Effectiveness of masks and respirators against respiratory infections in healthcare workers: a systematic review and meta-analysis
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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.
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Offeddu 2017 concluded that masks (either N95/P2 respirators or medical/surgical masks) were effective against clinical respiratory infections (RR 0.59, 95% CI 0.46 to 0.77) and influenza-like illness (RR 0.34, 95% CI 0.14 to 0.82).
“A similar meta‐analysis, Offeddu 2017, based on two trials concluded that masks (either N95/P2 respirators or medical/surgical masks) were effective against clinical respiratory infections (RR 0.59, 95% CI 0.46 to 0.77) and ILI (RR 0.34, 95% CI 0.14 to 0.82) (MacIntyre 2011; MacIntyre 2015).”
From Physical interventions to interrupt or reduce the spread of respiratory viruses (2023) · cites this paper as Offeddu 2017
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- Authors
- Offeddu, V., Yung, C. F., Low, M. S. F., & Tam, C. C.
- Affiliations
- National University of Singapore (SG)
- KK Women's and Children's Hospital (SG)
- Corresponding author
- Offeddu, Vittoria
- Venue
- Clinical Infectious Diseases
- Publisher
- Oxford University Press (OUP)
- Published
- 2017-08-07
- Volume
- 65
- Issue
- 11
- Pages
- 1934-1942
- ISSN
- 1058-4838 (ISSN-L)
- 1537-6591
- PMC
- PMC7108111
- OpenAlex
- W2743706615
- Cited by
- 297
- References
- 49
- Citations by year
- 2026: 4 · 2025: 12 · 2024: 18 · 2023: 12 · 2022: 30 · 2021: 79 · 2020: 134 · 2019: 5 · 2018: 1 · 2017: 2
- FWCI
- 7.08
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Clinical Infectious Diseases (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- LSHTM Research Online (London School of Hygiene and Tropical Medicine) (submittedVersion)
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Infection Control and Ventilation
- Health Sciences › Medicine › Infectious Diseases › Infection Control in Healthcare
- Health Sciences › Health Professions › Occupational Therapy › Occupational Health and Safety in Workplaces
- Keywords
- face masks, respirators, N95 respirators, respiratory infections, healthcare workers, occupational infection prevention, influenza-like illness, bacterial respiratory infections, SARS, respiratory protection
- MeSH terms
- Health Personnel, Humans, Influenza, Human, Masks, Ventilators, Mechanical, Respiratory Protective Devices, Respiratory Tract Infections, Virus Diseases, Randomized Controlled Trials as Topic, Occupational Exposure, Infection Control, Severe Acute Respiratory Syndrome, Observational Studies as Topic
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