“The cookie monster muffler”: Perceptions and behaviours of hospital healthcare workers around the use of masks and respirators in the hospital setting.

  • Holly Seale UNSW Australia
  • Jun-Sup Leem UNSW Australia
  • Julie Gallard Centre for Hospital Epidemiology and Staff Services, Prince of Wales Hospital, Sydney, Australia
  • Rajneesh Kaur UNSW Australia
  • Abrar Ahmad Chughtai UNSW Australia
  • Mohamed Tashani UNSW Australia
  • Raina MacIntyre UNSW Australia


To ensure masks and respirators protect healthcare workers (HCWs) during respiratory virus outbreaks or a pandemic, individual, environmental, organizational and cultural issues associated with their use must be addressed. To explore the current knowledge, attitudes and practices regarding the use of these products, we conducted interviews with HCWs from a major tertiary referral hospital in Sydney, Australia. A qualitative study involving semi-structured interviews was undertaken at a tertiary hospital in Sydney Australia. HCWs from wards in which risk from respiratory infections is considered to be high (i.e. ICU, ED and respiratory wards), were invited to participate. A broad spectrum of attitudes was expressed regarding the use of masks and respirators, with many participants expressing uncertainty surrounding their use and level of effectiveness. Most participants who stated that they had previous experience with using masks or respirators agreed that the latter provided more protection and should be the product used in a respiratory infection setting. A lack of training amongst the HCWs, uncertainty regarding hospital or health authority guidelines and the discomfort and difficulty associated with mask/respirator use, were highlighted to be the core issues resulting in poor implementation of masks and respirators in the setting. While HCWs should take personal responsibility for donning facial protection when needed, the legal responsibility for employee use, adherence and occupational health and safety falls to the employer. An institutional commitment to a culture of safety systems, policies and practices is required to ensure a higher rate of adherence.

Author Biography

Holly Seale, UNSW Australia
Senior Lecturer School of Public Health and Community Medicine
Original Articles