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Trial registered on ANZCTR
Registration number
ACTRN12609000778280
Ethics application status
Approved
Date submitted
4/09/2009
Date registered
8/09/2009
Date last updated
29/03/2016
Type of registration
Prospectively registered
Titles & IDs
Public title
Efficacy of face masks against H1N1 swine influenza
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Scientific title
A randomised clinical trial of respirators and surgical masks in the prevention of H1N109 and respiratory pathogen infection in Chinese healthcare workers
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Secondary ID [1]
280478
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NA.
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Pandemic (H1N1) 2009, seasonal influenza, viral or bacterial respiratory infections
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Condition category
Condition code
Infection
239936
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0
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Other infectious diseases
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Arm One: N95 respirator
Respirators are personal protective fitted devices that cover the nose and mouths and operate by purifying the air inhaled by the wearer through filtering materials.
In this trial, participants will be asked to wear the respirator continuously on every shift (around 8 hours) over the four week period. They are to remove the respirator when: they exit the department/ward or when they enter the tea room for a break.
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Intervention code [1]
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Prevention
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Comparator / control treatment
Arm 2: Surgical masks-are loose-fitting facial coverings that are designed to prevent wound contamination in the patient from the cough or exhaled secretions of the physician, nurse or other healthcare worker. In this trial, participants will be asked to wear the surgical mask continuously on every shift (around 8 hours) over the four week period. They are to remove the mask when: they exit the department/ward or when they enter the tea room for a break.
Arm 3: N95 respirator-Participants in this arm will be asked to wear a respirator only when they are involved with a high risk procedure (HRP) (aerosol generating) or when they are caring for a patient with influenza-like-illness (ILI). They will be asked to remove the respirator when they have completed the HRP or when they have finished caring for the patient with ILI.
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Control group
Active
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Outcomes
Primary outcome [1]
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Clinical respiratory illness (CRI): defined as two or more respiratory or systemic symptoms
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Assessment method [1]
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Timepoint [1]
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The outcome of the study will be assessed on a daily basis over the five week period. Time to development of outcome will be measured
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Primary outcome [2]
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Influenza-like illness (ILI): defined as fever >38C plus one respiratory symptom
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Assessment method [2]
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Timepoint [2]
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The outcome of the study will be assessed on a daily basis over the five week period. Time to development of outcome will be measured
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Primary outcome [3]
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Laboratory-confirmed viral or bacterial respiratory infection: adenoviruses, human metapneumovirus, influenza A or B, pandemic (H1N1) 2009 influenza, coronaviruses 229E/NL63, parainfluenzaviruses 1, 2 and 3, respiratory syncytial virus A and B, rhinovirus A/B and coronavirus OC43/HKU1, streptococcus pneumoniae, legionella sp., bordetella pertussis, chlamydia, mycoplasma or haemophilus influenzae type B)
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Assessment method [3]
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Timepoint [3]
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The outcome of the study will be assessed on a daily basis over the five week period. Time to development of outcome will be measured
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Primary outcome [4]
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Laboratory-confirmed influenza A or B
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Assessment method [4]
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Timepoint [4]
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The outcome of the study will be assessed on a daily basis over the five week period. Time to development of outcome will be measured
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Primary outcome [5]
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Adherence with mask or respirator use
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Assessment method [5]
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Timepoint [5]
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We will monitor individual participant adherence with mask or respirator use over the four week time course by: (1) Observation: the head ward nurse will observe compliance on the ward on a daily basis and record the information on a structured form, (2) Self report: a diary card with tick boxes will be given to each subject, which they will carry with them during the day. Adherence to wearing the masks or respirators will be monitored by these diary cards and returned to researchers on a weekly basis. Exit interviews with participants will be conducted after the four weeks to gain further insights into adherence and other issues around the use of masks/respirators including adverse effects.
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Primary outcome [6]
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Laboratory confirmed pandemic (H1N1) 2009
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Assessment method [6]
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Timepoint [6]
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The outcome of the study will be assessed on a daily basis over the five week period. Time to development of outcome will be measured
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Primary outcome [7]
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Laboratory confirmed virus (any respiratory virus)
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Assessment method [7]
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Timepoint [7]
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The outcome of the study will be assessed on a daily basis over the five week period. Time to development of outcome will be measured
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Primary outcome [8]
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Laboratory confirmed bacterial respiratory infection
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Assessment method [8]
258132
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Timepoint [8]
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The outcome of the study will be assessed on a daily basis over the five week period. Time to development of outcome will be measured
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Secondary outcome [1]
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The following measure will be used to measure compliance and infection control:
Self report: a diary card with tick boxes for the respirator/mask use will be given to each subject, which they will carry with them during the day. They will tick the responses after each shift. Adherence to wearing the respirator/mask will be monitored by these diary cards that will be returned to researchers on a weekly basis. Time from enrolment to onset of illness will be measured.
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Assessment method [1]
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Timepoint [1]
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Participants will be asked to complete their diary card on a daily basis. A member of the research team will assess these cards on a weekly basis.
