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Alhadad SB, Ponampalam R, Lim LSX, Low ICC, Kshitij R, Abdul Karim AB, Salamoon ZB, Marimuthu YS, Lee JKW. Effects of Heat Exposure and Ice Slurry Ingestion on Risk-Taking Behavior in Healthcare Workers. Med Sci Sports Exerc 2024; 56:2016-2025. [PMID: 38767972 DOI: 10.1249/mss.0000000000003486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/22/2024]
Abstract
PURPOSE Healthcare workers (HCWs) wearing personal protective equipment (PPE) experience physiological strain that can impair motor and psychological functions, potentially affecting patient care. We assessed the effects of heat exposure on maximal strength and risk-taking behavior among PPE-wearing HCWs and the efficacy of ice slurry to alleviate adverse effects. METHODS Seventeen HCWS completed two experimental trials in a crossover design, consuming 5 g·kg -1 of body mass of ambient drink (AMB) or ice slurry (ICE) before donning PPE and undergoing 2 h of simulated decontamination exercise (wet-bulb globe temperature (WBGT): 25.9°C ± 0.8°C, PPE microenvironment WBGT: 29.1°C ± 2.1°C). Body core temperature ( Tc ), heart rate (HR), chest skin temperature ( Tsk ), ratings of perceived exertion (RPE), thermal sensation (RTS), maximal voluntary contraction (MVC), risk-taking behavior (balloon analogue risk-taking task (BART)), and salivary cortisol were assessed. RESULTS Predrinking to postdrinking ∆ Tc was greater in ICE (-0.2°C ± 0.1°C) than AMB (-0.0°C ± 0.1°C, P = 0.003). Post-drinking RTS was lower in ICE (2.7 ± 1.2) than AMB (4.1 ± 0.4, P < 0.001). ICE and AMB had similar Tc and HR (both P > 0.05), but Tsk was lower in ICE than AMB ( P = 0.049). A lower MVC (30.3 ± 6.7 vs 27.4 ± 4.9 kg, P = 0.001) and higher BART-adjusted total pump count (472 ± 170 vs 615 ± 174 pumps, P = 0.017) was observed pretrial to posttrial in AMB but absent in ICE (both P > 0.05). Salivary cortisol was similar between trials ( P = 0.42). CONCLUSIONS Heat-exposed PPE-wearing HCWs had impaired maximal strength and elevated risk-taking behavior. This may increase the risk of avoidable workplace accidents that can jeopardize HCWs and patient care. Ice slurry ingestion alleviated these heat-related impairments, suggesting its potential as an ergogenic aid.
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Affiliation(s)
| | - R Ponampalam
- Department of Emergency Medicine, Singapore General Hospital, SINGAPORE
| | | | | | - Rahalkar Kshitij
- Department of Emergency Medicine, Singapore General Hospital, SINGAPORE
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Yang HY, Chou HL, Leow CHW, Kao CC, Daniel D, Jaladara V, Khoe LC, Latha PK, Mahendradhata Y, Nguyen PM, Sirijatuphat R, Soemarko DS, Venugopal V, Zhang K, Lee JKW. Poor personal protective equipment practices were associated with heat-related symptoms among Asian healthcare workers: a large-scale multi-national questionnaire survey. BMC Nurs 2024; 23:145. [PMID: 38429747 PMCID: PMC10905833 DOI: 10.1186/s12912-024-01770-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 01/28/2024] [Indexed: 03/03/2024] Open
Abstract
BACKGROUND It is pertinent to understand the perceptions of healthcare workers (HCWs) with their associated personal protective equipment (PPE) usage and heat strain symptoms experienced to effectively combat the negative effects of heat stress during treatment and care activities. METHODS We evaluated the associated heat stress perceived by HCWs across Asia and validated a questionnaire on perceptions of heat stress, associated PPE usage, and heat strain symptoms experienced. The questionnaire was administered to 3,082 HCWs in six Asian regions. Factor analyses, including Cronbach's alpha, assessed the questionnaire's validity and reliability. Structural equation modelling analysed the effects of knowledge, attitudes and practices, and heat strain symptoms. RESULTS The questionnaire was found to be reliable in assessing HCWs' knowledge, and attitudes and practices towards heat stress and PPE usage (both Cronbach's alpha = 0.9), but not heat strain symptoms (Cronbach's alpha = 0.6). Despite knowledge of heat stress, HCWs had negative attitudes and practices regarding PPE usage (β1 = 0.6, p < 0.001). Knowledge (path coefficient = 0.2, p < 0.001), and negative attitudes and practices (path coefficient = 0.2, p < 0.001) of HCWs towards heat stress and PPE usage adversely affected symptoms experienced. CONCLUSIONS The questionnaire was not reliable in assessing symptoms. HCWs should, nevertheless, still self-assess their symptoms for early detection of heat strain. To effectively attenuate heat strain, understanding HCWs' attitudes and practices towards PPE usage should guide policymakers in implementing targeted heat management strategies.
