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Ungar R, Gur-Arie R, Heriot GS, Jamrozik E. Burdens of infection control on healthcare workers: a scoping review. J Hosp Infect 2024; 146:76-81. [PMID: 38141665 DOI: 10.1016/j.jhin.2023.12.003] [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: 03/30/2023] [Revised: 12/05/2023] [Accepted: 12/14/2023] [Indexed: 12/25/2023]
Abstract
INTRODUCTION Hospital-acquired infections (HAIs) pose a significant risk to patients, and are a major focus of infection prevention and control policies (IPC). One under-recognized reason for the generally poor compliance with IPC is that it is burdensome for healthcare workers (HCWs). AIM To identify the burdens of IPC for HCWs. METHODS PubMed and CINAHL were searched for studies published in English since 2000 regarding compliance with IPC and the burdens associated with compliance. After screening 1018 initial results, 25 articles were included in the final review. RESULTS Evidence was found for burdens including dermatological complications, headaches, sensory symptoms and time pressure. Tools designed to measure compliance with IPC have limitations, and rarely assess the burdens of compliance. A strong safety culture predicted positive compliance, while knowledge of the underlying rationale for IPC had a non-linear relationship with compliance. CONCLUSION Future research should clarify IPC-related burdens and how these may be minimized to achieve better compliance.
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Affiliation(s)
- R Ungar
- Melbourne Medical School, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Australia
| | - R Gur-Arie
- Center for Health Promotion and Disease Prevention, Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA
| | - G S Heriot
- Department of Infectious Diseases, University of Melbourne, Peter Doherty Institute for Infection and Immunity, Melbourne, Australia
| | - E Jamrozik
- Ethox Centre and Pandemic Sciences Institute, University of Oxford, Oxford, UK; Department of Medicine, Royal Melbourne Hospital, University of Melbourne, Melbourne, Australia; Monash Bioethics Centre, Monash University, Melbourne, Australia.
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Hou X, He Y, Chen F, Li Y, Wu M, Chen K, Zhou Z. The relationship between the frequency of headaches associated with the personal protective equipment and its influencing factors is mediated by depression: A cross-sectional study. Heliyon 2024; 10:e24744. [PMID: 38317913 PMCID: PMC10839872 DOI: 10.1016/j.heliyon.2024.e24744] [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: 09/21/2023] [Revised: 12/03/2023] [Accepted: 01/12/2024] [Indexed: 02/07/2024] Open
Abstract
Background To evaluate the factors affecting personal protective equipment (PPE) associated with headaches in healthcare workers during the first hit of coronavirus disease 2019 (COVID-19) outbreak in China in order to provide evidence for improving the prevention and treatment of PPE-associated headaches in frontline medical personnel. Methods In this cross-sectional study, the baseline characteristics and the prevalence of the PPE-associated headaches among frontline healthcare workers at Wuhan Taikang Hospital were objectively evaluated by means of a questionnaire survey. We obtained predictors of PPE-associated headaches frequency by multiple regression analyses. The path analysis model was applied to determine the interrelationships between the variables related to PPE-associated headaches frequency. Results Among the 520 participants, 436 (83.85 %) reported PPE-associated headaches during the anti-epidemic period. Compare with non-PPE-associated headache, age, PHQ-9 score >10, nurses, and PSQI>5were statistically significant found in participants with PPE-associated headaches. Multivariable linear regression showed that the occupation(nurse), pre-existing primary headache diagnosis, headache intensity and depression were risk factors for the frequency of PPE-associated headaches. The path analysis model observed that direct effects from occupation (nurse), pre-existing primary headache diagnosis, headache intensity and depression on the frequency of PPE-associated headaches. Depression indirectly mediated the effects of headache intensity and sleep quality on headache frequency. (All P < 0.05). Conclusion This study provided a path analysis model that illustrates the relationships between PPE-associated headaches frequency and its related factors among healthcare workers during the COVID-19 pandemic. It is crucial to the management of PPE-associated headaches to reduce its consequences for frontline healthcare workers.
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Affiliation(s)
- Xianhua Hou
- Department of Neurology, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
- Wuhan Taikang Tongji Hospital, Wuhan, China
| | - Yuxuan He
- Department of Neurology, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Fei Chen
- Department of Neurology, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Yang Li
- Department of Neurology, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
- Wuhan Taikang Tongji Hospital, Wuhan, China
| | - Min Wu
- Department of Neurology, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Kangning Chen
- Department of Neurology, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
- Wuhan Taikang Tongji Hospital, Wuhan, China
| | - Zhenhua Zhou
- Department of Neurology, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
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Yüksel Aslıer NG, Karataş M. Eustachian tube dysfunction after using different types of masks during the coronavirus disease 2019 pandemic. J Laryngol Otol 2024:1-5. [PMID: 38224045 DOI: 10.1017/s0022215124000124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2024]
Abstract
OBJECTIVE This study aimed to investigate the relationship between the use of different types of masks (N95/filtering facepiece type 2, surgical) and Eustachian tube dysfunction in healthcare workers. METHODS The study included 37 healthcare workers using N95/filtering facepiece type 2 masks and 35 using surgical masks for at least 6 hours per day, and 42 volunteers who are not healthcare workers using surgical masks for less than 6 hours per day. Participants' demographic features, clinical data and Eustachian Tube Dysfunction Questionnaire scores were compared. RESULTS The frequencies of autophony and aural fullness were significantly higher in the healthcare workers using N95/filtering facepiece type 2 masks. Autophony and aural fullness were significantly greater in the post-mask period than the pre-mask period. Middle-ear peak pressures and Eustachian Tube Dysfunction Questionnaire scores were higher in healthcare workers who used N95/filtering facepiece type 2 masks. CONCLUSION Healthcare workers who used N95/filtering facepiece type 2 masks had worsened middle-ear pressures and Eustachian Tube Dysfunction Questionnaire scores. Use of N95/filtering facepiece type 2 masks was associated with higher rates of autophony, aural fullness and higher Eustachian Tube Dysfunction Questionnaire scores in the post-mask period.
