Relative efficacy of masks and respirators as source control for viral aerosol shedding from people infected with SARS-CoV-2: a controlled human exhaled breath aerosol experimental study.

Autor:	Lai J; Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, MD, USA., Coleman KK; Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, MD, USA., Tai SS; Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, MD, USA., German J; Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, MD, USA., Hong F; Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, MD, USA., Albert B; Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, MD, USA., Esparza Y; Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, MD, USA., Rastogi D; Department of Chemical and Biomolecular Engineering, University of Maryland, College Park, MD, USA., Srikakulapu A; Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, MD, USA., Kalliomäki P; Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, MD, USA., Schanz M; Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, MD, USA., Smith AA; Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, MD, USA., Sierra Maldonado I; Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, MD, USA., Oertel M; Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, MD, USA., Fadul N; Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, MD, USA., Gold TL; Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, MD, USA., McPhaul K; Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, MD, USA., Ma T; Department of Epidemiology and Biostatistics, University of Maryland School of Public Health, College Park, MD, USA., Cowling BJ; World Health Organization Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, The University of Hong Kong, Hong Kong Special Administrative Region, China., Milton DK; Maryland Institute for Applied Environmental Health, University of Maryland School of Public Health, College Park, MD, USA. Electronic address: dmilton@umd.edu.
Jazyk:	angličtina
Zdroj:	EBioMedicine [EBioMedicine] 2024 Jun; Vol. 104, pp. 105157. Date of Electronic Publication: 2024 May 30.
DOI:	10.1016/j.ebiom.2024.105157
Abstrakt:	Background: Tight-fitting masks and respirators, in manikin studies, improved aerosol source control compared to loose-fitting masks. Whether this translates to humans is not known. Methods: We compared efficacy of masks (cloth and surgical) and respirators (KN95 and N95) as source control for SARS-CoV-2 viral load in exhaled breath of volunteers with COVID-19 using a controlled human experimental study. Volunteers (N = 44, 43% female) provided paired unmasked and masked breath samples allowing computation of source-control factors. Findings: All masks and respirators significantly reduced exhaled viral load, without fit tests or training. A duckbill N95 reduced exhaled viral load by 98% (95% CI: 97%-99%), and significantly outperformed a KN95 (p < 0.001) as well as cloth and surgical masks. Cloth masks outperformed a surgical mask (p = 0.027) and the tested KN95 (p = 0.014). Interpretation: These results suggest that N95 respirators could be the standard of care in nursing homes and healthcare settings when respiratory viral infections are prevalent in the community and healthcare-associated transmission risk is elevated. Funding: Defense Advanced Research Projects Agency, National Institute of Allergy and Infectious Diseases, Centers for Disease Control and Prevention, the Bill & Melinda Gates Foundation, and The Flu Lab. Competing Interests: Declaration of interests B.J.C. consults for AstraZeneca, Fosun Pharma, GlaxoSmithKline, Haleon, Moderna, Novavax, Pfizer, Roche, and Sanofi Pasteur. D.K.M. consults for A.I.R LLC and holds stock options for Lumen Bioscience, Inc. The authors declare no other competing interests. (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)
Databáze:	MEDLINE
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