Efficacy of FFP3 respirators for prevention of SARS-CoV-2 infection in healthcare workers

Mark Ferris; Rebecca Ferris; Chris Workman; Eoin O’connor; David A. Enoch; Emma Goldesgeyme; Natalie Quinnell; Parth Patel; Jo Wright; Geraldine Martell; Christine Moody; Ashley Shaw; Christopher J.R. Illingworth; Nicholas J. Matheson; Michael P. Weekes

doi:10.7554/eLife.71131

Efficacy of FFP3 respirators for prevention of SARS-CoV-2 infection in healthcare workers

Mark Ferris^*, Rebecca Ferris, Chris Workman, Eoin O’connor, David A. Enoch, Emma Goldesgeyme, Natalie Quinnell, Parth Patel, Jo Wright, Geraldine Martell, Christine Moody, Ashley Shaw, Christopher J.R. Illingworth, Nicholas J. Matheson, Michael P. Weekes^*

^*Corresponding author for this work

Cambridge Lab Addenbrookes

Research output: Contribution to journal › Article › peer-review

22 Citations (Scopus)

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Abstract

Background: Respiratory protective equipment recommended in the UK for healthcare workers (HCWs) caring for patients with COVID-19 comprises a fluid-resistant surgical mask (FRSM), except in the context of aerosol generating procedures (AGPs). We previously demonstrated frequent pauci- and asymptomatic severe acute respiratory syndrome coronavirus 2 infection HCWs during the first wave of the COVID-19 pandemic in the UK, using a comprehensive PCR-based HCW screening programme (Rivett et al., 2020; Jones et al., 2020).

Methods: Here, we use observational data and mathematical modelling to analyse infection rates amongst HCWs working on 'red' (coronavirus disease 2019, COVID-19) and 'green' (non-COVID-19) wards during the second wave of the pandemic, before and after the substitution of filtering face piece 3 (FFP3) respirators for FRSMs.

Results: Whilst using FRSMs, HCWs working on red wards faced an approximately 31-fold (and at least fivefold) increased risk of direct, ward-based infection. Conversely, after changing to FFP3 respirators, this risk was significantly reduced (52-100% protection).

Conclusions: FFP3 respirators may therefore provide more effective protection than FRSMs for HCWs caring for patients with COVID-19, whether or not AGPs are undertaken.

Funding: Wellcome Trust, Medical Research Council, Addenbrooke's Charitable Trust, NIHR Cambridge Biomedical Research Centre, NHS Blood and Transfusion, UKRI.

Original language	English
Article number	e71131
Number of pages	13
Journal	eLife
Volume	10
DOIs	https://doi.org/10.7554/eLife.71131
Publication status	Published - 16 Nov 2021

Bibliographical note

Funding Information: This research was funded in part by a Wellcome Trust Senior Clinical Research Fellowship [108070/Z/15/Z] and grants from Addenbrooke’s Charitable Trust and the NIHR Cambridge Biomedical Research Centre to MPW. NJM was funded by an MRC Clinician Scientist Fellowship [MR/P008801/1] and NHSBT workpackage [WPA15-02]. CJRI was supported by UKRI through the JUNIPER modelling consortium [grant number MR/V038613/1] and by the Medical Research Council [MC_UU_00002/11, MC_UU_12014].

Open Access: Copyright Ferris et al. This article is distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use and
redistribution provided that the original author and source are credited.

Publisher Copyright: © Copyright Ferris et al.

Citation: Ferris, Mark, et al. "Efficacy of FFP3 respirators for prevention of SARS-CoV-2 infection in healthcare workers." ELife 10 (2021): e71131.

