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Quartucci C, Wibowo R, Do V, Bose-O Reilly S, Nowak D, Weilnhammer V, Weinmann T, Rakete S. Assessment of subjective well-being of healthcare workers in response to heat and personal protective equipment under controlled conditions using a standardized protocol. J Occup Med Toxicol 2024; 19:16. [PMID: 38750499 PMCID: PMC11095016 DOI: 10.1186/s12995-024-00418-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 05/08/2024] [Indexed: 05/19/2024] Open
Abstract
BACKGROUND Due to climate change, the increasing frequency of hot summer days and heat waves can result in occupational heat strain, especially in non-air-conditioned workplaces. Healthcare workers (HCW) engaged in patient care are particularly affected, as they are additionally exposed to physical stress. The use of personal protective equipment (PPE) can aggravate heat strain in HCW. This study aimed to examine the subjective well-being of HCW when exposed to heat and PPE under controlled conditions. METHODS This study was designed as a randomized crossover trial. Participants performed standardized healthcare tasks in a climatic chamber for approximately 3.5 h at different indoor temperatures (22 °C and 27 °C) and varied working conditions (with or without PPE). The effects on participants' subjective well-being, encompassing thermal, physiological and psychological stress were assessed using a customized questionnaire. RESULTS Heat had a greater effect than PPE on thermal, physical and psychological stress. Conversely, PPE had a greater effect on physical demand and effort. For the majority of outcomes, combined exposure to heat and PPE resulted in the highest perceived discomfort. Furthermore, the participants reported increased sweating and other discomforts when working at elevated temperatures or with PPE. CONCLUSIONS In this study, heat and PPE, but particularly the combination of both factors, were identified as unfavorable working environments. Although the trials were conducted in a controlled environment, the outcomes provide valuable information about the effect of heat and PPE on HCW in a real-life setting. Furthermore, the design used in this study can be beneficial in evaluating the effect of mitigation strategies.
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Affiliation(s)
- Caroline Quartucci
- Institute and Clinic for Occupational, Social and Environmental Medicine, LMU University Hospital, LMU Munich, Munich, Germany
- Institute for Occupational Health and Product Safety, Bavarian Health and Food Safety Authority, Environmental Health, Munich, Germany
| | - Razan Wibowo
- Institute and Clinic for Occupational, Social and Environmental Medicine, LMU University Hospital, LMU Munich, Munich, Germany
- Institute for Occupational Health and Product Safety, Bavarian Health and Food Safety Authority, Environmental Health, Munich, Germany
| | - Viet Do
- Institute and Clinic for Occupational, Social and Environmental Medicine, LMU University Hospital, LMU Munich, Munich, Germany
| | - Stephan Bose-O Reilly
- Institute and Clinic for Occupational, Social and Environmental Medicine, LMU University Hospital, LMU Munich, Munich, Germany
- Department of Public Health, Medical Informatics and Technology, Health Services Research and Health Technology Assessment, UMIT - University for Health Sciences, Hall in Tirol, Austria
| | - Dennis Nowak
- Institute and Clinic for Occupational, Social and Environmental Medicine, LMU University Hospital, LMU Munich, Munich, Germany
| | - Veronika Weilnhammer
- Institute for Occupational Health and Product Safety, Bavarian Health and Food Safety Authority, Environmental Health, Munich, Germany
| | - Tobias Weinmann
- Institute and Clinic for Occupational, Social and Environmental Medicine, LMU University Hospital, LMU Munich, Munich, Germany
| | - Stefan Rakete
- Institute and Clinic for Occupational, Social and Environmental Medicine, LMU University Hospital, LMU Munich, Munich, Germany.
