Araştırma Makalesi
BibTex RIS Kaynak Göster

Surgical mask usage effects: a self-questionnaire study of 7.014 responders during the COVID-19 pandemic

Yıl 2024, Cilt: 22 Sayı: 1, 35 - 48, 26.04.2024
https://doi.org/10.20518/tjph.1349593

Öz

Objective: WHO has advised to conduct research the adverse consequences of surgical mask use in the community. This study aimed to determine the effects of surgical mask use during the COVID-19 pandemic.
Methods: This descriptive study was conducted with 7014 respondents from 81 provinces of Turkey between August and November 2021. In the collection of data, a form on socio demographic characteristics, knowledge level questionnaire on surgical mask use, surgical mask usage characteristics questionnaire, and questionnaire on symptoms related to surgical mask use were used. In the analysis of the data, number, percentage, mean, standard deviation, Chi-square, and logistic regression analysis were used.
Results: The mean age of the respondents was 33.1±12.5 years, 54.8% of whom were women. 42.4% of the respondents stated that they felt protected by the mask and 69.7% of them stated that they had problems with the use of masks. The mean score of the respondents’ knowledge questionnaire regarding the use of surgical masks was found to be 5.33 ± 1.88. The mean symptom score of the respondents after the use of surgical masks was 2.57±2.67. During mask use, respiratory symptoms were seen most commonly, by 72.9% of the respondents. There was a significant relationship between male gender, chronic disease, not washing hands after contact with masks, removing masks in public enviroment, having spare masks, and symptoms after surgical mask use (p<0.05).
Conclusion: Hand contact with the mask, and not washing the hands afterwards, removing the surgical mask were modifiable factors that increase the risk.

Destekleyen Kurum

Afyonkarahisar Health Sciences University Scientific Research Projects Commission

Proje Numarası

21.GENEL.008

Teşekkür

We would like to thank everyone who participated in the study.

