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Published in: BMC Public Health 1/2012

Open Access 01-12-2012 | Research article

Wearing face masks in public during the influenza season may reflect other positive hygiene practices in Japan

Authors: Koji Wada, Kuniko Oka-Ezoe, Derek R Smith

Published in: BMC Public Health | Issue 1/2012

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Abstract

Background

Although the wearing of face masks in public has not been recommended for preventing influenza, these devices are often worn in many Asian countries during the influenza season. In Japan, it is thought that such behavior may be an indicator of other positive hygiene practices. The aim of this study, therefore, was to determine if wearing a face mask in public is associated with other positive hygiene practices and health behaviors among Japanese adults.

Methods

We initially recruited around 3,000 Japanese individuals ranging from 20 to 69 years of age who were registered with a web survey company. Participants were asked to recall their personal hygiene practices during the influenza season of the previous year. Logistic regression analysis was then used to examine the associations between wearing a face mask in public and personal hygiene practices and health behaviors.

Results

A total of 3,129 persons responded to the survey, among whom 38% reported that they had worn a face mask in public during the previous influenza season. Wearing a face mask in public was associated with various self-reported hygiene practices including: frequent hand washing (adjusted Odds Ratio [OR]: 1.67; 95% Confidence Interval [95%CI]: 1.34-1.96), occasional hand washing (OR: 1.43; 95%CI: 1.10-1.75), frequently avoiding crowds (OR: 1.85; 95%CI: 1.70-1.98), occasionally avoiding crowds (OR: 1.65; 95%CI: 1.53-1.76), frequent gargling (OR: 1.68; 95%CI: 1.51-1.84), occasional gargling (OR: 1.46; 95%CI: 1.29-1.62), regularly avoiding close contact with an infected person (OR: 1.50; 95%CI: 1.33-1.67), occasionally avoiding close contact with an infected person (OR: 1.31; 95%CI: 1.16-1.46), and being vaccinated of influenza in the last season (OR: 1.31; 95%CI: 1.17-1.45).

