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Mok YJ, Fong QW, Law S, Seah EJD, Lum KLJ, Yeo JJJ, Lee L, Ang SWE. Operational requirements of medical posts in migrant worker dormitories during the COVID-19 outbreak in Singapore. Singapore Med J 2024; 65:S12-S17. [PMID: 34823324 PMCID: PMC11073660 DOI: 10.11622/smedj.2021218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 02/07/2021] [Indexed: 11/18/2022]
Affiliation(s)
| | - Qi Wei Fong
- National Healthcare Group Polyclinics, Singapore
| | - Shipei Law
- National Healthcare Group Polyclinics, Singapore
| | | | | | | | - Lexin Lee
- Department of Psychology, Tan Tock Seng Hospital, Singapore
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2
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Yang J, Zhao Y, Guo T, Luo X, Ji K, Zhou M, Wan F. The impact of tree species and planting location on outdoor thermal comfort of a semi-outdoor space. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2023; 67:1689-1701. [PMID: 37500793 DOI: 10.1007/s00484-023-02532-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 05/23/2023] [Accepted: 07/19/2023] [Indexed: 07/29/2023]
Abstract
Previous studies have shown that tree arrangement provides effective regulation of the outdoor thermal environment and combats the urban heat island (UHI) effect. To further explore semi-outdoor thermal environment improvement using tree arrangement, we selected two common arbor species from Guangdong Province, namely, Lagerstroemia speciosa and Bombax ceiba. We discuss the influence of courtyard tree arrangements on the thermal environment of semi-outdoor spaces (courtyards and overhead spaces) of a teaching building in a hot-humid area. The ENVI-met model was used and verified with field measurements; the universal thermal climate index (UTCI) was used as an index to evaluate the thermal environment of semi-outdoor spaces. We found that (1) adjusting the distance between trees and buildings reduced the UTCI values by 0.4 (overhead spaces) and 0.8 ℃ (courtyards); and (2) when the distance between the arbor and the building is fixed, the UTCI values of arranging Lagerstroemia speciosa can be reduced by up to 0.5 (overhead spaces) and 1.0 ℃ (courtyards) compared to that of Bombax ceiba; this study provides practical suggestions for the layout of trees in semi-outdoor spaces of teaching buildings in the hot-humid areas of China.
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Affiliation(s)
- Jiahao Yang
- School of Architecture and Urban Planning, Guangzhou University, Guangzhou, Guangdong, China
| | - Yang Zhao
- School of Architecture and Urban Planning, Guangzhou University, Guangzhou, Guangdong, China.
| | - Tongye Guo
- School of Architecture and Urban Planning, Guangzhou University, Guangzhou, Guangdong, China
| | - Xinyi Luo
- School of Architecture and Urban Planning, Guangzhou University, Guangzhou, Guangdong, China
| | - Kefu Ji
- School of Architecture and Urban Planning, Guangzhou University, Guangzhou, Guangdong, China
| | - Mao Zhou
- School of Architecture and Urban Planning, Guangzhou University, Guangzhou, Guangdong, China
| | - Fengdeng Wan
- School of Architecture and Urban Planning, Guangzhou University, Guangzhou, Guangdong, China
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3
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Jahangiri H, Zamanian Z, Daneshmandi H, Seif M, Jamshidi H. Investigating the short-term effects of using full-body hospital personal protective equipment and changes in physical workload intensity on human physiological and cognitive performance. ERGONOMICS 2023; 66:1295-1309. [PMID: 36343173 DOI: 10.1080/00140139.2022.2145375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 11/01/2022] [Indexed: 06/16/2023]
Abstract
The present study investigated the short-term effects of using Personal Protective Equipment (PPE) and physical workload intensity on human physiological and cognitive performance among 21 males and 19 females. PPE1 consisted of a medical coverall and surgical mask, while PPE2 consisted of impermeable full-body coverall, shoe covers, latex gloves, N95 mask, and face shield. Objective assessments were heart rate, energy expenditure, core body temperature, clothing microclimate temperature and humidity, and cognitive performance were the continuous performance test and N-Back test. Subjective assessments included thermal sensation, perceived fatigue/skin wetness/clothing moisture. Using PPE2 and increased workload intensity significantly increased the values of all physiological parameters and the subjective ratings of fatigue, thermal sensation, skin wetness, and clothing moisture. Moreover, the participants' cognitive performance was not affected by the type of PPE.Practitioner summary: Healthcare workers are at the highest risk in the fight against pandemics. Therefore, these people are required to use personal protective equipment. Using this equipment may have difficulties. The results show physiological strain and higher subjective ratings associated with using full-body hospital PPE and increased physical workload.
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Affiliation(s)
- Hamid Jahangiri
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zahra Zamanian
- Department of Ergonomics, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hadi Daneshmandi
- Research Center for Health Sciences, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mozhgan Seif
- Non-Communicable Diseases Research Center, Department of Epidemiology, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hamid Jamshidi
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
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4
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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. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND 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] [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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5
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De Sario M, de'Donato FK, Bonafede M, Marinaccio A, Levi M, Ariani F, Morabito M, Michelozzi P. Occupational heat stress, heat-related effects and the related social and economic loss: a scoping literature review. Front Public Health 2023; 11:1173553. [PMID: 37601227 PMCID: PMC10434255 DOI: 10.3389/fpubh.2023.1173553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 06/01/2023] [Indexed: 08/22/2023] Open
Abstract
Introduction While there is consistent evidence on the effects of heat on workers' health and safety, the evidence on the resulting social and economic impacts is still limited. A scoping literature review was carried out to update the knowledge about social and economic impacts related to workplace heat exposure. Methods The literature search was conducted in two bibliographic databases (Web of Science and PubMed), to select publications from 2010 to April 2022. Results A total of 89 studies were included in the qualitative synthesis (32 field studies, 8 studies estimating healthcare-related costs, and 49 economic studies). Overall, consistent evidence of the socioeconomic impacts of heat exposure in the workplace emerges. Actual productivity losses at the global level are nearly 10% and are expected to increase up to 30-40% under the worst climate change scenario by the end of the century. Vulnerable regions are mainly low-latitude and low- and middle-income countries with a greater proportion of outdoor workers but include also areas from developed countries such as southern Europe. The most affected sectors are agriculture and construction. There is limited evidence regarding the role of cooling measures and changes in the work/rest schedule in mitigating heat-related productivity loss. Conclusion The available evidence highlights the need for strengthening prevention efforts to enhance workers' awareness and resilience toward occupational heat exposure, particularly in low- and middle-income countries but also in some areas of developed countries where an increase in frequency and intensity of heat waves is expected under future climate change scenarios.
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Affiliation(s)
- Manuela De Sario
- Department of Epidemiology Lazio Regional Health Service, Rome, Italy
| | | | - Michela Bonafede
- Occupational and Environmental Medicine, Epidemiology and Hygiene Department, Italian Workers' Compensation Authority (INAIL), Rome, Italy
| | - Alessandro Marinaccio
- Occupational and Environmental Medicine, Epidemiology and Hygiene Department, Italian Workers' Compensation Authority (INAIL), Rome, Italy
| | - Miriam Levi
- Epidemiology Unit, Department of Prevention, Central Tuscany Local Health Authority, Florence, Italy
| | - Filippo Ariani
- Regional Centre for the Analysis of Data on Occupational and Work-Related Injuries and Diseases, Central Tuscany Local Health Authority, Florence, Italy
| | - Marco Morabito
- Institute of Bioeconomy, National Research Council (IBE-CNR), Florence, Italy
| | - Paola Michelozzi
- Department of Epidemiology Lazio Regional Health Service, Rome, Italy
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6
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Bansal A, Cherbuin N, Davis DL, Peek MJ, Wingett A, Christensen BK, Carlisle H, Broom M, Schoenaker DAJM, Dahlstrom JE, Phillips CB, Vardoulakis S, Nanan R, Nolan CJ. Heatwaves and wildfires suffocate our healthy start to life: time to assess impact and take action. Lancet Planet Health 2023; 7:e718-e725. [PMID: 37558352 DOI: 10.1016/s2542-5196(23)00134-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 06/08/2023] [Accepted: 06/15/2023] [Indexed: 08/11/2023]
Abstract
Adverse environmental exposures in utero and early childhood are known to programme long-term health. Climate change, by contributing to severe heatwaves, wildfires, and other natural disasters, is plausibly associated with adverse pregnancy outcomes and an increase in the future burden of chronic diseases in both mothers and their babies. In this Personal View, we highlight the limitations of existing evidence, specifically on the effects of severe heatwave and wildfire events, and compounding syndemic events such as the COVID-19 pandemic, on the short-term and long-term physical and mental health of pregnant women and their babies, taking into account the interactions with individual and community vulnerabilities. We highlight a need for an international, interdisciplinary collaborative effort to systematically study the effects of severe climate-related environmental crises on maternal and child health. This will enable informed changes to public health policy and clinical practice necessary to safeguard the health and wellbeing of current and future generations.
