N95 Mask Doesn’t Prevent Flu's Spread


A new study on the efficacy of surgical masks compared with respirator masks in combating the spread of influenza shouldn’t lead directly to increased prophylactic mask usage, one hospitalist group leader says. In fact, with hospitals and patients fully aware of another potential H1N1 flu pandemic this winter, HM groups should focus more on traditional hygiene issues and staff management to stem the impact of flu season, says William Ford, MD, FHM, medical director at Cogent Healthcare and director of the hospitalist program at Temple University in Philadelphia.

The randomized controlled trial published online (JAMA. October 2009. doi:10.1001/jama.2009.1466) ) tracked 446 nurses in EDs, medical units, and pediatric units in eight tertiary-care hospitals in Ontario. Researchers found that influenza infection occurred in 23.6% of nurses in the surgical-mask group and in 22.9% of nurses in the N95 respirator group (absolute risk difference –0.73%; 95% CI, –8.8% to 7.3%; P=0.86).

Dr. Ford says masks "can't hurt" as helpful barriers against the spread of influenza among hospital workers, but HM directors would be better served planning for staffing issues and emphasizing prevention. That includes harping on "hand-washing, hand-washing, and hand-washing," as well as being prepared to implement emergency schedules to rotate physicians into floor shifts should rank-and-file hospitalists call out sick.

"As hospitalist directors, I'd be very cognizant of my backup contingency plan," Dr. Ford says. "We have to take certain steps this year in a worst-case scenario."

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