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Affiliation(s)
- Hsiao-Yu Yang
- Institute of Environmental and Occupational Health Sciences, National Taiwan University College of Public Health, 10055, Taipei, Taiwan
- Department of Public Health, National Taiwan University College of Public Health, 10055, Taipei, Taiwan
- Department of Environmental and Occupational Medicine, National Taiwan University Hospital, 100225, Taipei, Taiwan
- Population Health Research Center, National Taiwan University, 10617, Taipei City, Taiwan
| | - Hsiu-Ling Chou
- Department of Nursing, Asia Eastern University of Science and Technology, 220303, New Taipei City, Taiwan
- Department of Nursing, Far Eastern Memorial Hospital, 220216, New Taipei City, Taiwan
| | - Clarence Hong Wei Leow
- Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, 117593, Singapore, Singapore
- Campus for Research Excellence and Technological Enterprise (CREATE), National University of Singapore, 138602, Singapore, Singapore
| | - Ching-Chiu Kao
- Department of Nursing, Wan Fang Hospital, Taipei Medical University, 116079, Taipei, Taiwan
- School of Nursing, College of Nursing, Taipei Medical University, 110301, Taipei, Taiwan
| | - D Daniel
- Department of Health Behaviour, Environment and Social Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, 55281, Yogyakarta, Indonesia
| | - Vena Jaladara
- Department of Health Behaviour, Environment and Social Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, 55281, Yogyakarta, Indonesia
| | - Levina Chandra Khoe
- Department of Community Medicine, Faculty of Medicine, Universitas Indonesia, 10430, Jakarta, Indonesia
| | - P K Latha
- Sri Ramachandra Institute of Higher Education & Research, 600116, Chennai, Tamil Nadu, India
| | - Yodi Mahendradhata
- Center for Tropical Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, 55281, Yogyakarta, Indonesia
- Department of Health Policy and Management, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, 55281, Yogyakarta, Indonesia
| | - Phuong Minh Nguyen
- Department of Military Occupational Medicine, Vietnam Military Medical University, Hanoi, Vietnam
| | - Rujipas Sirijatuphat
- Division of Infectious Diseases and Tropical Medicine, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, 10700, Bangkok, Thailand
| | - Dewi Sumaryani Soemarko
- Department of Community Medicine, Faculty of Medicine, Universitas Indonesia, 10430, Jakarta, Indonesia
| | - Vidhya Venugopal
- Sri Ramachandra Institute of Higher Education & Research, 600116, Chennai, Tamil Nadu, India
| | - Kai Zhang
- Department of Environmental Health Sciences, School of Public Health, University at Albany, State University of New York, 12144, Rensselaer, NY, USA
| | - Jason Kai Wei Lee
- Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, 117593, Singapore, Singapore.
- Campus for Research Excellence and Technological Enterprise (CREATE), National University of Singapore, 138602, Singapore, Singapore.
- Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, 117593, Singapore, Singapore.
- Heat Resilience and Performance Centre, Yong Loo Lin School of Medicine, National University of Singapore, Block MD9, 2 Medical Drive Level 4, 117593, Singapore, Singapore.
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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] [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. 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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Comparison of adaptive thermal comfort with face masks in library building in Guangzhou, China. THERMAL SCIENCE AND ENGINEERING PROGRESS 2023; 37. [PMCID: PMC9724504 DOI: 10.1016/j.tsep.2022.101597] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
During the COVID-19 pandemic, wearing masks in public spaces has become a protective strategy. Field tests and questionnaire surveys were carried out at a university library in Guangzhou, China, during June 2021 and January 2022. The indoor environmental parameters were observed, thermal sensation votes of students on various environmental parameters were collected, symptoms of students wearing masks were quantified, and the appropriate amount of time to wear masks was established. To identify acceptable and comfortable temperature ranges, the relationship between thermal sensation and thermal index was investigated. During summer and winter, people wearing masks are symptomatic for a certain duration. The most frequently voted symptom was facial heat (62.7 % and 54.6 % during summer and winter, respectively), followed by dyspnea. During summer, more than 80 % of the participants subjects were uncomfortable and showed some symptoms after wearing masks for more than 2 h (3 h during winter). In the summer air conditioning environment in Guangzhou, the neutral Top was 26.4 °C, and the comfortable Top range was 25.1–27.7 °C. Under the natural ventilation environment in winter, the neutral Top was 20.5 °C, and the comfortable Top range was 18.5–22.5 °C. This study may provide guidance for indoor office work and learning to wear masks in Guangzhou.