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Affiliation(s)
- Amita Bansal
- School of Medicine and Psychology, College of Health and Medicine, Australian National University, Canberra, ACT, Australia; John Curtin School of Medical Research, College of Health and Medicine, Australian National University, Canberra, ACT, Australia
| | - Nicolas Cherbuin
- National Centre for Epidemiology and Population Health, College of Health and Medicine, Australian National University, Canberra, ACT, Australia
| | - Deborah L Davis
- Midwifery, University of Canberra, ACT, Australia; ACT Government, Health Directorate, ACT, Australia
| | - Michael J Peek
- School of Medicine and Psychology, College of Health and Medicine, Australian National University, Canberra, ACT, Australia; The Canberra Hospital, Canberra Health Services, ACT, Australia
| | - Amanda Wingett
- National Aboriginal Community Controlled Health Organisation, Canberra, ACT, Australia
| | - Bruce K Christensen
- School of Medicine and Psychology, College of Health and Medicine, Australian National University, Canberra, ACT, Australia
| | - Hazel Carlisle
- School of Medicine and Psychology, College of Health and Medicine, Australian National University, Canberra, ACT, Australia; The Canberra Hospital, Canberra Health Services, ACT, Australia
| | - Margaret Broom
- Midwifery, University of Canberra, ACT, Australia; The Canberra Hospital, Canberra Health Services, ACT, Australia
| | - Danielle A J M Schoenaker
- School of Primary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton, Southampton, UK; NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK; School of Medical, Indigenous and Health Sciences, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, Australia
| | - Jane E Dahlstrom
- School of Medicine and Psychology, College of Health and Medicine, Australian National University, Canberra, ACT, Australia; The Canberra Hospital, Canberra Health Services, ACT, Australia
| | - Christine B Phillips
- School of Medicine and Psychology, College of Health and Medicine, Australian National University, Canberra, ACT, Australia; Companion House Refugee Medical Service, Canberra, ACT, Australia
| | - Sotiris Vardoulakis
- National Centre for Epidemiology and Population Health, College of Health and Medicine, Australian National University, Canberra, ACT, Australia
| | - Ralph Nanan
- Sydney Medical School and Charles Perkins Center Nepean, University of Sydney, NSW, Australia
| | - Christopher J Nolan
- School of Medicine and Psychology, College of Health and Medicine, Australian National University, Canberra, ACT, Australia; John Curtin School of Medical Research, College of Health and Medicine, Australian National University, Canberra, ACT, Australia; The Canberra Hospital, Canberra Health Services, ACT, Australia.
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7
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Santurtún A, Shaman J. Work accidents, climate change and COVID-19. THE SCIENCE OF THE TOTAL ENVIRONMENT 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] [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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8
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Fang Z, Mao Y, Zhu Y, Lu J, Zheng Z, Chen X. Human thermal physiological response of wearing personal protective equipment: An educational building semi-open space experimental investigation. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 877:162779. [PMID: 36924973 PMCID: PMC10014506 DOI: 10.1016/j.scitotenv.2023.162779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 03/06/2023] [Accepted: 03/06/2023] [Indexed: 05/03/2023]
Abstract
With the outbreak and spread of the COVID-19 epidemic, HCWs are frequently required to wear personal protective equipment (PPE) for nucleic acid sample collection in semi-open transition spaces. Wearing PPE causes significant psychological and physical stress in HCWs. In this study, operative temperature (Top) and wet-bulb globe temperature (WBGT) were used to assess thermal conditions through field experiments, while multiple physiological parameters were measured in the subjects. The results indicated that the subjects showed statistically significant differences in thermal perception and physiological parameters with and without PPE. Using observed increases in heart rate (HR), auditory canal temperature (Tac), mean skin temperature (MST), and end-tidal CO2 pressure, subjects were shown to have an increased metabolic rate and heat storage while wearing PPE. Additionally, a decrease in oxygen concentration was also observed, and this decrease may be linked to fatigue and cognitive impairment. Moreover, HR, MST, and Tac showed a significant linear relationship, which increased with temperature and operative temperature, and the HR response was stronger with PPE than without PPE. The neutral, preferred, and acceptable temperatures were significantly lower with PPE than without PPE, and the deviations for neutral Top/WBGT were 9.5/7.1 °C and preferred Top/WBGT was 2.2/4.0 °C, respectively. Moreover, the upper limits of acceptable WBGT, 29.4 °C with PPE and 20.4 °C without PPE, differed significantly between the two phases. Furthermore, the recorded physiological parameter responses and thermal perception responses of the subjects while wearing PPE indicated that they were at risk of thermal stress. Overall, these results suggest that people who wear PPE should focus on their health and thermal stress. This study provides a reference for the development of strategies to counteract heat stress and improve thermal comfort.
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Affiliation(s)
- Zhaosong Fang
- School of Civil Engineering, Guangzhou University, Guangzhou, China
| | - Yudong Mao
- School of Civil Engineering, Guangzhou University, Guangzhou, China
| | - Yongcheng Zhu
- The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Jiaxin Lu
- School of Civil Engineering, Guangzhou University, Guangzhou, China
| | - Zhimin Zheng
- School of Civil Engineering, Guangzhou University, Guangzhou, China.
| | - Xiaohui Chen
- The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
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Wang W, He BJ. Co-occurrence of urban heat and the COVID-19: Impacts, drivers, methods, and implications for the post-pandemic era. SUSTAINABLE CITIES AND SOCIETY 2023; 90:104387. [PMID: 36597490 PMCID: PMC9801697 DOI: 10.1016/j.scs.2022.104387] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 12/28/2022] [Accepted: 12/29/2022] [Indexed: 05/05/2023]
Abstract
Cities, the main place of human settlements, are under various mega challenges such as climate change, population increase, economic growth, urbanization, and pandemic diseases, and such challenges are mostly interlinked. Urban heat, due to heatwaves and heat islands, is the combined effect of climate change and urbanization. The COVID-19 is found to be a critical intervention of urban heat. However, the interrelationship between COVID-19 and urban heat has not been fully understood, constraining urban planning and design actions for improving the resilience to the dual impacts of heat and the pandemic. To close this research gap, this paper conducted a review on the co-occurrence of urban heat and the COVID-19 pandemic for a better understanding of their synergies, conflicts or trade-offs. The research involves a systematic review of urban temperature anomalies, variations in air pollutant concentrations, unbalanced energy development, and thermal health risks during the pandemic lockdown. In addition, this paper further explored data sources and analytical methods adopted to screen and identify the interventions of COVID-19 to urban heat. Overall, this paper is of significance for understanding the impact of COVID-19 on urban heat and provides a reference for coping with urban heat and the pandemic simultaneously. The world is witnessing the co-existence of heat and the pandemic, even in the post-pandemic era. This study can enlighten city managers, planners, the public, and researchers to collaborate for constructing a robust and resilient urban system for dealing with more than one challenges.