Kaynakça

  • WHO- Mask use in the context of COVID-19. [Internet]. Available at: https://www.who.int/publications-detail-redirect/advice-on-the-use-of-masks-in-the-community-during-home-care-and-in-healthcare-settings-in-the-context-of-the-novel-coronavirus-(2019-ncov)-outbreak Accessed September 155,2022
  • T.R. Ministry of Health, 2022. Bakan Koca, Koronavirüse İlişkin Son Durumu Değerlendirdi. T.C. Saglik Bakanligi. [Internet]. Avaible at: https://www.saglik.gov.tr/TR,65032/bakan-koca-koronaviruse-iliskin-son-durumu-degerlendirdi.html Accessed September 15,2022
  • Zheng R, Zhou Y, Fu Y, et al. Prevalence and associated factors of depression and anxiety among nurses during the outbreak of COVID-19 in China: A cross-sectional study. Int J Nurs Stud. 2021;114(2021):1–8.
  • WHO. WHO- Coronavirus disease (COVID-19) advice for the public: When and how to use masks [Internet]. Available at: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public/when-and-how-to-use-masks Accessed October 25,2022
  • Howard J, Huang A, Li Z, et al. An evidence review of face masks against COVID-19. Proc Natl Acad Sci. 2021;118(4):1–12.
  • MacIntyre CR, Dwyer D, Seale H, et al. The first randomized, controlled clinical trial of mask use in households to prevent respiratory virus transmission. Int J Infect Dis. 2008;12(Supplement 1): e328.
  • Teng JLL, Fok KMN, Lin KPK, et al. Substantial decline in ınvasive pneumococcal disease during coronavirus disease 2019 pandemic in Hong Kong. Clin Infect Dis Off Publ Infect Dis Soc Am. 2022;74(2):335–8.
  • WHO. WHO- Mask use in the context of COVID-19 [Internet]. Available at: https://www.who.int/publications-detail-redirect/advice-on-the-use-of-masks-in-the-community-during-home-care-and-in-healthcare-settings-in-the-context-of-the-novel-coronavirus-(2019-ncov)-outbreak Accessed October 25,2022
  • CDC. Centers for Disease Control and Prevention. Masks and Respirators [Internet]. Available at: https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/masks.html Accessed October 25,2022
  • Anadolu Ajansı. Türkiye genelinde 25 ilde maske takma zorunluluğu getirildi [Internet]. Available at: https://www.aa.com.tr/tr/koronavirus/turkiye-genelinde-25-ilde-maske-takma-zorunlulugu-getirildi/1847514 Accessed October 25,2022
  • Dünya Gazetesi. https://www.dunya.com/gundem/629-gun-sonra-maskesiz-sosyal-hayat-haberi-659302. Dünya Gazetesi; 629 gün sonra maskesiz sosyal hayat. Available at: https://www.dunya.com/gundem/629-gun-sonra-maskesiz-sosyal-hayat-haberi-659302 Accessed October 25,2022
  • Clapham HE, Cook AR. Face masks help control transmission of COVID-19. The Lancet Digital Health. 2021;3(3):e136-e137.
  • Rebmann T, Carrico R, Wang J. Physiologic and other effects and compliance with long-term respirator use among medical intensive care unit nurses. Am J Infect Control. 2013;41(12):1218–23.
  • Tan KT, Greaves MW. N95 acne. Int J Dermatol. 2004;43(7):522–3.
  • Hu K, Fan J, Li X, Gou X, Li X, Zhou X. The adverse skin reactions of health care workers using personal protective equipment for COVID-19. Medicine (Baltimore). 2020;99(24):1–5.
  • Al Badri FM. Surgical mask contact dermatitis and epidemiology of contact dermatitis in healthcare workers. Curr Allergy Clin Immunol. 2017;30(3):183–8.
  • Roberge RJ, Kim JH, Coca A. Protective facemask impact on human thermoregulation: An overview. Ann Occup Hyg. 2012;56(1):102–12.
  • Scarano A, Inchingolo F, Lorusso F. Facial skin temperature and discomfort when wearing protective face masks: Thermal infrared imaging evaluation and hands moving the mask. Int J Environ Res Public Health. 2020;17(13): E4624.
  • Ehsan RB, Tehreem F, Ata F, Kanwal N, Jabbar M, Alyas MA. Assessment of frequency and severity of mask-ınduced dry eye in university students during COVID-19. Clinical Medicine Research. 2022;11(5):120-125.
  • Ku JL, Sun MH, Yen YC, Chi CC. Mask-related adverse skin reactions and risk factors: A literature review. Dermatologica Sinica. 2023;41(3):153-159.
  • Scheid JL, Lupien SP, Ford GS, West SL. Commentary: Physiological and Psychological Impact of Face Mask Usage during the COVID-19 Pandemic. Int J Environ Res Public Health. 2020;17(18):1–12.
