In this review, we focused on 3 personal protective measures and 1 environmental measure. Other
potential environmental measures include humidification in dry environments (48), increasing ventilation (49), and use of upper-room UV light (50), but
there is limited evidence to support these measures.
Further investigations on the effectiveness of respiratory etiquette and surface cleaning through conducting RCTs would be helpful to provide evidence
with higher quality; evaluation of the effectiveness of
these measures targeting specific population groups,
such as immunocompromised persons, would also be
beneficial (Table 2). Future cost-effectiveness evaluations could provide more support for the potential
use of these measures. Further research on transmission modes and alternative interventions to reduce
influenza transmission would be valuable in improving pandemic preparedness. Finally, although our review focused on nonpharmaceutical measures to be
taken during influenza pandemics, the findings could
also apply to severe seasonal influenza epidemics.
Evidence from RCTs of hand hygiene or face masks
did not support a substantial effect on transmission of
laboratory-confirmed influenza, and limited evidence
was available on other environmental measures.