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Affiliation(s)
- Nesibe Gül Yüksel Aslıer
- Department of Otorhinolaryngology, Health Science University, Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey
| | - Mesut Karataş
- Department of Otorhinolaryngology, Health Science University, Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey
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Harber P, Beckett WS. Health effects of filtering facepiece respirators: Research and clinical implications of comfort, thermal, skin, psychologic, and workplace effects. Am J Ind Med 2023; 66:1017-1032. [PMID: 37702368 DOI: 10.1002/ajim.23535] [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: 06/08/2023] [Revised: 08/28/2023] [Accepted: 09/04/2023] [Indexed: 09/14/2023]
Abstract
Filtering facepiece respirators (FFR's) such as N95s have become widely used in appropriate settings for personal respiratory protection and are increasingly used beyond workplace settings. Concerns about possible adverse effects have appeared in many publications, particularly since the COVID-19 pandemic led to much more widespread use. This paper synthesizes known effects based upon review of publications in PubMed since 1995, addressing effects other than pulmonary and cardiovascular (reviewed elsewhere). Findings: (1) Subjective discomfort is very frequently reported; this includes general discomfort or organ-system-specific complaints such as respiratory, headache, dermatologic, and heat. Research methods are widely divergent, and we propose a taxonomy to classify such studies by methodology, study population (subjects, experimental vs. observational methodology, comparator, specificity, and timeframe) to facilitate synthesis. (2) Objective measures of increased heat and humidity within the mask are well documented. (3) Frequency and characteristics of dermatologic effects have been insufficiently evaluated. (4) Physical mask designs are varied, making generalizations challenging. (5) More studies of impact on work performance and communication are needed. (6) Studies of effect of FFR design and accompanying training materials on ease and consistency of use are needed.
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Affiliation(s)
- Philip Harber
- Environmental Health Sciences, University of Arizona Mel and Enid Zuckerman College of Public Health, Tucson, Arizona, USA
| | - William S Beckett
- Mount Auburn Hospital (Emeritus Status), Cambridge, Massachusetts, USA
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Al-Qudimat AR, Singh K, Mustafa E, Nashwan AJ, Al-Zoubi RM, Yassin A, Aboumarzouk OM, Al-Ansari A. Psychosocial impact of COVID-19 pandemic: experience of healthcare workers in Qatar. Front Public Health 2023; 11:1283925. [PMID: 37927872 PMCID: PMC10620932 DOI: 10.3389/fpubh.2023.1283925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Accepted: 09/28/2023] [Indexed: 11/07/2023] Open
Abstract
Background The COVID-19 pandemic has had a profound and global impact on healthcare systems worldwide, presenting unprecedented challenges for healthcare workers (HCWs) on the front. We aimed to evaluate the prevalence of anxiety and depression symptoms during the coronavirus pandemic among healthcare professionals in Qatar. Methods A cross-sectional study where an electronic questionnaire containing demographics, and psychosocial questions were made on Google Docs and Microsoft Team, and were sent through email and WhatsApp to healthcare workers, including doctors, nurses, allied health and others working at Hamad Medical Corporation in Qatar, from June 1, 2021, to January 1st 2023. ANOVA, t-test and multiple linear regression were used to see the association between the psychological factors and sociodemographic variables using STATA version 17 software. Results A total of 829 participants were included in this study (response rate: 55%). The average age of the participants is 36.0 ± 7.1; 65.9% were males; 2.3% were doctors and 53% were nurses, 38.7% were allied healthcare professionals and 6% were others. Psychological, social effects, and workplace were shown to significantly related to their marital status, career, and hospital setting (p < 0.01 for each). Similar to this, dealing with COVID-19 patients and their education level with the length of time working at the designated facility were all connected with the health professional safety score (p < 0.05). Conclusion During the COVID-19 epidemic, healthcare workers in Qatar experienced a high incidence of negative psychosocial symptoms. To alleviate these outcomes, it would be useful to implement screening procedures for such symptoms and to devise preventive measures accordingly.
