Dataset Information

Effect of Wearing a Face Mask on Hand-to-Face Contact by Children in a Simulated School Environment: The Back-to-School COVID-19 Simulation Randomized Clinical Trial.

ABSTRACT:

Importance

Wearing a face mask in school can reduce SARS-CoV-2 transmission but it may also lead to increased hand-to-face contact, which in turn could increase infection risk through self-inoculation.

Objective

To evaluate the effect of wearing a face mask on hand-to-face contact by children while at school.

Design, setting, and participants

This prospective randomized clinical trial randomized students from junior kindergarten to grade 12 at 2 schools in Toronto, Ontario, Canada, during August 2020 in a 1:1 ratio to either a mask or control class during a 2-day school simulation. Classes were video recorded from 4 angles to accurately capture outcomes.

Interventions

Participants in the mask arm were instructed to bring their own mask and wear it at all times. Students assigned to control classes were not required to mask at any time (grade 4 and lower) or in the classroom where physical distancing could be maintained (grade 5 and up).

Main outcomes and measures

The primary outcome was the number of hand-to-face contacts per student per hour on day 2 of the simulation. Secondary outcomes included hand-to-mucosa contacts and hand-to-nonmucosa contacts. A mixed Poisson regression model was used to derive rate ratios (RRs), adjusted for age and sex with a random intercept for class with bootstrapped 95% CIs.

Results

A total of 174 students underwent randomization and 171 students (mask group, 50.6% male; control group, 52.4% male) attended school on day 2. The rate of hand-to-face contacts did not differ significantly between the mask and the control groups (88.2 vs 88.7 events per student per hour; RR, 1.00; 95% CI, 0.78-1.28; P = >.99). When compared with the control group, the rate of hand-to-mucosa contacts was significantly lower in the mask group (RR, 0.12; 95% CI, 0.07-0.21), while the rate of hand-to-nonmucosa contacts was higher (RR, 1.40; 95% CI, 1.08-1.82).

Conclusions and relevance

In this clinical trial of simulated school attendance, hand-to-face contacts did not differ among students required to wear face masks vs students not required to wear face masks; however, hand-to-mucosa contracts were lower in the face mask group. This suggests that mask wearing is unlikely to increase infection risk through self-inoculation.

Trial registration

ClinicalTrials.gov Identifier: NCT04531254.

SUBMITTER: Science M

PROVIDER: S-EPMC9593317 | biostudies-literature | 2022 Dec

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Effect of Wearing a Face Mask on Hand-to-Face Contact by Children in a Simulated School Environment: The Back-to-School COVID-19 Simulation Randomized Clinical Trial.

Science Michelle M Caldeira-Kulbakas Monica M Parekh Rulan S RS Maguire Bryan R BR Carroll Stacie S Anthony Samantha J SJ Bitnun Ari A Bourns Laura E LE Campbell Douglas M DM Cohen Eyal E Dodds Alison A Dubey Vinita V Friedman Jeremy N JN Greenwood Jodi L JL Hopkins Jessica P JP Imgrund Ryan R Korczak Daphne J DJ Looi Thomas T Louca Emily E Mertz Dominik D Nashid John J Panzera Giovanna G Schneiderman Jane E JE Schwartz Kevin L KL Streitenberger Laurie L Vuppal Sunayna S Walsh Catharine M CM Jüni Peter P Matava Clyde T CT

JAMA pediatrics 20221201 12

<h4>Importance</h4>Wearing a face mask in school can reduce SARS-CoV-2 transmission but it may also lead to increased hand-to-face contact, which in turn could increase infection risk through self-inoculation.<h4>Objective</h4>To evaluate the effect of wearing a face mask on hand-to-face contact by children while at school.<h4>Design, setting, and participants</h4>This prospective randomized clinical trial randomized students from junior kindergarten to grade 12 at 2 schools in Toronto, Ontario, ...[more]

PMID: 36279142

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Project description:Recent studies suggest that covering the face inhibits the recognition of identity and emotional expressions. However, it might also make the eyes more salient, since they are a reliable index to orient our social and spatial attention. This study investigates (1) whether the pervasive interaction with people with face masks fostered by the COVID-19 pandemic modulates the processing of spatial information essential to shift attention according to other's eye-gaze direction (i.e., gaze-cueing effect: GCE), and (2) whether this potential modulation interacts with motor responses (i.e., Simon effect). Participants were presented with face cues orienting their gaze to a congruent or incongruent target letter location (gaze-cueing paradigm) while wearing a surgical mask (Mask), a patch (Control), or nothing (No-Mask). The task required to discriminate the identity of the lateralized target letters by pressing one of two lateralized response keys, in a corresponding or a non-corresponding position with respect to the target. Results showed that GCE was not modulated by the presence of the Mask, but it occurred in the No-Mask condition, confirming previous studies. Crucially, the GCE interacted with Simon effect in the Mask and Control conditions, though in different ways. While in the Mask condition the GCE emerged only when target and response positions corresponded (i.e., Simon-corresponding trials), in the Control condition it emerged only when they did not correspond (i.e., Simon-non-corresponding trials). These results indicate that people with face masks induce us to jointly orient our visual attention in the direction of the seen gaze (GCE) in those conditions resembling (or associated with) a general approaching behavior (Simon-corresponding trials). This is likely promoted by the fact that we tend to perceive wearing the mask as a personal safety measure and, thus, someone wearing the face mask is perceived as a trustworthy person. In contrast, people with a patch on their face can be perceived as more threatening, therefore inducing a GCE in those conditions associated with a general avoidance behavior (Simon-non-corresponding trials).

Dataset Information

Effect of Wearing a Face Mask on Hand-to-Face Contact by Children in a Simulated School Environment: The Back-to-School COVID-19 Simulation Randomized Clinical Trial.

Importance

Objective

Design, setting, and participants

Interventions

Main outcomes and measures

Results

Conclusions and relevance

Trial registration

Publications

Effect of Wearing a Face Mask on Hand-to-Face Contact by Children in a Simulated School Environment: The Back-to-School COVID-19 Simulation Randomized Clinical Trial.

Similar Datasets

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