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Secondary outcome [2]
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The following measure will be used to measure compliance and infection control:
Exit interviews with participants will be conducted after the four weeks to gain further insights into adherence and other issues around the use of respirators/masks including adverse effects. We will specifically ask about pain, discomfort, skin necrosis, difficulty breathing, headaches, adherence to infection control protocol associated with respirator/mask use (hand hygiene, face touching etc) and perceptions about patient communication issues associated with respirator/mask wearing.
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Assessment method [2]
257431
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Timepoint [2]
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Interviews with participants will be completed at the end of the four weeks.
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Eligibility
Key inclusion criteria
Any nurse, doctor or ward clerk who works full time at the hospital
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
Yes
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Key exclusion criteria
1) Males with beards, long moustaches or long facial hair stubble
2) Clinical staff with a current respiratory illness, rhinitis and/or allergy (Staff who report having a respiratory illness at the time of recruitment will have their participation delayed by two weeks once they have become asymptomatic)
3) Part-time worker
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Study design
Purpose of the study
Prevention
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
The unit of randomisation will be hospitals, which will be randomised to one of the three trial arms. Allocation concealment will not be used.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
A secure computerised randomisation program will be used to cluster randomise the hospitals.
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
1/12/2009
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Actual
1/12/2009
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Date of last participant enrolment
Anticipated
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Actual
14/12/2009
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
1800
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Accrual to date
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Final
1669
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Recruitment outside Australia
Country [1]
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China
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State/province [1]
2007
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Funding & Sponsors
Funding source category [1]
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Government body
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Name [1]
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National Health and Medical Research Council - NHMRC
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Address [1]
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GPO Box 1421
Canberra ACT 2601
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Country [1]
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Australia
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Primary sponsor type
University
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Name
School of Public Health and Community Medicine, University of New South Wales
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Address
Samuels Building
The University of New South Wales
Sydney NSW 2052
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Country
Australia
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Secondary sponsor category [1]
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Government body
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Name [1]
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Beijing Centre for Disease Control and Surviellance
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Address [1]
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No. 16 He Pingli Middle Street, Dong Cheng District, Beijing, 100013, China
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Country [1]
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China
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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University of New South Wales
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Ethics committee address [1]
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UNSW Research Services Rupert Myers Building, Level 3 The University of New South Wales NSW 2052
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
243728
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Approval date [1]
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20/08/2009
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Ethics approval number [1]
243728
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09225
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Summary
Brief summary
A prospective, three-armed cluster randomized trial of respirator/mask use in frontline health care workers (HCWs) to determine the efficacy of two different kinds of respirators/face masks (N95’s, and surgical masks) during the influenza season on the transmission of pandemic H1N1 09, seasonal influenza and other respiratory viruses. Other respiratory viruses such as respiratory syncytial virus (RSV), adenovirus, parainfluenza viruses, coronaviruses, human metapneumovirus (hMPV), rhinoviruses etc are also associated with outbreaks of acute respiratory disease. Health care workers (HCWs) from the emergency departments, respiratory wards and infectious disease wards of major hospitals in Beijing, China will be recruited. These wards are selected because they are a setting in which repeated and multiple exposures to viral respiratory infections are present for staff. Hospitals will be allocated to one of the three study arms. Participants will be provided with one of two types of masks/respirators (depending on the arm to which the hospital they work in has been randomised) to be worn for four weeks when working on the ward. All participants will be followed up for five weeks (the four weeks of wearing the masks and an extra week of non-mask wearing)
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Trial website
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Trial related presentations / publications
MacIntyre C.R, Wang Q, Seale H, Yang P et.al. A randomised clinical trial of three policy options for N95 respirators and medical masks in health workers. (2013) American Journal of Respiratory and Critical Care Medicine. 187 (9), pp. 960-966
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Public notes
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Contacts
Principal investigator
Name
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Dr Raina MacIntyre
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Address
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School of Public Health and Community Medicine Level 3,
Samuels Building
The University of New South Wales
Sydney NSW 2052
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Country
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Australia
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Phone
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+61 2 9385 2517
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Dr Holly Seale
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Address
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School of Public Health and Community Medicine
Level 3, Samuels Building
The University of New South Wales
Sydney NSW 2052
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Country
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Australia
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Phone
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+61 2 9385 3129
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Fax
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+61 2 9313 6185
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Email
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[email protected]
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Contact person for scientific queries
Name
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Professor C. Raina MacIntyre
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Address
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School of Public Health and Community Medicine
Level 3, Samuels Building
The University of New South Wales
Sydney NSW 2052
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Country
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Australia
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Phone
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+61 2 9385 2517
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Fax
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+61 2 9313 6185
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Email
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
Source
Title
Year of Publication
DOI
Embase
A randomized clinical trial of three options for N95 respirators and medical masks in health workers.
2013
https://dx.doi.org/10.1164/rccm.201207-1164OC
N.B. These documents automatically identified may not have been verified by the study sponsor.
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