Conclusions

Overall, this study suggests that wearing a face mask in public may be associated with other personal hygiene practices and health behaviors among Japanese adults. Rather than preventing influenza itself, face mask use might instead be a marker of additional, positive hygiene practices and other favorable health behaviors in the same individuals.
Literature
2.
go back to reference Institute of Medicine: Preventing Transmission of Pandemic Influenza and Other Viral Respiratory Diseases. 2011, Washington DC: The National Academies Institute of Medicine: Preventing Transmission of Pandemic Influenza and Other Viral Respiratory Diseases. 2011, Washington DC: The National Academies
3.
go back to reference Kawaguchi R, Miyazono M, Noda T, Takayama Y, Sasai Y, Iso H: Influenza (H1N1) 2009 outbreak and school closure, Osaka prefecture. Japan. Emerg Infect Dis. 2009, 15 (10): 1685-10.3201/eid1510.091029.CrossRefPubMed Kawaguchi R, Miyazono M, Noda T, Takayama Y, Sasai Y, Iso H: Influenza (H1N1) 2009 outbreak and school closure, Osaka prefecture. Japan. Emerg Infect Dis. 2009, 15 (10): 1685-10.3201/eid1510.091029.CrossRefPubMed
4.
go back to reference Burgess A, Horii M: Risk, ritual and health responsibilisation: Japan’s ‘safety blanket’ of surgical face mask-wearing. Sociol Health Illn. 2012, 34 (8): 1184-1198. 10.1111/j.1467-9566.2012.01466.x.CrossRefPubMed Burgess A, Horii M: Risk, ritual and health responsibilisation: Japan’s ‘safety blanket’ of surgical face mask-wearing. Sociol Health Illn. 2012, 34 (8): 1184-1198. 10.1111/j.1467-9566.2012.01466.x.CrossRefPubMed
5.
go back to reference Canini L, Andreoletti L, Ferrari P, D'Angelo R, Blanchon T, Lemaitre M, Filleul L, Ferry JP, Desmaizieres M, Smadja S, et al: Surgical mask to prevent influenza transmission in households: a cluster randomized trial. PLoS One. 2010, 5 (11): e13998-10.1371/journal.pone.0013998.CrossRefPubMedPubMedCentral Canini L, Andreoletti L, Ferrari P, D'Angelo R, Blanchon T, Lemaitre M, Filleul L, Ferry JP, Desmaizieres M, Smadja S, et al: Surgical mask to prevent influenza transmission in households: a cluster randomized trial. PLoS One. 2010, 5 (11): e13998-10.1371/journal.pone.0013998.CrossRefPubMedPubMedCentral
6.
go back to reference Tracht SM, Del Valle SY, Hyman JM: Mathematical modeling of the effectiveness of facemasks in reducing the spread of novel influenza A (H1N1). PLoS One. 2010, 5 (2): e9018-10.1371/journal.pone.0009018.CrossRefPubMedPubMedCentral Tracht SM, Del Valle SY, Hyman JM: Mathematical modeling of the effectiveness of facemasks in reducing the spread of novel influenza A (H1N1). PLoS One. 2010, 5 (2): e9018-10.1371/journal.pone.0009018.CrossRefPubMedPubMedCentral
7.
go back to reference Cowling BJ, Chan KH, Fang VJ, Cheng CK, Fung RO, Wai W, Sin J, Seto WH, Yung R, Chu DW, et al: Facemasks and hand hygiene to prevent influenza transmission in households: a cluster randomized trial. Ann Intern Med. 2009, 151 (7): 437-446.CrossRefPubMed Cowling BJ, Chan KH, Fang VJ, Cheng CK, Fung RO, Wai W, Sin J, Seto WH, Yung R, Chu DW, et al: Facemasks and hand hygiene to prevent influenza transmission in households: a cluster randomized trial. Ann Intern Med. 2009, 151 (7): 437-446.CrossRefPubMed
8.
go back to reference Aiello AE, Murray GF, Perez V, Coulborn RM, Davis BM, Uddin M, Shay DK, Waterman SH, Monto AS: Mask use, hand hygiene, and seasonal influenza-like illness among young adults: a randomized intervention trial. J Infect Dis. 2010, 201 (4): 491-498. 10.1086/650396.CrossRefPubMed Aiello AE, Murray GF, Perez V, Coulborn RM, Davis BM, Uddin M, Shay DK, Waterman SH, Monto AS: Mask use, hand hygiene, and seasonal influenza-like illness among young adults: a randomized intervention trial. J Infect Dis. 2010, 201 (4): 491-498. 10.1086/650396.CrossRefPubMed
9.
go back to reference Aiello AE, Perez V, Coulborn RM, Davis BM, Uddin M, Monto AS: Facemasks, hand hygiene, and influenza among young adults: a randomized intervention trial. PLoS One. 2012, 7 (1): e29744-10.1371/journal.pone.0029744.CrossRefPubMedPubMedCentral Aiello AE, Perez V, Coulborn RM, Davis BM, Uddin M, Monto AS: Facemasks, hand hygiene, and influenza among young adults: a randomized intervention trial. PLoS One. 2012, 7 (1): e29744-10.1371/journal.pone.0029744.CrossRefPubMedPubMedCentral
10.
go back to reference Ferng YH, Wong-McLoughlin J, Barrett A, Currie L, Larson E: Barriers to mask wearing for influenza-like illnesses among urban Hispanic households. Public Health Nurs. 2011, 28 (1): 13-23. 10.1111/j.1525-1446.2010.00918.x.CrossRefPubMed Ferng YH, Wong-McLoughlin J, Barrett A, Currie L, Larson E: Barriers to mask wearing for influenza-like illnesses among urban Hispanic households. Public Health Nurs. 2011, 28 (1): 13-23. 10.1111/j.1525-1446.2010.00918.x.CrossRefPubMed
11.
go back to reference Larson EL, Ferng Y, Wong-McLoughlin J, Wang S, Haber M, Morse SS: Impact of non-pharmaceutical interventions on URIs and influenza in crowded, urban households. Public Health Rep. 2010, 125 (2): 178-PubMedPubMedCentral Larson EL, Ferng Y, Wong-McLoughlin J, Wang S, Haber M, Morse SS: Impact of non-pharmaceutical interventions on URIs and influenza in crowded, urban households. Public Health Rep. 2010, 125 (2): 178-PubMedPubMedCentral
12.