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Affiliation(s)
- Ahmad R. Al-Qudimat
- Surgical Research Section, Department of Surgery, Hamad Medical Corporation, Doha, Qatar
- Department of Public Health, College of Health Sciences, QU-Health, Qatar University, Doha, Qatar
| | - Kalpana Singh
- Department of Nursing Research, Hamad Medical Corporation, Doha, Qatar
| | - Emad Mustafa
- Department of Nursing Research, Hamad Medical Corporation, Doha, Qatar
| | | | - Raed M. Al-Zoubi
- Surgical Research Section, Department of Surgery, Hamad Medical Corporation, Doha, Qatar
- Department of Biomedical Sciences, College of Health Sciences, QU-Health, Qatar University, Doha, Qatar
- Department of Chemistry, College of Science, Jordan University of Science and Technology, Irbid, Jordan
| | - Aksam Yassin
- Surgical Research Section, Department of Surgery, Hamad Medical Corporation, Doha, Qatar
- Center of Medicine and Health Sciences, Dresden International University, Dresden, Germany
| | - Omar M. Aboumarzouk
- Surgical Research Section, Department of Surgery, Hamad Medical Corporation, Doha, Qatar
- School of Medicine, Dentistry and Nursing, The University of Glasgow, Glasgow, United Kingdom
| | - Abdulla Al-Ansari
- Surgical Research Section, Department of Surgery, Hamad Medical Corporation, Doha, Qatar
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Kumar P, Nath K, Prasad A, Tiwari LK, Chowdhry BK, Sinha AK, Chaudhary N. Effects of the Use of N95 Masks on the Vital Signs of Healthy Healthcare Workers During the COVID-19 Pandemic: A Hospital-Based Cross-Sectional Study. Cureus 2023; 15:e40622. [PMID: 37476108 PMCID: PMC10355089 DOI: 10.7759/cureus.40622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/19/2023] [Indexed: 07/22/2023] Open
Abstract
BACKGROUND AND AIMS The N95 filtering facepiece respirator (FR) is the most commonly recommended respiratory protection used in healthcare settings. However, concerns have been raised about its use because it can increase respiratory resistance and dead space. The primary objective of this study was to determine the effect of wearing N95 masks on the vital signs, i.e., oxygen saturation, pulse rate, and respiratory rate, of the participant health workers. Our secondary objective was to assess the subjective feeling of discomfort when wearing N95 masks. METHODS The study participants were healthy healthcare workers taking care of coronavirus disease 2019 (COVID-19)-infected pediatric cases who did at least six hours of continuous shift duty in the pediatric COVID-19 ward at a tertiary care hospital in the eastern part of India. They were evaluated for vital signs at various time intervals while wearing N95 masks. Subjective discomfort at any point in time was also noted. RESULTS We found a significant variation in the mean oxygen saturation (SpO2) and heart rate (HR) reduction across the four different points. The pair-wise comparison showed a small but significant decrease in the mean SpO2 of 98.3% (1.1) at six hours as compared with a mean SpO2 of 98.7% (0.9) at three hours. Similarly, a significant increase was noted for a mean HR of 84.7 bpm (11.2) at six hours compared with a baseline of 82.3 bpm (9.2) and 83.2 bpm (8.8) at three hours. CONCLUSION The continuous use of an N95 mask leads to a mild increase in respiratory rate. However, heart rate and oxygen saturation vary significantly at different points in time after N95 mask use.
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Affiliation(s)
- Pradeep Kumar
- Pediatrics, All India Institute of Medical Sciences, Patna, IND
| | - Kunal Nath
- Pediatrics, All India Institute of Medical Sciences, Patna, IND
| | - Arun Prasad
- Pediatrics, All India Institute of Medical Sciences, Patna, IND
| | - Lokesh K Tiwari
- Pediatrics, All India Institute of Medical Sciences, Rishikesh, IND
| | | | - Amit K Sinha
- Pediatric Surgery, All India Institute of Medical Sciences, Patna, IND
| | - Neha Chaudhary
- Community and Family Medicine, All India Institute of Medical Sciences, Patna, IND
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van Kampen V, Marek EM, Sucker K, Jettkant B, Kendzia B, Strauß B, Ulbrich M, Deckert A, Berresheim H, Eisenhawer C, Hoffmeyer F, Weidhaas S, Behrens T, Brüning T, Bünger J. Influence of face masks on the subjective impairment at different physical workloads. Sci Rep 2023; 13:8133. [PMID: 37208370 DOI: 10.1038/s41598-023-34319-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 04/27/2023] [Indexed: 05/21/2023] Open
Abstract
To quantify the subjective and cognitive impairment caused by wearing face masks at work, 20 men and 20 women (median age 47 years, range 19-65) were tested under different ergometer workloads while wearing surgical mask, community mask, FFP2 respirator or no mask in a randomized and partially double-blinded design. Masks were worn also at the workplace for four hours. Subjective impairment was recorded by questionnaires. Cognitive performance was tested before and after the workplace examination. Subjective feeling of heat, humidity, and difficult breathing increased with rising physical exertion and wearing time for all three mask types, most notably for FFP2. Even when blinded, participants with FFP2 reported difficult breathing already at rest. During physical exertion, individuals with low tolerance to discomfort reported significantly stronger impairment (OR 1.14, 95% CI 1.02-1.27). Regarding light work, older subjects (OR 0.95, 95% CI 0.92-0.98) and women (OR 0.84, 95% CI 0.72-0.99) showed significantly lower and atopic subjects stronger impairment (OR 1.16, 95% CI 1.06-1.27). No significant influence of mask wearing was detected on cognitive performance. Wearing a mask had no effect on cognitive performance, but led to discomfort which increased with physical exertion and wearing time. Individuals who tolerate discomfort poorly felt more impaired by wearing a mask during physical exertion.