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Affiliation(s)
- Wei Wang
- Centre for Climate-Resilient and Low-Carbon Cities, School of Architecture and Urban Planning, Chongqing University, Chongqing, 400045, China
- Institute for Smart City of Chongqing University in Liyang, Chongqing University, Liyang, 213300, Jiangsu, China
| | - Bao-Jie He
- Centre for Climate-Resilient and Low-Carbon Cities, School of Architecture and Urban Planning, Chongqing University, Chongqing, 400045, China
- Institute for Smart City of Chongqing University in Liyang, Chongqing University, Liyang, 213300, Jiangsu, China
- Key Laboratory of New Technology for Construction of Cities in Mountain Area, Ministry of Education, Chongqing University, Chongqing, 400045, China
- State Key Laboratory of Subtropical Building Science, South China University of Technology, Guangzhou, 510641, China
- Network for Education and Research on Peace and Sustainability (NERPS), Hiroshima University, Hiroshima, 739-8530, Japan
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10
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Bonafede M, Levi M, Pietrafesa E, Binazzi A, Marinaccio A, Morabito M, Pinto I, de’ Donato F, Grasso V, Costantini T, Messeri A. Workers’ Perception Heat Stress: Results from a Pilot Study Conducted in Italy during the COVID-19 Pandemic in 2020. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19138196. [PMID: 35805854 PMCID: PMC9266050 DOI: 10.3390/ijerph19138196] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 06/22/2022] [Accepted: 07/01/2022] [Indexed: 11/17/2022]
Abstract
Many workers are exposed to the effects of heat and often to extreme temperatures. Heat stress has been further aggravated during the COVID-19 pandemic by the use of personal protective equipment to prevent SARS-CoV-2 infection. However, workers’ risk perception of heat stress is often low, with negative effects on their health and productivity. The study aims to identify workers’ needs and gaps in knowledge, suggesting the adaptation of measures that best comply with the needs of both workers and employers. A cross-sectional online questionnaire survey was conducted in Italy in the hottest months of 2020 (June–October) through different multimedia channels. The data collected were analyzed using descriptive statistics; analytical tests and analysis of variance were used to evaluate differences between groups of workers. In total, 345 questionnaires were collected and analyzed. The whole sample of respondents declared that heat is an important contributor to productivity loss and 83% of workers did not receive heat warnings from their employer. In this context, the internet is considered as the main source of information about heat-related illness in the workplace. Results highlight the need to increase workers’ perception of heat stress in the workplace to safeguard their health and productivity. About two-thirds of the sample stated that working in the sun without access to shaded areas, working indoors without adequate ventilation, and nearby fire, steam, and hot surfaces, represent the main injuries’ risk factors.
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Affiliation(s)
- Michela Bonafede
- Occupational and Environmental Medicine, Epidemiology and Hygiene Department, Italian Workers’ Compensation Authority (INAIL), 00143 Rome, Italy; (M.B.); (E.P.); (A.B.); (A.M.)
| | - Miriam Levi
- Epidemiology Unit, Department of Prevention, Local Health Authority Tuscany Centre, 50135 Florence, Italy;
| | - Emma Pietrafesa
- Occupational and Environmental Medicine, Epidemiology and Hygiene Department, Italian Workers’ Compensation Authority (INAIL), 00143 Rome, Italy; (M.B.); (E.P.); (A.B.); (A.M.)
| | - Alessandra Binazzi
- Occupational and Environmental Medicine, Epidemiology and Hygiene Department, Italian Workers’ Compensation Authority (INAIL), 00143 Rome, Italy; (M.B.); (E.P.); (A.B.); (A.M.)
| | - Alessandro Marinaccio
- Occupational and Environmental Medicine, Epidemiology and Hygiene Department, Italian Workers’ Compensation Authority (INAIL), 00143 Rome, Italy; (M.B.); (E.P.); (A.B.); (A.M.)
| | - Marco Morabito
- Institute of Bioeconomy, National Research Council (IBE-CNR), 50019 Florence, Italy;
| | - Iole Pinto
- Physical Agents Sector, Regional Public Health Laboratory, 53100 Siena, Italy;
| | - Francesca de’ Donato
- Department of Epidemiology Lazio Regional Health Service, ASL ROMA 1, 00147 Rome, Italy; (F.d.D.); (T.C.)
| | - Valentina Grasso
- LaMMA Consortium—Weather Forecaster and Researcher at Laboratory of Monitoring and Environmental Modelling for Sustainable Development, 50019 Florence, Italy;
| | - Tiziano Costantini
- Department of Epidemiology Lazio Regional Health Service, ASL ROMA 1, 00147 Rome, Italy; (F.d.D.); (T.C.)
| | - Alessandro Messeri
- LaMMA Consortium—Weather Forecaster and Researcher at Laboratory of Monitoring and Environmental Modelling for Sustainable Development, 50019 Florence, Italy;
- Climate and Sustainability Foundation, 50100 Florence, Italy
- AMPRO—Professional Weather Association, 00142 Rome, Italy
- Correspondence: ; Tel.: +39-055-522-6041
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11
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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; 34:101971. [PMCID: PMC8983079 DOI: 10.1016/j.csite.2022.101971] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [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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Ashikur R. A scoping review of COVID-19-related stress coping resources among nurses. Int J Nurs Sci 2022; 9:259-267. [PMID: 35284150 PMCID: PMC8903132 DOI: 10.1016/j.ijnss.2022.02.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 01/23/2022] [Accepted: 02/26/2022] [Indexed: 12/23/2022] Open
Abstract
Objective The entire mental health hazard among the nurses dealing with COVID-19 is just the tip of the iceberg. The goal of this study was to find acceptable and adaptive coping techniques for nurses in order to keep the healthcare system resilient during and after the COVID-19 pandemic. Method The scoping review search took place from January 2020 to May 2021 published articles, and the results were saved in Endnote software. For data synthesis and review, the Joanna Briggs Institute manual and PRISMA-ScR principles were followed. Following backward and forward screening to exclude redundant, irrelevant, and ineligible studies, 13 studies (3,613 nurses) were finally selected for this review. Results The majorities of participants in these studies were female and had children, and worked in departments of critical care, emergency, and fever clinics. Safety concerns for family or colleagues, as well as a lack of safe working environment, were the primary causes of the mental illness. Professional responsibility attitude, COVID-19 training, workplace safety, team spirit, and a few relaxation activities such as deep breathing, reading books, watching movies, and praying, on the other hand, were found to be beneficial for stress coping among nurses. Conclusion Mentally fit nurses are more capable and flexible in the face of any life-threatening outbreak, even if it is very contagious. Several coping strategies were found to be effective for nurses during the COVID-19 pandemic, whereas problem-specific intervention trials might yield even better results. We should not delay specific mental health interventions to keep them viable and more efficient during a pandemic battlefield, whereas Post-Traumatic Stress Disorder and suicide rates can destroy the entire health care system.
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Affiliation(s)
- Rahman Ashikur
- Dhaka Medical College Hospital, Ministry of Health and Family Welfare, Bangladesh.,National Institute of Preventive and Social Medicine, Mohakhali, Bangladesh
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13
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Zou Q, Gai Y, Cai Y, Gai X, Xiong S, Wei N, Jiang M, Chen L, Liu Y, Gai J. Eco-friendly chitosan@silver/plant fiber membranes for masks with thermal comfortability and self-sterilization. CELLULOSE (LONDON, ENGLAND) 2022; 29:5711-5724. [PMID: 35615225 PMCID: PMC9122807 DOI: 10.1007/s10570-022-04582-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 02/16/2022] [Indexed: 05/05/2023]
Abstract
UNLABELLED The surgical masks have been essential consumables for public in the COVID-19 pandemic. However, long-time wearing masks will make wearers feel uncomfortable and massive discarded non-biodegradable masks lead to a heavy burden on our environment. In this paper, we adopt degradable chitosan@silver (CS@Ag) core-shell fibers and plant fibers to prepare an eco-friendly mask with excellent thermal comfort, self-sterilization, and antiviral effects. The thermal network of CS@Ag core-shell fibers highly improves the in-plane thermal conductivity of masks, which is 4.45 times higher than that of commercial masks. Because of the electrical conductivity of Ag, the fabricated mask can be electrically heated to warm the wearer in a cold environment and disinfect COVID-19 facilely at room temperature. Meanwhile, the in-situ reduced silver nanoparticles (AgNPs) endow the mask with superior antibacterial properties. Therefore, this mask shows a great potential to address the urgent need for a thermally comfortable, antibacterial, antiviral, and eco-friendly mask. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s10570-022-04582-x.
