N95 masks for aerosol generating procedures. Because of the paucity of high-quality studies in the healthcare setting, the advocacy of mask types is not entirely evidence-based. Evidence from laboratory studies of potential airborne spread of influenza from shedding patients indicate that guidelines related to the current 1-meter respiratory zone may need to be extended to a larger respiratory zone and include protection from ocular inoculation.
C02 01  X    @0 002B27B
C02 02  X    @0 002B27B02
C03 01  X  FRE  @0 Personnel sanitaire @5 09
C03 01  X  ENG  @0 Health staff @5 09
C03 01  X  SPA  @0 Personal sanitario @5 09
C03 02  X  FRE  @0 Grippe @5 10
C03 02  X  ENG  @0 Influenza @5 10
C03 02  X  SPA  @0 Gripe @5 10
C03 03  X  FRE  @0 Chirurgie @5 11
C03 03  X  ENG  @0 Surgery @5 11
C03 03  X  SPA  @0 Cirugía @5 11
C03 04  X  FRE  @0 Masque @5 12
C03 04  X  ENG  @0 Mask @5 12
C03 04  X  SPA  @0 Máscara @5 12
C03 05  X  FRE  @0 Intubation @5 13
C03 05  X  ENG  @0 Intubation @5 13
C03 05  X  SPA  @0 Intubación @5 13
C03 06  X  FRE  @0 Réanimation @5 14
C03 06  X  ENG  @0 Resuscitation @5 14
C03 06  X  SPA  @0 Reanimación @5 14
C03 07  X  FRE  @0 Soin intensif @5 15
C03 07  X  ENG  @0 Intensive care @5 15
C03 07  X  SPA  @0 Cuidado intensivo @5 15
C07 01  X  FRE  @0 Virose
C07 01  X  ENG  @0 Viral disease
C07 01  X  SPA  @0 Virosis
C07 02  X  FRE  @0 Infection
C07 02  X  ENG  @0 Infection
C07 02  X  SPA  @0 Infección
N21       @1 102
N44 01      @1 OTO
N82       @1 OTO

Format Inist (serveur)

NO : PASCAL 10-0159611 INIST
ET : Protecting healthcare workers from pandemic influenza: N95 or surgical masks?
AU : GRALTON (Jan); MCLAWS (Mary-Louise)
AF : School of Public Health & Community Medicine, The University of New South Wales/Sydney NSW/Australie (1 aut., 2 aut.)
DT : Publication en série; Niveau analytique
SO : Critical care medicine; ISSN 0090-3493; Coden CCMDC7; Etats-Unis; Da. 2010; Vol. 38; No. 2; Pp. 657-667; Bibl. 97 ref.
LA : Anglais
EA : Objective: The successful management of an influenza pandemic will be reliant on the expertise of healthcare workers at high risk for occupationally acquired influenza. Recommended infection control measures for healthcare workers include surgical masks to protect against droplet-spread respiratory transmissible infections and N95 masks to protect against aerosol-spread infections. A literature review was undertaken for evidence of superior protective value of N95 masks or surgical masks for healthcare workers against influenza and extraneous factors influencing conferred protection. Methods: Four scientific search engines using 12 search sequences identified 21 mask studies in healthcare settings for the prevention of transmission of respiratory syncytial virus, Bordetella pertussis, and severe acute respiratory syndrome. Each was critically assessed in accordance with Australian National Health Medical Research Council guidelines. An additional 25 laboratory-based publications were also reviewed. Results: All studies reviewed used medium or lower level evidence study design. In the majority of studies, important con-founders included the unrecognized impact of concurrent bundling of other infection control measures, mask compliance, contamination from improper doffing of masks, and ocular inoculation. Only three studies directly compared the protective value of surgical masks with N95 masks. The majority of laboratory studies identified both mask types as having a range of filtration efficiency, yet N95 masks afford superior protection against particles of a similar size to influenza. Conclusions: World Health Organization guidelines recommend surgical masks for all patient care with the exception of N95 masks for aerosol generating procedures. Because of the paucity of high-quality studies in the healthcare setting, the advocacy of mask types is not entirely evidence-based. Evidence from laboratory studies of potential airborne spread of influenza from shedding patients indicate that guidelines related to the current 1-meter respiratory zone may need to be extended to a larger respiratory zone and include protection from ocular inoculation.
CC : 002B27B; 002B27B02
FD : Personnel sanitaire; Grippe; Chirurgie; Masque; Intubation; Réanimation; Soin intensif
FG : Virose; Infection
ED : Health staff; Influenza; Surgery; Mask; Intubation; Resuscitation; Intensive care
EG : Viral disease; Infection
SD : Personal sanitario; Gripe; Cirugía; Máscara; Intubación; Reanimación; Cuidado intensivo
LO : INIST-17751.354000181829320390
ID : 10-0159611

Links to Exploration step

Pascal:10-0159611

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