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Affiliation(s)
- Vera van Kampen
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Bürkle-de-la-Camp-Platz 1, 44789, Bochum, Germany.
| | - Eike-Maximillian Marek
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Bürkle-de-la-Camp-Platz 1, 44789, Bochum, Germany
| | - Kirsten Sucker
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Bürkle-de-la-Camp-Platz 1, 44789, Bochum, Germany
| | - Birger Jettkant
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Bürkle-de-la-Camp-Platz 1, 44789, Bochum, Germany
| | - Benjamin Kendzia
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Bürkle-de-la-Camp-Platz 1, 44789, Bochum, Germany
| | - Bianca Strauß
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Bürkle-de-la-Camp-Platz 1, 44789, Bochum, Germany
| | - Melanie Ulbrich
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Bürkle-de-la-Camp-Platz 1, 44789, Bochum, Germany
| | - Anja Deckert
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Bürkle-de-la-Camp-Platz 1, 44789, Bochum, Germany
| | - Hans Berresheim
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Bürkle-de-la-Camp-Platz 1, 44789, Bochum, Germany
| | - Christian Eisenhawer
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Bürkle-de-la-Camp-Platz 1, 44789, Bochum, Germany
| | - Frank Hoffmeyer
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Bürkle-de-la-Camp-Platz 1, 44789, Bochum, Germany
| | - Simon Weidhaas
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Bürkle-de-la-Camp-Platz 1, 44789, Bochum, Germany
| | - Thomas Behrens
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Bürkle-de-la-Camp-Platz 1, 44789, Bochum, Germany
| | - Thomas Brüning
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Bürkle-de-la-Camp-Platz 1, 44789, Bochum, Germany
| | - Jürgen Bünger
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Bürkle-de-la-Camp-Platz 1, 44789, Bochum, Germany
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Plaut S. “Long COVID-19” and viral “fibromyalgia-ness”: Suggesting a mechanistic role for fascial myofibroblasts (Nineveh, the shadow is in the fascia). Front Med (Lausanne) 2023; 10:952278. [PMID: 37089610 PMCID: PMC10117846 DOI: 10.3389/fmed.2023.952278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 02/27/2023] [Indexed: 04/08/2023] Open
Abstract
The coronavirus pandemic has led to a wave of chronic disease cases; “Long COVID-19” is recognized as a new medical entity and resembles “fibromyalgia” which, likewise, lacks a clear mechanism. Observational studies indicate that up to 30%–40% of convalescent COVID-19 patients develop chronic widespread pain and fatigue and fulfill the 2016 diagnostic criteria for “fibromyalgia.” A recent study suggested a theoretical neuro-biomechanical model (coined “Fascial Armoring”) to help explain the pathogenesis and cellular pathway of fibromyalgia, pointing toward mechanical abnormalities in connective tissue and fascia, driven by contractile myo/fibroblasts and altered extracellular matrix remodeling with downstream corresponding neurophysiological aberrations. This may help explain several of fibromyalgia’s manifestations such as pain, distribution of pain, trigger points/tender spots, hyperalgesia, chronic fatigue, cardiovascular abnormalities, metabolic abnormalities, autonomic abnormalities, small fiber neuropathy, various psychosomatic symptoms, lack of obvious inflammation, and silent imaging investigations. Pro-inflammatory and pro-fibrotic pathways provide input into this mechanism via stimulation of proto/myofibroblasts. In this hypothesis and theory paper the theoretical model of Fascial Armoring is presented to help explain the pathogenesis and manifestations of “long COVID-19” as a disease of immuno-rheumo-psycho-neurology. The model is also used to make testable experimental predictions on investigations and predict risk and relieving factors.
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Kisielinski K, Hirsch O, Wagner S, Wojtasik B, Funken S, Klosterhalfen B, Kanti Manna S, Prescher A, Sukul P, Sönnichsen A. Physio-metabolic and clinical consequences of wearing face masks—Systematic review with meta-analysis and comprehensive evaluation. Front Public Health 2023; 11:1125150. [PMID: 37089476 PMCID: PMC10116418 DOI: 10.3389/fpubh.2023.1125150] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 02/17/2023] [Indexed: 04/08/2023] Open
Abstract
BackgroundAs face masks became mandatory in most countries during the COVID-19 pandemic, adverse effects require substantiated investigation.MethodsA systematic review of 2,168 studies on adverse medical mask effects yielded 54 publications for synthesis and 37 studies for meta-analysis (on n = 8,641, m = 2,482, f = 6,159, age = 34.8 ± 12.5). The median trial duration was only 18 min (IQR = 50) for our comprehensive evaluation of mask induced physio-metabolic and clinical outcomes.ResultsWe found significant effects in both medical surgical and N95 masks, with a greater impact of the second. These effects included decreased SpO2 (overall Standard Mean Difference, SMD = −0.24, 95% CI = −0.38 to −0.11, p < 0.001) and minute ventilation (SMD = −0.72, 95% CI = −0.99 to −0.46, p < 0.001), simultaneous increased in blood-CO2 (SMD = +0.64, 95% CI = 0.31–0.96, p < 0.001), heart rate (N95: SMD = +0.22, 95% CI = 0.03–0.41, p = 0.02), systolic blood pressure (surgical: SMD = +0.21, 95% CI = 0.03–0.39, p = 0.02), skin temperature (overall SMD = +0.80 95% CI = 0.23–1.38, p = 0.006) and humidity (SMD +2.24, 95% CI = 1.32–3.17, p < 0.001). Effects on exertion (overall SMD = +0.9, surgical = +0.63, N95 = +1.19), discomfort (SMD = +1.16), dyspnoea (SMD = +1.46), heat (SMD = +0.70), and humidity (SMD = +0.9) were significant in n = 373 with a robust relationship to mask wearing (p < 0.006 to p < 0.001). Pooled symptom prevalence (n = 8,128) was significant for: headache (62%, p < 0.001), acne (38%, p < 0.001), skin irritation (36%, p < 0.001), dyspnoea (33%, p < 0.001), heat (26%, p < 0.001), itching (26%, p < 0.001), voice disorder (23%, p < 0.03), and dizziness (5%, p = 0.01).DiscussionMasks interfered with O2-uptake and CO2-release and compromised respiratory compensation. Though evaluated wearing durations are shorter than daily/prolonged use, outcomes independently validate mask-induced exhaustion-syndrome (MIES) and down-stream physio-metabolic disfunctions. MIES can have long-term clinical consequences, especially for vulnerable groups. So far, several mask related symptoms may have been misinterpreted as long COVID-19 symptoms. In any case, the possible MIES contrasts with the WHO definition of health.ConclusionFace mask side-effects must be assessed (risk-benefit) against the available evidence of their effectiveness against viral transmissions. In the absence of strong empirical evidence of effectiveness, mask wearing should not be mandated let alone enforced by law.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021256694, identifier: PROSPERO 2021 CRD42021256694.
