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The effectiveness and efficacy of respiratory protective equipment (RPE) in dentistry and other health care settings: a systematic review.

Abstract：

OBJECTIVE:The global pandemic of coronavirus disease-19, caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), is the latest hazard facing healthcare workers (HCW) including dental care workers (DCW). It is clear that the major mode of SARS-CoV-2 transmission is the airborne route, through inhalation of virus-infested aerosols and droplets. Several respiratory protection equipment (RPE), including masks, face shields/visors, and respirators, are available to obviate facial and conjunctival contamination by microbes. However, as their barrier value against microbial inhalation has not been evaluated, we systematically reviewed the data on the effectiveness and efficacy of facemasks and respirators, including protective eyewear, with particular emphasis on dental healthcare. MATERIAL AND METHODS:PubMed, MEDLINE, the Cochrane Library, and Embase databases were searched between 01January 1990 and 15 May 2020. RESULTS:Of 310 identified English language records, 21 were included as per eligibility criteria. In clinical terms, wearing layered, face-fitting masks/respirators and protective-eyewear can limit the spread of infection among HCWs. Specifically, combined interventions such as a face mask and a face shield, better resist bioaerosol inhalation than either alone. The prolonged and over-extended use of surgical masks compromise their effectiveness. CONCLUSIONS:In general, RPE is effective as a barrier protection against aerosolized microbes in healthcare settings. But their filtration efficacy is compromised by the (i) inhalant particle size, (ii) airflow dynamics, (iii) mask-fit factor, (iv) period of wear, (v) 'wetness' of the masks, and (vi) their fabrication quality. The macro-data presented here should inform policy formulation on RPE wear amongst HCWs.

journal_name

Acta Odontol Scand

journal_title

Acta odontologica Scandinavica

authors

Samaranayake LP,Fakhruddin KS,Ngo HC,Chang JWW,Panduwawala C

doi

10.1080/00016357.2020.1810769

subject

Has Abstract

pub_date

2020-11-01 00:00:00

pages

626-639

issue

eissn

0001-6357

issn

1502-3850

journal_volume

pub_type

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The effectiveness and efficacy of respiratory protective equipment (RPE) in dentistry and other health care settings: a systematic review.