Effectiveness of Masks and Respirators Against Respiratory Infections in Healthcare Workers: A Systematic Review and Meta-Analysis
Identifieur interne : 000632 ( Pmc/Checkpoint ); précédent : 000631; suivant : 000633Effectiveness of Masks and Respirators Against Respiratory Infections in Healthcare Workers: A Systematic Review and Meta-Analysis
Auteurs : Vittoria Offeddu ; Chee Fu Yung [Singapour] ; Mabel Sheau Fong Low ; Clarence C. Tam [Royaume-Uni]Source :
- Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America [ 1058-4838 ] ; 2017.
Abstract
In this systematic review and meta-analysis, we found evidence for a protective effect of facemasks and respirators against clinical respiratory infection among healthcare workers, and limited evidence for superiority of respirators. However, the existing evidence is sparse and findings inconsistent.
Url:
DOI: 10.1093/cid/cix681
PubMed: 29140516
PubMed Central: 7108111
Affiliations:
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Effectiveness of Masks and Respirators Against Respiratory Infections in Healthcare Workers: A Systematic Review and Meta-Analysis</title><author><name sortKey="Offeddu, Vittoria" sort="Offeddu, Vittoria" uniqKey="Offeddu V" first="Vittoria" last="Offeddu">Vittoria Offeddu</name><affiliation><nlm:aff id="AF0001"><institution>Saw Swee Hock School of Public Health, National University of Singapore</institution></nlm:aff></affiliation></author><author><name sortKey="Yung, Chee Fu" sort="Yung, Chee Fu" uniqKey="Yung C" first="Chee Fu" last="Yung">Chee Fu Yung</name><affiliation wicri:level="1"><nlm:aff id="AF0002"><institution>Infectious Disease Service, Department of Paediatrics, KK Women’s and Children’s Hospital</institution>,<country>Singapore</country></nlm:aff><country xml:lang="fr">Singapour</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Low, Mabel Sheau Fong" sort="Low, Mabel Sheau Fong" uniqKey="Low M" first="Mabel Sheau Fong" last="Low">Mabel Sheau Fong Low</name><affiliation><nlm:aff id="AF0001"><institution>Saw Swee Hock School of Public Health, National University of Singapore</institution></nlm:aff></affiliation></author><author><name sortKey="Tam, Clarence C" sort="Tam, Clarence C" uniqKey="Tam C" first="Clarence C" last="Tam">Clarence C. Tam</name><affiliation><nlm:aff id="AF0001"><institution>Saw Swee Hock School of Public Health, National University of Singapore</institution></nlm:aff></affiliation><affiliation wicri:level="1"><nlm:aff id="AF0003"><institution>London School of Hygiene & Tropical Medicine</institution>,<addr-line>London</addr-line>,<country>United Kingdom</country></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">29140516</idno><idno type="pmc">7108111</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7108111</idno><idno type="RBID">PMC:7108111</idno><idno type="doi">10.1093/cid/cix681</idno><date when="2017">2017</date><idno type="wicri:Area/Pmc/Corpus">001718</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">001718</idno><idno type="wicri:Area/Pmc/Curation">001718</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">001718</idno><idno type="wicri:Area/Pmc/Checkpoint">000632</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">000632</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Effectiveness of Masks and Respirators Against Respiratory Infections in Healthcare Workers: A Systematic Review and Meta-Analysis</title><author><name sortKey="Offeddu, Vittoria" sort="Offeddu, Vittoria" uniqKey="Offeddu V" first="Vittoria" last="Offeddu">Vittoria Offeddu</name><affiliation><nlm:aff id="AF0001"><institution>Saw Swee Hock School of Public Health, National University of Singapore</institution></nlm:aff></affiliation></author><author><name sortKey="Yung, Chee Fu" sort="Yung, Chee Fu" uniqKey="Yung C" first="Chee Fu" last="Yung">Chee Fu Yung</name><affiliation wicri:level="1"><nlm:aff id="AF0002"><institution>Infectious Disease Service, Department of Paediatrics, KK Women’s and Children’s Hospital</institution>,<country>Singapore</country></nlm:aff><country xml:lang="fr">Singapour</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Low, Mabel Sheau Fong" sort="Low, Mabel Sheau Fong" uniqKey="Low M" first="Mabel Sheau Fong" last="Low">Mabel Sheau Fong Low</name><affiliation><nlm:aff id="AF0001"><institution>Saw Swee Hock School of Public Health, National University of Singapore</institution></nlm:aff></affiliation></author><author><name sortKey="Tam, Clarence C" sort="Tam, Clarence C" uniqKey="Tam C" first="Clarence C" last="Tam">Clarence C. Tam</name><affiliation><nlm:aff id="AF0001"><institution>Saw Swee Hock School of Public Health, National University of Singapore</institution></nlm:aff></affiliation><affiliation wicri:level="1"><nlm:aff id="AF0003"><institution>London School of Hygiene & Tropical Medicine</institution>,<addr-line>London</addr-line>,<country>United Kingdom</country></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author></analytic><series><title level="j">Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America</title><idno type="ISSN">1058-4838</idno><idno type="eISSN">1537-6591</idno><imprint><date when="2017">2017</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>In this systematic review and meta-analysis, we found evidence for a protective effect of facemasks and respirators against clinical respiratory infection among healthcare workers, and limited evidence for superiority of respirators. 