Preventing Transmission of Pandemic Influenza and Other Viral Respiratory Diseases: Personal Protective Equipment for Healthcare Personnel: Update 2010 (2011)

Severe Acute Respiratory Syndrome (SARS)

Seto et al., 2003

Case-control study in five Hong Kong hospitals of 13 SARS-infected staff and 241 non-infected staff

Odds ratio of staff with specific protection not getting infected:

• Masks: OR= 13 (95% CI 3 to 60, p = 0.0001)

• Gloves: OR = 2 (95% CI 0.6 to 7, p = 0.364)

• Gowns: OR not calculated

• Handwashing: OR = 5 (95% CI 1 to 19, p = 0.047)

Loeb et al., 2004

Retrospective cohort study of 43 nurses working with SARS patients in Toronto critical care units

Risk of acquiring SARS based on use of PPE:

• Gown: RR = 0.36 (95% CI 0.10 to 1.24, p = 0.12)

• Gloves: RR = 0.45 (95% CI 0.14 to 1.46, p = 0.22)

• N95 (respirator at least once) or surgical mask: RR = 0.23 (95% CI 0.07 to 0.78, p = .02)

• N95: RR = 0.22 (95% CI 0.05 to 0.93, p = 0.06)

• Surgical mask:^a RR = 0.45 (95% CI 0.07 to 2.71, p = 0.56)

• N95 vs. surgical mask:^b RR = 0.50 (95% CI 0.06 to 4.23, p = 0.51)

Teleman et al., 2004

Case-control study in Singapore of 36 healthcare workers with probable SARS and 50 healthcare workers in the same ward with history of exposure

Adjusted odds ratio (multivariate analysis) associated with transmission of SARS:

• Wearing of N95 mask: 0.1 (95% CI 0.02 to 0.9, p = 0.04)

• Wearing of gloves: 1.5 (95% CI 0.3 to 7.2, p = 0.6)

• Wearing of gowns: 0.5 (95% CI 0.4 to 6.9, p = 0.6)

• Handwashing after each patient: 0.07 (95% CI 0.008 to 0.7, p = 0.02)

Respiratory Syncytial Virus (RSV)

Hall and Douglas, 1981

Comparison of use and nonuse of gowns and masks by staff members on a pediatric ward with children < 3 years old

• Proportion of infants acquiring RSV:

• • When masks and gowns were used by staff: 32%

  • When masks and gowns were not used by staff: 41%

• Proportion of staff acquiring RSV:

• • During the time masks and gowns were used by staff: 33%

  • During the time masks and gowns were not used by staff: 42%

• Measurable benefit not found in controlling spread of RSV

Gala et al., 1986

Comparison of use and nonuse of eye– nose goggles by staff members on an infant ward

• Frequency of RSV infection in hospital personnel:

• • Three weeks during goggle use: 8% (p = 0.003)

  • Three weeks with no goggle use: 34% (p = 0.003)

Agah et al., 1987

Comparison of use and nonuse of mask or goggles by staff members caring for children with RSV infections on a pediatric inpatient service

• RSV illness rate in healthcare workers caring for children with RSV infections:

• • Wore masks or goggles: 5% (p < 0.01 compared to no masks or goggles category)

  • Did not wear masks or goggles: 61%

Madge et al., 1992

Prospective study of four infection control strategies in preventing RSV in four pediatric wards

• Combination of cohort nursing with use of gowns and gloves significantly reduced RSV infection

• Use of gowns and gloves alone did not result in a significant reduction of infection