Document Type : original article


1 Occupational Medicine Specialist Faculty of Medicine, Department of Occupational, Mashhad University of Medical Sciences, Mashhad, Iran

2 Social Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

3 Imam Reza and Ghaem Hospitals, Mashhad University of Medical Sciences, Mashhad, Iran


Background: The present study was performed to investigate the level of knowledge, attitude, and performance of healthcare personnel working in COVID-19 hospitals in Mashhad regarding the use of respiratory protection equipment.
Methods: This cross-sectional study was conducted on 536 personnel working in hospitals admitting COVID-19 patients in Mashhad, Iran. The participants completed a questionnaire containing data related to the knowledge, attitude, and performance of healthcare workers regarding the use of respiratory protection equipment.
Results: According to the results, the evaluated knowledge levels were weak (1.1%), moderate (32.7%), and good (66.2%). Moreover, the levels of attitude were moderate (7.9%) and good (92.1%). In addition, the performance showed moderate (3.6%) and good (96.4%) levels. The mean score of knowledge was significantly higher among employees over 35 years of age (P<0.001), employees with 10 years or more work experience (P<0.001), and among males, compared to females (P<0.001). The mean score of performance was also significantly higher in males than in female employees (P<0.001), in married, compared to single employees (P<0.001), and among individuals who had close contact with a COVID-19 patient (P<0.001).
Conclusion: According to the results of the study, there was an acceptable level of knowledge, attitude, and performance among healthcare personnel working in the COVID-19 hospitals of Mashhad regarding the use of respiratory protection equipment. However, more training in this field seems useful, especially for people with less experience and age.


  1. Organization WH. Critical preparedness, readiness and response actions for COVID-19: interim guidance, 22 March 2020. World Health Organization; 2020.
  2. Coronavirus [Internet]. World Health Organization 2021. Cited
  3. Wu Z, McGoogan JM. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72 314 cases from the Chinese Center for Disease Control and Prevention. Jama. 2020; 323(13), 1239-1242.
  4. United Nations World Tourism Organization. Impact assessment of the Covid-19 outbreak on international tourism online available at https://, retrieved on 15th April 2020.
  5. Koh D. Occupational risks for COVID-19. Occupational Medicine. 2020.
  6. Fleming M. Lardner R. Strategies to promote safe behavior as part of a health and safety management system. Contact Research Report, 2002; 430-38.
  7. Honarbakhsh M, Jahangiri M, Ghaem H. Knowledge, perceptions and practices of healthcare workers regarding the use of respiratory protection equipment at Iran hospitals. Journal of infection prevention. 2018; 19(1):29-36.
  8. Safety O, Administration H. Occupational Safety and Health Standards on Respiratory Protection, 29 CFR 1910. 134. 2017.
  9. Nemati M, Ebrahimi B, Nemati F. Assessment of Iranian nurses’ knowledge and anxiety toward COVID-19 during the current outbreak in Iran. Arch Clin Infect Dis. 2020; 15(COVID-19). e102848
  10. Haghighi F, Kouhi P, Amini M, Mohammadkarimi V, Sepehrpoor M, Hosseini A, Moosavi M, Sadeghi Boogar S. Knowledge, Attitude, and Practice Toward COVID-19 Among HealthcareWorkers in Shiraz, Iran. Shiraz E-Med J. 2020 December; 21(12):e108872.
  11. Zhang M, Zhou M, Tang F, Wang Y, Nie H, Zhang L, You G. Knowledge, attitude, and practice regarding COVID-19 among healthcare workers in Henan, China. J Hosp Infect. 2020; 105(2):183–7.
  12. Ogolodom MP, Mbaba A, Alazigha N, Erondu OF, Egbe NO, Golden I, Ugwuanyi DC, Achi GI, Eke CM. Knowledge, attitudes and fears of healthcare workers towards the corona virus disease (COVID-19) pandemic in south-south, Nigeria.Health Sci J. 2020.
  13. De Perio MA, Brueck SE, Mueller CA, Milne CK, Rubin MA, Gundlapalli AV, Mayer J. Evaluation of 2009 pandemic influenza A (H1N1) exposures and illness among physicians in training. American journal of infection control. 2012; 40(7):617-21.
  14. Jahangiri M, Sareban Zadeh K, Bashar OL and Saleh Zadeh H. Risk perception, safety attitude and safety performance in supervisors of construction sites in Shiraz. Journal of Ergonomics 2013; 1: 10–18.
  15. Nickell LA, Crighton EJ, Tracy CS, Al-Enazy H, Bolaji Y, Hanjrah S, Hussain A, Makhlouf S and Upshur RE. Psychosocial effects of SARS on hospital staff: survey of a large tertiary care institution. Canadian Medical Association Journal 2004; 170(1): 793–798.
  16. Mortazavi S, Asilian H and Oostakhan M. The relationship between safety climate factors and workers behavior working in potentially dangerous situations in height among construction workers. Iranian Journal of Public Health 2011; 8(12): 51–60.
  17. Nour MO, Babilghith AO, Natto HA, Al-Amin FO and Alawneh SM. Knowledge, attitude and practices of healthcare providers towards MERS-CoV infection at Makkah hospitals, KSA. International Research Journal of Medicine and Medical Sciences 2015; 3(1):103–112.
  18. Sanaei Nasab H, Ghofranipour F, Kazemnejad A, Khavanin A and Tavakoli R. Evaluation of knowledge, attitude and behavior of workers towards occupational health and safety. Iranian J Publ Health 2009; 38: 125–129.
  19. Tam DKP, Lee S, Lee SS: Impact of SARS on avian influenza preparedness in healthcare workers. Infection 2007, 35:320–325.
  20. Akpodiete A, Isara AR: Concerns about the knowledge of multi drug resistant tuberculosis among health care workers and patients in southern Nigeria. Am J Respir Crit Care Med 2014, 189:A3215.