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Contamination by respiratory viruses on outer surface of medical masks used by hospital healthcare workers.
BMC Infect Dis. 2019 Jun 03; 19(1):491.BI

Abstract

BACKGROUND

Medical masks are commonly used in health care settings to protect healthcare workers (HCWs) from respiratory and other infections. Airborne respiratory pathogens may settle on the surface of used masks layers, resulting in contamination. The main aim of this study was to study the presence of viruses on the surface of medical masks.

METHODS

Two pilot studies in laboratory and clinical settings were carried out to determine the areas of masks likely to contain maximum viral particles. A laboratory study using a mannequin and fluorescent spray showed maximum particles concentrated on upper right, middle and left sections of the medical masks. These findings were confirmed through a small clinical study. The main study was then conducted in high-risk wards of three selected hospitals in Beijing China. Participants (n = 148) were asked to wear medical masks for a shift (6-8 h) or as long as they could tolerate. Used samples of medical masks were tested for presence of respiratory viruses in upper sections of the medical masks, in line with the pilot studies.

RESULTS

Overall virus positivity rate was 10.1% (15/148). Commonly isolated viruses from masks samples were adenovirus (n = 7), bocavirus (n = 2), respiratory syncytial virus (n = 2) and influenza virus (n = 2). Virus positivity was significantly higher in masks samples worn for > 6 h (14.1%, 14/99 versus 1.2%, 1/49, OR 7.9, 95% CI 1.01-61.99) and in samples used by participants who examined > 25 patients per day (16.9%, 12/71 versus 3.9%, 3/77, OR 5.02, 95% CI 1.35-18.60). Most of the participants (83.8%, 124/148) reported at least one problem associated with mask use. Commonly reported problems were pressure on face (16.9%, 25/148), breathing difficulty (12.2%, 18/148), discomfort (9.5% 14/148), trouble communicating with the patient (7.4%, 11/148) and headache (6.1%, 9/148).

CONCLUSION

Respiratory pathogens on the outer surface of the used medical masks may result in self-contamination. The risk is higher with longer duration of mask use (> 6 h) and with higher rates of clinical contact. Protocols on duration of mask use should specify a maximum time of continuous use, and should consider guidance in high contact settings. Viruses were isolated from the upper sections of around 10% samples, but other sections of masks may also be contaminated. HCWs should be aware of these risks in order to protect themselves and people around them.

Authors+Show Affiliations

School of Public Health and Community Medicine, UNSW Medicine, University of New South Wales, Level 2, Samuels Building, Sydney, 2052, Australia. abrar.chughtai@unsw.edu.au.University of New South Wales, Virology Research Laboratory, Prince of Wales Hospital, Randwick, NSW, 2031, Australia.SAViD (Serology & Virology Division), Prince of Wales Hospital, Randwick, Australia.Infection Prevention Management and Staff Health Services- St Vincent's Hospital, Sydney, Australia.Beijing Center for Diseases Prevention and Control, Beijing, China.Beijing Center for Diseases Prevention and Control, Beijing, China.Beijing Center for Diseases Prevention and Control, Beijing, China.Beijing Center for Diseases Prevention and Control, Beijing, China.Fangshan Center for Diseases Prevention and Control, Beijing, China.Biosecurity Program, The Kirby Institute, University of New South Wales, Sydney, NSW, 2052, Australia. College of Public Service & Community Solutions, and College of Health Solutions, Arizona State University, Phoenix, AZ, 85004, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31159777

