Cited by 298Infection Control and VentilationInfection Control in HealthcareOccupational Health and Safety in Workplaces

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Effectiveness of Masks and Respirators Against Respiratory Infections in Healthcare Workers: A Systematic Review and Meta-Analysis

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Offeddu, Vittoria, Yung, Chee Fu, Low, Mabel Sheau Fong, Tam, Clarence C·2017·Clinical Infectious Diseases

DOI 10.1093/cid/cix681PMC PMC7108111

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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.

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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
ORCID: Offeddu, Vittoria
Yung, Chee Fu
Low, Mabel Sheau Fong
Tam, Clarence C
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
DOI: 10.1093/cid/cix681
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 › Medicine › Public Health, Environmental and Occupational Health › 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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Effectiveness of Masks and Respirators Against Respiratory Infections in Healthcare Workers: A Systematic Review and Meta-Analysis

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