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Johnson DP, Lulla V. Predicting COVID-19 community infection relative risk with a Dynamic Bayesian Network. Front Public Health 2022; 10:876691. [PMID: 36388264 PMCID: PMC9650227 DOI: 10.3389/fpubh.2022.876691] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 10/10/2022] [Indexed: 01/21/2023] Open
Abstract
As COVID-19 continues to impact the United States and the world at large it is becoming increasingly necessary to develop methods which predict local scale spread of the disease. This is especially important as newer variants of the virus are likely to emerge and threaten community spread. We develop a Dynamic Bayesian Network (DBN) to predict community-level relative risk of COVID-19 infection at the census tract scale in the U.S. state of Indiana. The model incorporates measures of social and environmental vulnerability-including environmental determinants of COVID-19 infection-into a spatial temporal prediction of infection relative risk 1-month into the future. The DBN significantly outperforms five other modeling techniques used for comparison and which are typically applied in spatial epidemiological applications. The logic behind the DBN also makes it very well-suited for spatial-temporal prediction and for "what-if" analysis. The research results also highlight the need for further research using DBN-type approaches that incorporate methods of artificial intelligence into modeling dynamic processes, especially prominent within spatial epidemiologic applications.
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Affiliation(s)
- Daniel P. Johnson
- Department of Geography, Indiana University – Purdue University at Indianapolis, Indianapolis, IN, United States,*Correspondence: Daniel P. Johnson
| | - Vijay Lulla
- Center for Complex Networks and Systems Research, Indiana University, Bloomington, IN, United States
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Morrison SA. Moving in a hotter world: Maintaining adequate childhood fitness as a climate change countermeasure. Temperature (Austin) 2022; 10:179-197. [PMID: 37332309 PMCID: PMC10274554 DOI: 10.1080/23328940.2022.2102375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Revised: 07/09/2022] [Accepted: 07/12/2022] [Indexed: 10/16/2022] Open
Abstract
Children cope with high temperatures differently than adults do, largely because of slight alterations in their body proportions and heat loss mechanisms compared to fully mature humans. Paradoxically, all current tools of assessing thermal strain have been developed on adults. As the Earth's warming continues to accelerate, children are set to bear the health risk brunt of rising global temperatures. Physical fitness has a direct impact on heat tolerance, yet children are less fit and more obese than ever before. Longitudinal research reveals that children have 30% lower aerobic fitness than their parents did at the same age; this deficit is greater than can be recovered by training alone. So, as the planet's climate and weather patterns become more extreme, children may become less capable of tolerating it. This comprehensive review provides an outline of child thermoregulation and assessment of thermal strain, before moving to summarize how aerobic fitness can modulate hyperthermia, heat tolerance, and behavioral thermoregulation in this under-researched population. The nature of child physical activity, physical fitness, and one's physical literacy journey as an interconnected paradigm for promoting climate change resilience is explored. Finally, future research foci are suggested to encourage continued exploration of this dynamic field, notable since more extreme, multifactorial environmental stressors are expected to continue challenging the physiological strain of the human population for the foreseeable future.
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A Literature Review of Cooling Center, Misting Station, Cool Pavement, and Cool Roof Intervention Evaluations. ATMOSPHERE 2022. [DOI: 10.3390/atmos13071103] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Heat islands and warming temperatures are a growing global public health concern. Although cities are implementing cooling interventions, little is known about their efficacy. We conducted a literature review of field studies measuring the impact of urban cooling interventions, focusing on cooling centers, misting stations, cool pavements, and cool or green roofs. A total of 23 articles met the inclusion criteria. Studies of cooling centers measured the potential impact, based on evaluations of population proximity and heat-vulnerable populations. Reductions in temperature were reported for misting stations and cool pavements across a range of metrics. Misting station use was evaluated with temperature changes and user questionnaires. The benefits and disadvantages of each intervention are presented, and metrics for evaluating cooling interventions are compared. Gaps in the literature include a lack of measured impacts on personal thermal comfort, limited documentation on intervention costs, the need to standardize temperature metrics, and evaluation criteria.
