A Systematic Review and Meta-analysis of the Efficacy of Medical Masks and N95 Respirators for Protection Against Respiratory Infectious Diseases

Gaohong Wu; Qingyang Ji; Huiwen Huang; Xueping Zhu

doi:doi:10.11648/j.sjph.20221003.16

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A Systematic Review and Meta-analysis of the Efficacy of Medical Masks and N95 Respirators for Protection Against Respiratory Infectious Diseases

Gaohong Wu, Qingyang Ji, Huiwen Huang, Xueping Zhu

Published in Science Journal of Public Health (Volume 10, Issue 3)

Received: 12 May 2022 Accepted: 13 June 2022 Published: 16 June 2022

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Abstract

To evaluate the efficacy of N95 respirators and medical masks for protection against respiratory infectious diseases, including COVID-19. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) and observational studies evaluating the use of N95 respirators and medical masks for protection against respiratory infectious diseases. We retrieved relevant articles published from January 1994 to January 2020 by searching the PubMed, EMBASE, Cochrane CENTRAL, and Web of Science databases. The study quality was evaluated using the Cochrane Risk of Bias tool with RevMan 5.3 software. Eleven RCTs adjusted for clustering were included in the meta-analysis. Compared with the control group, N95 respirators or medical masks conferred significant protection against respiratory infectious diseases (odds ratio (OR) = 0.20; 95% CI: 0.08–0.51). Compared to medical masks, N95 respirators conferred significant protection against respiratory infectious diseases (OR = 0.75; 95% confidence interval (CI): 0.57–0.99). Meta-analysis of 10 observational studies adjusting for clustering also suggested that N95 respirators and medical masks are effective for protection against respiratory infectious diseases (OR = 0.30; 95% CI: 0.15–0.63). Given the body of evidence through a systematic review and meta-analyses, our findings supported the use of N95 respirators or medical masks has a significantly greater protective effect against respiratory infectious diseases among medical workers compared with those who did not use these types of PPE. However, only one case report showed the effectiveness of medical masks for preventing COVID-19. Although medical masks and N95 respirators may confer significant protection against respiratory infectious diseases, there is insufficient evidence to conclude that these types of personal protective equipment offer similar protection against COVID-19. Moreover, in the absence of sufficient resources during an epidemic, medical masks and N95 respirators should be reserved for high-risk, aerosol-generating producing procedures.

Published in	Science Journal of Public Health (Volume 10, Issue 3)
DOI	10.11648/j.sjph.20221003.16
Page(s)	142-157
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2022. Published by Science Publishing Group

Keywords

Respiratory Infectious Diseases, COVID-19, Medical Masks, N95 Respirators, Meta-analysis

References

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APA Style

Gaohong Wu, Qingyang Ji, Huiwen Huang, Xueping Zhu. (2022). A Systematic Review and Meta-analysis of the Efficacy of Medical Masks and N95 Respirators for Protection Against Respiratory Infectious Diseases. Science Journal of Public Health, 10(3), 142-157. https://doi.org/10.11648/j.sjph.20221003.16

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ACS Style

Gaohong Wu; Qingyang Ji; Huiwen Huang; Xueping Zhu. A Systematic Review and Meta-analysis of the Efficacy of Medical Masks and N95 Respirators for Protection Against Respiratory Infectious Diseases. Sci. J. Public Health 2022, 10(3), 142-157. doi: 10.11648/j.sjph.20221003.16

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AMA Style

Gaohong Wu, Qingyang Ji, Huiwen Huang, Xueping Zhu. A Systematic Review and Meta-analysis of the Efficacy of Medical Masks and N95 Respirators for Protection Against Respiratory Infectious Diseases. Sci J Public Health. 2022;10(3):142-157. doi: 10.11648/j.sjph.20221003.16

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@article{10.11648/j.sjph.20221003.16,
  author = {Gaohong Wu and Qingyang Ji and Huiwen Huang and Xueping Zhu},
  title = {A Systematic Review and Meta-analysis of the Efficacy of Medical Masks and N95 Respirators for Protection Against Respiratory Infectious Diseases},
  journal = {Science Journal of Public Health},
  volume = {10},
  number = {3},
  pages = {142-157},
  doi = {10.11648/j.sjph.20221003.16},
  url = {https://doi.org/10.11648/j.sjph.20221003.16},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.sjph.20221003.16},
  abstract = {To evaluate the efficacy of N95 respirators and medical masks for protection against respiratory infectious diseases, including COVID-19. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) and observational studies evaluating the use of N95 respirators and medical masks for protection against respiratory infectious diseases. We retrieved relevant articles published from January 1994 to January 2020 by searching the PubMed, EMBASE, Cochrane CENTRAL, and Web of Science databases. The study quality was evaluated using the Cochrane Risk of Bias tool with RevMan 5.3 software. Eleven RCTs adjusted for clustering were included in the meta-analysis. Compared with the control group, N95 respirators or medical masks conferred significant protection against respiratory infectious diseases (odds ratio (OR) = 0.20; 95% CI: 0.08–0.51). Compared to medical masks, N95 respirators conferred significant protection against respiratory infectious diseases (OR = 0.75; 95% confidence interval (CI): 0.57–0.99). Meta-analysis of 10 observational studies adjusting for clustering also suggested that N95 respirators and medical masks are effective for protection against respiratory infectious diseases (OR = 0.30; 95% CI: 0.15–0.63). Given the body of evidence through a systematic review and meta-analyses, our findings supported the use of N95 respirators or medical masks has a significantly greater protective effect against respiratory infectious diseases among medical workers compared with those who did not use these types of PPE. However, only one case report showed the effectiveness of medical masks for preventing COVID-19. Although medical masks and N95 respirators may confer significant protection against respiratory infectious diseases, there is insufficient evidence to conclude that these types of personal protective equipment offer similar protection against COVID-19. Moreover, in the absence of sufficient resources during an epidemic, medical masks and N95 respirators should be reserved for high-risk, aerosol-generating producing procedures.},
 year = {2022}
}