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Affiliation(s)
- Kai Kisielinski
- Orthopaedic and Trauma Surgery, Clinical Medicine, Private Practice, Düsseldorf, Germany
- *Correspondence: Kai Kisielinski
| | - Oliver Hirsch
- Department of Psychology, Fachhochschule für Oekonomie und Management (FOM) University of Applied Sciences, Siegen, Germany
| | - Susanne Wagner
- Veterinary Medicine, Wagner Medical Science Liason (MSL) Management, Blankenfelde-Mahlow, Germany
| | - Barbara Wojtasik
- Department of Genetics and Biosystematics, Faculty of Biology, University of Gdańsk, Gdansk, Poland
| | - Stefan Funken
- Internal Medicine, Clinical Medicine, Private Practice, Moers, Germany
| | | | - Soumen Kanti Manna
- Biophysics and Structural Genomics Division, Saha Institute of Nuclear Physics, Kolkata, India
| | - Andreas Prescher
- Institute of Molecular and Cellular Anatomy (MOCA), Rhine-Westphalia Technical University of Aachen, Aachen, Germany
| | - Pritam Sukul
- Rostock Medical Breath Research Analytics and Technologies (ROMBAT), Department of Anesthesiology and Intensive Care, University Medicine Rostock, Rostock, Germany
- Pritam Sukul
| | - Andreas Sönnichsen
- Internal Medicine, Clinical Medicine, Private Practice, Gesundheit für Österreich e.V. (Health for Austria), Vienna, Austria
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10
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Demirag ME, Akyil M, Karasal M, Bayram S, Metin SK, Tokgoz FA, Baysungur V, Evman S. Prospective analysis of the physiological changes caused by prolonged use of N95-type masks. Ann Thorac Med 2023; 18:86-89. [PMID: 37323373 PMCID: PMC10263074 DOI: 10.4103/atm.atm_429_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Revised: 01/29/2023] [Accepted: 02/09/2023] [Indexed: 06/17/2023] Open
Abstract
INTRODUCTION The clinical and physiological effects of long-duration use of N95-type masks without ventilation valves, on health-care workers during the coronavirus disease-2019 (COVID-19) pandemic, were evaluated. METHODS All volunteering personnel working in operating theater or intensive care unit, using nonventilated N95 type respiratory masks, minimum for a 2-h noninterrupted duration were observed. The partial oxygen saturation (SpO2) and heart rate (HR) were recorded before wearing the N95 mask and at 1st and 2nd h. Volunteers were then questioned for any symptoms. RESULTS A total of 210 measurements were completed in 42 (24 males and 18 females) eligible volunteers, each having 5 measurements, on different days. The median age was 32.7. Premask, 1st h, and 2nd h median values for SpO2 were 99%, 97%, and 96%, respectively (P < 0.001). The median HR was 75 premask, 79 at 1st h, and 84/min at 2nd h (P < 0.001). A significant difference between all three consecutive measurements of HR was achieved. Statistical difference was only reached between premask and other SpO2 measurements (1st and 2nd h). Complaints seen in the group were head ache (36%), shortness of breath (27%), palpitation (18%), and nausea feeling (2%). Two individuals took off their masks to breathe, on 87th and 105th min, respectively. CONCLUSIONS Long duration (>1 h) use of N95-type masks causes a significant reduction in SpO2 measurements and increase in HR. Despite being an essential personal protective equipment in COVID-19 pandemic, it should be used with short intermittent time periods in health-care providers with known heart disease, pulmonary insufficiency, or psychiatric disorders.