DOI: https:// doi. org/ 10. 7554/ eLife. 71131

Keywords

COVID-19
FFP3
Healthcare worker
Mask
PPE
Personal protective equipment
Respirator
SARS-CoV-2

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Cite this

Ferris, M., Ferris, R., Workman, C., O’connor, E., Enoch, D. A., Goldesgeyme, E., Quinnell, N., Patel, P., Wright, J., Martell, G., Moody, C., Shaw, A., Illingworth, C. J. R., Matheson, N. J., & Weekes, M. P. (2021). Efficacy of FFP3 respirators for prevention of SARS-CoV-2 infection in healthcare workers. eLife, 10, Article e71131. https://doi.org/10.7554/eLife.71131

@article{8bb31201d10a405487455bc05f312bf9,

title = "Efficacy of FFP3 respirators for prevention of SARS-CoV-2 infection in healthcare workers",

abstract = "Background: Respiratory protective equipment recommended in the UK for healthcare workers (HCWs) caring for patients with COVID-19 comprises a fluid-resistant surgical mask (FRSM), except in the context of aerosol generating procedures (AGPs). We previously demonstrated frequent pauci- and asymptomatic severe acute respiratory syndrome coronavirus 2 infection HCWs during the first wave of the COVID-19 pandemic in the UK, using a comprehensive PCR-based HCW screening programme (Rivett et al., 2020; Jones et al., 2020). Methods: Here, we use observational data and mathematical modelling to analyse infection rates amongst HCWs working on 'red' (coronavirus disease 2019, COVID-19) and 'green' (non-COVID-19) wards during the second wave of the pandemic, before and after the substitution of filtering face piece 3 (FFP3) respirators for FRSMs. Results: Whilst using FRSMs, HCWs working on red wards faced an approximately 31-fold (and at least fivefold) increased risk of direct, ward-based infection. Conversely, after changing to FFP3 respirators, this risk was significantly reduced (52-100% protection). Conclusions: FFP3 respirators may therefore provide more effective protection than FRSMs for HCWs caring for patients with COVID-19, whether or not AGPs are undertaken. Funding: Wellcome Trust, Medical Research Council, Addenbrooke's Charitable Trust, NIHR Cambridge Biomedical Research Centre, NHS Blood and Transfusion, UKRI.",

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author = "Mark Ferris and Rebecca Ferris and Chris Workman and Eoin O{\textquoteright}connor and Enoch, {David A.} and Emma Goldesgeyme and Natalie Quinnell and Parth Patel and Jo Wright and Geraldine Martell and Christine Moody and Ashley Shaw and Illingworth, {Christopher J.R.} and Matheson, {Nicholas J.} and Weekes, {Michael P.}",

note = "Funding Information: This research was funded in part by a Wellcome Trust Senior Clinical Research Fellowship [108070/Z/15/Z] and grants from Addenbrooke{\textquoteright}s Charitable Trust and the NIHR Cambridge Biomedical Research Centre to MPW. NJM was funded by an MRC Clinician Scientist Fellowship [MR/P008801/1] and NHSBT workpackage [WPA15-02]. CJRI was supported by UKRI through the JUNIPER modelling consortium [grant number MR/V038613/1] and by the Medical Research Council [MC_UU_00002/11, MC_UU_12014]. Open Access: Copyright Ferris et al. This article is distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use and redistribution provided that the original author and source are credited. Publisher Copyright: {\textcopyright} Copyright Ferris et al. Citation: Ferris, Mark, et al. {"}Efficacy of FFP3 respirators for prevention of SARS-CoV-2 infection in healthcare workers.{"} ELife 10 (2021): e71131. DOI: https:// doi. org/ 10. 7554/ eLife. 71131",

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AU - Ferris, Mark

AU - Ferris, Rebecca

AU - Workman, Chris

AU - O’connor, Eoin

AU - Enoch, David A.

AU - Goldesgeyme, Emma

AU - Quinnell, Natalie

AU - Patel, Parth

AU - Wright, Jo

AU - Martell, Geraldine

AU - Moody, Christine

AU - Shaw, Ashley

AU - Illingworth, Christopher J.R.

AU - Matheson, Nicholas J.

AU - Weekes, Michael P.