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Zand S, Motlagh MS, Golmohammadi R, Aliabadi M, Tapak L, Babamiri M. Effects of wearing medical gowns at different temperatures on the physiological responses of female healthcare workers during the COVID-19 Pandemic. Work 2024:WOR230360. [PMID: 38339951 DOI: 10.3233/wor-230360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND Using medical gowns with high protection against COVID-19 among healthcare workers (HCWs) may limit heat exchange, resulting in physiological challenges. OBJECTIVE This study aimed to compare the physiological and neurophysiological responses of female HCWs when using two typical medical gowns at different temperatures during the COVID-19 pandemic. METHODS Twenty healthy female HCWs participated in this study. Participants wore two types of medical gowns: Spunbond gown (SG) and laminate gown (LG). They walked on a treadmill in a controlled climate chamber for 30 minutes at three different temperatures (24, 28, and 32°C). Heart rate (HR), skin surface temperature (ST), clothing surface temperature (CT), ear temperature (ET), blood oxygen percentage (SaO2), galvanic skin response (GSR), and blood pressure were measured before and after walking on a treadmill. The study's results were analyzed using SPSS26. RESULTS The study found that LG led to an average increase of 0.575°C in CT compared to SG at the same temperatures (P < 0.03). The average HR increased by 6.5 bpm in LG at 28°C compared to SG at a comfortable temperature (P = 0.01). The average ET in SG and GSR in LG at 32°C increased by 0.39°C and 0.25μS, respectively, compared to the comfortable temperature (P < 0.02). CONCLUSION The study recommends maintaining a comfortable temperature range in hospitals to prevent physiological challenges among HCWs wearing medical gowns with high protection against COVID-19. This is important because using LG, compared to SG, at high temperatures can increase HR, ET, CT, and GSR.
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Affiliation(s)
- Sepideh Zand
- Center of Excellence for Occupational Health, Occupational Health and Safety Research Center, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Masoud Shafiee Motlagh
- Center of Excellence for Occupational Health, Occupational Health and Safety Research Center, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Rostam Golmohammadi
- Center of Excellence for Occupational Health, School of Public Health and Research Center for Health Sciences, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Mohsen Aliabadi
- Center of Excellence for Occupational Health, Occupational Health and Safety Research Center, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Leili Tapak
- Department of Biostatistics, School of Public Health and Modeling of Noncommunicable Diseases Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Mohammad Babamiri
- Department of Ergonomics, School of Public Health and Research Center for Health Sciences, Hamadan University of Medical Sciences, Hamadan, Iran
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Figi CE, Herstein JJ, Beam EL, Le AB, Hewlett AL, Lawler JV, Lowe JJ, Gibbs SG. Literature review of physiological strain of personal protective equipment on personnel in the high-consequence infectious disease isolation environment. Am J Infect Control 2023; 51:1384-1391. [PMID: 37182761 DOI: 10.1016/j.ajic.2023.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 05/08/2023] [Accepted: 05/09/2023] [Indexed: 05/16/2023]
Abstract
BACKGROUND Heat strain and dehydration can affect an individual's physical and mental performance. The purpose of this review was to examine the literature for the impact of heat strain on health care workers (HCWs) who care for patients with high-consequence infectious diseases (HCIDs) while wearing personal protective equipment (PPE), discuss the risks of impaired safety caused by heat strain and dehydration in HCID environments, identify attempts to combat PPE-related heat strain, recognize limitations, and provide suggestions for further research. METHODS A literature search was performed in PubMed or MEDLINE and Google Scholar. Authors screened abstracts for inclusion criteria and reviewed articles if the abstracts were considered to include information relevant to the aim. RESULTS The search terms yielded 30 articles that were sorted based on environment setting, physiological impact, and interventions. DISCUSSION The safety of the HCWs and patients can be enhanced through the development and usage of cooler, more comfortable PPE materials and ensembles to help slow the rate of dehydration and support the regulation of core body temperature. CONCLUSIONS Heat strain caused by wearing PPE is an occupational health concern for HCWs in the high-risk environment, that is, HCID care. Future studies are needed to develop innovative PPE ensembles that can reduce heat strain and improve well-being.