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Affiliation(s)
- Melis E. Demirag
- Department of Otorhinolaryngology, Kartal Lutfi Kirdar Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Mustafa Akyil
- Department of Thoracic Surgery, Sureyyapasa Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Merve Karasal
- Department of Thoracic Surgery, Sureyyapasa Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Serkan Bayram
- Department of Thoracic Surgery, Sureyyapasa Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Serda Kanbur Metin
- Department of Thoracic Surgery, Sureyyapasa Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Fatma A. Tokgoz
- Department of Pulmonology, Yedikule Chest Diseases Hospital, University of Health Sciences, Istanbul, Turkey
| | - Volkan Baysungur
- Department of Thoracic Surgery, Sureyyapasa Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Serdar Evman
- Department of Thoracic Surgery, Sureyyapasa Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
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11
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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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12
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Patel S, Mohapatra E, Suganthy AK, Shah S, Abraham J, Nanda R, Behera AK, Gupta A. A pilot study to evaluate the changes in venous blood gas parameters and hypoxia biomarkers in health care workers using different kinds of masks. Lung India 2023; 40:134-142. [PMID: 37006097 PMCID: PMC10174648 DOI: 10.4103/lungindia.lungindia_343_22] [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: 06/29/2022] [Revised: 07/21/2022] [Accepted: 08/01/2022] [Indexed: 03/05/2023] Open
Abstract
Background The study is aimed to investigate the metabolic alterations and changes in biochemical parameters associated with extended mask. Methods It was a prospective comparative study conducted on 129 participants comprised of 37 healthy controls and 92 health care workers using different kind of masks like, cloth mask, surgical masks and N95-FFR/PPE. Two samples on day-1 and day-10 were collected for analysis of blood gas parameters, serum hypoxia-inducible factor-α (HIF-α), and erythropoietin (EPO). Results Oxygen saturation percentage (sO2) of 72.68 (P = 0.033) was significantly low, whereas, Na+ (P = 0.05) and Ca2+ (P < 0.001) were raised in exposed individuals than the healthy controls. The serum HIF-α level of 3.26 ng/mL, was considerable higher in the exposed individuals than controls (P = 0.001). pO2 and sO2 were the lowest and HIF-α and EPO were raised in N95-FFR/PPE of all mask users (P < 0.01). A significant difference was evidenced for pCO2, pH, Na+, Ca2+, and EPO in the exposed group. A positive correlation between the duration of mask use (in hours) with HIF-α (r = 0.247, P = 0.005) and Ca2+ (r = 0.306, P < 0.001) was observed. The major complaints in N95-FFR/PPE users were headache (15.2%) and polydipsia (33.3%). Conclusion The study findings depicted a significant metabolic alterations in PPE/N95 users which could be due to chronic hypoxic exposure of the tissues.
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Affiliation(s)
- Suprava Patel
- Department of Biochemistry, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India
| | - Eli Mohapatra
- Department of Biochemistry, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India
| | - Asha K. Suganthy
- Department of Biochemistry, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India
| | - Seema Shah
- Department of Biochemistry, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India
| | - Jessy Abraham
- Department of Biochemistry, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India
| | - Rachita Nanda
- Department of Biochemistry, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India
| | - Ajoy K. Behera
- Department of Pulmonary Medicine, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India
| | - Ashish Gupta
- Department of Pathology and Laboratory Medicine, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India
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13
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Park SY, Cheong HS, Kwon KT, Sohn KM, Heo ST, Lee S, Chung US, Lee SH. Guidelines for Infection Control and Burnout Prevention in Healthcare Workers Responding to COVID-19. Infect Chemother 2023; 55:150-165. [PMID: 37021430 PMCID: PMC10079438 DOI: 10.3947/ic.2022.0164] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 02/27/2023] [Indexed: 03/30/2023] Open
Abstract
During the coronavirus disease 2019 (COVID-19) pandemic, frontline healthcare workers (HCWs) suffered more distress from the possibility of contracting the virus, quarantine, social stigma, and prejudice against their families. Many studies have investigated the impact of the pandemic on HCWs; however, studies or guidelines presenting strategies to overcome these challenges are lacking. As part of a 2020 research project supported by the Ministry of Health and Welfare, titled "Health impact assessment of healthcare workers undertaking coronavirus disease 2019 treatment and management in Korea: Identifying problems and researching effective solutions" (HC20C0003), we created guidelines to respond to serious problems posed by infection control. and burnout among HCWs during COVID-19 response measures throughout the extended pandemic period. We formulated the guidelines by means of a systematic review and collated them with the latest literature. The guidelines will highlight the gravity and impact of infection control and burnout among HCWs responding to COVID-19 and include potential prevention strategies, and they can be used as a reference in the event of another emerging infectious disease outbreak in the future.
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Affiliation(s)
- Se Yoon Park
- Department of Hospital Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Korea
- Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Korea
- Centers for Digital Health, Yongin Severance Hospital, Yonsei University Health System, Yongin, Korea
| | - Hae Suk Cheong
- Division of Infectious Diseases, Department of Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, Korea
| | - Ki Tae Kwon
- Division of Infectious Diseases, Department of Internal Medicine, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University, Daegu, Korea.
| | - Kyung Mok Sohn
- Division of Infectious Diseases, Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Korea
| | - Sang Taek Heo
- Department of Internal Medicine, Jeju National University School of Medicine, Jeju, Korea
| | - Shinwon Lee
- Department of Internal Medicine, Pusan National University School of Medicine and Medical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Un Sun Chung
- Department of Psychiatry, School of Medicine, Kyungpook National University, Daegu, Korea
| | - So Hee Lee
- Department of Psychiatry, National Medical Center, Seoul, Korea
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14
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Metin KM, Semercioğlu CS, Hatipoğlu ÇA, Esmer H, Kayretli H, İnan LE, Kınıklı S, Yoldaş TK. Headache caused by the use of personal protective equipment in healthcare workers during the COVID-19 pandemic period. Heliyon 2023; 9:e14493. [PMID: 36942249 PMCID: PMC10008808 DOI: 10.1016/j.heliyon.2023.e14493] [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: 11/15/2022] [Revised: 02/28/2023] [Accepted: 03/08/2023] [Indexed: 03/14/2023] Open
Abstract
Objective Coronavirus 2019 disease (COVID-19), the cause of the ongoing pandemic, is an acute respiratory tract infection, which has made it necessary for healthcare personnel to use protective equipment such as N95 masks, protective goggles and visors. External compression headaches caused by the compression of the pericranial soft tissues by wearing hats, helmets, or goggles (worn during swimming or diving) have been previously described. In our study, we aimed to evaluate the presence and characteristics of personal protective equipment-associated headaches in healthcare workers during the COVID-19 pandemic period and to determine the effects of such headaches. Materials and methods A face-to-face questionnaire was delivered to 300 male and female healthcare personnel between the ages of 18-56 working in healthcare units where COVID-19 patients were evaluated and treated. The data from 296 completed questionnaires was evaluated. Results We included 296 participants (166 females and 130 males) in our study; the mean age was 33.98 ± 8.52 years (range 18-56). One hundred ninety-six (66.22%) participants indicated that they had new onset personal protective equipment-associated headaches. Percentages of those with newly emergent headaches because of protective equipment were higher in the following participant groups: females (p = 0.045), those with COVID-19 disease history (p < 0.001), and those diagnosed with headaches before the pandemic (p = 0.001). Conclusion Our study showed the presence of new-onset headaches associated with personal protective equipment in healthcare workers during the COVID-19 pandemic. Personal protective equipment-related headaches were associated with the following factors: female sex, a history of COVID-19 disease, and the presence of primary headaches diagnosed before the pandemic.
