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Not recommended to use face masks outside the healthcare service

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We often see images of civilians wearing face masks in the media, apparently to protect themselves against respiratory viruses. However, there is very little evidence that the use of face masks by healthy people in normal social situations has any effect. On the contrary, if used incorrectly, they can increase the risk of infection and disease.

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We often see images of civilians wearing face masks in the media, apparently to protect themselves against respiratory viruses. However, there is very little evidence that the use of face masks by healthy people in normal social situations has any effect. On the contrary, if used incorrectly, they can increase the risk of infection and disease.


How are influenza and common cold viruses transmitted?

Influenza and common cold viruses are transmitted when viruses from the respiratory tract of a sick person come into contact with the mucous membranes of the eyes, nose or mouth of another person in three ways:

  • Airborne through sneezing or coughing, so that the virus is inhaled or comes into contact with the mucosa of the eyes, nose or mouth of people nearby
  • By direct contact when the virus is on a person’s hands and is transmitted to others
  • By indirect contact when the virus has been transmitted to objects by sneezing / coughing on them or by touch.

Why are face masks ineffective outside the health service?

Face masks are primarily designed to prevent transmission of infectious agents from healthcare professionals to vulnerable patients, so they are designed to prevent the transmission of infection from the wearer.  They also have a somewhat protective effect for the wearer by preventing larger droplets from entering the respiratory tract from the surroundings.

However, the mask must sit tightly around the mouth and nose to have a protective effect. This is difficult to achieve without prior training. Furthermore, the masks have limited effect and lifetime. They are only effective for larger particles (such as droplets) and must be replaced regularly to remain effective.

Why do face masks pose a risk of infection?

Face masks are uncomfortable, and as a rule, untrained personnel who wear face masks frequently touch the mask and their face. If you have been in contact with contaminated surfaces, you may unconsciously touch your eyes and mouth afterwards thereby increasing the risk of infection.

Face masks are intended for one-time use and quickly acquire bacteria and viruses both inside and out. Without having good routines to avoid touching the mask during and after use, for removing it without contaminating your hands, or for performing hand hygiene afterwards, the infection may spread further.

How to prevent infection?

Based on this, the Norwegian Institute of Public Health does not recommend the use of face masks outside the healthcare service. Exceptions are if a person is in close contact with sick people, such as caring for sick family members.

To prevent infection, people who are sick should avoid coughing or sneezing directly onto others and, if possible keep at least one metre away from other people. Use a face mask if leaving the house or if closer contact is necessary.  Try to cough / sneeze into a paper tissue (disposed carefully afterwards followed by handwashing or hand disinfection) or into the crook of the elbow.

Good hand hygiene, both among the sick and the healthy, is very important to prevent transmission of infection. Wash hands frequently and thoroughly with soap and lukewarm water, especially when you have been in contact with other people. Hand disinfection is a good alternative if handwashing facilities are unavailable. If your hands are visibly dirty or wet, hand disinfection has a limited effect. Therefore, hand washing with soap and water is recommended in these situations.

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