A cluster randomised trial of cloth masks compared with medical masks in healthcare workers.
A cluster randomised trial of cloth masks compared with medical masks in healthcare workers.
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DOI：
10.1136/bmjopen-2014-006577
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发表时间：
2015-04-22
期刊：
影响因子：
2.9
通讯作者：
Wang Q
中科院分区：
文献类型：
--
作者：
MacIntyre CR;Seale H;Dung TC;Hien NT;Nga PT;Chughtai AA;Rahman B;Dwyer DE;Wang Q
这项研究的目的是比较布质口罩和医用口罩在医院医护人员中的效果。零假设是医用口罩和布质口罩之间没有区别。越南河内14家二级/三级医院。1607名医院医务人员，年龄≥18 岁，在选定的高危病房全职工作。医院病房被随机分为医用口罩、布口罩或对照组(通常做法，包括戴口罩)。参与者连续4周在每个班次使用口罩。临床呼吸道疾病(CRI)、流感样疾病(ILI)和实验室确认的呼吸道病毒感染。与医用口罩臂相比，布口罩臂的ILI率显著高于医用口罩臂(RR=13.00，95%CI1.69~100.07)。与对照组相比，布面口罩的ILI发生率也明显更高。口罩使用情况分析显示，布面口罩组ILI(RR=6.64，95%CI 1.45~28.65)和实验室确认病毒(RR=1.72，95%CI 1.01~2.94)显著高于医用口罩组。布质口罩的微粒渗透率接近97%，医用口罩的渗透率为44%。这项研究是第一次对布质口罩进行随机对照试验，研究结果警告不要使用布质口罩。这是一个重要的发现，为职业健康和安全提供信息。保湿、重复使用口罩和过滤不良可能会增加感染的风险。还需要进一步的研究，以告知全球范围内布质口罩的广泛使用。然而，作为一项预防措施，不应向卫生工作者推荐口罩，特别是在高危情况下，需要更新指南。澳大利亚和新西兰临床试验注册：ACTRN12610000887077。
The aim of this study was to compare the efficacy of cloth masks to medical masks in hospital healthcare workers (HCWs). The null hypothesis is that there is no difference between medical masks and cloth masks. 14 secondary-level/tertiary-level hospitals in Hanoi, Vietnam. 1607 hospital HCWs aged ≥18 years working full-time in selected high-risk wards. Hospital wards were randomised to: medical masks, cloth masks or a control group (usual practice, which included mask wearing). Participants used the mask on every shift for 4 consecutive weeks. Clinical respiratory illness (CRI), influenza-like illness (ILI) and laboratory-confirmed respiratory virus infection. The rates of all infection outcomes were highest in the cloth mask arm, with the rate of ILI statistically significantly higher in the cloth mask arm (relative risk (RR)=13.00, 95% CI 1.69 to 100.07) compared with the medical mask arm. Cloth masks also had significantly higher rates of ILI compared with the control arm. An analysis by mask use showed ILI (RR=6.64, 95% CI 1.45 to 28.65) and laboratory-confirmed virus (RR=1.72, 95% CI 1.01 to 2.94) were significantly higher in the cloth masks group compared with the medical masks group. Penetration of cloth masks by particles was almost 97% and medical masks 44%. This study is the first RCT of cloth masks, and the results caution against the use of cloth masks. This is an important finding to inform occupational health and safety. Moisture retention, reuse of cloth masks and poor filtration may result in increased risk of infection. Further research is needed to inform the widespread use of cloth masks globally. However, as a precautionary measure, cloth masks should not be recommended for HCWs, particularly in high-risk situations, and guidelines need to be updated. Australian New Zealand Clinical Trials Registry: ACTRN12610000887077.
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影响因子：
6.4
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