Person wearing a surgical face mask in a busy urban public space, such as a shopping center or public transport. Show subtle interactions with others in the background, highlighting the mask's protective role amidst a modern cityscape.
A pragmatic randomized trial conducted in Norway evaluated whether wearing surgical face masks in public spaces reduces self-reported respiratory symptoms. More than 4,600 adults participated, with half instructed to wear masks in locations such as shopping centers, public transportation, and other high-traffic areas. Over 14 days, the trial monitored the participants’ respiratory health outcomes, revealing notable findings.
Runar Barstad Solberg, one of the researchers, explained, “We aimed to understand if wearing masks, even outside of clinical settings, could meaningfully reduce respiratory infections among the general public.”
The results were clear. The intervention group, those who wore masks, had a lower incidence of self-reported respiratory symptoms. Specifically, 8.9% of the mask-wearing group reported symptoms compared to 12.2% of the control group. This yielded a marginal odds ratio of 0.71, meaning a significant reduction in risk for those wearing masks.
The Numbers Speak Loudly
The study spanned from February to April 2023 and involved 4,647 participants. Among these, 2,788 were women, with a mean age of 51 years. The trial divided participants into two arms, with 2,313 individuals wearing masks and 2,262 not wearing them. The intervention led to a 3.2% absolute risk reduction in respiratory symptoms over the 14-day period.
Atle Fretheim, another leading investigator, said, “The trial was designed with the goal of assessing not just covid-19 risk, but overall respiratory health. The protective benefits of masks against general respiratory symptoms can have far-reaching implications.”
Beyond Covid-19: Mask-Wearing and General Health
Although the study’s focus was initially on covid-19, the results point to a broader protective benefit of face masks. The researchers did not observe a significant effect on covid-19 infections, with minimal cases reported across both groups. However, the overall reduction in respiratory symptoms suggests masks offer more than just viral protection. This could influence future health policies and mask recommendations, particularly in peak respiratory illness seasons.
Petter Elstrøm emphasized, “Our findings suggest that wearing masks during flu season, or when respiratory infections are on the rise, could be a key preventive measure. It isn’t just about covid anymore. We’re looking at overall community health.”
Mask-Wearing in Context
Despite the observed benefits, not everyone is eager to wear masks in public spaces. Previous studies, including systematic reviews of observational studies, have shown mixed results regarding the efficacy of masks outside healthcare settings. However, this trial contributes fresh evidence to the discussion, particularly in terms of community health during periods of increased respiratory infections.
Mette Fagernes, one of the co-researchers, remarked, “The debate over mask-wearing is likely to continue, but our study shows tangible health benefits. Masks could become a recommended measure during cold and flu season, especially in crowded areas.”
The team concluded that while masks may not completely prevent viral transmission, their ability to reduce the risk of respiratory symptoms makes them a valuable tool in public health.
Citation:
Solberg RB, Fretheim A, Elgersma IH, Fagernes M, Iversen BG, Hemkens LG, Rose CJ, Elstrøm P. Personal protective effect of wearing surgical face masks in public spaces on self-reported respiratory symptoms in adults: pragmatic randomised superiority trial. BMJ. 2023;386. doi:10.1136/bmj-2023-078918.
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