Evidence map›Paper›PMID 34887270›Full record

Observational studyBMJ open2021

Assessing effective mask use by the public in two countries: an observational study.

Clare L Atzema, Ivona Mostarac, Dana Button, Peter C Austin, Arshia P Javidan, Lauren Wintraub, Allen Li, Raumil V Patel, Daniel Dongjoo Lee, Nathaniel P Latham and 11 more

Open access · goldAbstract readObservational Study
In one paragraph

Observational study in BMJ open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
0.9field-weighted citation impact, top 24% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 7 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

21 authors at 4 institutions in 2 countries.

Clare L AtzemaSunnybrook Health Sciences Centre, Toronto, Ontario, Canada clare.atzema@ices.on.ca.ORCID 0000-0002-7236-5522
Ivona MostaracSunnybrook Health Sciences Centre, Toronto, Ontario, Canada.ORCID 0000-0001-9621-983X
Dana ButtonOregon Health & Science University, School of Medicine, Portland, Oregon, USA.
Peter C AustinSunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
Arshia P JavidanInstitute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.ORCID 0000-0002-7541-2857
Lauren WintraubTemerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
Allen LiUniversity of Ottawa Faculty of Medicine, Ottawa, Ontario, Canada.ORCID 0000-0001-6615-7295
Raumil V PatelInstitute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.
Daniel Dongjoo LeeInstitute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.
Nathaniel P LathamSunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
Eric A LathamSunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
Patrick C M BrownOregon Health & Science University, School of Medicine, Portland, Oregon, USA.
Rita D SomogyiOregon Health & Science University, School of Medicine, Portland, Oregon, USA.
Alex ChangOregon Health & Science University, School of Medicine, Portland, Oregon, USA.
Huong NguyenOregon Health & Science University, School of Medicine, Portland, Oregon, USA.
Sara BuerkOregon Health & Science University, School of Medicine, Portland, Oregon, USA.
Bin ChenOregon Health & Science University, School of Medicine, Portland, Oregon, USA.
Tristen ZimmermanOregon Health & Science University, School of Medicine, Portland, Oregon, USA.
Trevor FunariOregon Health & Science University, School of Medicine, Portland, Oregon, USA.ORCID 0000-0002-1465-2590
Cameron ColbertOregon Health & Science University, School of Medicine, Portland, Oregon, USA.
Bory KeaOregon Health & Science University, School of Medicine, Portland, Oregon, USA.
Oregon Health & Science University · USSunnybrook Health Science Centre · CAUniversity of Toronto · CAUniversity of Ottawa · CA

Funding

Optimal Anticoagulation Strategies for Acute Atrial FibrillationK08HL140105 · NHLBI · OREGON HEALTH & SCIENCE UNIVERSITY · PI KEA, BORY · 2018 to 2020
$487k
NHLBI NIH HHS K08 HL140105
6 · The paper itself

Abstract

objectivesDuring the COVID-19 pandemic wearing a mask in public has been recommended in some settings and mandated in others. How often this advice is followed, how well, and whether it inadvertently leads to more disease transmission opportunities due to a combination of improper use and physical distancing lapses is unknown.

designCross-sectional observational study performed in June-August 2020.

settingEleven outdoor and indoor public settings (some with mandated mask use, some without) each in Toronto, Ontario, and in Portland, Oregon.

participantsAll passers-by in the study settings. OUTCOME MEASURES: Mask use, incorrect mask use, and number of breaches (ie, coming within 2 m of someone else where both parties were not properly masked).

resultsWe observed 36 808 persons, the majority of whom were estimated to be aged 31-65 years (49%). Two-thirds (66.7%) were wearing a mask and 13.6% of mask-wearers wore them incorrectly. Mandatory mask-use settings were overwhelmingly associated with mask use (adjusted OR 79.2; 95% CI 47.4 to 135.1). Younger age, male sex, Torontonians, and public transit or airport settings (vs in a store) were associated with lower adjusted odds of wearing a mask. Mandatory mask-use settings were associated with lower adjusted odds of mask error (OR 0.30; 95% CI 0.14 to 0.73), along with female sex and Portland subjects. Subjects aged 81+ years (vs 31-65 years) and those on public transit and at the airport (vs stores) had higher odds of mask errors. Mask-wearers had a large reduction in adjusted mean number of breaches (rate ratio (RR) 0.19; 95% CI 0.17 to 0.20). The 81+ age group had the largest association with breaches (RR 7.77; 95% CI 5.32 to 11.34).

conclusionsMandatory mask use was associated with a large increase in mask-wearing. Despite 14% of them wearing their masks incorrectly, mask users had a large reduction in the mean number of breaches (disease transmission opportunities). The elderly and transit users may warrant public health interventions aimed at improving mask use.

Indexed as

COVID-19PandemicsAgedCross-Sectional StudiesFemaleHumansMaleMasksSARS-CoV-2COVID-19health policypublic health

Identifiers

PMID34887270
PMCPMC8662585
OpenAlexW4200259654

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.