Modeling the Effectiveness of Respiratory Protective Devices in Reducing Influenza Outbreak

Risk Anal. 2019 Mar;39(3):647-661. doi: 10.1111/risa.13181. Epub 2018 Sep 19.


Outbreaks of influenza represent an important health concern worldwide. In many cases, vaccines are only partially successful in reducing the infection rate, and respiratory protective devices (RPDs) are used as a complementary countermeasure. In devising a protection strategy against influenza for a given population, estimates of the level of protection afforded by different RPDs is valuable. In this article, a risk assessment model previously developed in general form was used to estimate the effectiveness of different types of protective equipment in reducing the rate of infection in an influenza outbreak. It was found that a 50% compliance in donning the device resulted in a significant (at least 50% prevalence and 20% cumulative incidence) reduction in risk for fitted and unfitted N95 respirators, high-filtration surgical masks, and both low-filtration and high-filtration pediatric masks. An 80% compliance rate essentially eliminated the influenza outbreak. The results of the present study, as well as the application of the model to related influenza scenarios, are potentially useful to public health officials in decisions involving resource allocation or education strategies.

Keywords: Infection control; influenza epidemic model; personal protective equipment.

MeSH terms

  • Communicable Disease Control*
  • Disease Outbreaks
  • Epidemics / prevention & control
  • Humans
  • Infection Control
  • Influenza Vaccines
  • Influenza, Human / epidemiology*
  • Influenza, Human / prevention & control*
  • Models, Theoretical
  • Occupational Exposure
  • Prevalence
  • Public Health
  • Reproducibility of Results
  • Respiratory Protective Devices*
  • Risk Assessment / methods*


  • Influenza Vaccines