Recommendations regarding the use of protective masks/ respirators by health professionals at risk of exposure to sars-cov-2: scoping review
Keywords:Mask medical; N95 respirator; Surgical mask; Personal protective equipment; Health professional.
Objective: To analyze governmental recommendations and scientific evidence regarding the use of respiratory protectors by health professionals in the context of the SARS-CoV-2 pandemic. Method: Scoping Review, following the protocol proposed by the Joanna Briggs Institute (JBI), Version 2020. The PCC (Population, Concept and Context) strategy was used to formulate the following guiding question: “What are the recommendations regarding the use of masks? Respiratory protection respirators by health professionals facing the risk of contamination by SARS-CoV-2? ”. Searches were carried out in six international databases and in gray literature and on government websites in different countries, from July to August 2020. Results: 20 studies published in 2020 were included. On the methodology of the studies, 1 (5%) study descriptive, 1 (5%) narrative review, 2 (10%) systematic review with meta-analysis, 2 systematic reviews (10%), 8 (40%) literature review and 6 (30%) technical report. Conclusion: There are differences regarding: type of respiratory protection in routine care, when there is no generation of aerosols, with studies that indicate the use of surgical masks and others that recommend the use of a particulate respirator; there is an indication of different particulate respirators of varying degrees of protection, for the same scenario of clinical exposure, and there is conflict regarding the scenario of greater exposure for health professionals, in disagreement of which procedures generate aerosols.
Ağalar, C., & Engin, D. Ö. (2020).Protective measures for COVID-19 for healthcare providers and laboratory personne. Revista turca de ciências médicas. 50,578-584.10.3906/sag-2004-132.
Anderson, E. L., Turnham, P., Griffin, J. C., & Clarke, C. C (2020). Consideration of the Aerosol Transmission for COVID-19 and Public Health. Risck Analysis. 40(5). https://doi.org/10.1111/risa.13500.
Australian Government (2020, May). Guidance on the use of personal protective equipment (PPE) in hospitals during the COVID-19 outbreak, v.5. https://www.health.gov.au/resources/publications/guidance-on-the-use-of-personal-protective-equipment-ppe-in-hospitals-during-the-covid-19-outbreak.
Azap, A., & Erdinç, F. (2020). Medical mask or N95 respirator: When and how to use? Turk J MedSci. 50(1), 633-637. https://doi.org/10.3906/sag-2004-199.
Bartoszko, J. J., Farooqi, M. A. M., Alhazzani, W., & LOEB, M. (2020). Medical masks vs N95 respirators for preventing COVID-19 in healthcare workers: A systematic review and meta-analysis of randomized trials. Influenza ando ther Respiratory Viruses.14(4), 365-373. https://doi.org/10.1111/irv.12745.
Bourouiba, L. (2020). Turbulent Gas Clouds and Respiratory Pathogen Emissions. Jama. 323 (18), 1837-1838. 10.1001/jama.2020.4756.
Brasil. Agência Nacional de Vigilância Sanitária (ANVISA) (2020). Nota técnica 07/2020-GVIMS/GGTES/ANVISA-Orientações para prevenção e vigilância epidemiológica das infecções por sars-cov-2 (covid-19) dentro dos serviços de saúde. (complementar à nota técnica gvims/ggtes/anvisa nº 04/2020). https://www20.anvisa.gov.br/segurancadopaciente/index.php/alertas?task=callelement&format=raw&item_id=855&element=f85c494b-2b32-4109-b8c1-083cca2b7db6&method=download&args=912a2edf85fe0367a04ff6eb7ccde989.
Centers for Disease Control and Prevention (2020). Coronavirus Disease 2019 (COVID-19): Interim Infection Prevention and Control Recommendations for Healthcare Personnel During the Coronavirus Disease 2019 (COVID-19) Pandemic. Centers for Disease Control and Prevention. USA, (d). https://www.cdc.gov/coronavirus/2019-ncov/hcp/infection-control-recommendations.html
Cook, T. M. (2020). Personal protective equipment during the coronavirus disease (COVID) 2019 pandemic - a narrative review. Anaesthesia.75 (7), 920-927. https://doi.org/10.1111/anae.15071.
European Centre for Disease Prevention and Control (2020). Guidance for wearing and removing personal protective equipament in healthcare settings for the care of patients with suspected or confirmed COVID-19. Estocolmo (a). https://www.ecdc.europa.eu/en/publications-data/guidance-wearing-and-removing-personal-protective-equipment-healthcare-settings.