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Affiliation(s)
- Qian Zou
- State Key Laboratory of Polymer Materials Engineering, Polymer Research Institute of Sichuan University, Chengdu, 610065 Sichuan China
| | - Yinuo Gai
- Chengdu Yucai, No. 7 School Xuedao Branch, Chengdu, 610065 Sichuan China
| | - Yajuan Cai
- Sichuan Guojian Inspection Co., Ltd, No. 17, Section 1, Kangcheng Road, Jiangyang District, Luzhou, 646099 Sichuan China
| | - Xiaotang Gai
- Wuyuzhang Honors College of Sichuan University, Chengdu, 610065 Sichuan China
- College of Computer Science of Sichuan University, Chengdu, 610065 Sichuan China
| | - Siwei Xiong
- State Key Laboratory of Polymer Materials Engineering, Polymer Research Institute of Sichuan University, Chengdu, 610065 Sichuan China
| | - Nanjun Wei
- State Key Laboratory of Polymer Materials Engineering, Polymer Research Institute of Sichuan University, Chengdu, 610065 Sichuan China
| | - Mengying Jiang
- State Key Laboratory of Polymer Materials Engineering, Polymer Research Institute of Sichuan University, Chengdu, 610065 Sichuan China
| | - Liye Chen
- State Key Laboratory of Polymer Materials Engineering, Polymer Research Institute of Sichuan University, Chengdu, 610065 Sichuan China
| | - Yang Liu
- State Key Laboratory of Polymer Materials Engineering, Polymer Research Institute of Sichuan University, Chengdu, 610065 Sichuan China
| | - Jinggang Gai
- State Key Laboratory of Polymer Materials Engineering, Polymer Research Institute of Sichuan University, Chengdu, 610065 Sichuan China
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Shi D, Song J, Du R, Chan PW. Dual challenges of heat wave and protective facemask-induced thermal stress in Hong Kong. BUILDING AND ENVIRONMENT 2021; 206:108317. [PMID: 34483458 PMCID: PMC8407939 DOI: 10.1016/j.buildenv.2021.108317] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Revised: 08/24/2021] [Accepted: 08/28/2021] [Indexed: 06/13/2023]
Abstract
During the COVID-19 pandemic, wearing protective facemasks (PFMs) can effectively reduce infection risk, but the use of PFMs can amplify heat-related health risks. We studied the amplified PFM-induced human thermal stress via both field measurements and model simulations over a typical subtropical mountainous city, Hong Kong. First, a hot and humid PFM microenvironment has been observed with high temperature (34-35 °C) and high humidity (80-95%), resulting in an aggravated facial thermal stress with a maximal PFM-covered facial heat flux of 500 W/m2 under high-intensity activities. Second, to predict the overall PFM-inclusive human thermal stress, we developed a new facial thermal load model, S PFM and a new human-environment adaptive thermal stress (HEATS) model by coupling S PFM with an enhanced thermal comfort model to resolve modified human-environment interactions with the intervention of PFM under realistic climatic and topographical conditions. The model was then applied to predict spatiotemporal variations of PFM-inclusive physiological subjective temperature (PST) and corresponding heat stress levels during a typical heat wave event. It was found wearing PFM can significantly aggravate human thermal stress over Hong Kong with a spatially averaged PST increment of 5.0 °C and an additional spatial area of 158.4% exposed to the severest heat risks. Besides, PFM-inclusive PST was found to increase nonlinearly with terrain slopes at a rate of 1.3-3.9 °C/10°(slope), owing to elevated metabolic heat production. Furthermore, urban residents were found to have higher PFM-aggravated heat risks than rural residents, especially at night due to synergistic urban heat and moisture island effects.
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Affiliation(s)
- Dachuan Shi
- Department of Mechanical Engineering, The University of Hong Kong, Pokfulam Road, Hong Kong SAR, China
| | - Jiyun Song
- Department of Mechanical Engineering, The University of Hong Kong, Pokfulam Road, Hong Kong SAR, China
- Department of Geography, The University of Hong Kong, Pokfulam Road, Hong Kong SAR, China
| | - Ruiqing Du
- Department of Mechanical Engineering, The University of Hong Kong, Pokfulam Road, Hong Kong SAR, China
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Suen WS, Huang G, Kang Z, Gu Y, Fan J, Shou D. Development of wearable air-conditioned mask for personal thermal management. BUILDING AND ENVIRONMENT 2021; 205:108236. [PMID: 34393325 PMCID: PMC8349477 DOI: 10.1016/j.buildenv.2021.108236] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 08/02/2021] [Accepted: 08/04/2021] [Indexed: 05/24/2023]
Abstract
A mask that creates a physical barrier to protect the wearer from breathing in airborne bacteria or viruses, reducing the risk of infection in polluted air and potentially contaminated environments, has become a daily necessity for the public especially as COVID-19 has exploded around the world. However, the use of masks often causes soaring temperatures and thick humid air, leading to thermal and wear discomfort and breathing difficulties for a number of people, and further increasing the elevated risk of heat illnesses including heat stroke and heat exhaustion. When wearers become highly active or work under high tension, the excess sweat generated negatively affects the functionality of masks. Here, we report on an innovative design of an air-conditioned mask (AC Mask) system, facilitating thermoregulation in the mask microclimate, ease of breathing, and wear comfort. The AC Mask system is developed by integrating a cost-effective and lightweight thermoelectric (TE) and ventilation unit in a wearable 3D printed mask device, compatible with existing disposable masks, to protect end users safely against toxic particles such as viruses. A wind-guided tunnel has been developed for quick and efficient ventilation of cooling air. Based on a human trial, reductions in the apparent microclimate temperature and the humidity by 3.5 °C and 50%, respectively, have been achieved under a low voltage. With the excellent thermal management properties, the AC Mask will find also wide application among professional end-users such as construction workers, firefighters, and medical personnel.
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Affiliation(s)
- Wing Sze Suen
- Institute of Textiles and Clothing, The Hong Kong Polytechnic University, Kowloon, Hong Kong, China
| | - Guanghan Huang
- Institute of Textiles and Clothing, The Hong Kong Polytechnic University, Kowloon, Hong Kong, China
| | - Zhanxiao Kang
- Institute of Textiles and Clothing, The Hong Kong Polytechnic University, Kowloon, Hong Kong, China
| | - Yuheng Gu
- Institute of Textiles and Clothing, The Hong Kong Polytechnic University, Kowloon, Hong Kong, China
| | - Jintu Fan
- Institute of Textiles and Clothing, The Hong Kong Polytechnic University, Kowloon, Hong Kong, China
| | - Dahua Shou
- Institute of Textiles and Clothing, The Hong Kong Polytechnic University, Kowloon, Hong Kong, China
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16
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Butnaru GI, Haller AP, Dragolea LL, Anichiti A, Tacu Hârșan GD. Students' Wellbeing during Transition from Onsite to Online Education: Are There Risks Arising from Social Isolation? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:9665. [PMID: 34574589 PMCID: PMC8467860 DOI: 10.3390/ijerph18189665] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 09/02/2021] [Accepted: 09/08/2021] [Indexed: 11/24/2022]
Abstract
The COVID-19 pandemic has caused disruption to activities in many fields, including education and lifestyle. Major changes have taken place in the education system, where specific activities migrated suddenly from onsite to online. As a result, this period has witnessed an increased interest in impact studies that analyse the perceptions of the actors involved in the educational process. Based on the survey data (N = 665), the perceptions of the students in Romanian universities with regard to the effects of online education during the pandemic on their wellbeing were analysed. The empirical apparatus-SEM analysis-reached the following conclusions: the students' wellbeing was increased under the traditional education system; the economic crisis has caused concern, and a decrease in their wellbeing; their contamination fear is moderate to low, and does not influence their wellbeing; they have been discouraged in terms of their personal development during the pandemic, and their wellbeing has suffered as a result; the role of institutions is extremely important, given that the students' ability to study online depends on the universities' efficiency in implementing the online system.