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Affiliation(s)
- Claire E Figi
- Department of Epidemiology and Biostatistics, School of Public Health, Texas A&M University, College Station, TX.
| | - Jocelyn J Herstein
- Department of Environmental, Agricultural, and Occupational Health, University of Nebraska Medical Center, College of Public Health, 985110 Nebraska Medical Center, Omaha, NE.
| | - Elizabeth L Beam
- College of Nursing, University of Nebraska Medical Center, 985330 Nebraska Medical Center, Omaha, NE.
| | - Aurora B Le
- Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, MI.
| | - Angela L Hewlett
- Global Center for Health Security, University of Nebraska Medical Center, 986161 Nebraska Medical Center, Omaha, NE; Department of Internal Medicine, Division of Infectious Diseases, University of Nebraska Medical Center, 983332 Nebraska Medical Center, Omaha, NE.
| | - James V Lawler
- Global Center for Health Security, University of Nebraska Medical Center, 986161 Nebraska Medical Center, Omaha, NE.
| | - John J Lowe
- Department of Environmental, Agricultural, and Occupational Health, University of Nebraska Medical Center, College of Public Health, 985110 Nebraska Medical Center, Omaha, NE; Global Center for Health Security, University of Nebraska Medical Center, 986161 Nebraska Medical Center, Omaha, NE.
| | - Shawn G Gibbs
- Department of Environmental and Occupational Health, School of Public Health, Texas A&M University, College Station, TX.
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Tetzlaff EJ, Goulet N, Gorman M, Richardson GRA, Kenny GP. The Intersection of the COVID-19 Pandemic and the 2021 Heat Dome in Canadian Digital News Media: A Content Analysis. Int J Environ Res Public Health 2023; 20:6674. [PMID: 37681814 PMCID: PMC10488163 DOI: 10.3390/ijerph20176674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 08/18/2023] [Accepted: 08/25/2023] [Indexed: 09/09/2023]
Abstract
During the 2021 Heat Dome, 619 people in British Columbia died due to the heat. This public health disaster was made worse by the ongoing COVID-19 pandemic. Few studies have explored the intersection of heat with COVID-19, and none in Canada. Considering that climate change is expected to increase the frequency of extreme heat events, it is important to improve our understanding of intersecting public health crises. Thus, this study aimed to explore media-based public health communication in Canada during the COVID-19 pandemic and the 2021 Heat Dome. A qualitative content analysis was conducted on a subset of media articles (n = 520) related to the COVID-19 pandemic which were identified through a previous media analysis on the 2021 Heat Dome (n = 2909). Many of the articles provided conflicting health messages that may have confused the public about which health protective actions to take. The articles also showed how the COVID-19 pandemic may have exacerbated the health impacts of the 2021 Heat Dome, as pandemic-related public health measures may have deterred people away from protecting themselves from heat. This study, which provides novel insight into the prioritization of public health messaging when an extreme heat event occurs concurrently with a pandemic, supports the need for consistent heat health guidance.
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Affiliation(s)
- Emily J. Tetzlaff
- Human and Environmental Physiology Research Unit, School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, ON K1N 6N5, Canada; (E.J.T.); (G.P.K.)
- Heat Division, Climate Change and Innovation Bureau, Healthy Environment and Consumer Safety Branch, Safe Environments Directorate, Health Canada, Ottawa, ON K1A 0K9, Canada;
| | - Nicholas Goulet
- Human and Environmental Physiology Research Unit, School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, ON K1N 6N5, Canada; (E.J.T.); (G.P.K.)
- Heat Division, Climate Change and Innovation Bureau, Healthy Environment and Consumer Safety Branch, Safe Environments Directorate, Health Canada, Ottawa, ON K1A 0K9, Canada;
- Behavioural and Metabolic Research Unit, School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, ON K1N 6N5, Canada
| | - Melissa Gorman
- Heat Division, Climate Change and Innovation Bureau, Healthy Environment and Consumer Safety Branch, Safe Environments Directorate, Health Canada, Ottawa, ON K1A 0K9, Canada;
| | - Gregory R. A. Richardson
- Heat Division, Climate Change and Innovation Bureau, Healthy Environment and Consumer Safety Branch, Safe Environments Directorate, Health Canada, Ottawa, ON K1A 0K9, Canada;
| | - Glen P. Kenny
- Human and Environmental Physiology Research Unit, School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, ON K1N 6N5, Canada; (E.J.T.); (G.P.K.)
