BOHS on Public Covering of Nose and Mouth to Prevent the Spread of COVID-19

There is much debate about “face masks” being worn in public.

It is generally accepted that covering one’s mouth when coughing is appropriate to prevent spreading infection. Coughing into a tissue or handkerchief is maybe better. This is sometimes called “respiratory etiquette”. That is because these measures prevent droplets which carry infection from being sprayed far enough to be inhaled by others.

As we contemplate returning to work and to public spaces, it seems we are unlikely to see relaxing of social distancing rules so much as adoption of measures to help relieve the extent of lockdown. Measures that enhance respiratory etiquette may assist in reducing the risk of people unwittingly infecting others and therefore could potentially make an important contribution to controlling infection spread. We note however that scientific evidence on the benefits of public covering of nose and mouth to prevent the spread of COVID-19 is limited and inconclusive.

BOHS notes that public spaces are invariably other people’s work-spaces and therefore we would welcome measures that people take to help prevent themselves from inadvertently spreading COVID-19, including enhanced respiratory etiquette. This would include the use of face coverings, such as cloth masks, that may help control spread of the virus by reducing droplet spread. However, proper hygiene is required to ensure that this is effective.

We caution that widespread public use of face coverings may have unintended consequences such as giving a false sense of security with the effect of reducing diligence in observing hygiene and social distancing measures. Nevertheless, provided the parameters for recommending the use of face coverings in the public arena are clearly established and supported by good advice on use, BOHS would support such measures to help minimize exposure at source.

We do not endorse the private use of respiratory protective equipment by the general public for personal use, except where it is to support people in situations of particular vulnerability. Respirators and PPE are used to protect individuals (such as healthcare workers and others at high risk of being exposed to exhaled droplets). Such equipment only works well when it is properly fitted and used in combination with a management system and other personal protective and decontamination measures. 

Our concern is that personal choices about enhanced respiratory etiquette for use in public places do not override the duties of employers to ensure that properly risk-assessed and planned measures are in place in each workplace to manage social distancing, hygiene and, where necessary deploying equipment to protect workers from harmful health exposures.

As stated above the literature on this subject is limited, but will no doubt evolve over coming months. BOHS has established expert groups to regularly review the position and provide guidance that reflects consensus on scientific evidence and matters of best practice.