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Affiliation(s)
- Gina Ionela Butnaru
- Department of Management, Marketing and Business Administration, Faculty of Economics and Business Administration, Alexandru Ioan Cuza University of Iași, 700505 Iași, Romania;
| | - Alina-Petronela Haller
- “Gheorghe Zane” Institute for Economic and Social Research, Iași Branch of Romanian Academy, 700488 Iași, Romania;
| | - Larisa-Loredana Dragolea
- Department of Business Administration and Marketing, Faculty of Economics, 1 Decembrie 1918 University of Alba Iulia, 510009 Alba Iulia, Romania;
| | - Alexandru Anichiti
- Department of Business Administration, Ștefan cel Mare University of Suceava, 13 University Street, 720229 Suceava, Romania;
| | - Georgia-Daniela Tacu Hârșan
- “Gheorghe Zane” Institute for Economic and Social Research, Iași Branch of Romanian Academy, 700488 Iași, Romania;
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Yoshihara A, Dierickx EE, Brewer GJ, Sekiguchi Y, Stearns RL, Casa DJ. Effects of Face Mask Use on Objective and Subjective Measures of Thermoregulation During Exercise in the Heat. Sports Health 2021; 13:463-470. [PMID: 34196240 PMCID: PMC8404762 DOI: 10.1177/19417381211028212] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND While increased face mask use has helped reduce COVID-19 transmission, there have been concerns about its influence on thermoregulation during exercise in the heat, but consistent, evidence-based recommendations are lacking. HYPOTHESIS No physiological differences would exist during low-to-moderate exercise intensity in the heat between trials with and without face masks, but perceptual sensations could vary. STUDY DESIGN Crossover study. LEVEL OF EVIDENCE Level 2. METHODS Twelve physically active participants (8 male, 4 female; age = 24 ± 3 years) completed 4 face mask trials and 1 control trial (no mask) in the heat (32.3°C ± 0.04°C; 54.4% ± 0.7% relative humidity [RH]). The protocol was 60 minutes of walking and jogging between 35% and 60% of relative VO2max. Rectal temperature (Trec), heart rate (HR), temperature and humidity inside and outside of the face mask (Tmicro_in, Tmicro_out, RHmicro_in, RHmicro_out) and perceptual variables (rating of perceived exertion (RPE), thermal sensation, thirst sensation, fatigue level, and overall breathing discomfort) were monitored throughout all trials. RESULTS Mean Trec and HR increased at 30- and 60-minute time points compared with 0-minute time points, but no difference existed between face mask trials and control trials (P > 0.05). Mean Tmicro_in, RHmicro_in, and humidity difference inside and outside of the face mask (ΔRHmicro) were significantly different between face mask trials (P < 0.05). There was no significant difference in perceptual variables between face mask trials and control trials (P > 0.05), except overall breathing discomfort (P < 0.01). Higher RHmicro_in, RPE, and thermal sensation significantly predicted higher overall breathing discomfort (r2 = 0.418; P < 0.01). CONCLUSION Face mask use during 60 minutes of low-to-moderate exercise intensity in the heat did not significantly affect Trec or HR. Although face mask use may affect overall breathing discomfort due to the changes in the face mask microenvironment, face mask use itself did not cause an increase in whole body thermal stress. CLINICAL RELEVANCE Face mask use is feasible and safe during exercise in the heat, at low-to-moderate exercise intensities, for physically active, healthy individuals.
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Affiliation(s)
- Ayami Yoshihara
- Department of Kinesiology, Korey Stringer Institute, University of Connecticut, Storrs, Connecticut
| | - Erin E. Dierickx
- Department of Kinesiology, Korey Stringer Institute, University of Connecticut, Storrs, Connecticut
| | - Gabrielle J. Brewer
- Department of Kinesiology, Korey Stringer Institute, University of Connecticut, Storrs, Connecticut
| | - Yasuki Sekiguchi
- Department of Kinesiology, Korey Stringer Institute, University of Connecticut, Storrs, Connecticut
| | - Rebecca L. Stearns
- Department of Kinesiology, Korey Stringer Institute, University of Connecticut, Storrs, Connecticut
| | - Douglas J. Casa
- Department of Kinesiology, Korey Stringer Institute, University of Connecticut, Storrs, Connecticut
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18
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van Veelen MJ, Voegele A, Rauch S, Kaufmann M, Brugger H, Strapazzon G. COVID-19 Pandemic in Mountainous Areas: Impact, Mitigation Strategies, and New Technologies in Search and Rescue Operations. High Alt Med Biol 2021; 22:335-341. [PMID: 34319777 PMCID: PMC8558066 DOI: 10.1089/ham.2020.0216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 05/29/2021] [Indexed: 12/03/2022] Open
Abstract
van Veelen, Michiel J., Anna Voegele, Simon Rauch, Marc Kaufmann, Hermann Brugger, and Giacomo Strapazzon. COVID-19 pandemic in mountainous areas: impact, mitigation strategies, and new technologies in search and rescue operations. High Alt Med Biol. 22:335-341, 2021.-Mitigating the spread of COVID-19, an airborne infection, can lead to delays in the prehospital response and impair the performance of search and rescue (SAR) services in mountainous and remote areas. We provide an overview of the developing epidemiological situation related to the COVID-19 pandemic in mountainous areas and review current protocols to determine their suitability for mountain rescue teams. We also discuss using novel technologies to reduce the adverse effects caused by COVID-19 mitigation strategies such as delays caused by donning personal protective equipment (PPE) and reduced rescuer performance due to impaired movement and ventilation. COVID-19 has spread even in mountainous and remote locations. Dedicated protocols for the use of PPE appropriate for SAR rescuers exerting physical effort in remote areas and using technologies such as drones, telemedicine, and localization and contact tracing applications could contribute to an effective and timely emergency response in mountainous and remote settings.