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON K1H 8L6, Canada
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Mezger NCS, Eickel F, Lorenz R, Griesel M. [Sustainability in private surgical practice-A narrative review]. Coloproctology 2023; 45:1-10. [PMID: 37362611 PMCID: PMC10158674 DOI: 10.1007/s00053-023-00711-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/28/2023]
Abstract
Background Surgery is contributing to the climate crisis, not least in the outpatient sector. The present publication aims to identify the challenges this poses, and to provide clear, preferably evidence-based recommendations on environmental protection while simultaneously reducing costs. Method Narrative review with a non-systematic search and selection in PubMed/MEDLINE and grey area literature as well as expert interviews. Results Numerous primary articles, evidence syntheses, practical recommendations for action and checklists were identified and two experts were interviewed. Environmental issues were identified in the production and procurement, transport of people and goods, usage of materials, pharmaceuticals including anesthetic gases and energy consumption in the outpatient practice and also in disposal, recycling, and sterilization. High-quality publications do not describe a lack of knowledge on alternatives but on a lack of implementation in clinical practice. Therefore, the identified issues were classified in the 5‑R scheme (reduce, reuse, recycle, rethink, research) to present recommendations for action, which are synergetic in terms of cost reduction, patient and staff satisfaction. Furthermore, changes in regulatory frameworks are discussed. Conclusion Outpatient surgery comes with relevant consumption of resources and carbon emissions. There are numerous opportunities for action that combine environmental protection with cost reduction as well as patient and staff satisfaction. Incentives, guidelines, and legal framework conditions are needed for comprehensive environmental protection in the private sector.
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Affiliation(s)
- Nikolaus Christian Simon Mezger
- Institut für Medizinische Epidemiologie, Biometrie und Informatik, Martin-Luther Universität Halle-Wittenberg, Halle (Saale), Deutschland
- Global and Public Health Department, Karolinska Institutet, Stockholm, Schweden
- Centre for Planetary Health Policy (CPHP), c/o KLUG – Deutsche Allianz Klimawandel und Gesundheit e. V., Cuvrystr. 1, 10997 Berlin, Deutschland
| | | | | | - Mirko Griesel
- Klinik für Anästhesiologie und Intensivtherapie, Universitätsklinikum Leipzig, Leipzig, Deutschland
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Santurtún A, Shaman J. Work accidents, climate change and COVID-19. Sci Total Environ 2023; 871:162129. [PMID: 36773906 PMCID: PMC9911145 DOI: 10.1016/j.scitotenv.2023.162129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 01/17/2023] [Accepted: 02/05/2023] [Indexed: 06/18/2023]
Abstract
The effects brought by climate change and the pandemic upon worker health and wellbeing are varied and necessitate the identification and implementation of improved strategic interventions. This review aims, firstly, to assess how climate change affects occupational accidents, focusing on the impacts of extreme air temperatures and natural disasters; and, secondly, to analyze the role of the pandemic in this context. Our results show that the manifestations of climate change affect workers physically while on the job, psychologically, and by modifying the work environment and conditions; all these factors can cause stress, in turn increasing the risk of suffering a work accident. There is no consensus on the impact of the COVID-19 pandemic on work accidents; however, an increase in adverse mental effects on workers in contact with the public (specifically in healthcare) has been described. It has also been shown that this strain affects the risk of suffering an accident. During the pandemic, many people began to work remotely, and what initially appeared to be a provisional situation has been made permanent or semi-permanent in some positions and companies. However, we found no studies evaluating the working conditions of those who telework. In relation to the combined impact of climate change and the pandemic on occupational health, only publications focusing on the synergistic effect of heat due to the obligation to wear COVID-19-specific PPE, either outdoors or in poorly acclimatized indoor environments, were found. It is essential that preventive services establish new measures, train workers, and determine new priorities for adapting working conditions to these altered circumstances.