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Affiliation(s)
- Kübra Mehel Metin
- Ministry of Health Ankara Training and Research Hospital, Neurology Clinic, Ankara, Turkey
| | | | - Çiğdem Ataman Hatipoğlu
- Ministry of Health Ankara Training and Research Hospital, İnfectious Diseases Clinic, Ankara, Turkey
| | - Hüseyin Esmer
- Ministry of Health Ankara Training and Research Hospital, İnfectious Diseases Clinic, Ankara, Turkey
| | - Hatice Kayretli
- Ministry of Health Ankara Training and Research Hospital, İnfectious Diseases Clinic, Ankara, Turkey
| | - Levent Ertuğrul İnan
- Ministry of Health Ankara Training and Research Hospital, Neurology Clinic, Ankara, Turkey
| | - Sami Kınıklı
- Ministry of Health Ankara Training and Research Hospital, İnfectious Diseases Clinic, Ankara, Turkey
| | - Tahir Kurtuluş Yoldaş
- Ministry of Health Ankara Training and Research Hospital, Neurology Clinic, Ankara, Turkey
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15
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Zhu Y, Mao Y, Li Y, Tang T, Jiang H, Qiao S, Lin S, Zheng Z, Fang Z, Chen X. Field investigation of the heat stress in outdoor of healthcare workers wearing personal protective equipment in South China. Front Public Health 2023; 11:1166056. [PMID: 37143989 PMCID: PMC10151780 DOI: 10.3389/fpubh.2023.1166056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 03/20/2023] [Indexed: 05/06/2023] Open
Abstract
Since the advent of coronavirus disease 2019 (COVID-19), healthcare workers (HCWs) wearing personal protective equipment (PPE) has become a common phenomenon. COVID-19 outbreaks overlap with heat waves, and healthcare workers must unfortunately wear PPE during hot weather and experience excessive heat stress. Healthcare workers are at risk of developing heat-related health problems during hot periods in South China. The investigation of thermal response to heat stress among HCWs when they do not wear PPE and when they finish work wearing PPE, and the impact of PPE use on HCWs' physical health were conducted. The field survey were conducted in Guangzhou, including 11 districts. In this survey, HCWs were invited to answer a questionnaire about their heat perception in the thermal environment around them. Most HCWs experienced discomfort in their back, head, face, etc., and nearly 80% of HCWs experienced "profuse sweating." Up to 96.81% of HCWs felt "hot" or "very hot." The air temperature had a significant impact on thermal comfort. Healthcare workers' whole thermal sensation and local thermal sensation were increased significantly by wearing PPE and their thermal sensation vote (TSV) tended towards "very hot." The adaptive ability of the healthcare workers would decreased while wearing PPE. In addition, the accept range of the air temperature (T a) were determined in this investigation. Graphical Abstract.
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Affiliation(s)
- Yongcheng Zhu
- The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yudong Mao
- School of Civil Engineering, Guangzhou University, Guangzhou, China
| | - Yanling Li
- The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Tianwei Tang
- School of Civil Engineering, Guangzhou University, Guangzhou, China
| | - Huilin Jiang
- The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Sicheng Qiao
- The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Shaopeng Lin
- The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Zhimin Zheng
- School of Civil Engineering, Guangzhou University, Guangzhou, China
| | - Zhaosong Fang
- School of Civil Engineering, Guangzhou University, Guangzhou, China
- Zhaosong Fang,
| | - Xiaohui Chen
- The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- *Correspondence: Xiaohui Chen,
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16
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Grafeneder J, Fuhrmann V, Tscherny K, Niederer M, Schreiber W, Herkner H, Roth D, Kienbacher CL. COVID-19: Masks do not influence neurocognitive performance during a shift at the emergency department. World J Emerg Med 2023; 14:317-321. [PMID: 37425077 PMCID: PMC10323511 DOI: 10.5847/wjem.j.1920-8642.2023.071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 02/27/2023] [Indexed: 07/11/2023] Open
Affiliation(s)
- Jürgen Grafeneder
- Department of Emergency Medicine, Medical University of Vienna, Wien 1090, Austria
| | - Verena Fuhrmann
- Department of Emergency Medicine, Medical University of Vienna, Wien 1090, Austria
| | - Katharina Tscherny
- Department of Emergency Medicine, Medical University of Vienna, Wien 1090, Austria
- Department of Anaesthesiology and Intensive Care, Hospital Scheibbs, Scheibbs 3270, Austria
| | - Maximilian Niederer
- Department of Emergency Medicine, Medical University of Vienna, Wien 1090, Austria
- Department of Anaesthesiology and Intensive Care, Hospital Scheibbs, Scheibbs 3270, Austria
| | - Wolfgang Schreiber
- Department of Emergency Medicine, Medical University of Vienna, Wien 1090, Austria
| | - Harald Herkner
- Department of Emergency Medicine, Medical University of Vienna, Wien 1090, Austria
| | - Dominik Roth
- Department of Emergency Medicine, Medical University of Vienna, Wien 1090, Austria
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17
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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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18
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Jain VM, Parihar SRS, Acharya S, Acharya S. Effects of wearing personal protective equipment (PPE) and its role in affecting the work efficiency of dentists during the COVID-19 pandemic. Work 2023; 76:3-10. [PMID: 36872823 DOI: 10.3233/wor-220083] [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] [Indexed: 03/03/2023] Open
