Environmental measures to prevent transmission of infectious diseases (multiple reviews)
What is this? Environmental measures (including interventions as wide ranging as cleaning of surfaces and border controls) are among the non-pharmaceutical interventions being used to minimise transmission of COVID-19. Several reviews are summarised here, with more details, including citations and links to the full reviews, available further down this page.
What was found: Several environmental interventions have been studied for a variety of infectious diseases. These measures include the cleaning of surfaces and other objects, closure of hospital wards, border controls and closure of schools (which is covered in a separate summary, available here).
The Xiao review (search done in August 2018) did not find evidence of a major effect of surface or object cleaning on transmission of influenza.
The Wong review (search done in July 2014) concluded that it is uncertain whether ward closures are effective at controlling outbreaks of infectious diseases because of the lack of controlled studies.
The Putri review (search done up to April 2020) recommended limited interactions between healthcare departments as a means of preventing the transmission of COVID-19.
The Burns review (search done up to 13 November 2020) found that travel restrictions reducing or stopping cross-border travel were beneficial at reducing the transmission of SARS-CoV-2, screening travellers at borders (including those with symptoms or who had potentially been exposed to COVID‐19) would reduce imported or exported cases of COVID-19 and delay outbreaks and that screening based on testing reduced imported or exported cases and cases detected; quarantine may be beneficial for preventing the transmission of SARS-CoV-2 and that quarantine and screening at borders may be beneficial for preventing the transmission of SARS-CoV-2.
Earlier reviews by Saunders-Hasting (search done in July 2016) and Jefferson (search done in October 2010) concluded that it is uncertain whether border controls are effective at controlling outbreaks of infectious diseases and whether screening at ports of entry is effective at controlling outbreaks of infectious diseases, respectively, because of insufficient evidence.
What are the reviews:
Citation: Burns J, Movsisyan A, Stratil JM, et al. International travel‐related control measures to contain the COVID‐19 pandemic: a rapid review. Cochrane Database of Systematic Reviews. 2021;(3):CD013717.
In this version of the Cochrane rapid review, the authors searched for studies on control measures for international travel during the COVID-19 pandemic. They did not restrict their searches by language of publication and did the search up to 13 November 2020. The review updates an earlier version of the review, which also included data from other pandemics. This version includes 49 modelling studies and 13 observational studies.
Citation: Fong MW, Gao H, Wong JY, et al. Nonpharmaceutical measures for pandemic influenza in non-healthcare settings: social distancing measures. Emerging Infectious Diseases. 2020;26(5):976.
In this series of systematic reviews, the authors searched for studies of the effects of social distancing measures for pandemic influenza, and covered six measures: isolating ill individuals, contact tracing, quarantining exposed individuals, school measures or closures, workplace measures or closures, and crowd avoidance, with multiple search periods documented up to November 2018. They included 107 epidemiological studies, 37 simulation studies, 12 observational studies, and one interventional study; and also analyzed archival data from the 1918 influenza pandemic.
Citation: Jefferson T, Del Mar CB, Dooley L, et al. Physical interventions to interrupt or reduce the spread of respiratory viruses. Cochrane Database of Systematic Reviews. 2011;(7):CD006207.
In this earlier version of a Cochrane review, the authors searched for randomized trials and observational studies of physical interventions that might prevent respiratory virus transmission. They did not restrict by language of publication and did their searches in October 2010. They identified 67 eligible studies, spread across many different interventions.
Citation: Putri SI, Anulus A. Preventive actions to minimizing the coronavirus disease 19 (COVID-19) transmissions among health workers: a systematic review. Journal of the Medical Sciences. 2020;52(3):148-57.
In this rapid review, the authors searched for studies about disease transmission prevention among healthcare workers. The authors restricted their searches to studies published in English or Indonesian between January and April 2020. They included 7 studies.
Citation: Saunders-Hastings P, Reisman J, Krewski D. Assessing the state of knowledge regarding the effectiveness of interventions to contain pandemic influenza transmission: a systematic review and narrative synthesis. PLoS One. 2016;11(12):e0168262.
In this systematic overview and narrative syntheses, the authors searched for systematic reviews and meta-analyses of pharmaceutical and non-pharmaceutical interventions for containing pandemic influenza transmission. They did not restrict their searches by date or language of publication and did the search in July 2016. They included 17 reviews.
Citation: Wong H, Eso K, Ip A, et al. Use of ward closure to control outbreaks among hospitalized patients in acute care settings: a systematic review. Systematic Reviews. 2015;4(1):152.
In this systematic review, the authors searched for studies in which ward closure was used to control outbreaks of infectious diseases among patients hospitalized in acute care facilities. They did not restrict their searches by date, type or language of publication and did the search in July 2014. They identified 67 case series, 14 case-control studies and 16 studies of other designs. Among these, 11 studies focused on diseases of the respiratory system, including SARS. There were no controlled comparisons of ward closures versus other interventions.
Citation: Xiao J, Shiu EY, Gao H, et al. Nonpharmaceutical Measures for Pandemic Influenza in Nonhealthcare Settings: Personal Protective and Environmental Measures. Emerging Infectious Diseases 2020;26(5):967-75.
In this systematic review, the authors searched for studies of non-pharmaceutical measures for reducing influenza transmission in community settings. They did not restrict their searches by language of publication and did the search in August 2018. They included studies on hand hygiene (7 randomized trials), face masks (7 randomized trials) or both (6 randomized trials), and surface or object cleaning (1 randomized trial and 1 observational study).