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Figures
- Figure 1:
Selection of studies for the meta-analysis.
- Figure 2:
Results of meta-analysis to determine effectiveness of N95 respirators versus surgical masks in protecting health care workers against acute respiratory infection. Outcomes were (A) laboratory-confirmed respiratory infection, (B) influenza-like illness and (C) workplace absenteeism. Values less than 1.0 favour N95 respirator. CI = confidence interval, NA = not applicable, RCT = randomized controlled trial.
Tables
Study Setting Participants Outcomes Interventions Notes Randomized controlled trials Loeb et al., 200911 8 hospitals in Ontario, Canada: emergency departments, acute medical units and pediatric units 446 nurses; individual-level randomization Laboratory-confirmed respiratory infection, influenza-like illness, workplace absenteeism
5-wk follow-up
Intervention: targeted use, fit-tested N95 respirator
Control: targeted use, surgical mask
Noninferiority trial
Detection of influenza A and B, respiratory syncytial virus metapneumovirus, parainfluenza virus, rhinovirus–enterovirus, coronavirus and adenovirus
MacIntyre et al., 2011/201412,13 15 hospitals in Beijing: emergency departments and respiratory wards 1441 nurses, doctors and ward clerks; cluster randomization by hospital Laboratory-confirmed respiratory infection, influenza-like illness
5-wk follow-up
Intervention 1: continual use, fit-tested N95 respirator
Intervention 2: continual use, non–fit-tested N95 respirator
Control: continual use, surgical mask
Detection of influenza A and B, respiratory syncytial virus metapneumovirus, parainfluenza virus, rhinovirus–enterovirus, coronavirus, adenovirus, Streptococcus pneumoniae, Bordetella pertussis, Chlamydophila pneumoniae, Mycoplasma pneumoniae and Haemophilus influenzae type B MacIntyre et al., 201314 19 hospitals in Beijing: emergency departments and respiratory wards 1669 nurses, doctors and ward clerks; cluster randomization by ward Laboratory-confirmed respiratory infection, influenza-like illness
5-wk follow-up
Intervention 1: continual use, fit-tested N95 respirator
Intervention 2: targeted use, fit-tested N95 respirator
Control: continual use, surgical mask
Detection of influenza A and B, respiratory syncytial virus metapneumovirus, parainfluenza virus, rhinovirus–enterovirus, coronavirus, adenovirus, S. pneumoniae, B. pertussis, C. pneumoniae, M. pneumoniae and H. influenzae type B Cohort study Loeb et al., 200415 2 hospitals in Ontario: coronary care units and ICUs with SARS patients 43 nurses Laboratory-confirmed respiratory infection Intervention: N95 respirator
Control: surgical mask
Retrospective
Only 20 nurses reported exposures and consistent use of facial protective equipment
Detection of SARS
Case–control studies Seto et al., 200316 5 hospitals in Hong Kong: emergency departments and medicine units 13 infected (cases) and 241 noninfected (controls) nurses, doctors, health care assistants and domestic staff Laboratory-confirmed respiratory infection N95 respirator
Surgical mask
Paper mask
No cases in N95 respirator or surgical mask groups
143 controls wore either surgical mask or N95 respirator
Detection of SARS
Zhang et al., 201317 25 hospitals in Beijing: emergency departments, respiratory wards, ICUs, outpatient departments, technical clinic departments and management 51 infected (cases) and 204 noninfected (controls) doctors, nurses, technicians and other Laboratory-confirmed respiratory infection N95 respirator
Surgical mask
Cloth mask
Cases and controls matched 1:4 by hospital, ward, age and sex
40 cases wore either N95 respirator or surgical mask
159 controls wore either surgical mask or N95 respirator
Detection of pandemic H1N1 influenza virus
Note: ICU = intensive care unit, SARS = severe acute respiratory syndrome.
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