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Romanovsky AA. Papers published by the journal Temperature are cited more often than those published by more prestigious journals. Temperature (Austin) 2022; 9:1-7. [PMID: 35655668 PMCID: PMC9154765 DOI: 10.1080/23328940.2022.2048549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Affiliation(s)
- Andrej A. Romanovsky
- School of Molecular Sciences, Arizona State University, Tempe, AZ, USA
- Zharko Pharma, Olympia, WA, USA
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Stephens D, Brearley M, Vermeulen L. Heat Health Management in a Quarantine and Isolation Facility in the Tropics. Prehosp Disaster Med 2022; 37:1-6. [PMID: 35225212 PMCID: PMC8948486 DOI: 10.1017/s1049023x22000255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 12/01/2021] [Accepted: 12/08/2021] [Indexed: 11/10/2022]
Abstract
INTRODUCTION The Howard Springs Quarantine Facility (HSQF) is located in tropical Northern Australia and has 875 blocks of four rooms (3,500 rooms in total) spread over 67 hectares. The HSQF requires a large outdoor workforce walking outdoor pathways to provide individual care in the ambient climate. The personal protective equipment (PPE) required for the safety of quarantine workers varies between workgroups and limits body heat dissipation that anecdotally contributes to excessive sweating, which combined with heat stress symptoms of fatigue, headache, and irritability, likely increases the risk of workplace injuries including infection control breaches. STUDY OBJECTIVE The purpose of this study was the description of qualitative and quantitative assessment for HSQF workers exposed to tropical environmental conditions and provision of evidenced-based strategies to mitigate the risk of heat stress in an outdoor quarantine and isolation workforce. METHODS The study comprised two components - a cross-sectional physiological monitoring study of 18 workers (eight males/ten females; means: 41.4 years; 1.69m; 80.6kg) during a single shift in November 2020 and a subjective heat health survey completed by participants on a minimum of four occasions across the wet season/summer period from November 2020 through February 2021. The physiological monitoring included continuous core temperature monitoring and assessment of fluid balance. RESULTS The mean apparent temperature across first-half and second-half of the shift was 34.7°C (SD = 0.8) and 35.6°C (SD = 1.9), respectively. Across the work shift (mean duration 10.1 hours), the mean core temperature of participants was 37.3°C (SD = 0.2) with a range of 37.0°C - 37.7°C. The mean maximal core temperature of participants was 37.7°C (SD = 0.3). In the survey, for the workforce in full PPE, 57% reported feeling moderately, severely, or unbearably hot compared to 49% of those in non-contact PPE, and the level of fatigue was reported as moderate to severe in just over 25% of the workforce in both groups. CONCLUSION Heat stress is a significant risk in outdoor workers in the tropics and is amplified in the coronavirus disease 2019 (COVID-19) frontline workforce required to wear PPE in outdoor settings. A heat health program aimed at mitigating risk, including workplace education, limiting exposure times, encouraging hydration, buddy system, active cooling, and monitoring, is recommended to limit PPE breaches and other workplace injuries in this workforce.
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Affiliation(s)
- Dianne Stephens
- National Critical Care and Trauma Response Centre, Darwin, Northern Territory, Australia
| | - Matt Brearley
- National Critical Care and Trauma Response Centre, Darwin, Northern Territory, Australia
| | - Lisa Vermeulen
- Northern Territory Department of Health, Centre for National Resilience, Casuarina, Northern Territory, Australia
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Sharif Nia H, Chong PP, Yiong Huak C, Gorgulu O, Taghipour B, Sivarajan Froelicher E, Pahlevan Sharif S, Rahmatpour P. Clinical accuracy and agreement between tympanic and forehead body temperature measurements for screening of patients with COVID-19. J Clin Nurs 2021; 31:3272-3285. [PMID: 34908206 DOI: 10.1111/jocn.16166] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Revised: 11/12/2021] [Accepted: 11/27/2021] [Indexed: 01/08/2023]
Abstract
AIM To investigate the accuracy, reliability and agreement between infrared forehead thermometers versus infrared tympanic thermometers temperature, a cross-sectional study was conducted in April 2020. METHODS The forehead and tympanic temperatures of 615 subjects were measured simultaneously in three exposed SARS-COV-2 groups at one hospital in Iran, during April 2020. These comparisons were evaluated by Bland-Altman Plot, repeatability, Passing-Bablok regression and Lin's concordance correlation coefficient. The receiver operating characteristic (ROC) analysis was done to describe the discrimination accuracy of a diagnostic test. The study adhered to STROBE checklist for cross-sectional studies. RESULTS A Bland-Altman plot indicated that the limits of agreement between the forehead and tympanic temperature were -0.259 to +0.19°C. Passing-Bablok regression analysis illustrated that the infrared forehead was not linearly related to tympanic temperatures (reference method), with a slope estimate that was significantly different from 1.00. The infrared forehead thermometer showed poor precision and lower accuracy than the tympanic. The forehead temperature readings had 60.0% sensitivity and 44.4% specificity (p > .05) to predict disease. CONCLUSION According to the results of study, there is no evidence that the assessment of temperature by infrared forehead thermometer could discriminate between the two groups (positive and negative).