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TY  - JOUR
T1  - A Systematic Review and Meta-analysis of the Efficacy of Medical Masks and N95 Respirators for Protection Against Respiratory Infectious Diseases
AU  - Gaohong Wu
AU  - Qingyang Ji
AU  - Huiwen Huang
AU  - Xueping Zhu
Y1  - 2022/06/16
PY  - 2022
N1  - https://doi.org/10.11648/j.sjph.20221003.16
DO  - 10.11648/j.sjph.20221003.16
T2  - Science Journal of Public Health
JF  - Science Journal of Public Health
JO  - Science Journal of Public Health
SP  - 142
EP  - 157
PB  - Science Publishing Group
SN  - 2328-7950
UR  - https://doi.org/10.11648/j.sjph.20221003.16
AB  - To evaluate the efficacy of N95 respirators and medical masks for protection against respiratory infectious diseases, including COVID-19. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) and observational studies evaluating the use of N95 respirators and medical masks for protection against respiratory infectious diseases. We retrieved relevant articles published from January 1994 to January 2020 by searching the PubMed, EMBASE, Cochrane CENTRAL, and Web of Science databases. The study quality was evaluated using the Cochrane Risk of Bias tool with RevMan 5.3 software. Eleven RCTs adjusted for clustering were included in the meta-analysis. Compared with the control group, N95 respirators or medical masks conferred significant protection against respiratory infectious diseases (odds ratio (OR) = 0.20; 95% CI: 0.08–0.51). Compared to medical masks, N95 respirators conferred significant protection against respiratory infectious diseases (OR = 0.75; 95% confidence interval (CI): 0.57–0.99). Meta-analysis of 10 observational studies adjusting for clustering also suggested that N95 respirators and medical masks are effective for protection against respiratory infectious diseases (OR = 0.30; 95% CI: 0.15–0.63). Given the body of evidence through a systematic review and meta-analyses, our findings supported the use of N95 respirators or medical masks has a significantly greater protective effect against respiratory infectious diseases among medical workers compared with those who did not use these types of PPE. However, only one case report showed the effectiveness of medical masks for preventing COVID-19. Although medical masks and N95 respirators may confer significant protection against respiratory infectious diseases, there is insufficient evidence to conclude that these types of personal protective equipment offer similar protection against COVID-19. Moreover, in the absence of sufficient resources during an epidemic, medical masks and N95 respirators should be reserved for high-risk, aerosol-generating producing procedures.
VL  - 10
IS  - 3
ER  -

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Author Information

Gaohong Wu

Department of Neonatology, Zhuhai Women and Children’s Hospital, Zhuhai, China
Qingyang Ji

Department of Neonatology, Zhuhai Women and Children’s Hospital, Zhuhai, China
Huiwen Huang

Department of Neonatology, Zhuhai Women and Children’s Hospital, Zhuhai, China
Xueping Zhu

Department of Neonatology, Children’s Hospital of Soochow University, Suzhou, China

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APA Style

Gaohong Wu, Qingyang Ji, Huiwen Huang, Xueping Zhu. (2022). A Systematic Review and Meta-analysis of the Efficacy of Medical Masks and N95 Respirators for Protection Against Respiratory Infectious Diseases. Science Journal of Public Health, 10(3), 142-157. https://doi.org/10.11648/j.sjph.20221003.16

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ACS Style

Gaohong Wu; Qingyang Ji; Huiwen Huang; Xueping Zhu. A Systematic Review and Meta-analysis of the Efficacy of Medical Masks and N95 Respirators for Protection Against Respiratory Infectious Diseases. Sci. J. Public Health 2022, 10(3), 142-157. doi: 10.11648/j.sjph.20221003.16

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AMA Style

Gaohong Wu, Qingyang Ji, Huiwen Huang, Xueping Zhu. A Systematic Review and Meta-analysis of the Efficacy of Medical Masks and N95 Respirators for Protection Against Respiratory Infectious Diseases. Sci J Public Health. 2022;10(3):142-157. doi: 10.11648/j.sjph.20221003.16

