Efficacy of face masks and respirators in preventing upper respiratory tract bacterial colonization and co-infection in hospital healthcare workers

MacIntyre, C. Raina; Wang, Quanyi; Rahman, Bayzidur; Seale, Holly; Ridda, Iman; Gao, Zeyu; Yang, Peng; Shi, Weixian; Pang, Xinghuo; Zhang, Yi; Moa, Aye; Dwyer, Dominic E.

doi:10.1016/j.ypmed.2014.01.015

Cited by 76 publications

(89 citation statements)

References 46 publications

(73 reference statements)

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“…These findings may have important implications for policy and practice, but the role of respirators to help combat antibiotic resistant bacteria has not been tested in an RCT. The analysis also found that simultaneous infection of healthcare workers with two bacteria and a virus, or a bacterium and two viruses was common, 45 and that an N95 respirator significantly protected against dual infections.…”

Section: Stat E O F T H E a Rt R Ev I E Wmentioning

confidence: 90%

“…9 10 Bacterial colonisation An analysis published in 2014 showed that laboratory confirmed bacterial colonisation (mainly Streptococcus pneumoniae and Haemophilus influenzae) is common in healthcare workers with symptoms of respiratory illness. 45 Importantly, N95 respirators significantly reduced the risk of bacterial colonisation by 62% compared with no mask and by 46% compared with medical masks, which were not efficacious. These findings may have important implications for policy and practice, but the role of respirators to help combat antibiotic resistant bacteria has not been tested in an RCT.…”

Section: Stat E O F T H E a Rt R Ev I E Wmentioning

confidence: 97%

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Facemasks for the prevention of infection in healthcare and community settings

MacIntyre

Chughtai

2015

BMJ

271

300

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Facemasks are recommended for diseases transmitted through droplets and respirators for respiratory aerosols, yet recommendations and terminology vary between guidelines. The concepts of droplet and airborne transmission that are entrenched in clinical practice have recently been shown to be more complex than previously thought. Several randomised clinical trials of facemasks have been conducted in community and healthcare settings, using widely varying interventions, including mixed interventions (such as masks and handwashing), and diverse outcomes. Of the nine trials of facemasks identified in community settings, in all but one, facemasks were used for respiratory protection of well people. They found that facemasks and facemasks plus hand hygiene may prevent infection in community settings, subject to early use and compliance. Two trials in healthcare workers favoured respirators for clinical respiratory illness. The use of reusable cloth masks is widespread globally, particularly in Asia, which is an important region for emerging infections, but there is no clinical research to inform their use and most policies offer no guidance on them. Health economic analyses of facemasks are scarce and the few published cost effectiveness models do not use clinical efficacy data. The lack of research on facemasks and respirators is reflected in varied and sometimes conflicting policies and guidelines. Further research should focus on examining the efficacy of facemasks against specific infectious threats such as influenza and tuberculosis, assessing the efficacy of cloth masks, investigating common practices such as reuse of masks, assessing compliance, filling in policy gaps, and obtaining cost effectiveness data using clinical efficacy estimates.

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Section: Stat E O F T H E a Rt R Ev I E Wmentioning

confidence: 90%

Section: Stat E O F T H E a Rt R Ev I E Wmentioning

confidence: 97%

Facemasks for the prevention of infection in healthcare and community settings

MacIntyre

Chughtai

2015

BMJ

271

300

View full text Add to dashboard Cite

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“…Facemasks offer less protection against M. tuberculosis transmission as they have a lower filtration efficiency and a higher degree of face seal leakage than respirators (Coia et al, 2013; Cleveland, Robison & Panlilio, 2009; Macintyre et al, 2014). In a resource-limited setting where there are few/no respirators available, wearing of facemasks may help decrease transmission even if each individual HCW is not completely protected (Menon, 2013; Macintyre et al, 2014; Nicas, 1995). Use of a facemask that reduces inhalation of particles by 50% has been estimated to give the same level of protection as a doubling of room ventilation, but at a much lower cost (Menon, 2013).…”

Section: Discussionmentioning

confidence: 99%

“…The broad spectrum activity of fPANI may confer protection against other respiratory pathogens that also have a high burden in LMICs, such as bacterially derived pneumonia (Macintyre et al, 2014). …”

Section: Discussionmentioning

confidence: 99%

The tuberculocidal activity of polyaniline and functionalised polyanilines

Robertson

Dalton

Wiles

et al. 2016

PeerJ

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Tuberculosis is considered a leading cause of death worldwide. More than 95% of cases and deaths occur in low-and middle-income countries. In resource-limited countries, hospitals often lack adequate facilities to manage and isolate patients with infectious tuberculosis (TB), relying instead on personal protective equipment, such as facemasks, to reduce nosocomial transmission of the disease. Facemasks impregnated with an antimicrobial agent may be a cost-effective way of adding an extra level of protection against the spread of TB by reducing the risk of disease transmission. Conducting polymers, such as polyaniline (PANI), and their functionalised derivatives are a novel class of antimicrobial agents with potential as non-leaching additives to provide contamination resistant surfaces. We have investigated the antimicrobial action of PANI and a functionalised derivative, poly-3-aminobenzoic acid (P3ABA), against mycobacteria and have determined the optimal treatment time and concentration to achieve significant knockdown of Mycobacterium smegmatis and Mycobacterium tuberculosis on an agar surface. Results indicated that P3ABA is a potential candidate for use as an anti-tuberculoid agent in facemasks to reduce TB transmission.

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“…14,28–30 Research has found these policies to be effective at positively influencing students’ dietary behaviors and physical activity levels. 31–33 However, despite these findings, recommended policies and practices have not been uniformly adopted across the United States. 34–37 Consequently, a critical next step in addressing childhood obesity through the school environment is to foster a better understanding of the factors facilitating schools to implement higher nutrition and physical activity standards.…”

mentioning

confidence: 99%

The Role of Family and Community Involvement in the Development and Implementation of School Nutrition and Physical Activity Policy

Kehm

Davey

Nanney

2015

Journal of School Health

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BACKGROUND Although there are several evidence-based recommendations directed at improving nutrition and physical activity standards in schools, these guidelines have not been uniformly adopted throughout the United States. Consequently, research is needed to identify facilitators promoting schools to implement these recommendations. Therefore, this study analyzed the 2008 School Health Profiles Principal Survey (Profiles) to explore the role of family and community involvement in school nutrition and physical activity standards. METHODS Survey data on nutrition and physical activity policies, as well as family and community involvement, were available for 28 states, representing 6732 secondary schools. One-factor analysis of variance (ANOVA), 2-sample t-tests, Pearson’s chi-square tests, and multiple logistic and linear regression models were employed in this analysis. RESULTS Family and community involvement were associated with schools more frequently utilizing healthy eating strategies and offering students healthier food options. Further, involvement was associated with greater support for physical education staff and more intramural sports opportunities for students. CONCLUSIONS Though family and community involvement have the potential to have a positive influence on school nutrition and physical activity policies and practices, involvement remains low in schools. Increased efforts are needed to encourage collaboration among schools, families, and communities to ensure the highest health standards for all students.

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Efficacy of face masks and respirators in preventing upper respiratory tract bacterial colonization and co-infection in hospital healthcare workers

Cited by 76 publications

References 46 publications

Facemasks for the prevention of infection in healthcare and community settings

Facemasks for the prevention of infection in healthcare and community settings

The tuberculocidal activity of polyaniline and functionalised polyanilines

The Role of Family and Community Involvement in the Development and Implementation of School Nutrition and Physical Activity Policy

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