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Effectiveness of Masks and Respirators Against Respiratory Infections in Healthcare Workers: A Systematic Review and Meta-Analysis.
Clin Infect Dis. 2017 Nov 13; 65(11):1934-1942.CI

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+Show Affiliations

Saw Swee Hock School of Public Health, National University of Singapore.Infectious Disease Service, Department of Paediatrics, KK Women's and Children's Hospital, Singapore.Saw Swee Hock School of Public Health, National University of Singapore.Saw Swee Hock School of Public Health, National University of Singapore. London School of Hygiene & Tropical Medicine, London, United Kingdom.

Pub Type(s)

Journal Article
Meta-Analysis
Review
Systematic Review

Language

eng

PubMed ID

29140516

Citation

Offeddu, Vittoria, et al. "Effectiveness of Masks and Respirators Against Respiratory Infections in Healthcare Workers: a Systematic Review and Meta-Analysis." Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, vol. 65, no. 11, 2017, pp. 1934-1942.
Offeddu V, Yung CF, Low MSF, et al. Effectiveness of Masks and Respirators Against Respiratory Infections in Healthcare Workers: A Systematic Review and Meta-Analysis. Clin Infect Dis. 2017;65(11):1934-1942.
Offeddu, V., Yung, C. F., Low, M. S. F., & Tam, C. C. (2017). Effectiveness of Masks and Respirators Against Respiratory Infections in Healthcare Workers: A Systematic Review and Meta-Analysis. Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, 65(11), 1934-1942. https://doi.org/10.1093/cid/cix681
Offeddu V, et al. Effectiveness of Masks and Respirators Against Respiratory Infections in Healthcare Workers: a Systematic Review and Meta-Analysis. Clin Infect Dis. 2017 Nov 13;65(11):1934-1942. PubMed PMID: 29140516.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effectiveness of Masks and Respirators Against Respiratory Infections in Healthcare Workers: A Systematic Review and Meta-Analysis. AU - Offeddu,Vittoria, AU - Yung,Chee Fu, AU - Low,Mabel Sheau Fong, AU - Tam,Clarence C, PY - 2017/04/28/received PY - 2017/07/29/accepted PY - 2017/11/16/entrez PY - 2017/11/16/pubmed PY - 2018/7/12/medline KW - Facemasks KW - N95 respirators KW - influenza KW - respiratory infections KW - severe acute respiratory syndrome (SARS) SP - 1934 EP - 1942 JF - Clinical infectious diseases : an official publication of the Infectious Diseases Society of America JO - Clin Infect Dis VL - 65 IS - 11 N2 - 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. SN - 1537-6591 UR - https://www.unboundmedicine.com/medline/citation/29140516/Effectiveness_of_Masks_and_Respirators_Against_Respiratory_Infections_in_Healthcare_Workers:_A_Systematic_Review_and_Meta_Analysis_ L2 - https://academic.oup.com/cid/article-lookup/doi/10.1093/cid/cix681 DB - PRIME DP - Unbound Medicine ER -