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<front><journal-meta><journal-id journal-id-type="nlm-ta">Clin Infect Dis</journal-id><journal-id journal-id-type="iso-abbrev">Clin. Infect. Dis</journal-id><journal-id journal-id-type="publisher-id">cid</journal-id><journal-title-group><journal-title>Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America</journal-title></journal-title-group><issn pub-type="ppub">1058-4838</issn><issn pub-type="epub">1537-6591</issn><publisher><publisher-name>Oxford University Press</publisher-name><publisher-loc>US</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">29140516</article-id><article-id pub-id-type="pmc">7108111</article-id><article-id pub-id-type="doi">10.1093/cid/cix681</article-id><article-id pub-id-type="publisher-id">cix681</article-id><article-categories><subj-group subj-group-type="heading"><subject>Review Article</subject></subj-group></article-categories><title-group><article-title>Effectiveness of Masks and Respirators Against Respiratory Infections in Healthcare Workers: A Systematic Review and Meta-Analysis</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Offeddu</surname><given-names>Vittoria</given-names></name><xref ref-type="aff" rid="AF0001">1</xref><xref ref-type="corresp" rid="c1"></xref><pmc-comment>vittoria.offeddu@nus.edu.sg </pmc-comment>
</contrib><contrib contrib-type="author"><name><surname>Yung</surname><given-names>Chee Fu</given-names></name><xref ref-type="aff" rid="AF0002">2</xref></contrib><contrib contrib-type="author"><name><surname>Low</surname><given-names>Mabel Sheau Fong</given-names></name><xref ref-type="aff" rid="AF0001">1</xref></contrib><contrib contrib-type="author"><name><surname>Tam</surname><given-names>Clarence C</given-names></name><xref ref-type="aff" rid="AF0001">1</xref><xref ref-type="aff" rid="AF0003">3</xref></contrib></contrib-group><aff id="AF0001"><label>1</label><institution>Saw Swee Hock School of Public Health, National University of Singapore</institution></aff><aff id="AF0002"><label>2</label><institution>Infectious Disease Service, Department of Paediatrics, KK Women’s and Children’s Hospital</institution>,<country>Singapore</country></aff><aff id="AF0003"><label>3</label><institution>London School of Hygiene & Tropical Medicine</institution>,<addr-line>London</addr-line>,<country>United Kingdom</country></aff><author-notes><corresp id="c1">Correspondence: V. Offeddu, Postdoctoral Fellow, Saw Swee Hock School of Public Health, National University of Singapore Tahir Foundation Bldg, 12 Science Dr 2, No. 10-01, Singapore 117549 (<email>vittoria.offeddu@nus.edu.sg</email>).</corresp></author-notes><pub-date pub-type="ppub"><day>01</day><month>12</month><year>2017</year></pub-date><pub-date pub-type="epub" iso-8601-date="2017-08-07"><day>07</day><month>8</month><year>2017</year></pub-date><volume>65</volume><issue>11</issue><fpage>1934</fpage><lpage>1942</lpage><history><date date-type="received"><day>28</day><month>4</month><year>2017</year></date><date date-type="accepted"><day>29</day><month>7</month><year>2017</year></date></history><permissions><copyright-statement>© The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.</copyright-statement><copyright-year>2017</copyright-year><license><license-p>This article is made available via the PMC Open Access Subset for unrestricted re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the COVID-19 pandemic or until permissions are revoked in writing. Upon expiration of these permissions, PMC is granted a perpetual license to make this article available via PMC and Europe PMC, consistent with existing copyright protections.</license-p></license></permissions><self-uri xlink:href="cix681.pdf"></self-uri><abstract abstract-type="teaser"><p>In this systematic review and meta-analysis, we found evidence for a protective effect of facemasks and respirators against clinical respiratory infection among healthcare workers, and limited evidence for superiority of respirators. However, the existing evidence is sparse and findings inconsistent.</p></abstract><abstract><title>Abstract</title><p>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.</p></abstract><kwd-group><kwd>Facemasks</kwd><kwd>N95 respirators</kwd><kwd>respiratory infections</kwd><kwd>severe acute respiratory syndrome (SARS)</kwd><kwd>influenza</kwd></kwd-group><counts><page-count count="9"></page-count></counts></article-meta></front></pmc><affiliations><list><country><li>Royaume-Uni</li><li>Singapour</li></country></list><tree><noCountry><name sortKey="Low, Mabel Sheau Fong" sort="Low, Mabel Sheau Fong" uniqKey="Low M" first="Mabel Sheau Fong" last="Low">Mabel Sheau Fong Low</name><name sortKey="Offeddu, Vittoria" sort="Offeddu, Vittoria" uniqKey="Offeddu V" first="Vittoria" last="Offeddu">Vittoria Offeddu</name></noCountry><country name="Singapour"><noRegion><name sortKey="Yung, Chee Fu" sort="Yung, Chee Fu" uniqKey="Yung C" first="Chee Fu" last="Yung">Chee Fu Yung</name></noRegion></country><country name="Royaume-Uni"><noRegion><name sortKey="Tam, Clarence C" sort="Tam, Clarence C" uniqKey="Tam C" first="Clarence C" last="Tam">Clarence C. 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