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Affiliation(s)
- Michiel J. van Veelen
- Institute of Mountain Emergency Medicine, Eurac Research, Bolzano, Italy
- Emergency Medical Services (COVID-1 Intermediate Care Unit), Bolzano Hospital, Bolzano, Italy
| | - Anna Voegele
- Institute of Mountain Emergency Medicine, Eurac Research, Bolzano, Italy
| | - Simon Rauch
- Institute of Mountain Emergency Medicine, Eurac Research, Bolzano, Italy
- Department of Anesthesia and Intensive Care, “F. Tappeiner” Hospital, Merano, Italy
| | - Marc Kaufmann
- Emergency Medical Services (COVID-1 Intermediate Care Unit), Bolzano Hospital, Bolzano, Italy
- Emergency Medical Services 112, Health Care System Alto Adige, Bolzano, Italy
| | - Hermann Brugger
- Institute of Mountain Emergency Medicine, Eurac Research, Bolzano, Italy
- Department of Anesthesiology and Intensive Care Medicine, Medical University Innsbruck, Innsbruck, Austria
| | - Giacomo Strapazzon
- Institute of Mountain Emergency Medicine, Eurac Research, Bolzano, Italy
- Department of Anesthesiology and Intensive Care Medicine, Medical University Innsbruck, Innsbruck, Austria
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Jegodka Y, Lagally L, Mertes H, Deering K, Schoierer J, Buchberger B, Bose-O'Reilly S. Hot days and Covid-19: Online survey of nurses and nursing assistants to assess occupational heat stress in Germany during summer 2020. THE JOURNAL OF CLIMATE CHANGE AND HEALTH 2021; 3:100031. [PMID: 35313705 PMCID: PMC8925298 DOI: 10.1016/j.joclim.2021.100031] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 07/18/2021] [Indexed: 05/22/2023]
Abstract
OBJECTIVES Our aim was to identify if working during hot days while wearing Covid-19 related personal protective equipment causes occupational heat stress for nurses and nursing assistants in Germany. DESIGN Using an online survey, we assessed the impact of hot weather on nurses and nursing assistants working with personal protective equipment. Respondents were recruited by distributing the link to the survey via personal communication, email and various social media channels to nursing staff from hospitals, nursing homes and outpatient care. RESULTS There were in total 428 participants (18.2% male, 82.5% female), mostly (30.5%) aged between 45 and 55 years. Half of respondents (48.3%) had more than 20 years of experience in nursing. Cardiac, pulmonary, or other pre-existing conditions were reported by 46.2%.Nurses and nursing assistants working in personal protective equipment during hot days were exposed to occupational heat stress. Work was found exhaustive by 96.5% of the participants during those days. 93.0% reported breathing problems and 85.8% reported difficulties with focusing on their work. Many workplaces did not provide adequate heat protection, with distinct differences concerning the amount of prophylactic and heat mitigating measures across institutions. There were significant differences across institutions when it comes to the number of drinks served (p < 0.001), the availability of room thermometers (p < 0.001), the use of mobile cooling devices (p < 0.001) and fans (p < 0.05). CONCLUSIONS Results suggest employers must make more of an effort to provide adequate heat protection for their nursing staff. In order to ensure patient care, there is a need for action; in particular, attention must be paid to the pre-existing health conditions of the nursing staff.
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Affiliation(s)
- Yvette Jegodka
- FOM University of Applied Sciences, Institute for Health and Social Sciences, Bismarckstr. 107, D-10625 Berlin, Germany
| | - Lena Lagally
- LMU Munich, University Hospital, Institute and Clinic for Occupational, Social and Environmental Medicine, Unit Global Environmental Health and Climate Change, Ziemssenstr. 5, D-80336 Munich, Germany
| | - Hanna Mertes
- LMU Munich, University Hospital, Institute and Clinic for Occupational, Social and Environmental Medicine, Unit Global Environmental Health and Climate Change, Ziemssenstr. 5, D-80336 Munich, Germany
| | - Katharina Deering
- LMU Munich, University Hospital, Institute and Clinic for Occupational, Social and Environmental Medicine, Unit Global Environmental Health and Climate Change, Ziemssenstr. 5, D-80336 Munich, Germany
| | - Julia Schoierer
- LMU Munich, University Hospital, Institute and Clinic for Occupational, Social and Environmental Medicine, Unit Global Environmental Health and Climate Change, Ziemssenstr. 5, D-80336 Munich, Germany
| | - Barbara Buchberger
- FOM University of Applied Sciences, Institute for Health and Social Sciences, Bismarckstr. 107, D-10625 Berlin, Germany
- Robert Koch Institute, Nordufer 20, D-13353 Berlin, Germany
| | - Stephan Bose-O'Reilly
- LMU Munich, University Hospital, Institute and Clinic for Occupational, Social and Environmental Medicine, Unit Global Environmental Health and Climate Change, Ziemssenstr. 5, D-80336 Munich, Germany
- UMIT - Private University for Health Sciences, Medical Informatics and Technology, Institute for Public Health, Medical Decision Making and HTA, Eduard-Wallnöfer Zentrum 1, A-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, Steinmetzstr. 1-3, D-93049 Regensburg, Germany
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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. ENVIRONMENTAL RESEARCH 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] [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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21
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Messeri A, Bonafede M, Pietrafesa E, Pinto I, de’Donato F, Crisci A, Lee JKW, Marinaccio A, Levi M, Morabito M. A Web Survey to Evaluate the Thermal Stress Associated with Personal Protective Equipment among Healthcare Workers during the COVID-19 Pandemic in Italy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:3861. [PMID: 33917051 PMCID: PMC8067771 DOI: 10.3390/ijerph18083861] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Revised: 03/26/2021] [Accepted: 04/04/2021] [Indexed: 01/07/2023]
Abstract
The pandemic has been afflicting the planet for over a year and from the occupational point of view, healthcare workers have recorded a substantial increase in working hours. The use of personal protective equipment (PPE), necessary to keep safe from COVID-19 increases the chances of overheating, especially during the summer seasons which, due to climate change, are becoming increasingly warm and prolonged. A web survey was carried out in Italy within the WORKLIMATE project during the summer and early autumn 2020. Analysis of variance (ANOVA) was used to evaluate differences between groups. 191 questionnaires were collected (hospital doctor 38.2%, nurses 33.5%, other healthcare professionals 28.3%). The impact of PPE on the thermal stress perception declared by the interviewees was very high on the body areas directly covered by these devices (78% of workers). Workers who used masks for more than 4 h per day perceived PPE as more uncomfortable (p < 0.001) compared to the others and reported a greater productivity loss (p < 0.001). Furthermore, the study highlighted a high perception of thermal stress among healthcare workers that worn COVID-19-PPE and this enhances the need for appropriate heat health warning systems and response measures addressed to the occupational sector.
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Affiliation(s)
- Alessandro Messeri
- Institute of Bioeconomy, National Research Council (IBE-CNR), 50019 Florence, Italy; (A.C.); (M.M.)
- Centre of Bioclimatology, University of Florence (UNIFI), 50144 Florence, Italy
| | - Michela Bonafede
- Occupational and Environmental Medicine, Epidemiology and Hygiene Department, Italian Workers’ Compensation Authority (INAIL), 00143 Rome, Italy; (M.B.); (E.P.); (A.M.)
| | - Emma Pietrafesa
- Occupational and Environmental Medicine, Epidemiology and Hygiene Department, Italian Workers’ Compensation Authority (INAIL), 00143 Rome, Italy; (M.B.); (E.P.); (A.M.)
| | - Iole Pinto
- Physical Agents Sector, Regional Public Health Laboratory, 53100 Siena, Italy;
| | - Francesca de’Donato
- Department of Epidemiology Lazio Regional Health Service, ASL ROMA 1, 00147 Rome, Italy;
| | - Alfonso Crisci
- Institute of Bioeconomy, National Research Council (IBE-CNR), 50019 Florence, Italy; (A.C.); (M.M.)
| | - Jason Kai Wei Lee
- Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117593, Singapore;
- Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore S117593, Singapore
- Global Asia Institute, National University of Singapore, Singapore S119076, Singapore
- N.1 Institute for Health, National University of Singapore, Singapore S117456, Singapore
- Institute for Digital Medicine, National University of Singapore, Singapore S117456, Singapore
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore 117609, Singapore
| | - Alessandro Marinaccio
- Occupational and Environmental Medicine, Epidemiology and Hygiene Department, Italian Workers’ Compensation Authority (INAIL), 00143 Rome, Italy; (M.B.); (E.P.); (A.M.)
| | - Miriam Levi
- Epidemiology Unit, Department of Prevention, Central Tuscany Local Health Authority, 50135 Florence, Italy;
| | - Marco Morabito
- Institute of Bioeconomy, National Research Council (IBE-CNR), 50019 Florence, Italy; (A.C.); (M.M.)