go back to reference Beh EJ, Smith DR: Real world occupational epidemiology, part 1: odds ratios, relative risk, and asbestosis. Arch Environ Occup Heal. 2011, 66 (2): 119-123. 10.1080/19338244.2011.564233.CrossRef Beh EJ, Smith DR: Real world occupational epidemiology, part 1: odds ratios, relative risk, and asbestosis. Arch Environ Occup Heal. 2011, 66 (2): 119-123. 10.1080/19338244.2011.564233.CrossRef
13.
go back to reference Zhang J, Yu KF: What's The relative risk? a method of correcting the odds ratio in cohort studies of common outcomes. JAMA. 1998, 280 (19): 1690-1691. 10.1001/jama.280.19.1690.CrossRefPubMed Zhang J, Yu KF: What's The relative risk? a method of correcting the odds ratio in cohort studies of common outcomes. JAMA. 1998, 280 (19): 1690-1691. 10.1001/jama.280.19.1690.CrossRefPubMed
14.
go back to reference Park JH, Cheong HK, Son DY, Kim SU, Ha CM: Perceptions and behaviors related to hand hygiene for the prevention of H1N1 influenza transmission among Korean university students during the peak pandemic period. BMC Infect Dis. 2010, 10: 222-10.1186/1471-2334-10-222.CrossRefPubMedPubMedCentral Park JH, Cheong HK, Son DY, Kim SU, Ha CM: Perceptions and behaviors related to hand hygiene for the prevention of H1N1 influenza transmission among Korean university students during the peak pandemic period. BMC Infect Dis. 2010, 10: 222-10.1186/1471-2334-10-222.CrossRefPubMedPubMedCentral
15.
go back to reference Lau JT, Griffiths S, Choi KC, Lin C: Prevalence of preventive behaviors and associated factors during early phase of the H1N1 influenza epidemic. Am J Infect Control. 2010, 38 (5): 374-380. 10.1016/j.ajic.2010.03.002.CrossRefPubMed Lau JT, Griffiths S, Choi KC, Lin C: Prevalence of preventive behaviors and associated factors during early phase of the H1N1 influenza epidemic. Am J Infect Control. 2010, 38 (5): 374-380. 10.1016/j.ajic.2010.03.002.CrossRefPubMed
16.
go back to reference Vartti AM, Oenema A, Schreck M, Uutela A, de Zwart O, Brug J, Aro AR: SARS knowledge, perceptions, and behaviors: a comparison between Finns and the Dutch during the SARS outbreak In 2003. Int J Behav Med. 2009, 16 (1): 41-48. 10.1007/s12529-008-9004-6.CrossRefPubMed Vartti AM, Oenema A, Schreck M, Uutela A, de Zwart O, Brug J, Aro AR: SARS knowledge, perceptions, and behaviors: a comparison between Finns and the Dutch during the SARS outbreak In 2003. Int J Behav Med. 2009, 16 (1): 41-48. 10.1007/s12529-008-9004-6.CrossRefPubMed
17.
go back to reference Smith DR, Mihashi M, Adachi Y, Shouyama Y, Mouri F, Ishibashi N, Ishitake T: Organizational climate and its relationship with needlestick and sharps injuries among Japanese nurses. Am J Infect Control. 2009, 37 (7): 545-550. 10.1016/j.ajic.2008.11.004.CrossRefPubMed Smith DR, Mihashi M, Adachi Y, Shouyama Y, Mouri F, Ishibashi N, Ishitake T: Organizational climate and its relationship with needlestick and sharps injuries among Japanese nurses. Am J Infect Control. 2009, 37 (7): 545-550. 10.1016/j.ajic.2008.11.004.CrossRefPubMed
18.
go back to reference Aiello AE, Coulborn RM, Aragon TJ, Baker MG, Burrus BB, Cowling BJ, Duncan A, Enanoria W, Fabian MP, Ferng YH, et al: Research findings from nonpharmaceutical intervention studies for pandemic influenza and current gaps in the research. Am J Infect Control. 2010, 38 (4): 251-258. 10.1016/j.ajic.2009.12.007.CrossRefPubMed Aiello AE, Coulborn RM, Aragon TJ, Baker MG, Burrus BB, Cowling BJ, Duncan A, Enanoria W, Fabian MP, Ferng YH, et al: Research findings from nonpharmaceutical intervention studies for pandemic influenza and current gaps in the research. Am J Infect Control. 2010, 38 (4): 251-258. 10.1016/j.ajic.2009.12.007.CrossRefPubMed
19.
go back to reference Del Valle SY, Tellier R, Settles GS, Tang JW: Can we reduce the spread of influenza in schools with face masks?. Am J Infect Control. 2010, 38 (9): 676-677. 10.1016/j.ajic.2010.03.012.CrossRefPubMed Del Valle SY, Tellier R, Settles GS, Tang JW: Can we reduce the spread of influenza in schools with face masks?. Am J Infect Control. 2010, 38 (9): 676-677. 10.1016/j.ajic.2010.03.012.CrossRefPubMed
20.
go back to reference MacIntyre CR, Cauchemez S, Dwyer DE, Seale H, Cheung P, Browne G, Fasher M, Wood J, Gao Z, Booy R: Face mask use and control of respiratory virus transmission in households. Emerg Infect Dis. 2009, 15 (2): 233-10.3201/eid1502.081167.CrossRefPubMedPubMedCentral MacIntyre CR, Cauchemez S, Dwyer DE, Seale H, Cheung P, Browne G, Fasher M, Wood J, Gao Z, Booy R: Face mask use and control of respiratory virus transmission in households. Emerg Infect Dis. 2009, 15 (2): 233-10.3201/eid1502.081167.CrossRefPubMedPubMedCentral
21.
go back to reference Kontos EZ, Emmons KM, Puleo E, Viswanath K: Contribution of communication inequalities to disparities in human papillomavirus vaccine awareness and knowledge. Am J Public Health. 2012, 102 (10): 1911-1920. 10.2105/AJPH.2011.300435.CrossRefPubMedPubMedCentral Kontos EZ, Emmons KM, Puleo E, Viswanath K: Contribution of communication inequalities to disparities in human papillomavirus vaccine awareness and knowledge. Am J Public Health. 2012, 102 (10): 1911-1920. 10.2105/AJPH.2011.300435.CrossRefPubMedPubMedCentral
Metadata
Title
Wearing face masks in public during the influenza season may reflect other positive hygiene practices in Japan
Authors
Koji Wada
Kuniko Oka-Ezoe
Derek R Smith
Publication date
01-12-2012
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2012
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-12-1065

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