  • TÜİK. TÜİK-Türkiye İstatistik Kurumu Adrese Dayalı Nüfus Kayıt Sistemi Sonuçları [Internet]. Available at: https://data.tuik.gov.tr/Bulten/Index?p=Adrese-Dayali-Nufus-Kayit-Sistemi-Sonuclari-2019-33705 Accessed October 25,2022
  • T.C. Aile, Çalışma ve Sosyal Hizmetler Bakanlığı. Engelli ve Yaşlı İstatistik Bülteni [Internet]. Available at: https://www.aile.gov.tr/media/42250/istatistik-bulteni-2020-mart.pdf Accessed October 25,2022
  • Kiliç S. Örnek büyüklüğü, güç kavramları ve örnek büyüklüğü hesaplaması. J Mood Disord. 2012;2(3):140–2.
  • T.R. Ministry of Health, 2023. COVID-19 Bilgilendirme Platformu. [Internet]. Avaible at: https://covid19.saglik.gov.tr/ Accessed March 03,2023
  • Sikakulya FK, Ssebuufu R, Mambo SB, et al. Use of face masks to limit the spread of the COVID-19 among western Ugandans: Knowledge, attitude and practices. PLoS One. 2021;16(3):e0248706.
  • Nagarajan R, Rubeshkumar P, Jagadeesan M, et al. (2022). Knowledge, attitude, and practice towards face mask use among residents of Greater Chennai Corporation, India, March 2021. Front Public Health.2022;10:938642.
  • Vijayakumar AE, Seethalakshmi S, Vinay M, Arjun S, Nikhithaa P. Knowledge, attitude, and practices of 2nd year MBBS students regarding the use of face mask to limit the spread of the new coronavirus disease. Natl J Physiol Pharm Pharmacol. 2022;12(6):894–8.
  • Polivka BJ, Eldeirawi K, Huntington-Moskos L, Nyenhuis SM. Mask Use Experiences, COVID-19, and Adults with Asthma: A Mixed-Methods Approach. J Allergy Clin Immunol Pract. 2022;10(1):116–23.
  • Epstein D, Korytny A, Isenberg Y, et al. Return to training in the COVID-19 era: The physiological effects of face masks during exercise. Scand J Med Sci Sports. 2021;31(1):70–5.
  • Escobedo P, Fernández-Ramos MD, López-Ruiz N, et al. Smart facemask for wireless CO2 monitoring. Nat Commun. 2022;13(1):72.
  • Alkan B, Özalevli S, Sert ÖA. Wearing a surgical mask: Effects on gas exchange and hemodynamic responses during maximal exercise. Clin Physiol Funct Imaging. 2022;42(4):286–91.
  • Okan ÖÜN, Okan ÖGYT. COVID-19 sürecinde maske takmaya ilişkin metaforik algıların incelenmesi ve maske takmanın psikolojik etkilerinin belirlenmesine yönelik nitel bir araştırma. In: II International Halıch Congress on Multidisciplinary Scientific Research Proceeding Book. 1.baskı. İstanbul; 2021. p. 310–8.
  • Henke L, Guseva M, Wagemans K, et al. Surgical face masks do not impair the decoding of facial expressions of negative affect more severely in older than in younger adults. Cogn Res Princ Implic. 2022;7(1):63.
  • Lee J, Kwon KH. Changes in the use of cosmetics worldwide due to increased use of masks in the coronavirus disease-19 pandemic. J Cosmet Dermatol. 2022;21(7):2708–12.
  • Techasatian L, Lebsing S, Uppala R, et al. The effects of the face mask on the skin underneath: a prospective survey during the COVID-19 pandemic. J Prim Care Community Health. 2020;11:1–7.
  • Szepietowski JC, Matusiak Ł, Szepietowska M, Krajewski PK, Białynicki-Birula R. Face mask-induced itch: A self-questionnaire study of 2,315 responders during the COVID-19 pandemic. Acta Derm Venereol. 2020;100(10):1–5.
  • Taleb R, Jad R, Salem R, et al. The effect of frequently wearing face masks during the COVID- 19 pandemic on the development of acne in adults: a crosssectional descriptive study. Bau J- Health Wellbeing. 2022;4(2):1–13.
  • Dash G, Patro N, Dwari BC, Abhisekh K. Mask-induced skin changes during COVID pandemic: A cross-sectional web-based survey among physicians in a tertiary care teaching hospital. J Cosmet Dermatol. 2022;21(5):1804–8.
  • Bukhari A, Dakhil AB, Albrkheel A, et al. Face mask-induced skin changes: a new common phenomenon during the coronavirus disease 2019 pandemic. Dermatol Reports. 2022;15(1):9526
  • Althobaiti HM, Althobaiti H, Khan M, Alsatti H, Samarkandy SJ. The association between facial dermatosis and face-mask wearing during COVID-19 in Saudi Arabia. Cureus. 2022;14(2):1–13.
  • Chen YJ, Qin G, Chen J, et al. Comparison of face-touching behaviors before and during the coronavirus disease 2019 pandemic. JAMA Netw Open. 2020;3(7):e2016924.
Yıl 2024, Cilt: 22 Sayı: 1, 35 - 48, 26.04.2024
https://doi.org/10.20518/tjph.1349593

