[Effectiveness of personal protective measures in prevention of nosocomial transmission of severe acute respiratory syndrome].
OBJECTIVE
To evaluate the effectiveness of personal protective measures of health care workers (HCWs) against severe acute respiratory syndrome (SARS).


METHODS
A case-control study from ten hospitals in Guangdong, with 180 non-infected and 77 infected staff members that accessed the isolation unit every day, and participated in direct first aid for severe SARS patients. All participants were surveyed about how they were using personal protective equipment (PPE), protective drugs and hygiene habits when caring for patients with SARS. Statistical analysis was done with either chi(2) or Fisher's exact test for univariate analysis, whereas we used forward stepwise selection (Waldesian) for logistic regression.


RESULTS
Univariate analysis showed that mask, gown, gloves, goggles, footwear, "hand-washing and disinfecting", gargle, "membrane protection", "taking shower and changing clothing after work", "avoid from eating and drinking in ward", oseltamivir phospha tall had protective effects (P < 0.05), but stepwise logistic regression showed significant differences for mask (OR = 0.78, 95% CI: 0.60 - 0.99), goggles (OR = 0.20, 95% CI: 0.10 - 0.41) and footwear (OR = 0.58, 95% CI: 0.39 - 0.86). Analysis for linear trend in proportions showed that dose response relationship existed in mask, gown, gloves, goggles, footwear, gargle, "membrane protection" and "taking shower and changing dree after work" (P < 0.01). The attack rate of HCWs who were rescuing severe SARS patients without any PPE was 61.5% (16/26). It seemed that the more the protective measures were used, the higher the protective effect was (P < 0.001), and could reach 100% if mask, gown, gloves, goggles, footwear, "hand-washing and disinfecting" were all used at the same time.


CONCLUSIONS
Nosocomial infection of SARS can be prevented effectively by precautions against droplets and personal contact. HCWs must take strict protection according to the guidance of WHO or Chinese MOH and pay attention to personal hygiene.
Yin
Wen-wu
WW
Chinese Field Epidemiology Training Program, Chinese Center for Disease Control and Prevention, Beijing 100050, China.
Gao
Li-dong
LD
Lin
Wei-sheng
WS
Gao
Li-dong
LD
Lin
Wei-sheng
WS
Du
Lin
L
Zhang
Xian-chang
XC
Zou
Qin
Q
Li
Ling-hui
LH
Liang
Wen-jia
WJ
Peng
Guo-wen
GW
He
Jian-feng
JF
Yu
De-wen
DW
Zhou
Duan-hua
DH
Lin
Jin-yan
JY
Zeng
Guang
G
D002681:China; D003428:Cross Infection / Q000517:prevention & control*; D005260:Female; D006281:Health Occupations / Q000193:education; D006801:Humans; D016015:Logistic Models; D008297:Male; D011482:Protective Devices / Q000145:classification / Q000706:statistics & numerical data; D045169:Severe Acute Respiratory Syndrome / Q000517:prevention & control* / Q000635:transmission; D011795:Surveys and Questionnaires