Observational study of the adherence to the correct use of face masks by the general population in open public places during two periods of the COVID-19 pandemic in four Spanish cities
e202201010
Keywords:
Pandemics, Infection control, Masks, Public health, Observational study, COVID-19, Population, SpainAbstract
Background: One of the steps adopted to mitigate the pandemic due to SARS-CoV-2 is the use of face masks by the general population. For a face mask to be effective it should cover the nose and the mouth. We wanted to measure the correct use of the face mask by the general population in open public spaces through direct observation.
Methods: We conducted an observational study of the proper use of face masks among the general population in open public places in Bilbao, Santander, Oviedo and Zaragoza from 16th to 26th July, 2020 and from 23rd January to 2nd March, 2021. Sampling for convenience; compliance of the proper use of a mask was evaluated when adults completely covered their mouth and nose. The type of mask and its improper use was registered using a standardized form. The results were obtained using frequency distribution, Pearson’s chi-squared test and multivariate logistic regression analysis.
Results: A total of 5,464 observations were documented. The overall compliance was 89.5%. We observed that the compliance in 2021 (94.7%) was 10.9 percentage points higher than in 2020 (83.8%) (p<0.001). The main cause of non-compliance was the incorrect placement of face masks (64%); 36% were without masks. The non-reusable face masks were most commonly worn (54.1%). We observed a significant increase in use of high-efficiency face masks in 2021 (27.1%) versus 2020 (13.7%).
Conclusions: In all the cities where the study was conducted we observed an increase in compliance of the proper use of face masks as well as an increased usage of high-efficiency masks. The main cause of non-compliance was incorrect placement.
Downloads
References
World Health Organization. WHO Director-General’s statement on IHR Emergency Committee on Novel Coronavirus (2019-nCoV). 30 January 2020. [Internet]. Geneva: World Health Organization; 2021 [citado 2021 may 05]. Disponible en: https://www.who.int/dg/speeches/detail/who-director-general-s-statement-on-ihr-emergency-committee-on-novel-coronavirus-(2019-ncov)
World Health Organization. COVID-19 Weekly Epidemiological Update-27 April 2021. Geneva: World Health Organization; 2021.
World Health Organization. Coronavirus disease (COVID-19) advice for the public [Internet]. Geneva: World Health Organization; 2021 [citado 2021 may 06]. Disponible en: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public
Nussbaumer-Streit B, Mayr V, Dobrescu AI, Chapman A, Persad E, Klerings I et al. Quarantine alone or in combination with other public health measures to control COVID-19: a rapid review. Cochrane Database Syst Rev. 2020;4(4):CD013574.
Liu Y, Morgenstern C, Kelly J, Lowe R, CMMID COVID-19 Working Group, Jit M. The impact of non-pharmaceutical interventions on SARS-CoV-2 transmission across 130 countries and territories. BMC Med. 2021;19(1):40.
Han E, Tan MMJ, Turk E, Sridhar D, Leung GM, Shibuya K et al. Lessons learnt from easing COVID-19 restrictions: an analysis of countries and regions in Asia Pacific and Europe. Lancet. 2020;396(10261):1525-1534.
University of Oxford [Internet]. Oxford: University of Oxford; 2021 [citado 2021 may 06]. Oxford COVID-19 Government Response Tracker. Disponible en: https://covidtracker.bsg.ox.ac.uk/
Cheng VC, Lau SK, Woo PC, Yuen KY. Severe acute respiratory syndrome coronavirus as an agent of emerging and reemerging infection. Clin Microbiol Rev. 2007;20(4):660-694.
Chu DK, Akl EA, Duda S, Solo K, Yaacoub S, Schünemann HJ; COVID-19 Systematic Urgent Review Group Effort (SURGE) study authors. Physical distancing, face masks, and eye protection to prevent person-to-person transmission of SARS-CoV-2 and COVID-19: a systematic review and meta-analysis. Lancet. 2020;395(10242):1973-1987.