- Centre of Bioclimatology, University of Florence (UNIFI), 50144 Florence, Italy
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22
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Possible Perception Bias in the Thermal Evaluation of Evaporation Cooling with a Misting Fan. CLEAN TECHNOLOGIES 2021. [DOI: 10.3390/cleantechnol3010011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Mist evaporation cooling (MEC) is increasingly used as a low-energy means to improve thermal comfort in hot environments. However, the thermal sensation votes (TSV) often overshoot values of Predicted Mean Vote (PMV) models. Evaluations of MEC may be affected by an expectation that mist feels cool or the “good subject” effect. Here, subjects are exposed to a misting fan and an identical fan without mist and asked which fan feels cooler. Unknown to the subjects, the misting fan has almost no cooling effect (about 0.4 K reduction in air temperature) and a hidden heater increased the temperature of the misting fan air flow, making it up to 1.6 K warmer than the fan without mist. Supplemental experiments told the subjects about the heater. Surveys of over 300 subjects when varying this misted air temperature showed a bias above random chance that people vote that a misting fan airflow was cooler, even when it was the same temperature or slightly warmer than the non-misting fan. It is possible that the expectation of cooling or good subject effect influences evaluations of mist. This effect should be considered in thermal comfort evaluations of mist cooling and in the deployment of MEC systems.
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23
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Duan X, Sun H, He Y, Yang J, Li X, Taparia K, Zheng B. Personal Protective Equipment in COVID-19: Impacts on Health Performance, Work-Related Injuries, and Measures for Prevention. J Occup Environ Med 2021; 63:221-225. [PMID: 33394877 PMCID: PMC7934332 DOI: 10.1097/jom.0000000000002123] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To assess impact of personal protective equipment (PPE) on healthcare providers (HCPs) in caring for COVID-19 patients. METHODS A cross-sectional survey was conducted over 50 hospitals in China. Descriptive analyses and Chi-square tests were performed on the collected data. RESULTS All 104 frontline HCPs report negative impacts of PPE on their clinical performance, 97% of them experienced discomfort and injuries caused by wearing PPE for long hours. Frontline HCPs provided suggestions to alleviate the negative impacts and to enhance communication between healthcare staff and patients. Two hundred eighty two non-frontline HCPs also revealed similar problems; however, we recorded a few discrepancies between answers given by frontline and non-frontline HCPs. CONCLUSIONS Wearing PPE for long hours degrades health performance. Measures were suggested to improve the design of PPE for protecting HCPs and enhancing their services to COVID patients.
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Affiliation(s)
- Xiaoqin Duan
- Department of Rehabilitation Medicine (Dr Duan); Department of Emergency and Critical Care Medicine (Dr Sun); Grade 2019 in Clinical Medicine, Jilin University (Mr He); Department of Respiratory and Critical Care Medicine (Dr Yang), Jilin University Second Hospital, Changchun, China; Department of Mechanical Engineering (Dr Li); Faculty of Science (Ms Taparia); Department of Surgery (Dr Duan, Dr Zheng), University of Alberta, Edmonton, Canada
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24
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Rim KT. COVID-19 pandemic and the protection of workers’ health from disinfectant chemicals. TOXICOLOGY AND ENVIRONMENTAL HEALTH SCIENCES 2021; 13:1-7. [PMCID: PMC7789888 DOI: 10.1007/s13530-020-00077-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/16/2020] [Indexed: 05/25/2023]
Abstract
Objective and methods This study examines the protection of workers from the “COVID-19” pandemic, especially healthcare workers, disinfection workers, and future prospects in occupational health. To summarize this concept, I searched the major websites using the key terms “COVID-19,” “coronavirus,” “pandemic,” “workers’ health,” and “quarantine” or “disinfection.” Results and conclusion The use of disinfectants is recognized to be effective in preventing viruses, but this is also increasing the need to solve problems, such as the side effects caused by the increase in disinfectant use. This paper presents the precautions for safer use of chemicals handled by workers during quarantine and disinfection and proposes policy suggestions. The COVID-19 pandemic will have long-lasting effects on workers. Syndromic methods for monitoring illness outside of healthcare settings can be useful adjuncts to conventional disease reporting. From these results, it is important that the precautions for chemicals’ safety handled by workers during quarantine and disinfection as well as policy suggestions for quarantine and disinfection workers are very important to protect workers.
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Affiliation(s)
- Kyung-Taek Rim
- Chemicals Research Bureau, Occupational Safety and Health Research Institute, Korea Occupational Safety and Health Agency, Daejeon, Korea
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25
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Heat stress and PPE during COVID-19: impact on healthcare workers' performance, safety and well-being in NHS settings. J Hosp Infect 2020; 108:185-188. [PMID: 33301841 PMCID: PMC7720696 DOI: 10.1016/j.jhin.2020.11.027] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 11/25/2020] [Accepted: 11/27/2020] [Indexed: 12/14/2022]
Abstract
Personal protective equipment (PPE) can potentiate heat stress, which may have a negative impact on the wearer's performance, safety and well-being. In view of this, a survey was distributed to healthcare workers (HCWs) required to wear PPE during the coronavirus disease 2019 pandemic in the UK to evaluate perceived levels of heat stress and its consequences. Respondents reported experiencing several heat-related illness symptoms, and heat stress impaired both cognitive and physical performance. The majority of respondents stated that wearing PPE made their job more difficult. These, and additional, responses suggest that modification to current working practices is required urgently to improve the resilience of HCWs to wearing PPE during pandemics.
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26
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Gelardi M, Fiore V, Giancaspro R, La Gatta E, Fortunato F, Resta O, Carpagnano GE, Santomasi C, Dimitri M, Foschino Barbaro MP, Lacedonia D, Scioscia G, Antonio L, Cassano M. Surgical mask and N95 in healthcare workers of Covid-19 departments: clinical and social aspects. ACTA BIO-MEDICA : ATENEI PARMENSIS 2020; 91:e2020171. [PMID: 33525214 PMCID: PMC7927551 DOI: 10.23750/abm.v91i4.10660] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 10/19/2020] [Indexed: 02/08/2023]
Abstract
Introdution. In order to prevent or slow down the transmission of COVID-19, various public health measures have been introduced, including social distancing, environmental disinfection and the use of personal protective equipment (PPE). In this perspective, the clinical practice of healthcare professionals has changed dramatically. As a matter of fact, the use of surgical masks and N95 has significantly worsened the job performance of workers who deal directly with COVID-19 disease. Methods. The study included 116 health workers employed in the pulmonology, intensive care and infectious diseases departments of Bari and Foggia Hospital, directly involved in the healthcare of patients affected by COVID-19. Between May 1, 2020 and May 31, 2020, each participant completed an online questionnaire aimed to investigate the impact of the COVID-19 pandemic on workers’ lifestyle changes and job performances. We compared the results based on the type of mask used by each participant (surgical mask vs N95). Results. Although disturbances related to the use of the mask arose earlier in subjects who wore the N95 (p = 0.0094), healthcare workers that wore surgical masks reported a statistically higher average score for a greater number of disorders. Conclusions. This is the first study that compares the effects of the two most used PPE on the quality of life of health workers and which highlights the greater discomfort caused by surgical masks. This result brings to light a serious social problem, being surgical masks widely used in everyday life by ordinary people and non-healthcare workers. (www.actabiomedica.it)
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27
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Lee J, Venugopal V, Latha PK, Alhadad SB, Leow CHW, Goh NYD, Tan E, Kjellstrom T, Morabito M, Lee JKW. Heat Stress and Thermal Perception amongst Healthcare Workers during the COVID-19 Pandemic in India and Singapore. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17218100. [PMID: 33153079 PMCID: PMC7663197 DOI: 10.3390/ijerph17218100] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 10/20/2020] [Accepted: 10/31/2020] [Indexed: 11/16/2022]
Abstract
The need for healthcare workers (HCWs) to wear personal protective equipment (PPE) during the coronavirus disease 2019 (COVID-19) pandemic heightens their risk of thermal stress. We assessed the knowledge, attitudes, and practices of HCWs from India and Singapore regarding PPE usage and heat stress when performing treatment and care activities. One hundred sixty-five HCWs from India (n = 110) and Singapore (n = 55) participated in a survey. Thirty-seven HCWs from Singapore provided thermal comfort ratings before and after ice slurry ingestion. Differences in responses between India and Singapore HCWs were compared. A p-value cut-off of 0.05 depicted statistical significance. Median wet-bulb globe temperature was higher in India (30.2 °C (interquartile range [IQR] 29.1-31.8 °C)) than in Singapore (22.0 °C (IQR 18.8-24.8 °C)) (p < 0.001). Respondents from both countries reported thirst (n = 144, 87%), excessive sweating (n = 145, 88%), exhaustion (n = 128, 78%), and desire to go to comfort zones (n = 136, 84%). In Singapore, reports of air-conditioning at worksites (n = 34, 62%), dedicated rest area availability (n = 55, 100%), and PPE removal during breaks (n = 54, 98.2%) were higher than in India (n = 27, 25%; n = 46, 42%; and n = 66, 60%, respectively) (p < 0.001). Median thermal comfort rating improved from 2 (IQR 1-2) to 0 (IQR 0-1) after ice slurry ingestion in Singapore (p < 0.001). HCWs are cognizant of the effects of heat stress but might not adopt best practices due to various constraints. Thermal stress management is better in Singapore than in India. Ice slurry ingestion is shown to be practical and effective in promoting thermal comfort. Adverse effects of heat stress on productivity and judgment of HCWs warrant further investigation.
