3児の親さん薬剤師のブログ

とある薬剤師です。感染症治療を考える素材をちょこっと提供。noteもあります https://note.com/twin1980

N95 Respirators vs Medical Masks for Preventing Influenza Among Health Care Personnel: A Randomized Clinical Trial

JAMAから報告されたマスクのRCT

米国7つの医療センターで2000人以上を集めてます。

The primary outcome was the incidence of laboratory-confirmed influenza.

 

www.ncbi.nlm.nih.gov

 

感想 まとめ

 

差がない結果になった。

N95の方が鼻口への接触感染を防ぐので、有利かなと思っていましたが、

関係なさそう。

メディカルマスクで良さそうな結果は、N95装着しての仕事は辛いので、少し安心なのかさらなる闇に突入なのか?

 

 N95 respirator : 207 (8.2% of HCP-seasons) 

 medical mask : 193 (7.2% of HCP-seasons)

 

difference, 1.0%, [95% CI, -0.5% to 2.5%]; P = .18)

adjusted odds ratio [OR], 1.18 [95% CI, 0.95-1.45]

 

 

Abstract


IMPORTANCE:

Clinical studies have been inconclusive about the effectiveness of N95 respirators and medical masks in preventing health care personnel (HCP) from acquiring workplace viral respiratory infections.

OBJECTIVE:

To compare the effect of N95 respirators vs medical masks for prevention of influenza and other viral respiratory infections among HCP.
DESIGN, SETTING, AND PARTICIPANTS:
A cluster randomized pragmatic effectiveness study conducted at 137 outpatient study sites at 7 US medical centers between September 2011 and May 2015, with final follow-up in June 2016. Each year for 4 years, during the 12-week period of peak viral respiratory illness, pairs of outpatient sites (clusters) within each center were matched and randomly assigned to the N95 respirator or medical mask groups.

INTERVENTIONS:

Overall, 1993 participants in 189 clusters were randomly assigned to wear N95 respirators (2512 HCP-seasons of observation) and 2058 in 191 clusters were randomly assigned to wear medical masks (2668 HCP-seasons) when near patients with respiratory illness.

MAIN OUTCOMES AND MEASURES:

The primary outcome was the incidence of laboratory-confirmed influenza. Secondary outcomes included incidence of acute respiratory illness, laboratory-detected respiratory infections, laboratory-confirmed respiratory illness, and influenzalike illness. Adherence to interventions was assessed.

RESULTS:

Among 2862 randomized participants (mean [SD] age, 43 [11.5] years; 2369 [82.8%]) women), 2371 completed the study and accounted for 5180 HCP-seasons. There were 207 laboratory-confirmed influenza infection events (8.2% of HCP-seasons) in the N95 respirator group and 193 (7.2% of HCP-seasons) in the medical mask group (difference, 1.0%, [95% CI, -0.5% to 2.5%]; P = .18) (adjusted odds ratio [OR], 1.18 [95% CI, 0.95-1.45]). There were 1556 acute respiratory illness events in the respirator group vs 1711 in the mask group (difference, -21.9 per 1000 HCP-seasons [95% CI, -48.2 to 4.4]; P = .10); 679 laboratory-detected respiratory infections in the respirator group vs 745 in the mask group (difference, -8.9 per 1000 HCP-seasons, [95% CI, -33.3 to 15.4]; P = .47); 371 laboratory-confirmed respiratory illness events in the respirator group vs 417 in the mask group (difference, -8.6 per 1000 HCP-seasons [95% CI, -28.2 to 10.9]; P = .39); and 128 influenzalike illness events in the respirator group vs 166 in the mask group (difference, -11.3 per 1000 HCP-seasons [95% CI, -23.8 to 1.3]; P = .08). In the respirator group, 89.4% of participants reported "always" or "sometimes" wearing their assigned devices vs 90.2% in the mask group.

CONCLUSIONS AND RELEVANCE:

Among outpatient health care personnel, N95 respirators vs medical masks as worn by participants in this trial resulted in no significant difference in the incidence of laboratory-confirmed influenza.

 

 

J-IDEO (ジェイ・イデオ) Vol.3 No.6

J-IDEO (ジェイ・イデオ) Vol.3 No.6