Öz

Proje Numarası

21.GENEL.008

Kaynakça

  • WHO- Mask use in the context of COVID-19. [Internet]. Available at: https://www.who.int/publications-detail-redirect/advice-on-the-use-of-masks-in-the-community-during-home-care-and-in-healthcare-settings-in-the-context-of-the-novel-coronavirus-(2019-ncov)-outbreak Accessed September 155,2022
  • T.R. Ministry of Health, 2022. Bakan Koca, Koronavirüse İlişkin Son Durumu Değerlendirdi. T.C. Saglik Bakanligi. [Internet]. Avaible at: https://www.saglik.gov.tr/TR,65032/bakan-koca-koronaviruse-iliskin-son-durumu-degerlendirdi.html Accessed September 15,2022
  • Zheng R, Zhou Y, Fu Y, et al. Prevalence and associated factors of depression and anxiety among nurses during the outbreak of COVID-19 in China: A cross-sectional study. Int J Nurs Stud. 2021;114(2021):1–8.
  • WHO. WHO- Coronavirus disease (COVID-19) advice for the public: When and how to use masks [Internet]. Available at: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public/when-and-how-to-use-masks Accessed October 25,2022
  • Howard J, Huang A, Li Z, et al. An evidence review of face masks against COVID-19. Proc Natl Acad Sci. 2021;118(4):1–12.
  • MacIntyre CR, Dwyer D, Seale H, et al. The first randomized, controlled clinical trial of mask use in households to prevent respiratory virus transmission. Int J Infect Dis. 2008;12(Supplement 1): e328.
  • Teng JLL, Fok KMN, Lin KPK, et al. Substantial decline in ınvasive pneumococcal disease during coronavirus disease 2019 pandemic in Hong Kong. Clin Infect Dis Off Publ Infect Dis Soc Am. 2022;74(2):335–8.
  • WHO. WHO- Mask use in the context of COVID-19 [Internet]. Available at: https://www.who.int/publications-detail-redirect/advice-on-the-use-of-masks-in-the-community-during-home-care-and-in-healthcare-settings-in-the-context-of-the-novel-coronavirus-(2019-ncov)-outbreak Accessed October 25,2022
  • CDC. Centers for Disease Control and Prevention. Masks and Respirators [Internet]. Available at: https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/masks.html Accessed October 25,2022
  • Anadolu Ajansı. Türkiye genelinde 25 ilde maske takma zorunluluğu getirildi [Internet]. Available at: https://www.aa.com.tr/tr/koronavirus/turkiye-genelinde-25-ilde-maske-takma-zorunlulugu-getirildi/1847514 Accessed October 25,2022
  • Dünya Gazetesi. https://www.dunya.com/gundem/629-gun-sonra-maskesiz-sosyal-hayat-haberi-659302. Dünya Gazetesi; 629 gün sonra maskesiz sosyal hayat. Available at: https://www.dunya.com/gundem/629-gun-sonra-maskesiz-sosyal-hayat-haberi-659302 Accessed October 25,2022
  • Clapham HE, Cook AR. Face masks help control transmission of COVID-19. The Lancet Digital Health. 2021;3(3):e136-e137.
  • Rebmann T, Carrico R, Wang J. Physiologic and other effects and compliance with long-term respirator use among medical intensive care unit nurses. Am J Infect Control. 2013;41(12):1218–23.
  • Tan KT, Greaves MW. N95 acne. Int J Dermatol. 2004;43(7):522–3.
  • Hu K, Fan J, Li X, Gou X, Li X, Zhou X. The adverse skin reactions of health care workers using personal protective equipment for COVID-19. Medicine (Baltimore). 2020;99(24):1–5.
  • Al Badri FM. Surgical mask contact dermatitis and epidemiology of contact dermatitis in healthcare workers. Curr Allergy Clin Immunol. 2017;30(3):183–8.
  • Roberge RJ, Kim JH, Coca A. Protective facemask impact on human thermoregulation: An overview. Ann Occup Hyg. 2012;56(1):102–12.
  • Scarano A, Inchingolo F, Lorusso F. Facial skin temperature and discomfort when wearing protective face masks: Thermal infrared imaging evaluation and hands moving the mask. Int J Environ Res Public Health. 2020;17(13): E4624.
  • Ehsan RB, Tehreem F, Ata F, Kanwal N, Jabbar M, Alyas MA. Assessment of frequency and severity of mask-ınduced dry eye in university students during COVID-19. Clinical Medicine Research. 2022;11(5):120-125.
  • Ku JL, Sun MH, Yen YC, Chi CC. Mask-related adverse skin reactions and risk factors: A literature review. Dermatologica Sinica. 2023;41(3):153-159.
  • Scheid JL, Lupien SP, Ford GS, West SL. Commentary: Physiological and Psychological Impact of Face Mask Usage during the COVID-19 Pandemic. Int J Environ Res Public Health. 2020;17(18):1–12.