Fehr, A. R., & Perlman, S. (2015). Coronaviruses: an Overview of their replication an pathogeneses. Methods in Molecular Biology.1282, 1-23.https://doi.org/10.1007/978-1-4939-2438-7_1.
Friese, C. R., Veenema, T. G., Johnson, J. S., Jayaraman, S., Chang, J. C., & Clever, L. H. (2020). Respiratory Protection Considerations for Healthcare Workers during the COVID-19 Pandemic. Health Security.18 (3), 237-240. https://doi.org/10.1089/hs.2020.0036.
Gordon, C., & Thompson, A. (2020). Use of personal protective equipment during the COVID-19 pandemic. British Journal of Nursing. 29(13), 748-752. https://www.researchgate.net/deref/http%3A%2F%2Fdx.doi.org%2F10.12968%2Fbjon.2020.29.13.748.
Ha, J. F. (2020). The protective equipment, and respirator: a narrative review. Int J Clin 74 (10), e 13578. https://doi.org/10.1111/ijcp.13578.
Helioterio, M. C., Lopes, F. Q. R. de S., de Souza, C. C., Souza, F. de O., Pinho, P. de S., Souza, F. N. F. de, & de Araújo, T. M. (2020). COVID-19: Por que a proteção de trabalhadores e trabalhadoras de saúde é prioritária no combate à pandemia? Trabalho, Educação e Saúde. 18(3), e00289121.https://doi.org/10.1590/1981-7746-sol00289.
Hirschmann, M. T., Hart, A., Henckel, J., Sadoghi, P., Seil, R., & Mouton, C. (2020). COVID-19 coronavirus: recommended personal protective equipment for the orthopaedic and trauma surgeon. KneeSurgery, Sports Traumatology, Arthroscopy. 28(6), 1690-1698. https://doi.org/10.1007/s00167-020-06022-4.
Jackon, T. et al. (2020). Classification of aerosol-generation procedures: a rapid systematic review. BMJ Open Respiratory Research. 7(1).
Jiang, F. et al. (2020). Review of the Clinical Characteristics of Coronavirus Disease 2019 (COVID-19). J Gen Intem Med.35(5). https://doi.org/10.1007/s00167-020-06022-4.
Jones, N. R., Qureshi, Z. U., Temple, R. J., Larwood, J. P. J., Greenhalgh, T., & Bourouiba, L. (2020). Two metres or one: what is the evidence for physical distancing in COVID-19? Bmj.370.http://dx.doi.org/10.1136/bmj.m3223.
Kaswa, R., & Govender, I. (2020). Novel coronavirus pandemic: A clinical overview. South African Family Practive. 62(1). https://doi.org/10.4102/safp.v62i1.5123.
Lana, R. M. et al. (2020). Emergência do Novo Coronavírus (SARS-CoV-2) e o Papel de uma Vigilância Nacional em Saúde Oportuna e Efetiva. Cadernos de Saúde Pública. 36(3). https://doi.org/10.1590/0102-311x00019620.
Lepelletier, D., & Grandbastien, B. et al. (2020). What face mask for what use in the context of COVID-19 pandemic? The French guidelines. Journal of Hospital Infection.105(3), 414-418.https://doi.org/10.1016/j.jhin.2020.04.036.
Lynch, J. B. et al. (2020). Infectious diseases society of America guidelines on infection prevention in patients with suspected or known COVID-19. Infectious Diseases Societyof America Guideli. https://www.idsociety.org/practice-guideline/covid-19-guideline-infection-prevention/.
Ministério da Saúde. Secretaria de Vigilância em Saúde (2020). Recomendações de proteção aos trabalhadores dos serviços de saúde no atendimento de COVID-19 e outras síndromes gripais. https://www.saude.go.gov.br/files/banner_coronavirus/GuiaMSRecomendacoesdeprotecaotrabalhadores-COVID-19.pdf.
Ministério da Saúde. Secretaria de Vigilância em Saúde. Boletim Epidemiológico Especial: Doença pelo coronavírus COVID-19. http://coronavirus.saude.gov.br/boletins epidemiológicos.
Moher, D. et al. (2009). Preferred Reporting Items for Systematic Reviews and Meta-Analyses the Prisma Statement. https://doi.org/10.1371/journal.pmed.1000097.
Munn, Z. et al. (2018). Systematic review or scoping review? Guidance for authors when choosing between a systematic or scoping review approach. BMC Medical Research Methodology. https://doi.org/10.1186/s12874-018-0611-x.
