Patterson P Daniel, Mcilvaine Quentin S, Nong Lily, Liszka Mary K, Miller Rebekah S, Guyette Francis X, Martin-Gill Christian
School of Medicine Department of Emergency Medicine University of Pittsburgh Pittsburgh Pennsylvania USA.
School of Health and Rehabilitation Sciences, Emergency Medicine Program University of Pittsburgh Pittsburgh Pennsylvania USA.
J Am Coll Emerg Physicians Open. 2022 Mar 26;3(2):e12699. doi: 10.1002/emp2.12699. eCollection 2022 Apr.
Wearing a mask is an important method for reducing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission in health care and public safety settings. We assess the evidence regarding masking in the workplace during the initial months of the COVID-19 pandemic (PROSPERO CRD4202432097).
We performed a systematic review of published literature from 4 databases and evaluated the quality of evidence with the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) framework. We searched for observational and experimental research involving public safety and health care workers. We included articles evaluating the use of masks, versus no mask, on the outcome of SARS-CoV-2 infection.
Our search yielded 15,013 records, of which 9 studies were included. Most studies (n = 8; 88.9%) involved infections or outbreaks among health care workers. The majority (88.9%) used in-depth interviews of cases and non-cases to obtain self-reported use of masks during periods of exposure. One of 9 studies quantitatively assessed differences in SARS-CoV-2 infection based on use of masks in non-patient care settings. Use of observational study designs, small sample sizes, inadequate control for confounding, and inadequate measurement of exposure and non-exposure periods with infected coworkers contributed to the quality of evidence being judged as very low.
The available evidence from the initial months of the pandemic suggests that the use of masks in congregate, non-patient care settings, such as breakrooms, helps to reduce risk of SARS-CoV-2 virus transmission. However, this evidence is limited and is of very low quality. Prospective studies incorporating active observation measures are warranted.
佩戴口罩是在医疗保健和公共安全环境中减少严重急性呼吸综合征冠状病毒2（SARS-CoV-2）传播的重要方法。我们评估了关于在2019冠状病毒病（COVID-19）大流行最初几个月工作场所佩戴口罩的证据（国际前瞻性系统评价注册库编号CRD4202432097）。
我们对来自4个数据库的已发表文献进行了系统评价，并使用推荐分级、评估、制定与评价（GRADE）框架评估证据质量。我们检索了涉及公共安全和医护人员的观察性和实验性研究。我们纳入了评估佩戴口罩与不佩戴口罩对SARS-CoV-2感染结果影响的文章。
我们的检索共获得15013条记录，其中9项研究被纳入。大多数研究（n = 8；88.9%）涉及医护人员中的感染或疫情暴发。大多数研究（88.9%）通过对病例和非病例进行深入访谈，以获取暴露期间自我报告的口罩使用情况。9项研究中有1项定量评估了在非患者护理环境中基于口罩使用情况的SARS-CoV-2感染差异。观察性研究设计的使用、样本量小、对混杂因素控制不足以及对与受感染同事的暴露和非暴露期测量不足，导致证据质量被判定为极低。
大流行最初几个月的现有证据表明，在诸如休息室等聚集性非患者护理环境中使用口罩有助于降低SARS-CoV-2病毒传播风险。然而，这一证据有限且质量极低。有必要开展纳入主动观察措施的前瞻性研究。
