Impact of respirator versus surgical masks on SARS-CoV-2 acquisition in healthcare workers: a prospective multicentre cohort

Antimicrobial Resistance & Infection Control

J. Carsten Möller¹  Sabine Güsewell²  Andrée Friedl³  Benedikt Wiggli³  Domenica Flury⁴  Thomas Egger⁴  Matthias Schlegel⁴  Pietro Vernazza⁴  Reto Thoma⁴  Giulia Scanferla⁴  Philipp Kohler⁴  Christian R. Kahlert⁵  Sabine Haller⁶  Danielle Vuichard-Gysin⁷  Stefan P. Kuster⁸  Onicio B. Leal-Neto⁹  Ulrike Besold^1,10  Reto Stocker^1,11  Philip Rieder^1,11  Markus Rütti^1,12  Lorenz Risch^1,13  Eva Lemmenmeier^1,14  Angela Brucher^1,15  Allison McGeer^1,16 

[1] Center for Neurological Rehabilitation, Zihlschlacht, Switzerland;Clinical Trials Unit, Cantonal Hospital of St. Gallen, St. Gallen, Switzerland;Division of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital Baden, Baden, Switzerland;Division of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland;Division of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland;Department of Infectious Diseases and Hospital Epidemiology, Children’s Hospital of Eastern Switzerland, St. Gallen, Switzerland;Division of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland;Department of Public and Global Health, University of Zurich, Zurich, Switzerland;Division of Infectious Diseases and Hospital Epidemiology, Thurgau Hospital Group, Münsterlingen, Switzerland;Swiss National Centre for Infection Prevention (Swissnoso), Bern, Switzerland;Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Zurich, Switzerland;Epitrack, Recife, Brazil;Department of Economics, University of Zurich, Zurich, Switzerland;Geriatric Clinic St. Gallen, St. Gallen, Switzerland;Hirslanden Clinic, Zurich, Switzerland;Hospital Region Fürstenland Toggenburg, Wil, Switzerland;Labormedizinisches Zentrum Dr Risch Ostschweiz AG, Buchs, Switzerland;Private Universität Im Fürstentum Liechtenstein, Triesen, Liechtenstein;Centre of Laboratory Medicine, University Institute of Clinical Chemistry, University of Bern, Bern, Switzerland;Private Clinic for Psychiatry and Psychotherapy, Clienia Littenheid AG, Littenheid, Switzerland;Psychiatry Services of the Canton of St. Gallen (South), Pfäfers, Switzerland;Sinai Health System, Toronto, Canada;

关键词: COVID-19;    Healthcare workers;    Respirator;    Surgical mask;    Aerosol;   

DOI  :  10.1186/s13756-022-01070-6

来源: Springer

【 摘 要 】

BackgroundThere is insufficient evidence regarding the role of respirators in the prevention of SARS-CoV-2 infection. We analysed the impact of filtering facepiece class 2 (FFP2) versus surgical masks on the risk of SARS-CoV-2 acquisition among Swiss healthcare workers (HCW).MethodsOur prospective multicentre cohort enrolled HCW from June to August 2020. Participants were asked about COVID-19 risk exposures/behaviours, including preferentially worn mask type when caring for COVID-19 patients outside of aerosol-generating procedures. The impact of FFP2 on (1) self-reported SARS-CoV-2-positive nasopharyngeal PCR/rapid antigen tests captured during weekly surveys, and (2) SARS-CoV-2 seroconversion between baseline and January/February 2021 was assessed.ResultsWe enrolled 3259 participants from nine healthcare institutions, whereof 716 (22%) preferentially used FFP2. Among these, 81/716 (11%) reported a SARS-CoV-2-positive swab, compared to 352/2543 (14%) surgical mask users; seroconversion was documented in 85/656 (13%) FFP2 and 426/2255 (19%) surgical mask users. Adjusted for baseline characteristics, COVID-19 exposure, and risk behaviour, FFP2 use was non-significantly associated with decreased risk for SARS-CoV-2-positive swab (adjusted hazard ratio [aHR] 0.8, 95% CI 0.6–1.0) and seroconversion (adjusted odds ratio [aOR] 0.7, 95% CI 0.5–1.0); household exposure was the strongest risk factor (aHR 10.1, 95% CI 7.5–13.5; aOR 5.0, 95% CI 3.9–6.5). In subgroup analysis, FFP2 use was clearly protective among those with frequent (> 20 patients) COVID-19 exposure (aHR 0.7 for positive swab, 95% CI 0.5–0.8; aOR 0.6 for seroconversion, 95% CI 0.4–1.0).ConclusionsRespirators compared to surgical masks may convey additional protection from SARS-CoV-2 for HCW with frequent exposure to COVID-19 patients.

【 授权许可】

CC BY