A survey of Alberta physicians' use of and attitudes toward face masks and face shields in the operating room setting

BackgroundThere is little evidence that surgical mask use by physicians in the operating room (OR) reduces surgical site infections (SSIs), but masks do protect the wearer from potentially infectious splashes. Face shields offer even more protection because they cover the eyes, but they may be perceived as offering less protection to the patient than do masks. The objectives of this study were to ascertain if there were predictors to determine which OR physicians are continuing to use masks and what their reasons are for doing so, and which OR physicians would accept face shields and their reasons for doing so.MethodsWe surveyed the province of Alberta's surgeons, general practice (GP) surgeons, anesthesiologists, and GP anesthetists to determine how many physicians in the OR wear surgical masks, their reasons for wearing surgical masks (ethical, legal, protection of the patient, protection of the wearer), and if they believe that face shields offer more protection to the patient or to the wearer. We also sought to examine which demographic factors affected their responses. The data were examined with χ2 analysis to assess the relationships of age and practitioner type, and for various outcome variables. A significance level of P < .05 was accepted as statistically significant.ResultsThe sex of the physician did not affect his/her responses. Older physicians believe that the OR team has an ethical and legal responsibility to wear surgical masks; masks are worn to prevent the spread of disease, not because it is tradition to do so; masks protect the wearer more than do face shields; and wearing face shields alone will subject the patient to higher rates of SSIs. Surgeons are more likely than are anesthesiologists to wear surgical masks in the OR and wear a surgical mask and a face shield if the patient has risk factors for a blood borne infection.ConclusionsAccording to our survey, age and profession were the most important variables that affected the potential use of surgical masks and face shields. Younger OR physicians likely would be amenable to using face shields in addition to masks in the OR to protect themselves from exposure to blood or bodily fluids.