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@article{10.11648/j.sjph.20221003.16,
  author = {Gaohong Wu and Qingyang Ji and Huiwen Huang and Xueping Zhu},
  title = {A Systematic Review and Meta-analysis of the Efficacy of Medical Masks and N95 Respirators for Protection Against Respiratory Infectious Diseases},
  journal = {Science Journal of Public Health},
  volume = {10},
  number = {3},
  pages = {142-157},
  doi = {10.11648/j.sjph.20221003.16},
  url = {https://doi.org/10.11648/j.sjph.20221003.16},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.sjph.20221003.16},
  abstract = {To evaluate the efficacy of N95 respirators and medical masks for protection against respiratory infectious diseases, including COVID-19. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) and observational studies evaluating the use of N95 respirators and medical masks for protection against respiratory infectious diseases. We retrieved relevant articles published from January 1994 to January 2020 by searching the PubMed, EMBASE, Cochrane CENTRAL, and Web of Science databases. The study quality was evaluated using the Cochrane Risk of Bias tool with RevMan 5.3 software. Eleven RCTs adjusted for clustering were included in the meta-analysis. Compared with the control group, N95 respirators or medical masks conferred significant protection against respiratory infectious diseases (odds ratio (OR) = 0.20; 95% CI: 0.08–0.51). Compared to medical masks, N95 respirators conferred significant protection against respiratory infectious diseases (OR = 0.75; 95% confidence interval (CI): 0.57–0.99). Meta-analysis of 10 observational studies adjusting for clustering also suggested that N95 respirators and medical masks are effective for protection against respiratory infectious diseases (OR = 0.30; 95% CI: 0.15–0.63). Given the body of evidence through a systematic review and meta-analyses, our findings supported the use of N95 respirators or medical masks has a significantly greater protective effect against respiratory infectious diseases among medical workers compared with those who did not use these types of PPE. However, only one case report showed the effectiveness of medical masks for preventing COVID-19. Although medical masks and N95 respirators may confer significant protection against respiratory infectious diseases, there is insufficient evidence to conclude that these types of personal protective equipment offer similar protection against COVID-19. Moreover, in the absence of sufficient resources during an epidemic, medical masks and N95 respirators should be reserved for high-risk, aerosol-generating producing procedures.},
 year = {2022}
}

Copy | Download

TY  - JOUR
T1  - A Systematic Review and Meta-analysis of the Efficacy of Medical Masks and N95 Respirators for Protection Against Respiratory Infectious Diseases
AU  - Gaohong Wu
AU  - Qingyang Ji
AU  - Huiwen Huang
AU  - Xueping Zhu
Y1  - 2022/06/16
PY  - 2022
N1  - https://doi.org/10.11648/j.sjph.20221003.16
DO  - 10.11648/j.sjph.20221003.16
T2  - Science Journal of Public Health
JF  - Science Journal of Public Health
JO  - Science Journal of Public Health
SP  - 142
EP  - 157
PB  - Science Publishing Group
SN  - 2328-7950
UR  - https://doi.org/10.11648/j.sjph.20221003.16
AB  - To evaluate the efficacy of N95 respirators and medical masks for protection against respiratory infectious diseases, including COVID-19. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) and observational studies evaluating the use of N95 respirators and medical masks for protection against respiratory infectious diseases. We retrieved relevant articles published from January 1994 to January 2020 by searching the PubMed, EMBASE, Cochrane CENTRAL, and Web of Science databases. The study quality was evaluated using the Cochrane Risk of Bias tool with RevMan 5.3 software. Eleven RCTs adjusted for clustering were included in the meta-analysis. Compared with the control group, N95 respirators or medical masks conferred significant protection against respiratory infectious diseases (odds ratio (OR) = 0.20; 95% CI: 0.08–0.51). Compared to medical masks, N95 respirators conferred significant protection against respiratory infectious diseases (OR = 0.75; 95% confidence interval (CI): 0.57–0.99). Meta-analysis of 10 observational studies adjusting for clustering also suggested that N95 respirators and medical masks are effective for protection against respiratory infectious diseases (OR = 0.30; 95% CI: 0.15–0.63). Given the body of evidence through a systematic review and meta-analyses, our findings supported the use of N95 respirators or medical masks has a significantly greater protective effect against respiratory infectious diseases among medical workers compared with those who did not use these types of PPE. However, only one case report showed the effectiveness of medical masks for preventing COVID-19. Although medical masks and N95 respirators may confer significant protection against respiratory infectious diseases, there is insufficient evidence to conclude that these types of personal protective equipment offer similar protection against COVID-19. Moreover, in the absence of sufficient resources during an epidemic, medical masks and N95 respirators should be reserved for high-risk, aerosol-generating producing procedures.
VL  - 10
IS  - 3
ER  -

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