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| |  Novel N95 Respirator Masks Offer Best Protection Against Respiratory Infection Among Healthcare Workers: Presented at ICAAC By Charlene Laino SAN FRANCISCO -- September 23, 2009 -- The first randomised controlled trial of N95 respirator masks shows they prevented three-fourths of respiratory infections in high-risk healthcare workers. In contrast, regular surgical masks didn’t appear to offer any protection against respiratory infections at all, researchers stated here at the 49th Annual Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC). “Surgical masks have no efficacy in the healthcare setting,” said Raina MacIntyre, MD, University of South Wales, Sydney, Australia, on September 17. The findings come on the heels of a recent United States Institute of Medicine report that recommends that healthcare workers use N95 respirators that are individually fit-tested. The study involved 1,936 healthcare workers at 24 hospitals in Beijing, China. They were cluster-randomised to wear surgical masks (3M brand), fit-tested N95 respirators (3M brand), or non-fit-tested N95 respirators during all their shifts for 4 consecutive weeks during the 2008 influenza season. Participants were followed for an additional week off randomisation. Because many healthcare workers “balked at the idea of” not wearing masks, the control group consisted of participants following “usual practice of masks or no masks” at 9 hospitals, Dr. MacIntyre said. The researchers tried to select centres with relatively low mask use, she said. Results showed that compared with controls, N95 respirators reduced the rate of clinical respiratory illness by 60% (3.9% vs 9.2%, P < .001) and the rate of influenza-like illness by 75% (0.36% vs 1.3%; P = .035). In contrast, surgical masks were no better than controls for prevention of clinical respiratory illness (6.7% vs 9.2%; P = .159) or influenza-like illness (0.6% vs 1.3%; P = .336). Surprisingly, non-fit-tested respirators appeared slightly more effective against clinical respiratory illness (risk ratio [RR] = 0.36; P < .001) and surgical masks (RR = 0.49; P = .014) compared with controls than did fit-tested masks (RR = 0.5; P = .005 and RR = 0.67; P = .151, respectively). However, Dr. MacIntyre said the researchers still recommended fit testing. Additionally, the US Occupational Safety and Health Administration requires fit testing, said John S. Adams, MD, of Knoxville Infectious Disease Consultants, Knoxville, Tennessee, during a question-and-answer session after the presentation. [Presentation title: The First Randomised, Controlled Clinical Trial of Surgical Masks Compared to Fit-Tested and Non-Fit Tested N95 Masks in the Prevention of Respiratory Virus Infection in Hospital Health Care Workers in Beijing, China. Abstract K-1918b]
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