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FFP3 masks: study shows they significantly reduce the risk of COVID-19 infection

Research adds weight to RCN calls for increased levels of protection for health care workers.

FFP3 face mask

A study by Cambridge University Hospitals NHS Foundation Trust has found wearing FFP3 face masks can considerably reduce the risk of health care workers becoming infected with COVID-19. 

For most of last year, the trust's Addenbrooke's Hospital followed national infection control guidance in place at the time, which stated health care workers should wear fluid resistant surgical masks, except when carrying out aerosol generating procedures (AGPs).

Through a programme of regular testing, they found that staff caring for patients with COVID-19 on "red" wards faced a risk of being infected that was up to 47 times higher than those on "green" non-COVID wards. 

In December, the trust made a local decision to routinely use FFP3 masks on red wards, regardless of whether AGPs were being carried out. 

They found the number of cases attributed to ward-based exposure fell significantly, with FFP3 respirators providing 31-100% protection (and most likely 100%) against infection from patients with COVID-19. 

The research concludes that the use of fluid-resistant surgical masks is "insufficient" to protect health care workers.

The RCN has been campaigning for national guidance to be changed so that FFP3 masks are worn by nursing staff caring for patients with known or suspected COVID-19 as a precautionary measure in all care settings.

We have written to the Prime Minister and recently met with health officials to stress the need for higher standards of protection to combat the threat of airborne spread of the disease. 

Rose Gallagher, RCN Professional Lead for Infection Prevention and Control, said: "This important study adds even further weight to our continuing call for nursing staff to be better protected from COVID-19 and given routine access to the highest levels of respiratory protective equipment whenever they need it.

"We are still seeing cases of COVID-19, even from some who have been vaccinated. It is vital staff are fully protected and there are no attempts to restrict or ease off on measures to further reduce the risk of infection."

Though a relatively small study, the RCN believes its findings are significant as it provides evidence of infection acquired in the workplace, specifically on wards caring for patients with COVID-19.  

“This challenges previous perceptions that staff who get infected with COVID-19 do so because of exposure outside of work,” Rose added. “The rapid reduction in infections on the red ward at a time of rapid increases in community infection demonstrates this clearly.”

Current UK guidance updated in June 2021 emphasises the need for local risk assessment and use of the hierarchy of controls to determine what type of PPE, in particular respiratory masks, is required.

The RCN continues to call for simplified infection prevention and control guidance, in line with that used in the US and Europe, which states that any health worker caring for patients with known or suspected COVID-19 has access to FFP3 masks in all settings. 

“This research means an urgent review of UK guidance is needed to ensure consistency in the supply and use of higher-level protective equipment for nursing staff,” concluded Rose.