Citation

Chughtai, Abrar Ahmad, et al. "Contamination By Respiratory Viruses On Outer Surface of Medical Masks Used By Hospital Healthcare Workers." BMC Infectious Diseases, vol. 19, no. 1, 2019, p. 491.
Chughtai AA, Stelzer-Braid S, Rawlinson W, et al. Contamination by respiratory viruses on outer surface of medical masks used by hospital healthcare workers. BMC Infect Dis. 2019;19(1):491.
Chughtai, A. A., Stelzer-Braid, S., Rawlinson, W., Pontivivo, G., Wang, Q., Pan, Y., Zhang, D., Zhang, Y., Li, L., & MacIntyre, C. R. (2019). Contamination by respiratory viruses on outer surface of medical masks used by hospital healthcare workers. BMC Infectious Diseases, 19(1), 491. https://doi.org/10.1186/s12879-019-4109-x
Chughtai AA, et al. Contamination By Respiratory Viruses On Outer Surface of Medical Masks Used By Hospital Healthcare Workers. BMC Infect Dis. 2019 Jun 3;19(1):491. PubMed PMID: 31159777.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Contamination by respiratory viruses on outer surface of medical masks used by hospital healthcare workers. AU - Chughtai,Abrar Ahmad, AU - Stelzer-Braid,Sacha, AU - Rawlinson,William, AU - Pontivivo,Giulietta, AU - Wang,Quanyi, AU - Pan,Yang, AU - Zhang,Daitao, AU - Zhang,Yi, AU - Li,Lili, AU - MacIntyre,C Raina, Y1 - 2019/06/03/ PY - 2019/01/28/received PY - 2019/05/20/accepted PY - 2019/6/5/entrez PY - 2019/6/5/pubmed PY - 2019/8/1/medline KW - Health care workers KW - Infection control KW - Mask KW - Viruses SP - 491 EP - 491 JF - BMC infectious diseases JO - BMC Infect Dis VL - 19 IS - 1 N2 - BACKGROUND: Medical masks are commonly used in health care settings to protect healthcare workers (HCWs) from respiratory and other infections. Airborne respiratory pathogens may settle on the surface of used masks layers, resulting in contamination. The main aim of this study was to study the presence of viruses on the surface of medical masks. METHODS: Two pilot studies in laboratory and clinical settings were carried out to determine the areas of masks likely to contain maximum viral particles. A laboratory study using a mannequin and fluorescent spray showed maximum particles concentrated on upper right, middle and left sections of the medical masks. These findings were confirmed through a small clinical study. The main study was then conducted in high-risk wards of three selected hospitals in Beijing China. Participants (n = 148) were asked to wear medical masks for a shift (6-8 h) or as long as they could tolerate. Used samples of medical masks were tested for presence of respiratory viruses in upper sections of the medical masks, in line with the pilot studies. RESULTS: Overall virus positivity rate was 10.1% (15/148). Commonly isolated viruses from masks samples were adenovirus (n = 7), bocavirus (n = 2), respiratory syncytial virus (n = 2) and influenza virus (n = 2). Virus positivity was significantly higher in masks samples worn for > 6 h (14.1%, 14/99 versus 1.2%, 1/49, OR 7.9, 95% CI 1.01-61.99) and in samples used by participants who examined > 25 patients per day (16.9%, 12/71 versus 3.9%, 3/77, OR 5.02, 95% CI 1.35-18.60). Most of the participants (83.8%, 124/148) reported at least one problem associated with mask use. Commonly reported problems were pressure on face (16.9%, 25/148), breathing difficulty (12.2%, 18/148), discomfort (9.5% 14/148), trouble communicating with the patient (7.4%, 11/148) and headache (6.1%, 9/148). CONCLUSION: Respiratory pathogens on the outer surface of the used medical masks may result in self-contamination. The risk is higher with longer duration of mask use (> 6 h) and with higher rates of clinical contact. Protocols on duration of mask use should specify a maximum time of continuous use, and should consider guidance in high contact settings. Viruses were isolated from the upper sections of around 10% samples, but other sections of masks may also be contaminated. HCWs should be aware of these risks in order to protect themselves and people around them. SN - 1471-2334 UR - https://www.unboundmedicine.com/medline/citation/31159777/Contamination_by_respiratory_viruses_on_outer_surface_of_medical_masks_used_by_hospital_healthcare_workers_ L2 - https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-019-4109-x DB - PRIME DP - Unbound Medicine ER -