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Affiliation(s)
- Ana Santurtún
- Unit of Legal Medicine, Department of Physiology and Pharmacology, University of Cantabria, IDIVAL, Santander, Spain.
| | - Jeffrey Shaman
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA; Columbia Climate School, Columbia University, New York, NY, USA
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7
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Zhu Y, Mao Y, Li Y, Tang T, Jiang H, Qiao S, Lin S, Zheng Z, Fang Z, Chen X. Field investigation of the heat stress in outdoor of healthcare workers wearing personal protective equipment in South China. Front Public Health 2023; 11:1166056. [PMID: 37143989 PMCID: PMC10151780 DOI: 10.3389/fpubh.2023.1166056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 03/20/2023] [Indexed: 05/06/2023] Open
Abstract
Since the advent of coronavirus disease 2019 (COVID-19), healthcare workers (HCWs) wearing personal protective equipment (PPE) has become a common phenomenon. COVID-19 outbreaks overlap with heat waves, and healthcare workers must unfortunately wear PPE during hot weather and experience excessive heat stress. Healthcare workers are at risk of developing heat-related health problems during hot periods in South China. The investigation of thermal response to heat stress among HCWs when they do not wear PPE and when they finish work wearing PPE, and the impact of PPE use on HCWs' physical health were conducted. The field survey were conducted in Guangzhou, including 11 districts. In this survey, HCWs were invited to answer a questionnaire about their heat perception in the thermal environment around them. Most HCWs experienced discomfort in their back, head, face, etc., and nearly 80% of HCWs experienced "profuse sweating." Up to 96.81% of HCWs felt "hot" or "very hot." The air temperature had a significant impact on thermal comfort. Healthcare workers' whole thermal sensation and local thermal sensation were increased significantly by wearing PPE and their thermal sensation vote (TSV) tended towards "very hot." The adaptive ability of the healthcare workers would decreased while wearing PPE. In addition, the accept range of the air temperature (T a) were determined in this investigation. Graphical Abstract.
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Affiliation(s)
- Yongcheng Zhu
- The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yudong Mao
- School of Civil Engineering, Guangzhou University, Guangzhou, China
| | - Yanling Li
- The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Tianwei Tang
- School of Civil Engineering, Guangzhou University, Guangzhou, China
| | - Huilin Jiang
- The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Sicheng Qiao
- The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Shaopeng Lin
- The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Zhimin Zheng
- School of Civil Engineering, Guangzhou University, Guangzhou, China
| | - Zhaosong Fang
- School of Civil Engineering, Guangzhou University, Guangzhou, China
- Zhaosong Fang,
| | - Xiaohui Chen
- The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- *Correspondence: Xiaohui Chen,
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8
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Mezger NCS, Eickel F, Lorenz R, Griesel M. [Sustainability in private surgical practice-A narrative review]. Chirurgie (Heidelb) 2023; 94:199-209. [PMID: 36602565 PMCID: PMC9813892 DOI: 10.1007/s00104-022-01785-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 11/24/2022] [Indexed: 01/06/2023]
Abstract
BACKGROUND Surgery is contributing to the climate crisis, not least in the outpatient sector. The present publication aims to identify the challenges this poses, and to provide clear, preferably evidence-based recommendations on environmental protection while simultaneously reducing costs. METHOD Narrative review with a non-systematic search and selection in PubMed/MEDLINE and grey area literature as well as expert interviews. RESULTS Numerous primary articles, evidence syntheses, practical recommendations for action and checklists were identified and two experts were interviewed. Environmental issues were identified in the production and procurement, transport of people and goods, usage of materials, pharmaceuticals including anesthetic gases and energy consumption in the outpatient practice and also in disposal, recycling, and sterilization. High-quality publications do not describe a lack of knowledge on alternatives but on a lack of implementation in clinical practice. Therefore, the identified issues were classified in the 5‑R scheme (reduce, reuse, recycle, rethink, research) to present recommendations for action, which are synergetic in terms of cost reduction, patient and staff satisfaction. Furthermore, changes in regulatory frameworks are discussed. CONCLUSION Outpatient surgery comes with relevant consumption of resources and carbon emissions. There are numerous opportunities for action that combine environmental protection with cost reduction as well as patient and staff satisfaction. Incentives, guidelines, and legal framework conditions are needed for comprehensive environmental protection in the private sector.
