Population Behavior Regarding the Use of Face Masks to Prevent the Transmission of Respiratory Infections: Lessons to Be Learned from the COVID-19 Pandemic.

Historically, the use of a face mask has been associated with personal protection during epidemics. However, the type of mask used and the way it is used can affect the level of protection it provides. To analyze the practices of using face masks in the population in the Northeast of Brazil, a cross-sectional study was carried out, from December 2021 to February 2022, through interviews with 308 people at bus stops (simple random sample). Pearson's Chi-square test was calculated to verify the association between exposure and outcome variables. The prevalence of clinical manifestations of COVID-19 was 21.4%. The most used type of mask was made of one- and two-layer fabric when compared to N-95 and a three-layer surgical mask and its use were associated with people in the age group of 18-39 years, an income less than four minimum wage and education level equivalent to elementary/secondary school. An association was found between the infrequent use of a mask in a public environment, removing or lowering the mask when coughing and not washing hands before removing the mask and the occurrence of clinical manifestations suggestive of COVID-19. This study showed that socioeconomic factors are associated with the type of face mask used by the population and that the hygiene behavior of face-mask users was also associated with the occurrence of clinical manifestations of COVID-19. This highlights the need for guidelines and educational strategies that address these aspects to better protect the population against possible respiratory epidemics, especially in countries with important risk factors related to the use of face masks, and highlights the need for clear and objective guidelines and educational strategies to better protect the population against possible epidemics.