title: Effectiveness of surgical masks against influenza bioaerosols.
abstract: BACKGROUND
  Most surgical masks are not certified for use as respiratory protective devices (RPDs). In the event of an influenza pandemic, logistical and practical implications such as storage and fit testing will restrict the use of RPDs to certain high-risk procedures that are likely to generate large amounts of infectious bioaerosols. Studies have shown that in such circumstances increased numbers of surgical masks are worn, but the protection afforded to the wearer by a surgical mask against infectious aerosols is not well understood.
  
  
  OBJECTIVE
  To develop and apply a method for assessing the protection afforded by surgical masks against a bioaerosol challenge.
  
  
  METHODS
  A dummy test head attached to a breathing simulator was used to test the performance of surgical masks against a viral challenge. Several designs of surgical masks commonly used in the UK healthcare sector were evaluated by measuring levels of inert particles and live aerosolised influenza virus in the air, from in front of and behind each mask.
  
  
  RESULTS
  Live influenza virus was measurable from the air behind all surgical masks tested. The data indicate that a surgical mask will reduce exposure to aerosolised infectious influenza virus; reductions ranged from 1.1- to 55-fold (average 6-fold), depending on the design of the mask.
  
  
  CONCLUSIONS
  We describe a workable method to evaluate the protective efficacy of surgical masks and RPDs against a relevant aerosolised biological challenge. The results demonstrated limitations of surgical masks in this context, although they are to some extent protective.
authors.affiliation: Health & Safety Laboratory (HSL), Buxton, Derbyshire, UK. catherine.makison@hsl.gov.uk
authors.forename: C
authors.initials: C
authors.lastname: Makison Booth
authors.forename: M
authors.initials: M
authors.lastname: Clayton
authors.forename: B
authors.initials: B
authors.lastname: Crook
authors.forename: J M
authors.initials: JM
authors.lastname: Gawn
mesh_terms: D000336:Aerosols; D002478:Cells, Cultured; D005069:Evaluation Studies as Topic; D006801:Humans; D017053:Infection Control / Q000379:methods*; D017758:Infectious Disease Transmission, Patient-to-Professional / Q000517:prevention & control; D007251:Influenza, Human / Q000517:prevention & control* / Q000635:transmission; D008397:Masks / Q000821:virology*; D009975:Orthomyxoviridae / Q000302:isolation & purification; D006113:United Kingdom
chemical_list: D000336:Aerosols