National Health Service. (2020). COVID-19: Infection prevention and control guidance, United Kingdom, v.3. https://www.gov.uk/government/publications/wuhan-novel-coronavirus-infection-prevention-and-control/covid-19-personal-protective-equipment-ppe.
O’Neil, C. A. et al. (2017). Caracterization of Aerosols Generated During Patient Care Activities. Clin Infect Dis. 65(8), 1335-1341. https://doi.org/10.1093/cid/cix535.
Organização Mundial de Saúde (2020). Orientação sobre o uso de máscaras no contexto da COVID-19. Tradução de OPAS- Brasília: Organização Pan-Americana de Saúde, 2020. https://iris.paho.org/handle/10665.2/51994.
Organização Panamericana de Saúde. Organização Mundial de Saúde (2020). OMS afirma que COVID-19 é agora caracterizada como pandemia. Genebra. https://www.paho.org/bra/index.php?option=com_content&view=article&id=6120:oms-afirma-que-covid-19-e-agora-caracterizada-como-pandemia&Itemid=812.
Organización Panamericana de La Salud (2020). Organização Mundial de laSalud. Alerta Epidemiológica: COVID-19 em personal de salud. https://www.paho.org/es/documentos/alerta-epidemiologica-covid-19-personal-salud-31-agosto-2020.
Park, S. H. (2020). Personal Protective Equipment. For Healthcare Workers during the COVID-19 pandemic. Infect Chemother. 52(5), 165-182. https://www.researchgate.net/deref/http%3A%2F%2Fdx.doi.org%2F10.3947%2Fic.2020.52.2.165.
Peters, M. D. J. et al. (2020). Chapter11: Scoping Reviews (2020 version). JBI Manual for Evidence Synthesis. https://wiki.jbi.global/display/MANUAL/Chapter+11%3A+Scoping+reviews.
Petsonk, E. L., & Harber, P. (2020). Respiratory protection for health care workers: A 2020 COVID‐19 perspective. American Journal of Industrial Medicine. 6. https://doi.org/10.1002/ajim.23144.
Setti, L. et al. (2020). Airborne transmission route of COVID-19: why 2 meters/6 feet of inter-personal distance could not be enough. Int. J.E. Res. Public Health. 17(8),2932. https://doi.org/10.3390/ijerph17082932.
Sharma, A. et al. (2020). Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2): A global pandemic and treatment strategies. International Journal of Antimicrobial Agents. 56(2), 106054. https://doi.org/10.1016/j.ijantimicag.2020.106054.
Smith, J. D. et al. (2016). Effectiveness of N95 Respirators versus surgical masks in protecting health care workers from acute respiratory infection: a systematic review and meta-analysis.CMAJ. 188(8), 567-574. https://doi.org/10.1503/cmaj.150835.
Sommerstein, R., & Fux, C. A., et al. (2020). Risk of SARS-CoV-2 transmission by aerosols, the rational use of masks, and protection of healthcare workers from COVID-19. Antimicrobial Resistance and Infection Control, 9 (1), 100. https://doi.org/10.1186/s13756-020-00763-0.
Teixeira, C. F. de S.et al. (2020). A Saúde dos profissionais de saúde no enfrentamento da pandemia de COVID-19. Ciência e Saúde coletiva. 25(9). http://dx.doi.org/10.1590/1413-81232020259.19562020.
Thomas, J. P., Srinivasan, A., Wickramarachchi, C. S., & Dhesi, P. K. et al. (2020). Evaluating the national PPE guidance for NHS healthcare workers during the COVID-19 pandemic. Clinical Medicine. 20(3), 242-247. https://doi.org/10.7861/clinmed.2020-0143.
Tricco, A. C. et al. (2018). Prisma Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation. Ann Intern Med. 169(7), 467-473. https://doi.org/10.7326/m18-0850.
Umer, F., Haji, Z., & Zafar, K. (2020). Role of respirators in controlling the spread of novel coronavirus (COVID-19) amongst dental healthcare providers: a review. International Endodontic Journal. 53(8), 1062-1067. https://doi.org/10.1111/iej.13313.
Wold Health Organization (WHO). (2020). Clinical management of COVID-19: Interim guidance. Genebra: WHO. https://www.paho.org/en/documents/clinical-management-covid-19-interim-guidance-who.
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Copyright (c) 2021 Walleska Souza Cavalcante; Alda Graciele Claudio dos Santos Almeida; Anyele Albuquerque Lima; Izabelly Carollynny Maciel Nunes; Patrícia de Carvalho Nagliate; Patrícia de Albuquerque Sarmento
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