Fong MW, Gao H, Wong JY, Xiao J, Shiu EYC, Ryu S et al. Nonpharmaceutical Measures for Pandemic Influenza in Nonhealthcare Settings-Social Distancing Measures. Emerg Infect Dis. 2020;26(5):976-984.
Jefferson T, Del Mar CB, Dooley L, Ferroni E, Al-Ansary LA, Bawazeer GA et al. Physical interventions to interrupt or reduce the spread of respiratory viruses. Cochrane Database Syst Rev. 2011;2011(7):CD006207. Update in: Cochrane Database Syst Rev. 2020 Nov 20.
Leung NHL, Chu DKW, Shiu EYC, Chan KH, McDevitt JJ, Hau BJP et al. Respiratory virus shedding in exhaled breath and efficacy of face masks. Nat Med. 2020;26(5):676-680. Epub 2020 Apr 3. Erratum in: Nat Med. 2020 May 27.
Brainard J, Jones NR, Lake IR, Hooper L, Hunter PR. Community use of face masks and similar barriers to prevent respiratory illness such as COVID-19: a rapid scoping review. Euro Surveill. 2020;25(49):2000725.
Scientific Brief: SARS-CoV-2 Transmission. [Internet]. Atlanta: Centers for Disease Control and Prevention; 2021 [citado 2021 may 07]. Disponible en: https://www.cdc.gov/coronavirus/2019-ncov/science/science-briefs/sars-cov-2-transmission.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fcoronavirus%2F2019-ncov%2Fscience%2Fscience-briefs%2Fscientific-brief-sars-cov-2.html
World Health Organization. Mask use in the context of COVID-19: interim guidance, 1 December 2020. Geneva: World Health Organization; 2020.
European Centre for Disease Prevention and Control. Using face masks in the community: first update. 15 February 2021. Stockholm: European Centre for Disease Prevention and Control; 2021.
Wang J, Pan L, Tang S, Ji JS, Shi X. Mask use during COVID-19: A risk adjusted strategy. Environ Pollut. 2020 Nov;266(Pt 1):115099.
#Masks4All [Internet]. 2021 [citado 2021 may 07]. What Countries Require Public Mask Usage To Help Contain COVID-19? Disponible en: https://masks4all.co/what-countries-require-masks-in-public/
Boletín Oficial del Estado. Real Decreto-ley 21/2020, de 9 de junio, de medidas urgentes de prevención, contención y coordinación para hacer frente a la crisis sanitaria ocasionada por el COVID-19. BOE núm. 163; de 10-06-2020.
Ministerio de Sanidad, Consumo y Bienestar Social. Vacuna Covid-19. Madrid: Ministerio de Sanidad, Consumo y Bienestar Social; 2021 [citado 2021 may 10]. Disponible en: https://www.mscbs.gob.es/profesionales/saludPublica/ccayes/alertasActual/nCov/vacunaCovid19.htm
European Centre for Disease Prevention and Control. Overview of the implementation of COVID-19 vaccination strategies and deployment plans in the EU/EEA – 6 May 2021. Stockholm: European Centre for Disease Prevention and Control; 2021.
European Centre for Disease Prevention and Control. SARS-CoV-2 - increased circulation of variants of concern and vaccine rollout in the EU/EEA, 14th update - 15 February 2021. Stockholm: European Centre for Disease Prevention and Control; 2021.
Instituto Carlos III. Estudio Nacional de sero-Epidemiología de la infección por SARS-CoV-2 en España (ENECOVID) [Internet]. Madrid: Instituto Carlos III; 2021 [citado 2021 may 01]. Disponible en: https://portalcne.isciii.es/enecovid19/
Instituto Carlos III. Monitorización del comportamiento y las actitudes de la población relacionadas con la COVID-19 en España (COSMO-SPAIN): Estudio OMS. [Internet]. Madrid: Instituto Carlos III; 2021 [citado 2021 may 02]. Disponible en: https://portalcne.isciii.es/cosmo-spain/
World Health Organization & WHO Patient Safety. Hand hygiene technical reference manual: to be used by health-care workers, trainers and observers of hand hygiene practices. Geneva: World Health Organization; 2009.