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Affiliation(s)
- Nikolaus Christian Simon Mezger
- Institut für Medizinische Epidemiologie, Biometrie und Informatik, Martin-Luther Universität Halle-Wittenberg, Halle (Saale), Deutschland. .,Global and Public Health Department, Karolinska Institutet, Stockholm, Deutschland. .,Centre for Planetary Health Policy (CPHP), c/o KLUG - Deutsche Allianz Klimawandel und Gesundheit e. V., Cuvrystr. 1, 10997, Berlin, Deutschland.
| | | | | | - Mirko Griesel
- Klinik für Anästhesiologie und Intensivtherapie, Universitätsklinikum Leipzig, Leipzig, Deutschland
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Yongcheng Zhu, Sichen Qiao, Weiming Wu, Yanling Li, Huilin Jian, Shaopeng Lin, Tianwei Tang, Zhimin Zheng, Yudong Mao, Xiaohui Chen, Zhaosong Fang. Thermal discomfort caused by personal protective equipment in healthcare workers during the delta COVID-19 pandemic in Guangzhou, China: A case study. Case Studies in Thermal Engineering 2022; 34. [ DOI: 10.1016/j.csite.2022.101971] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 02/10/2022] [Accepted: 03/23/2022] [Indexed: 06/17/2023]
Abstract
Background In contrast to the previous COVID-19 pandemic, most frontline healthcare workers (HCWs) worked on residents’ nucleic acid tests in outdoor environments, instead of taking care of COVID-19 patients in hospitals during the hot summer of 2021. Therefore, it is necessary to investigate the prevalence and characteristics of thermal discomfort caused by personal protective equipment (PPE). Methods A cross-sectional survey was conducted online at hospitals from 11 administrative regions of Guangzhou for the assessment of thermal discomfort among HCWs from June 12–16, 2021. Univariate and logistic regression analyses were used to explore the risk factors associated with thermal discomfort. Results A total of 3658 valid responses were collected. The thermal discomfort and humid discomfort levels increased from 2.91 ± 1.19 to 3.61 ± 0.72 and from 0.98 ± 1.36 to 3.06 ± 1.1 after wearing PPE, respectively (p < 0.01). Feelings of being “very hot” and “uncomfortably humid” were the most influenced by wearing PPE, increasing from 31% to 69.1% and from 9.1% to 45.7%, respectively. There were significant increases in the thermal discomfort level (3.75 ± 0.57 vs. 3.33 ± 0.89, p < 0.01) and the humid discomfort level (3.33 ± 0.95 vs. 2.54 ± 1.19, p < 0.01) between the comfortable group and uncomfortable group, accompanied by similar patterns in the feelings of being “very hot” and “uncomfortably humid.” For general thermal-related symptoms, the most common new-onset symptom was profuse sweating (80%) followed by labored breathing (55.2%) and excessive dehydration (46.8%), while facial swelling (74%) was associated with local thermal-related symptoms, followed by hand maceration erosion (56.7%) and visual impairment (49.3%). In the multivariate analysis, the apparent temperature of the environment (≥35 °C), working in negative-pressure ambulances and outdoors, continuing to wear PPE for 1–3 days during this period, being aged >40 years, and previous experiences fighting the pandemic were independently associated with thermal discomfort (p < 0.01). Immediately after PPE removal, 32.3% of respondents considered drinking ice water/another drink, followed by 25% shortening the duration of wearing PPE and 19.1% going to the toilet. A large proportion of the participants looked forward to modifications to the material of the suit (72.9%) and mask (53.4%) for heat dissipation and dehumidification, as well as anti-fogging goggles (60.2%), adding hydration equipment to PPE (53.4%), and using soft materials to reduce pressure (40%). Conclusions Thermal discomfort is common and degrades health physiology related to PPE in summer environments. This suggests that modifications to the current working practices are urgently required to improve the resilience of HCWs and enhance their services during pandemics.