N1 - Funding Information: This research was funded in part by a Wellcome Trust Senior Clinical Research Fellowship [108070/Z/15/Z] and grants from Addenbrooke’s Charitable Trust and the NIHR Cambridge Biomedical Research Centre to MPW. NJM was funded by an MRC Clinician Scientist Fellowship [MR/P008801/1] and NHSBT workpackage [WPA15-02]. CJRI was supported by UKRI through the JUNIPER modelling consortium [grant number MR/V038613/1] and by the Medical Research Council [MC_UU_00002/11, MC_UU_12014]. Open Access: Copyright Ferris et al. This article is distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use and redistribution provided that the original author and source are credited. Publisher Copyright: © Copyright Ferris et al. Citation: Ferris, Mark, et al. "Efficacy of FFP3 respirators for prevention of SARS-CoV-2 infection in healthcare workers." ELife 10 (2021): e71131. DOI: https:// doi. org/ 10. 7554/ eLife. 71131

PY - 2021/11/16

Y1 - 2021/11/16

N2 - Background: Respiratory protective equipment recommended in the UK for healthcare workers (HCWs) caring for patients with COVID-19 comprises a fluid-resistant surgical mask (FRSM), except in the context of aerosol generating procedures (AGPs). We previously demonstrated frequent pauci- and asymptomatic severe acute respiratory syndrome coronavirus 2 infection HCWs during the first wave of the COVID-19 pandemic in the UK, using a comprehensive PCR-based HCW screening programme (Rivett et al., 2020; Jones et al., 2020). Methods: Here, we use observational data and mathematical modelling to analyse infection rates amongst HCWs working on 'red' (coronavirus disease 2019, COVID-19) and 'green' (non-COVID-19) wards during the second wave of the pandemic, before and after the substitution of filtering face piece 3 (FFP3) respirators for FRSMs. Results: Whilst using FRSMs, HCWs working on red wards faced an approximately 31-fold (and at least fivefold) increased risk of direct, ward-based infection. Conversely, after changing to FFP3 respirators, this risk was significantly reduced (52-100% protection). Conclusions: FFP3 respirators may therefore provide more effective protection than FRSMs for HCWs caring for patients with COVID-19, whether or not AGPs are undertaken. Funding: Wellcome Trust, Medical Research Council, Addenbrooke's Charitable Trust, NIHR Cambridge Biomedical Research Centre, NHS Blood and Transfusion, UKRI.

AB - Background: Respiratory protective equipment recommended in the UK for healthcare workers (HCWs) caring for patients with COVID-19 comprises a fluid-resistant surgical mask (FRSM), except in the context of aerosol generating procedures (AGPs). We previously demonstrated frequent pauci- and asymptomatic severe acute respiratory syndrome coronavirus 2 infection HCWs during the first wave of the COVID-19 pandemic in the UK, using a comprehensive PCR-based HCW screening programme (Rivett et al., 2020; Jones et al., 2020). Methods: Here, we use observational data and mathematical modelling to analyse infection rates amongst HCWs working on 'red' (coronavirus disease 2019, COVID-19) and 'green' (non-COVID-19) wards during the second wave of the pandemic, before and after the substitution of filtering face piece 3 (FFP3) respirators for FRSMs. Results: Whilst using FRSMs, HCWs working on red wards faced an approximately 31-fold (and at least fivefold) increased risk of direct, ward-based infection. Conversely, after changing to FFP3 respirators, this risk was significantly reduced (52-100% protection). Conclusions: FFP3 respirators may therefore provide more effective protection than FRSMs for HCWs caring for patients with COVID-19, whether or not AGPs are undertaken. Funding: Wellcome Trust, Medical Research Council, Addenbrooke's Charitable Trust, NIHR Cambridge Biomedical Research Centre, NHS Blood and Transfusion, UKRI.

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Efficacy of FFP3 respirators for prevention of SARS-CoV-2 infection in healthcare workers

Abstract

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Keywords

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