World Health Organization [Internet]. 2021 [citado 2021 may 01]. WHO tool for behavioural insights on COVID-19. Disponible en: https://www.euro.who.int/en/health-topics/health-emergencies/coronavirus-covid-19/publications-and-technical-guidance/risk-communication-and-community-engagement/who-tool-for-behavioural-insights-on-covid-19
Betsch C, Wieler LH, Habersaat K; COSMO group. Monitoring behavioural insights related to COVID-19. Lancet. 2020;395(10232):1255-1256.
Imperial College London [Internet]. 2021 [citado 2021 may 03]. COVID-19 Behaviour Tracker. How are behaviuors changing in responde to COVID-19?. Disponible en: https://ichpanalytics.imperialcollegehealthpartners.com/t/BDAU/views/YouGovICLCOVID-19BehaviourTrack.er/Homepage?%3Aiid=1&%3AisGuestRedirectFromVizportal=y&%3Aembed=y
Elachola H, Gozzer E, Rahman NMM, Ditekemena J, Pando-Robles V, Pa K et al. Photo-epidemiology to estimate face covering use in select areas in Asia versus the Americas and Africa during the COVID-19 pandemic. J Travel Med. 2020;27(8):taaa121.
Moran KR, Del Valle SY. A meta-analysis of the association between gender and protective behaviors in response to respiratory epidemics and pandemics. PLoS One. 2016;11(10):e0164541.
Bish A, Michie S. Demographic and attitudinal determinants of protective behaviors during a pandemic: a review. Br J Health Psychol. 2010;15(Pt 4):797-824.
Tamamoto KA, Rousslang ND, Ahn HJ, Better HE, Hong RA. Public compliance with face uask Use in Honolulu and regional variation. Hawaii J Health Soc Welf. 2020;79(9):268-271.
Gosadi IM, Daghriri KA, Shugairi AA, Alharbi AH, Suwaydi AZ, Alharbi MA et al. Community-based observational assessment of compliance by the public with COVID19 preventive measures in the south of Saudi Arabia. Saudi J Biol Sci. 2021;28(3):1938-1943.
Studio Ludo [Internet]. [citado 2021 may 01]. SOMAD REPORT Systematic Observation of Mask Adherence & Distancing Philadelphia; 2021 [citado 2021 may 06]. Disponible en: https://www.studioludo.org/projects/SOMAD
Deschanvres C, Haudebourg T, Peiffer-Smadja N, Blanckaert K, Boutoille D, Lucet JC et al. How do the general population behave with facemasks to prevent COVID-19 in the community? A multi-site observational study. Antimicrob Resist Infect Control. 2021;10(1):61.
Downloads
Published
How to Cite
Issue
Section
Categories
License
Copyright (c) 2022 Marta Mateos Mazón, Carmen María Martínez Caballero, Juan José Mateos Mazón, Lorena de Carlos Negro, Laura del Otero Sanz
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Usted es libre de:
Compartir — copiar y redistribuir el material en cualquier medio o formato.
La licenciante no puede revocar estas libertades en tanto usted siga los términos de la licencia.
Bajo los siguientes términos:
Atribución — Usted debe dar crédito de manera adecuada , brindar un enlace a la licencia, e indicar si se han realizado cambios. Puede hacerlo en cualquier forma razonable, pero no de forma tal que sugiera que usted o su uso tienen el apoyo de la licenciante.
NoComercial — Usted no puede hacer uso del material con propósitos comerciales.
SinDerivadas — Si remezcla, transforma o crea a partir del material, no podrá distribuir el material modificado.
No hay restricciones adicionales — No puede aplicar términos legales ni medidas tecnológicas que restrinjan legalmente a otras a hacer cualquier uso permitido por la licencia.
Avisos:
No tiene que cumplir con la licencia para elementos del material en el dominio público o cuando su uso esté permitido por una excepción o limitación aplicable.
No se dan garantías. La licencia podría no darle todos los permisos que necesita para el uso que tenga previsto. Por ejemplo, otros derechos como publicidad, privacidad, o derechos morales pueden limitar la forma en que utilice el material.