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Affiliation(s)
- Jimmy Lee
- Ng Teng Fong General Hospital, Singapore 609606, Singapore; (J.L.); (E.T.)
| | - Vidhya Venugopal
- Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu 600116, India; (V.V.); (P.K.L.)
| | - P K Latha
- Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu 600116, India; (V.V.); (P.K.L.)
- AMET University, Chennai, Tamil Nadu 603112, India
| | - Sharifah Badriyah Alhadad
- NUS Graduate School for Integrative Sciences and Engineering, National University of Singapore, Singapore 119077, Singapore;
- Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117593, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore 117549, Singapore
| | - Clarence Hong Wei Leow
- Human Potential Translational Research Programme, National University of Singapore, Singapore 119228, Singapore; (C.H.W.L.); (N.Y.D.G.)
| | - Nicholas Yong De Goh
- Human Potential Translational Research Programme, National University of Singapore, Singapore 119228, Singapore; (C.H.W.L.); (N.Y.D.G.)
| | - Esther Tan
- Ng Teng Fong General Hospital, Singapore 609606, Singapore; (J.L.); (E.T.)
| | - Tord Kjellstrom
- Health and Environment International Trust, Nelson 7005, New Zealand;
- National Centre for Epidemiology and Population Health, Australian National University, Canberra 2601, Australia
| | - Marco Morabito
- Institute of BioEconomy, National Research Council, 50019 Florence, Italy;
- Centre of Bioclimatology, University of Florence, 50144 Florence, Italy
| | - Jason Kai Wei Lee
- Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117593, Singapore
- Human Potential Translational Research Programme, National University of Singapore, Singapore 119228, Singapore; (C.H.W.L.); (N.Y.D.G.)
- N.1 Institute for Health, National University of Singapore, Singapore 117456, Singapore
- Global Asia Institute, National University of Singapore, Singapore 119076, Singapore
- Correspondence:
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28
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Benmarhnia T. Linkages Between Air Pollution and the Health Burden From COVID-19: Methodological Challenges and Opportunities. Am J Epidemiol 2020; 189:1238-1243. [PMID: 32676643 PMCID: PMC7454309 DOI: 10.1093/aje/kwaa148] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 07/13/2020] [Indexed: 12/18/2022] Open
Abstract
The COVID-19 pandemic revealed and exacerbated existing social and economic health disparities and actionable epidemiological evidence is needed to identify potential vulnerability factors to help inform targeted responses. In this commentary, methodological challenges and opportunities regarding the links between air pollution and COVID-19 are discussed with a focus on: i) the role of differential exposure to air pollution across populations and explain spatio-temporal variability of the epidemic spread and resultant mortality; ii) the indirect impacts of interventions treated as natural experiments to control COVID-19 person-to-person spread on air pollution and population health. I first discuss the potential mechanisms between exposure to air pollution and COVID-19 and the opportunity to clearly formulate causal questions of interest through the target trial framework. Then, I discuss challenges regarding the use of quasi-experimental designs that capitalize on the differential timing of COVID-19 policies including the selection of control groups and potential violations of the common shock assumption. Finally, I discuss environmental justice implications of this many-headed beast of a crisis.
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Affiliation(s)
- Tarik Benmarhnia
- Department of Family Medicine and Public Health & Scripps Institution of Oceanography, University of California, San Diego, CA, USA
- Address correspondence to Tarik Benmarhnia, Department of Family Medicine and Public Health & Scripps Institution of Oceanography University of California, San Diego, 9500 Gilman Drive, La Jolla, 92093 CA, USA. Tel: +18589991428, E-mail:
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29
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Obinata H, Yokobori S, Ogawa K, Takayama Y, Kawano S, Ito T, Takiguchi T, Igarashi Y, Nakae R, Masuno T, Ohwada H. Indicators of Acute Kidney Injury as Biomarkers to Differentiate Heatstroke from Coronavirus Disease 2019: A Retrospective Multicenter Analysis. J NIPPON MED SCH 2020; 88:80-86. [PMID: 32863339 DOI: 10.1272/jnms.jnms.2021_88-107] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) and heat-related illness are systemic febrile diseases. These illnesses must be differentiated during a COVID-19 pandemic in summer. However, no studies have compared and distinguished heat-related illness and COVID-19. We compared data from patients with early heat-related illness and those with COVID-19. METHODS This retrospective observational study included 90 patients with early heat-related illness selected from the Heatstroke STUDY 2017-2019 (nationwide registries of heat-related illness in Japan) and 86 patients with laboratory-confirmed COVID-19 who had fever or fatigue and were admitted to one of two hospitals in Tokyo, Japan. RESULTS Among vital signs, systolic blood pressure (119 vs. 125 mm Hg, p = 0.02), oxygen saturation (98% vs. 97%, p < 0.001), and body temperature (36.6°C vs. 37.6°C, p<0.001) showed significant between-group differences in the heatstroke and COVID-19 groups, respectively. The numerous intergroup differences in laboratory findings included disparities in white blood cell count (10.8 × 103/μL vs. 5.2 × 103/μL, p<0.001), creatinine (2.2 vs. 0.85 mg/dL, p<0.001), and C-reactive protein (0.2 vs. 2.8 mg/dL, p<0.001), although a logistic regression model achieved an area under the curve (AUC) of 0.966 using these three factors. A Random Forest machine learning model achieved an accuracy, precision, recall, and AUC of 0.908, 0.976, 0.842, and 0.978, respectively. Creatinine was the most important feature of this model. CONCLUSIONS Acute kidney injury was associated with heat-related illness, which could be essential in distinguishing or evaluating patients with fever in the summer during a COVID-19 pandemic.
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Affiliation(s)
- Hirofumi Obinata
- Department of Emergency and Critical Care Medicine, Nippon Medical School.,Self-Defense Forces Central Hospital
| | - Shoji Yokobori
- Department of Emergency and Critical Care Medicine, Nippon Medical School.,Japan Association of Acute Medicine Heatstroke and Hypothermia Surveillance Committee
| | - Kei Ogawa
- Department of Industrial Administration, Tokyo University of Science
| | | | | | | | - Toru Takiguchi
- Department of Emergency and Critical Care Medicine, Nippon Medical School
| | - Yutaka Igarashi
- Department of Emergency and Critical Care Medicine, Nippon Medical School
| | - Ryuta Nakae
- Department of Emergency and Critical Care Medicine, Nippon Medical School
| | - Tomohiko Masuno
- Department of Emergency and Critical Care Medicine, Nippon Medical School
| | - Hayato Ohwada
- Department of Industrial Administration, Tokyo University of Science
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