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Bose-O'Reilly S, Daanen H, Deering K, Gerrett N, Huynen MMTE, Lee J, Karrasch S, Matthies-Wiesler F, Mertes H, Schoierer J, Shumake-Guillemot J, van den Hazel P, Frank van Loenhout JA, Nowak D. COVID-19 and heat waves: New challenges for healthcare systems. Environ Res 2021; 198:111153. [PMID: 33857461 PMCID: PMC8056477 DOI: 10.1016/j.envres.2021.111153] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 03/26/2021] [Accepted: 04/06/2021] [Indexed: 05/12/2023]
Abstract
Heat waves and Covid-19 overlap, as this pandemic continues into summer 2021. Using a narrative review, we identified overlapping risk groups and propose coping strategies. The high-risk groups for heat-related health problems as well as for high-risk COVID-19 groups overlap considerably (elderly with pre-existing health conditions). Health care facilities will again be challenged by Covid-19 during heat waves. Health care personnel are also at risk of developing heat related health problems during hot periods due to the use of personal protective equipment to shield themselves from SARS-CoV-2 and must therefore be protected from excessive heat periods. Some existing recommendations for heat health protection contradict recommendations for COVID-19 protection. This paper provides a preliminary overview of possible strategies and interventions to tackle these ambiguities. The existing recommendations for protection against heat-related illnesses need revisions to determine whether they include essential aspects of infection control and occupational safety and how they may be supplemented.
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Affiliation(s)
- Stephan Bose-O'Reilly
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Ziemssenstr. 1, 80336, Munich, Germany; Institute for Public Health, Medical Decision Making and HTA, UMIT - Private University for Health Sciences, Medical Informatics and Technology, Eduard-Wallnöfer Zentrum 1, 6060, Hall i.T., Austria; University Children's Hospital Regensburg (KUNO) at the Hospital St. Hedwig of the Order of St. John and the University Hospital, University of Regensburg, Regensburg, Germany.
| | - Hein Daanen
- Department of Human Movement Sciences. Faculty of Behavioral and Movement Sciences. Vrije Universiteit Amsterdam. Van der Boechorststraat 7, 1081, BT Amsterdam, the Netherlands
| | - Katharina Deering
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Ziemssenstr. 1, 80336, Munich, Germany
| | - Nicola Gerrett
- Department of Human Movement Sciences. Faculty of Behavioral and Movement Sciences. Vrije Universiteit Amsterdam. Van der Boechorststraat 7, 1081, BT Amsterdam, the Netherlands
| | | | - Jason Lee
- Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117593, Singapore; Global Asia Institute, National University of Singapore, Singapore; N.1 Institute for Health, National University of Singapore, 28 Medical Dr, Singapore 117456, Singapore; Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Institute for Digital Medicine, National University of Singapore, Singapore; Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore
| | - Stefan Karrasch
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Ziemssenstr. 1, 80336, Munich, Germany; Institute of Epidemiology, Helmholtz Zentrum München - German Research Centre for Environment and Health, Ingolstädter Landstraße 1, 85764, Neuherberg, Germany; Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research (DZL), Munich, Germany
| | - Franziska Matthies-Wiesler
- Institute of Epidemiology, Helmholtz Zentrum München - German Research Centre for Environment and Health, Ingolstädter Landstraße 1, 85764, Neuherberg, Germany
| | - Hanna Mertes
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Ziemssenstr. 1, 80336, Munich, Germany
| | - Julia Schoierer
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Ziemssenstr. 1, 80336, Munich, Germany
| | | | - Peter van den Hazel
- International Network on Children's Health, Environment and Safety (INCHES), Ellecom, the Netherlands
| | - Joris Adriaan Frank van Loenhout
- Centre for Research on the Epidemiology of Disasters (CRED), Institute of Health and Society, UCLouvain, Clos Chapelle-Aux-Champs 30, 1200, Woluwé-Saint-Lambert (Brussels), Belgium
| | - Dennis Nowak
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Ziemssenstr. 1, 80336, Munich, Germany; Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research (DZL), Munich, Germany
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