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Affiliation(s)
- Hamid Sharif Nia
- School of Nursing and Midwifery Amol, Mazandaran University of Medical Sciences, Sari, Iran
| | - Pei Pei Chong
- School of Biosciences, Faculty of Health and Medical Sciences, Taylor's University, Subang Jaya, Malaysia
| | | | - Ozkan Gorgulu
- Kirsehir Ahi Evran University, Faculty of Medicine, Department of Biostatistics and Medical Information Kirsehir, Kirsehir, Turkey
| | - Behzad Taghipour
- Imam Khomeini' s Hospital of Amol, Mazandaran University of Medical Science, Sari, Iran
| | - Erika Sivarajan Froelicher
- Department of Physiological Nursing, School of Nursing and Department of Epidemiology & Biostatistics, School of Medicine, University of California San Francisco, San Francisco, California, USA
| | - Saeed Pahlevan Sharif
- Taylor's Business School, Taylor's University Lakeside Campus, Subang Jaya, Malaysia
| | - Pardis Rahmatpour
- Department of Nursing, Alborz University of Medical Sciences, Karaj, Iran
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Morrison SA, Meh K, Sember V, Starc G, Jurak G. The Effect of Pandemic Movement Restriction Policies on Children's Physical Fitness, Activity, Screen Time, and Sleep. Front Public Health 2021; 9:785679. [PMID: 34938712 PMCID: PMC8685208 DOI: 10.3389/fpubh.2021.785679] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 11/12/2021] [Indexed: 01/22/2023] Open
Abstract
Background: The negative impact of isolation, confinement, and physical (in)activity due to pandemic movement restriction has been well-documented over the past year, but less is known on the impact of these policies on children's physical fitness. This study was designed to determine the effects of pandemic movement restriction policies on the 24-hour movement behavior (24-HMB) of children, and whether any alterations are reflected in worsening physical fitness outcomes determined via direct testing. Methods: A two-phase, repeated-measures study with matched controls was conducted. Phase One: N = 62 schoolchildren (N = 31 female) completed self-assessment questionnaires on 24-HMB in October 2018 (pre-pandemic) and again in April 2020, at the height of movement restrictions enacted in response to the COVID-19 pandemic first wave. Phase Two: physical fitness of the original N = 62 children were determined directly pre- and post-isolation using an eight-component standardized fitness test battery and compared to N = 62 control children who were matched for age, sex, school region, and fitness centile scores. Results: During lockdown (total duration: 63 days), moderate-to-vigorous physical activity (MVPA) decreased by ~46 min per day, screen time demonstrated a significant interaction effect, such that kids reported spending less recreational screen time on weekends during lockdown compared to no restriction, and sleep duration was consistently lower (95% CI: -104.1 to -45.5 min, p < 0.001). No interaction effect was present for direct fitness indicators, including: hand tapping (reaction time), standing broad jump, polygon backward obstacle course (coordination), sit-ups, stand-and-reach, bent-arm hang, 60-m, and 600-m run (p ≥ 0.05) although significant main effects are noted for both sexes. Conclusion: Initial changes in 24-HMB did not translate to reductions in physical fitness per se, likely due to the high initial fitness levels of the children. Further work is needed to confirm whether longer or repeated movement restrictions exacerbate initial negative 24-HMB trends, especially for children who are less fit when restrictions are initiated, prolonged, or repeated.
