CAMBRIDGE, England — Does diligently wearing a mask make an individual more likely to neglect washing their hands or other safety measures? Not as far as Cambridge University researchers can tell. Their new study, conducted using all available, relevant, and pre-existing data on this subject, concludes that wearing a mask does not make people more reckless regarding other COVID-19 health measures.
Today, more than 160 countries either recommend or mandate that citizens wear a face mask when entering shared indoor areas. Rewind a few months back, however, and the WHO at one point had warned that face masks may “create a false sense of security that can lead to neglecting other essential measures such as hand hygiene practices.” This phenomenon is known as risk compensation.
The research team at Cambridge set out to investigate if the WHO’s fears were justified, or perhaps overly worrisome. To accomplish this, first they had to fully understand the concept of risk compensation.
Risk compensation, in a nutshell, refers to the idea that people generally have a set “level” of risk in life that they’re comfortable with. As such, individuals’ actions and decisions often hinge on the level of risk they perceive at any given moment. For example, a person may jog a bit longer than usual because they know they’re going to have a fatty dinner.
While individual risk compensation is fairly straightforward, risk compensation among broader populations can be a bit harder to quantify. One observation often linked to population-level risk compensation is the alleged phenomenon of bike injuries going up whenever an area mandates that riders start wearing helmets. The idea being that riders feel more comfortable taking greater risks on the road because they’re wearing a helmet.
In essence, this is exactly what the WHO was warning against regarding masks. Just like riders wearing helmets supposedly being more reckless on the road, are mask-wearers more reckless regarding hand washing, etc?
Using risk compensation research to predict behavior when wearing masks
To answer this question, the study’s authors performed multiple investigations. First, they looked into prior research that investigated the legitimacy of the bike helmet/accident risk compensation theory. They also studies another risk compensation theory involving HPV vaccinations. Many believe that the introduction of HIV pre-exposure prophylaxis (PrEP) and HPV vaccinations are actually causing more people to have unsafe sex.
The analysis reveals that there isn’t much evidence to back up the bike-riding nor HPV risk compensation theories. Furthermore, some studies feature clear data showing that people given the HPV vaccine are less likely to engage in unprotected sex.
Next, 22 prior systematic reviews focusing on the effectiveness of wearing a mask on hindering viral transmission were analyzed. All of that data encompassed over 2,000 households, and many of those projects also collected data on hand hygiene habits. That research does not indicate that wearing a mask makes people any more likely to neglect washing their hands. A few studies even show that people who always wear a mask in public typically wash their hands more often.
Also, three of the analyzed studies note that people usually move away from others wearing masks. This suggests that mask wearing does not interfere with social distancing either.
“The concept of risk compensation, rather than risk compensation itself, seems the greater threat to public health through delaying potentially effective interventions that can help prevent the spread of disease,” says study leader Dame Theresa Marteau, a professor at the Behavior and Health Research Unit, in a release.
“Many public health bodies are coming to the conclusion that wearing a face covering might help reduce the spread of SARS-CoV-2, and the limited evidence available suggests their use doesn’t have a negative effect on hand hygiene,” adds co-author Dr. James Rubin from the Department of Psychological Medicine, King’s College London.
The study is published in BMJ Analysis.