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Latest UK guidance on when to wear protective face masks

A surgical face mask should be routinely worn by health professionals treating patients with respiratory infections such as influenza and pneumonia, according to latest guidance.

A mask is also recommended when dealing with diseases such as mumps, rubella and meningitis. But a respirator is needed when dealing with patients with chickenpox or measles.

New best practice guidance on the use of respiratory and facial protection equipment has been drawn up by a Healthcare Infection Society working group.

It sets out when masks, respirators and eye protection should be worn, as well as how to correctly fit and remove the protective equipment.

The HIS said work on the document was sparked by recent experiences of severe acute respiratory syndrome – better known as SARS – and the 2009 swine flu pandemic.

“It was apparent… that healthcare workers may have difficulty in choosing the correct type of facial and respiratory protection in any given clinical situation,” the guideline authors said in the Journal of Hospital Infection.

They said a surgical face mask will provide adequate respiratory and facial protection in the “majority of situations”. Masks will provide a barrier to splashes and droplets, though not against airborne – or aerosol – particles spread by coughing or sneezing.

A respirator, usually a filtering half face mask, will protect against aerosols, but is only required “for a very small number of pathogens that are truly transmissible via the airborne route” – or where aerosol-generating procedures involving infectious body fluids are being undertaken, for example intubation or surgery.    

The guidance also warns nurses not to pull their mask or respirator down and let it hang around their neck or to “fiddle” with it while it is in position on the face.

In addition, it states that protective equipment is still needed “irrespective” of the vaccination status, as it “provides the last line of protection to manage any residual risk”.

The guidance adds that eye protection, such as safety spectacles or full-face visors, is an element of facial protection that is “often forgotten” – but which should “always” be worn by those present in aerosol-generating procedures.

A Hospital Infection Society spokeswoman said that “with the influenza season almost upon us”, the guidance provided “important information for nurses in hospital and community settings”. 

“The publication highlights the risks associated with infectious particles and their routes of transmission and includes an extensive table as to when a surgical facemask or respirator should be worn, plus a list of dos and don’ts on using this equipment safely,” she added.

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Readers' comments (1)

  • I am glad that waering face mask is best practice guidance. Masks are readily supplied to patients and nurses where I worked. When I told the infection control inspector, I was told that they are waste of time and in fact they harbour infection. The question now is how often mask needs to be changed to be effective.

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