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Vanos JK, Marie Thomas W, Grundstein A, Hosokawa Y, Casa D. Bracing for heat and humidity amidst new challenges in Tokyo: Comment on: Vanos JK, Thomas WM, Grundstein AJ, Hosokawa Y, Liu Y, Casa DJ. A multi-scalar climatological analysis in preparation for extreme heat at the Tokyo 2020 Olympic and Paralympic Games. Temperature 2020;7(2):191-214, DOI: 10.1080/23328940.2020.1737479. Temperature (Austin) 2021; 8:206-208. [PMID: 34595324 DOI: 10.1080/23328940.2021.1960104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Affiliation(s)
- Jennifer K Vanos
- School of Sustainability, Arizona State University, Tempe, AZ, USA
| | | | - Andy Grundstein
- Department of Geography, University of Georgia, Athens, GA, USA
| | - Yuri Hosokawa
- Faculty of Sport Sciences, Waseda University: Tokorozawa, Saitama, JP, USA
| | - Doug Casa
- Korey Stringer Institute, Human Performance Laboratory, Department of Kinesiology, University of Connecticut, Storrs, CT, USA
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Buoite Stella A, Furlanis G, Frezza NA, Valentinotti R, Ajcevic M, Manganotti P. Autonomic dysfunction in post-COVID patients with and witfhout neurological symptoms: a prospective multidomain observational study. J Neurol 2021; 269:587-596. [PMID: 34386903 PMCID: PMC8359764 DOI: 10.1007/s00415-021-10735-y] [Citation(s) in RCA: 91] [Impact Index Per Article: 30.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 07/21/2021] [Accepted: 07/26/2021] [Indexed: 02/07/2023]
Abstract
The autonomic nervous system (ANS) can be affected by COVID-19, and dysautonomia may be a possible complication in post-COVID individuals. Orthostatic hypotension (OH) and postural tachycardia syndrome (POTS) have been suggested to be common after SARS-CoV-2 infection, but other components of ANS function may be also impaired. The Composite Autonomic Symptom Scale 31 (COMPASS-31) questionnaire is a simple and validated tool to assess dysautonomic symptoms. The aim of the present study was to administer the COMPASS-31 questionnaire to a sample of post-COVID patients with and without neurological complaints. Participants were recruited among the post-COVID ambulatory services for follow-up evaluation between 4 weeks and 9 months from COVID-19 symptoms onset. Participants were asked to complete the COMPASS-31 questionnaire referring to the period after COVID-19 disease. Heart rate and blood pressure were manually taken during an active stand test for OH and POTS diagnosis. One-hundred and eighty participants were included in the analysis (70.6% females, 51 ± 13 years), and OH was found in 13.8% of the subjects. Median COMPASS-31 score was 17.6 (6.9-31.4), with the most affected domains being orthostatic intolerance, sudomotor, gastrointestinal and pupillomotor dysfunction. A higher COMPASS-31 score was found in those with neurological symptoms (p < 0.01), due to more severe orthostatic intolerance symptoms (p < 0.01), although gastrointestinal (p < 0.01), urinary (p < 0.01), and pupillomotor (p < 0.01) domains were more represented in the non-neurological symptoms group. This study confirms the importance of monitoring ANS symptoms as a possible complication of COVID-19 disease that may persist in the post-acute period.
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Affiliation(s)
- Alex Buoite Stella
- Clinical Unit of Neurology, Department of Medicine, Surgery and Health Sciences, Trieste University Hospital-ASUGI, University of Trieste, Strada di Fiume, 447, 34149, Trieste, Italy
| | - Giovanni Furlanis
- Clinical Unit of Neurology, Department of Medicine, Surgery and Health Sciences, Trieste University Hospital-ASUGI, University of Trieste, Strada di Fiume, 447, 34149, Trieste, Italy
| | - Nicolò Arjuna Frezza
- School of Medicine and Surgery, Department of Medicine, Surgery and Health Sciences, Trieste University Hospital-ASUGI, University of Trieste, Strada di Fiume, 447, 34149, Trieste, Italy
| | - Romina Valentinotti
- Infectious Diseases, Trieste University Hospital-ASUGI, University of Trieste, Strada di Fiume, 447, 34149, Trieste, Italy
| | - Milos Ajcevic
- Clinical Unit of Neurology, Department of Medicine, Surgery and Health Sciences, Trieste University Hospital-ASUGI, University of Trieste, Strada di Fiume, 447, 34149, Trieste, Italy
- Department of Engineering and Architecture, University of Trieste, Via Alfonso Valerio 10, Trieste, Italy
| | - Paolo Manganotti
- Clinical Unit of Neurology, Department of Medicine, Surgery and Health Sciences, Trieste University Hospital-ASUGI, University of Trieste, Strada di Fiume, 447, 34149, Trieste, Italy.
