Comparison of Face-Touching Behaviors Before and During the Coronavirus Disease 2019 Pandemic
Comparison of Face-Touching Behaviors Before and During the Coronavirus Disease 2019 Pandemic
复制标题
DOI：
10.1001/jamanetworkopen.2020.16924
复制
发表时间：
2020-07-29
影响因子：
13.8
通讯作者：
Li, Xing
中科院分区：
文献类型：
--
作者：
Chen, Yong-Jian;Qin, Gang;Li, Xing
问题：戴口罩与减少面部接触行为有关吗？在这项横断面研究中，包括2019冠状病毒病（COVID-19）大流行前的4699名个体和2019冠状病毒病大流行期间的2887名个体，强制戴口罩政策与COVID-19大流行期间普通人群戴口罩的增加有关。戴口罩，无论是医用的还是织物的，都与触摸面部行为的减少有关，特别是触摸眼睛、鼻子和嘴巴。这些发现表明，强制性戴口罩政策与减少公共场所普通人群的面部接触行为有关，这可能有助于预防COVID-19的接触传播。这项横断面研究考察了冠状病毒病之前和期间的戴口罩和面部接触行为2019重要性口罩对一般人群在公共场所预防2019冠状病毒病（COVID-19）的有效性证据不足。因此，调查强制戴口罩政策与COVID-19传播相关行为之间的关联势在必行。目的探讨公共场所普通人群戴口罩与摸脸行为的关系。设计、设置和参与者本横断面研究使用了中国、日本、韩国、西欧（即英国、法国、德国、西班牙和意大利）和美国的普通人群在公共交通站、街道和公园中录制的视频，以分析公共场所戴口罩和触摸面部的行为。COVID-19疫情前的视频定义为二零一八年一月至二零一九年十月期间录制的视频，而COVID-19疫情期间的视频定义为二零二零年二月至二零二零年三月期间在中国、日本及韩国以及二零二零年三月期间在西欧及美国录制的视频。明确展示自己面部和面部接触行为的个体被包括在内，而那些行为受到拍摄或公共事件影响的个体被排除在外。中国、日本、韩国、西欧和美国在不同时间点颁布了强制戴口罩政策。主要结果及量度戴口罩人士的比例及触摸面部的发生率。结果该研究包括COVID-19大流行前的4699名个体和大流行期间的2887名个体。在研究期间，除美国外，所有地区的戴口罩人数都有所增加，1745人中有20人戴口罩，（1.1%）至1097人中的1090人（99.4%）在中国大陆（P < .001），1422人中有44人（3.1%）至893人中的346人（38.7%）日本（P < .001），717人中有6人（0.8%）至324人中的277人（85.5%）韩国（P < .001），546人中有1人在西欧（0.2%）至379例患者中的6例（1.6%）（P = 0.02），在美国（0.17）至194例患者中的1例（0.4%）。中国主要使用外科口罩（989个口罩[89.1%]），其他地区主要使用织物口罩（日本：371个口罩[95.1%];韩国：240个口罩[84.8%];西欧：6个口罩[85.7%];美国：5个口罩[100%]）。中国个人的面部触摸行为从COVID-19之前到COVID-19期间有所减少（1745次观察中发生72例[4.1%]，1097次观察中发生12例[1.1%]; P < .001），韩国（717次观察中有80次发生[11.2%]，324次观察中有7次发生[2.2%]; P < .001），欧洲（546个观察结果中有62例发生[11.4%]，379个观察结果中有23例发生[6.1%]; P = 0.01）。Logistic回归发现，在中国，戴口罩与触摸面部的减少有关（比值比[OR]，3.91; 95% CI，2.11-7.24）和韩国（OR，6.69; 95%CI，2.69-16.69）和触摸鼻子、嘴和眼睛（中国：OR，8.60; 95% CI，2.65-27.86;韩国：OR，29.27; 95% CI，1.79-478.22）。结论和相关性这项横断面研究的结果表明，强制戴口罩政策与COVID-19大流行期间戴口罩人数增加有关。戴口罩与减少面部触摸行为有关，特别是触摸眼睛，鼻子和嘴，这可能会防止COVID-19在公共区域的一般人群中的接触传播。
Question Is wearing face masks associated with reduced face-touching behaviors? Findings In this cross-sectional study, including 4699 individuals before the coronavirus disease 2019 (COVID-19) pandemic and 2887 individuals during the COVID-19 pandemic, mandatory mask-wearing policies were associated with increased mask wearing among the general population during the COVID-19 pandemic. Wearing masks, either medical or fabric, was associated with reduced face-touching behavior, especially touching of the eyes, nose, and mouth. Meaning These findings suggest that mandatory mask-wearing policies were associated with reducing face-touching behavior among the general population in public areas, which may help to prevent contact transmission of COVID-19.This cross-sectional study examines mask wearing and face-touching behaviors before and during the coronavirus disease 2019 (COVID-19) pandemic in China, Japan, South Korea, Western Europe, and the US.Importance There is insufficient evidence on the efficacy of masks in the general population for the prevention of coronavirus disease 2019 (COVID-19) in public areas. Therefore, it is imperative to investigate the association of mandatory mask-wearing policies with behaviors associated with the transmission of COVID-19. Objective