  • TÜİK. TÜİK-Türkiye İstatistik Kurumu Adrese Dayalı Nüfus Kayıt Sistemi Sonuçları [Internet]. Available at: https://data.tuik.gov.tr/Bulten/Index?p=Adrese-Dayali-Nufus-Kayit-Sistemi-Sonuclari-2019-33705 Accessed October 25,2022
  • T.C. Aile, Çalışma ve Sosyal Hizmetler Bakanlığı. Engelli ve Yaşlı İstatistik Bülteni [Internet]. Available at: https://www.aile.gov.tr/media/42250/istatistik-bulteni-2020-mart.pdf Accessed October 25,2022
  • Kiliç S. Örnek büyüklüğü, güç kavramları ve örnek büyüklüğü hesaplaması. J Mood Disord. 2012;2(3):140–2.
  • T.R. Ministry of Health, 2023. COVID-19 Bilgilendirme Platformu. [Internet]. Avaible at: https://covid19.saglik.gov.tr/ Accessed March 03,2023
  • Sikakulya FK, Ssebuufu R, Mambo SB, et al. Use of face masks to limit the spread of the COVID-19 among western Ugandans: Knowledge, attitude and practices. PLoS One. 2021;16(3):e0248706.
  • Nagarajan R, Rubeshkumar P, Jagadeesan M, et al. (2022). Knowledge, attitude, and practice towards face mask use among residents of Greater Chennai Corporation, India, March 2021. Front Public Health.2022;10:938642.
  • Vijayakumar AE, Seethalakshmi S, Vinay M, Arjun S, Nikhithaa P. Knowledge, attitude, and practices of 2nd year MBBS students regarding the use of face mask to limit the spread of the new coronavirus disease. Natl J Physiol Pharm Pharmacol. 2022;12(6):894–8.
  • Polivka BJ, Eldeirawi K, Huntington-Moskos L, Nyenhuis SM. Mask Use Experiences, COVID-19, and Adults with Asthma: A Mixed-Methods Approach. J Allergy Clin Immunol Pract. 2022;10(1):116–23.
  • Epstein D, Korytny A, Isenberg Y, et al. Return to training in the COVID-19 era: The physiological effects of face masks during exercise. Scand J Med Sci Sports. 2021;31(1):70–5.
  • Escobedo P, Fernández-Ramos MD, López-Ruiz N, et al. Smart facemask for wireless CO2 monitoring. Nat Commun. 2022;13(1):72.
  • Alkan B, Özalevli S, Sert ÖA. Wearing a surgical mask: Effects on gas exchange and hemodynamic responses during maximal exercise. Clin Physiol Funct Imaging. 2022;42(4):286–91.
  • Okan ÖÜN, Okan ÖGYT. COVID-19 sürecinde maske takmaya ilişkin metaforik algıların incelenmesi ve maske takmanın psikolojik etkilerinin belirlenmesine yönelik nitel bir araştırma. In: II International Halıch Congress on Multidisciplinary Scientific Research Proceeding Book. 1.baskı. İstanbul; 2021. p. 310–8.
  • Henke L, Guseva M, Wagemans K, et al. Surgical face masks do not impair the decoding of facial expressions of negative affect more severely in older than in younger adults. Cogn Res Princ Implic. 2022;7(1):63.
  • Lee J, Kwon KH. Changes in the use of cosmetics worldwide due to increased use of masks in the coronavirus disease-19 pandemic. J Cosmet Dermatol. 2022;21(7):2708–12.
  • Techasatian L, Lebsing S, Uppala R, et al. The effects of the face mask on the skin underneath: a prospective survey during the COVID-19 pandemic. J Prim Care Community Health. 2020;11:1–7.
  • Szepietowski JC, Matusiak Ł, Szepietowska M, Krajewski PK, Białynicki-Birula R. Face mask-induced itch: A self-questionnaire study of 2,315 responders during the COVID-19 pandemic. Acta Derm Venereol. 2020;100(10):1–5.
  • Taleb R, Jad R, Salem R, et al. The effect of frequently wearing face masks during the COVID- 19 pandemic on the development of acne in adults: a crosssectional descriptive study. Bau J- Health Wellbeing. 2022;4(2):1–13.
  • Dash G, Patro N, Dwari BC, Abhisekh K. Mask-induced skin changes during COVID pandemic: A cross-sectional web-based survey among physicians in a tertiary care teaching hospital. J Cosmet Dermatol. 2022;21(5):1804–8.
  • Bukhari A, Dakhil AB, Albrkheel A, et al. Face mask-induced skin changes: a new common phenomenon during the coronavirus disease 2019 pandemic. Dermatol Reports. 2022;15(1):9526
  • Althobaiti HM, Althobaiti H, Khan M, Alsatti H, Samarkandy SJ. The association between facial dermatosis and face-mask wearing during COVID-19 in Saudi Arabia. Cureus. 2022;14(2):1–13.
  • Chen YJ, Qin G, Chen J, et al. Comparison of face-touching behaviors before and during the coronavirus disease 2019 pandemic. JAMA Netw Open. 2020;3(7):e2016924.
Toplam 42 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Hizmetleri ve Sistemleri (Diğer)
Bölüm Araştırma Makalesi
Yazarlar