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15
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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: 10] [Impact Index Per Article: 3.3] [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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16
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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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17
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Foster J, Lloyd AB, Havenith G. Non-contact infrared assessment of human body temperature: The journal Temperature toolbox. Temperature (Austin) 2021; 8:306-319. [PMID: 34901315 PMCID: PMC8654479 DOI: 10.1080/23328940.2021.1899546] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 03/02/2021] [Accepted: 03/03/2021] [Indexed: 12/19/2022] Open
Abstract
The assessment of human internal/core temperature (T core) is relevant in many scientific disciplines, but also for public health authorities when attempting to identify individuals with fever. Direct assessment of T core is often invasive, impractical on a large scale, and typically requires close contact between the observer and the target subject. Non-contact infrared thermometry (NCIT) represents a practical solution in which T core can potentially be assessed from a safe distance and in mass screening scenarios, by measuring skin temperature at specific anatomical locations. However, the COVID-19 pandemic has clearly demonstrated that these devices are not being used correctly, despite expert guided specifications available in International Standard Organization (ISO) documents. In this review, we provide an overview of the most pertinent factors that should be considered by users of NCIT. This includes the most pertinent methodological and physiological factors, as well as an overview on the ability of NCIT to track human T core. For practical use, we provide a checklist based on relevant ISO standards which are simple to follow and should be consulted prior to using NCIT for assessment of human T core. Our intention is for users of NCIT to adopt this checklist, which may improve the performance of NCIT for its ability to track T core.
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Affiliation(s)
- Josh Foster
- Environmental Ergonomics Research Centre, School of Design and Creative Arts, Loughborough University, Loughborough, Leicestershire, UK
| | - Alex Bruce Lloyd
- Environmental Ergonomics Research Centre, School of Design and Creative Arts, Loughborough University, Loughborough, Leicestershire, UK
| | - George Havenith
- Environmental Ergonomics Research Centre, School of Design and Creative Arts, Loughborough University, Loughborough, Leicestershire, UK
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18
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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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19
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Abstract
ABSTRACT Protecting nurses in healthcare facilities from SARS-CoV-2 infection is essential for maintaining an adequate nursing force. Foundational guidelines, consistently utilized, protect the nursing staff from infection. This article describes guidelines designed to reduce acute infection and associated morbidity and mortality among nursing staff and improve compliance with infection prevention protocols.
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Affiliation(s)
- Terrance L Baker
- Terrance L. Baker is a staff physician at Johns Hopkins Medicine in Baltimore, Md., and associate faculty at the University of Maryland School of Nursing in Baltimore, Md., and State University of New York at Stony Brook School of Nursing in Brookhaven, N.Y. Jack V. Greiner is an associate professor of ophthalmology at Harvard Medical School in Boston, Mass. Modesta Vesonder is associate faculty at the University of Maryland School of Nursing in Baltimore, Md., and CEO of Katani Hospital in Katani, Kenya
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20
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Boateng GO, Phipps LM, Smith LE, Armah FA. Household Energy Insecurity and COVID-19 Have Independent and Synergistic Health Effects on Vulnerable Populations. Front Public Health 2021; 8:609608. [PMID: 33553095 PMCID: PMC7859644 DOI: 10.3389/fpubh.2020.609608] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 12/22/2020] [Indexed: 02/03/2023] Open
Abstract
Household energy insecurity (HEINS) is detrimental to the health of the poor and most vulnerable in resource-poor settings. However, this effect amidst the COVID-19 pandemic and the uneven implementation of restrictions can create a synergistic burden of diseases and health risks for the most vulnerable in low- and middle-income countries, exacerbating the health equity gap. Based on existing literature, this paper develops three key arguments: (1) COVID-19 increases the health risks of energy insecurity; (2) HEINS increases the risk of spreading COVID-19; and (3) the co-occurrence of COVID-19 and HEINS will have compounding health effects. These arguments make context-specific interventions, rather than a generic global health approach without recourse to existing vulnerabilities critical in reducing the spread of COVID-19 and mitigating the effects of energy insecurity. Targeted international efforts aimed at financing and supporting resource security, effective testing, contact tracing, and the equitable distribution of vaccines and personal protective equipment have the potential to ameliorate the synergistic effects of HEINS and COVID-19 in resource-poor countries.
