N95 respirator and surgical mask effectiveness against respiratory viral illnesses in the healthcare setting: A systematic review and meta‐analysis
Abstract Objective To examine the results, level of evidence, and methodologic quality of original studies regarding surgical mask effectiveness in minimizing viral respiratory illness transmission, and, in particular, the performance of the N95 respirator versus surgical mask. Methods Meta‐analysis...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2021-10-01
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| Series: | Journal of the American College of Emergency Physicians Open |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/emp2.12582 |
| _version_ | 1797835958359425024 |
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| author | Andrew P. Collins Benjamin C. Service Sunny Gupta Naser Mubarak Ibrahim Mamdouh Zeini Daryl C. Osbahr Anthony A. Romeo |
| author_facet | Andrew P. Collins Benjamin C. Service Sunny Gupta Naser Mubarak Ibrahim Mamdouh Zeini Daryl C. Osbahr Anthony A. Romeo |
| author_sort | Andrew P. Collins |
| collection | DOAJ |
| description | Abstract Objective To examine the results, level of evidence, and methodologic quality of original studies regarding surgical mask effectiveness in minimizing viral respiratory illness transmission, and, in particular, the performance of the N95 respirator versus surgical mask. Methods Meta‐analysis was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines with use of PubMed, MEDLINE, and the Cochrane Library databases. Results Eight studies (9164 participants) were included after screening 153 articles. Analyses showed statistically significant differences between N95 respirator versus surgical mask use to prevent influenza‐like‐illness (risk ratio [RR] = 0.81, 95% confidence interval [CI] = 0.68–0.94, P < 0.05), non‐influenza respiratory viral infection (RR = 0.62, 95% CI = 0.52–0.74, P < 0.05), respiratory viral infection (RR = 0.73, 95% CI = 0.65–0.82, P < 0.05), severe acute respiratory syndrome coronavirus (SARS‐CoV) 1 and 2 virus infection (RR = 0.17, 95% CI = 0.06–0.49, P < 0.05), and laboratory‐confirmed respiratory viral infection (RR = 0.75, 95% CI = 0.66–0.84, P < 0.05). Analyses did not indicate statistically significant results against laboratory‐confirmed influenza (RR = 0.87, CI = 0.74–1.03, P > 0.05). Conclusions N95 respirator use was associated with fewer viral infectious episodes for healthcare workers compared with surgical masks. The N95 respirator was most effective in reducing the risk of a viral infection in the hospital setting from the SARS‐CoV 1 and 2 viruses compared to the other viruses included in this investigation. Methodologic quality, risk of biases, and small number of original studies indicate the necessity for further research to be performed, especially in front‐line healthcare delivery settings. |
| first_indexed | 2024-04-09T15:00:58Z |
| format | Article |
| id | doaj.art-904dfc18b7ff47cba122299ac19a9670 |
| institution | Directory Open Access Journal |
| issn | 2688-1152 |
| language | English |
| last_indexed | 2024-04-09T15:00:58Z |
| publishDate | 2021-10-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American College of Emergency Physicians Open |
| spelling | doaj.art-904dfc18b7ff47cba122299ac19a96702023-05-01T17:35:54ZengWileyJournal of the American College of Emergency Physicians Open2688-11522021-10-0125n/an/a10.1002/emp2.12582N95 respirator and surgical mask effectiveness against respiratory viral illnesses in the healthcare setting: A systematic review and meta‐analysisAndrew P. Collins0Benjamin C. Service1Sunny Gupta2Naser Mubarak3Ibrahim Mamdouh Zeini4Daryl C. Osbahr5Anthony A. Romeo6University of Central Florida College of Medicine Orlando Florida USAOrlando Health Orthopedic Institute Orlando Florida USADepartment of Orthopedics University of Pennsylvania Philadelphia Pennsylvania USAUniversity of Central Florida College of Medicine Orlando Florida USAAdventHealth Orthopedic Institute Orlando Florida USAOrthopaedic Surgery, Rothman Orthopaedic Institute Florida Orlando Florida USADuPage Medical Group Musculoskeletal Institute Chicago Illinois USAAbstract Objective To examine the results, level of evidence, and methodologic quality of original studies regarding surgical mask effectiveness in minimizing viral respiratory illness transmission, and, in particular, the performance of the N95 respirator versus surgical mask. Methods Meta‐analysis was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines with use of PubMed, MEDLINE, and the Cochrane Library databases. Results Eight studies (9164 participants) were included after screening 153 articles. Analyses showed statistically significant differences between N95 respirator versus surgical mask use to prevent influenza‐like‐illness (risk ratio [RR] = 0.81, 95% confidence interval [CI] = 0.68–0.94, P < 0.05), non‐influenza respiratory viral infection (RR = 0.62, 95% CI = 0.52–0.74, P < 0.05), respiratory viral infection (RR = 0.73, 95% CI = 0.65–0.82, P < 0.05), severe acute respiratory syndrome coronavirus (SARS‐CoV) 1 and 2 virus infection (RR = 0.17, 95% CI = 0.06–0.49, P < 0.05), and laboratory‐confirmed respiratory viral infection (RR = 0.75, 95% CI = 0.66–0.84, P < 0.05). Analyses did not indicate statistically significant results against laboratory‐confirmed influenza (RR = 0.87, CI = 0.74–1.03, P > 0.05). Conclusions N95 respirator use was associated with fewer viral infectious episodes for healthcare workers compared with surgical masks. The N95 respirator was most effective in reducing the risk of a viral infection in the hospital setting from the SARS‐CoV 1 and 2 viruses compared to the other viruses included in this investigation. Methodologic quality, risk of biases, and small number of original studies indicate the necessity for further research to be performed, especially in front‐line healthcare delivery settings.https://doi.org/10.1002/emp2.12582COVID‐19influenzamaskN95 respiratorpersonal protective equipmentPPE |
| spellingShingle | Andrew P. Collins Benjamin C. Service Sunny Gupta Naser Mubarak Ibrahim Mamdouh Zeini Daryl C. Osbahr Anthony A. Romeo N95 respirator and surgical mask effectiveness against respiratory viral illnesses in the healthcare setting: A systematic review and meta‐analysis Journal of the American College of Emergency Physicians Open COVID‐19 influenza mask N95 respirator personal protective equipment PPE |
| title | N95 respirator and surgical mask effectiveness against respiratory viral illnesses in the healthcare setting: A systematic review and meta‐analysis |
| title_full | N95 respirator and surgical mask effectiveness against respiratory viral illnesses in the healthcare setting: A systematic review and meta‐analysis |
| title_fullStr | N95 respirator and surgical mask effectiveness against respiratory viral illnesses in the healthcare setting: A systematic review and meta‐analysis |
| title_full_unstemmed | N95 respirator and surgical mask effectiveness against respiratory viral illnesses in the healthcare setting: A systematic review and meta‐analysis |
| title_short | N95 respirator and surgical mask effectiveness against respiratory viral illnesses in the healthcare setting: A systematic review and meta‐analysis |
| title_sort | n95 respirator and surgical mask effectiveness against respiratory viral illnesses in the healthcare setting a systematic review and meta analysis |
| topic | COVID‐19 influenza mask N95 respirator personal protective equipment PPE |
| url | https://doi.org/10.1002/emp2.12582 |
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