To assess the association of mask wearing with face-touching behavior among the general population in public areas. Design, Setting, and Participants This cross-sectional study used videos recorded in public transportation stations, streets, and parks among the general population in China, Japan, South Korea, Western Europe (ie, England, France, Germany, Spain, and Italy), and the US to analyze mask-wearing and face-touching behavior in public areas. Videos before the COVID-19 pandemic were defined as those recorded from January 2018 to October 2019, and those during the COVID-19 pandemic were defined as those recorded during February 2020 to March 2020 in China, Japan, and South Korea and during March 2020 in Western Europe and the US. Individuals who clearly displayed their face and face-touching behavior were included, and those whose behaviors were influenced by filming or public events were excluded. Exposures Mandatory mask-wearing policies enacted at various time points in China, Japan, South Korea, Western Europe, and the US. Main Outcomes and Measures Proportion of individuals wearing masks and incidence of face touching. Results This study included 4699 individuals before the COVID-19 pandemic and 2887 individuals during the pandemic. During the periods studied, mask wearing increased in all regions except the US, from 20 of 1745 individuals (1.1%) to 1090 of 1097 individuals (99.4%) in mainland China (P < .001), 44 of 1422 individuals (3.1%) to 346 of 893 individuals (38.7%) in Japan (P < .001), 6 of 717 individuals (0.8%) to 277 of 324 individuals (85.5% ) in South Korea (P < .001), 1 of 546 individuals (0.2%) to 6 of 379 individuals (1.6%) in Western Europe (P = .02), and 1 of 269 individuals (0.4%) to 4 of 194 individuals (2.1%) in the US (P = .17). Surgical masks were predominant in China (989 masks [89.1%]), and fabric masks were predominant in the other regions (Japan: 371 masks [95.1%]; South Korea: 240 masks [84.8%]; Western Europe: 6 masks [85.7%]; US: 5 masks [100%]). Face-touching behaviors decreased from before COVID-19 to during COVID-19 among individuals in China (72 incidences of 1745 observations [4.1%] to 12 incidences of 1097 observations [1.1%]; P < .001), South Korea (80 incidences of 717 observations [11.2%] to 7 incidences of 324 observations [2.2%]; P < .001), and Europe (62 incidences of 546 observations [11.4%] to 23 incidences of 379 observations [6.1%]; P = .01). Logistic regression found that mask wearing was associated with a reduction in face touching in China (odds ratio [OR], 3.91; 95% CI, 2.11-7.24) and South Korea (OR, 6.69; 95% CI, 2.69-16.69) and of touching the nose, mouth, and eyes (China: OR, 8.60; 95% CI, 2.65-27.86; South Korea: OR, 29.27; 95% CI, 1.79-478.22). Conclusions and Relevance The findings of this cross-sectional study suggest that mandatory mask-wearing policies were associated with increased mask wearing during the COVID-19 pandemic. Mask wearing was associated with reduced face-touching behavior, especially touching of the eyes, nose, and mouth, which may prevent contact transmission of COVID-19 among the general population in public areas.