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Affiliation(s)
- Godfred O. Boateng
- Department of Kinesiology, College of Nursing and Health Innovations, The University of Texas at Arlington, Arlington, TX, United States
| | - Laura M. Phipps
- Department of Kinesiology, College of Nursing and Health Innovations, The University of Texas at Arlington, Arlington, TX, United States
| | - Laura E. Smith
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY, United States
| | - Frederick A. Armah
- Department of Environmental Science, University of Cape Coast, Cape Coast, Ghana
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21
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de Korte JQ, Bongers CCWG, Catoire M, Kingma BRM, Eijsvogels TMH. Cooling vests alleviate perceptual heat strain perceived by COVID-19 nurses. Temperature (Austin) 2021; 9:103-113. [PMID: 35655667 PMCID: PMC9154750 DOI: 10.1080/23328940.2020.1868386] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Cooling vests alleviate heat strain. We quantified the perceptual and physiological heat strain and assessed the effects of wearing a 21°C phase change material cooling vest on these measures during work shifts of COVID-19 nurses wearing personal protective equipment (PPE). Seventeen nurses were monitored on two working days, consisting of a control (PPE only) and a cooling vest day (PPE + cooling vest). Sub-PPE air temperature, gastrointestinal temperature (Tgi), and heart rate (HR) were measured continuously. Thermal comfort (2 [1–4] versus 1 [1–2], pcondtition < 0.001) and thermal sensation (5 [4–7] versus 4 [2–7], pcondition < 0.001) improved in the cooling vest versus control condition. Only 18% of nurses reported thermal discomfort and 36% a (slightly) warm thermal sensation in the cooling vest condition versus 81% and 94% in the control condition (OR (95%CI) 0.05 (0.01–0.29) and 0.04 (<0.01–0.35), respectively). Accordingly, perceptual strain index was lower in the cooling vest versus control condition (5.7 ± 1.5 versus 4.3 ± 1.7, pcondition < 0.001, respectively). No differences were observed for the physiological heat strain index Tgi and rating of perceived exertion across conditions. Average HR was slightly lower in the cooling vest versus the control condition (85 ± 12 versus 87 ± 11, pcondition = 0.025). Although the physiological heat strain among nurses using PPE was limited, substantial perceptual heat strain was experienced. A 21°C phase change material cooling vest can successfully alleviate the perceptual heat strain encountered by nurses wearing PPE.
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Affiliation(s)
- Johannus Q. de Korte
- Radboud university medical center, Radboud Institute for Health Sciences, Department of Physiology, Nijmegen, The Netherlands
| | - Coen C. W. G. Bongers
- Radboud university medical center, Radboud Institute for Health Sciences, Department of Physiology, Nijmegen, The Netherlands
| | - Milène Catoire
- TNO, the Netherlands Organization for Applied Sciences, Department of Human Performance, Unit Defence, Safety and Security, Soesterberg, The Netherlands
| | - Boris R. M. Kingma
- TNO, the Netherlands Organization for Applied Sciences, Department of Human Performance, Unit Defence, Safety and Security, Soesterberg, The Netherlands
- University of Copenhagen, Department of Nutrition, Exercise and Sports, Section for Integrative Physiology, Copenhagen, Denmark
| | - Thijs M. H. Eijsvogels
- Radboud university medical center, Radboud Institute for Health Sciences, Department of Physiology, Nijmegen, The Netherlands
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22
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Morris NB, Piil JF, Christiansen L, Flouris AD, Nybo L. Prolonged facemask use in the heat worsens dyspnea without compromising motor-cognitive performance. Temperature (Austin) 2020; 8:160-165. [PMID: 33997114 PMCID: PMC8098073 DOI: 10.1080/23328940.2020.1826840] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Background: Within the context of the COVID-19 pandemic, the WHO endorses facemask use to limit aerosol-spreading of the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, concerns have been raised regarding facemask-associated dyspnea, thermal distress and self-reported impairment of cognition. Accordingly, we tested how facemask-use affects motor-cognitive performances of relevance for occupational safety. We hypothesized that mask use would affect cognitively dominated performances and thermal discomfort, but not alter whole-body thermal balance. Methods: Eight participants completed a facemask and a barefaced (control) trial, in a counterbalanced order, in 40°C and 20% humidity conditions. Motor-cognitive performance, physiological (rectal, mean skin and local facial temperatures) and perceptual (thermal comfort and dyspnea) measures were assessed at baseline and following 45 min of light work (100 W). Results: Perceived dyspnea was aggravated with prolonged facemask use (p = 0.04), resulting in 36% greater breathlessness compared to control. However, no other differences were observed in motor-cognitive performance, physiological strain, or thermal discomfort. Conclusions: Contradicting negative self-reported impacts of facemask-use, only dyspnea was aggravated in the present study, thereby reinforcing global recommendations of mask use, even in hot environments. (Funded by: European Union’s Horizon 2020 research and innovation program under the grant agreement No 668786).
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Affiliation(s)
- Nathan B Morris
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Jacob F Piil
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Lasse Christiansen
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital, Copenhagen, Denmark
| | - Andreas D Flouris
- FAME Laboratory, Department of Exercise Science, University of Thessaly, Trikala, Greece
| | - Lars Nybo
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
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