Özlem Soyer Er 0000-0002-9272-2400

Meryem Yavuz Van Giersbergen 0000-0002-8661-0066

Proje Numarası 21.GENEL.008
Erken Görünüm Tarihi 20 Nisan 2024
Yayımlanma Tarihi 26 Nisan 2024
Gönderilme Tarihi 24 Ağustos 2023
Kabul Tarihi 3 Nisan 2024
Yayımlandığı Sayı Yıl 2024 Cilt: 22 Sayı: 1

Kaynak Göster

APA Soyer Er, Ö., & Yavuz Van Giersbergen, M. (2024). Surgical mask usage effects: a self-questionnaire study of 7.014 responders during the COVID-19 pandemic. Turkish Journal of Public Health, 22(1), 35-48. https://doi.org/10.20518/tjph.1349593
AMA Soyer Er Ö, Yavuz Van Giersbergen M. Surgical mask usage effects: a self-questionnaire study of 7.014 responders during the COVID-19 pandemic. TJPH. Nisan 2024;22(1):35-48. doi:10.20518/tjph.1349593
Chicago Soyer Er, Özlem, ve Meryem Yavuz Van Giersbergen. “Surgical Mask Usage Effects: A Self-Questionnaire Study of 7.014 Responders During the COVID-19 Pandemic”. Turkish Journal of Public Health 22, sy. 1 (Nisan 2024): 35-48. https://doi.org/10.20518/tjph.1349593.
EndNote Soyer Er Ö, Yavuz Van Giersbergen M (01 Nisan 2024) Surgical mask usage effects: a self-questionnaire study of 7.014 responders during the COVID-19 pandemic. Turkish Journal of Public Health 22 1 35–48.
IEEE Ö. Soyer Er ve M. Yavuz Van Giersbergen, “Surgical mask usage effects: a self-questionnaire study of 7.014 responders during the COVID-19 pandemic”, TJPH, c. 22, sy. 1, ss. 35–48, 2024, doi: 10.20518/tjph.1349593.
ISNAD Soyer Er, Özlem - Yavuz Van Giersbergen, Meryem. “Surgical Mask Usage Effects: A Self-Questionnaire Study of 7.014 Responders During the COVID-19 Pandemic”. Turkish Journal of Public Health 22/1 (Nisan 2024), 35-48. https://doi.org/10.20518/tjph.1349593.
JAMA Soyer Er Ö, Yavuz Van Giersbergen M. Surgical mask usage effects: a self-questionnaire study of 7.014 responders during the COVID-19 pandemic. TJPH. 2024;22:35–48.
MLA Soyer Er, Özlem ve Meryem Yavuz Van Giersbergen. “Surgical Mask Usage Effects: A Self-Questionnaire Study of 7.014 Responders During the COVID-19 Pandemic”. Turkish Journal of Public Health, c. 22, sy. 1, 2024, ss. 35-48, doi:10.20518/tjph.1349593.
Vancouver Soyer Er Ö, Yavuz Van Giersbergen M. Surgical mask usage effects: a self-questionnaire study of 7.014 responders during the COVID-19 pandemic. TJPH. 2024;22(1):35-48.

13955                                        13956                                                             13958                                       13959                                        28911


TURKISH JOURNAL OF PUBLIC HEALTH - TURK J PUBLIC HEALTH. online-ISSN: 1304-1096 

Copyright holder Turkish Journal of Public Health. This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International LicenseCreative Commons License