Abstract
BACKGROUND The risk of exposure to COVID-19 infection through droplets/aerosol in dental clinics has renewed focus on the utility and possible adverse effects of using personal protective equipment (PPE) on dentists. OBJECTIVE To obtain information from a cross-section of dentists regarding their PPE usage and to evaluate the possible risk factors that can influence their work efficiency. METHODS A 31-item cross-sectional survey with a structured multiple-choice questionnaire was designed. Social media and emails were used to circulate the questionnaire among dental professionals worldwide. A total of 317 respondents returned the completed forms. RESULTS A total of 184 (55%) participants reported getting soaking wet while wearing PPE at the end of the working hours (approximately eight hours of working). Many respondents (n = 286, 90%) reported that the use of PPE resulted in reduced visibility of the operating field. The majority of respondents (84%) felt that their overall work efficiency had reduced after using PPE. Binary logistic regression had shown that two significant factors that were associated with reduced work efficiency included, pre-existing systemic illness and getting soaking wet from wearing a PPE. CONCLUSION Definite protocols should be introduced that mandate the doffing of PPE for every patient, in a separate well-ventilated area where the skin can recuperate from the heat and pressure points caused by the PPE. Dentists should take greater care in choosing the appropriate PPE to prevent exacerbation of pre-existing illnesses, which may reduce their work efficiency.
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Affiliation(s)
- Vedushi M Jain
- Manipal College of Dental Sciences, Manipal Academy of Higher Education (MAHE), Manipal, India
| | | | - Shruthi Acharya
- Department of Oral Medicine and Radiology, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education (MAHE), Manipal, India
| | - Shashidhar Acharya
- Department of Public Health Dentistry, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education (MAHE), Manipal, India
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Balestracci B, La Regina M, Di Sessa D, Mucci N, Angelone FD, D'Ecclesia A, Fineschi V, Di Tommaso M, Corbetta L, Lachman P, Orlandini F, Tanzini M, Tartaglia R, Squizzato A. Patient safety implications of wearing a face mask for prevention in the era of COVID-19 pandemic: a systematic review and consensus recommendations. Intern Emerg Med 2023; 18:275-296. [PMID: 36103082 PMCID: PMC9472745 DOI: 10.1007/s11739-022-03083-w] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 08/11/2022] [Indexed: 02/01/2023]
Abstract
In the past, the use of face masks in western countries was essentially limited to occupational health. Now, because of the COVID-19 pandemic, mask-wearing has been recommended as a public health intervention. As potential side effects and some contraindications are emerging, we reviewed the literature to assess the impact of them in daily life on patient safety and to provide appropriate guidelines and recommendations. We performed a systematic review of studies investigating physiological impact, safety, and risk of masks in predefined categories of patients, which have been published in peer-reviewed journals with no time and language restrictions. Given the heterogeneity of studies, results were analyzed thematically. We used PRISMA guidelines to report our findings. Wearing a N95 respirator is more associated with worse side effects than wearing a surgical mask with the following complications: breathing difficulties (reduced FiO2, SpO2, PaO2 increased ETCO2, PaCO2), psychiatric symptoms (panic attacks, anxiety) and skin reactions. These complications are related to the duration of use and/or disease severity. Difficulties in communication is another issue to be considered especially with young children, older person and people with hearing impairments. Even if benefits of wearing face masks exceed the discomfort, it is recommended to take an "air break" after 1-2 h consecutively of mask-wearing. However, well-designed prospective studies are needed. The COVID-19 pandemic could represent a unique opportunity for collecting large amount of real-world data.
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Affiliation(s)
- Beatrice Balestracci
- SC Governo e rischio clinico, programmazione sanitaria e controllo di gestione, Azienda Sociosanitaria Ligure 5 (ASL5), La Spezia, Italy
| | - Micaela La Regina
- SC Governo e rischio clinico, programmazione sanitaria e controllo di gestione, Azienda Sociosanitaria Ligure 5 (ASL5), La Spezia, Italy.
| | - Domenico Di Sessa
- SC Governo e rischio clinico, programmazione sanitaria e controllo di gestione, Azienda Sociosanitaria Ligure 5 (ASL5), La Spezia, Italy
| | - Nicola Mucci
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | | | | | - Vittorio Fineschi
- Department of Anatomical, Histological, Forensic and Orthopaedic Sciences, Sapienza University, Rome, Italy
| | - Mariarosaria Di Tommaso
- Department of Gynaecology, Perinatology and Human Reproduction, University of Florence, Florence, Italy
| | - Lorenzo Corbetta
- Department of Interventional Pneumology, University of Florence, Florence, Italy
| | - Peter Lachman
- Lead Faculty Quality Improvement Programme- Royal College of Physicians of Ireland, Dublin, Ireland
| | | | | | - Riccardo Tartaglia
- Department of Innovation and Information Engineering, G. Marconi University, Rome, Italy
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20
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Ding X, Jian Z, Xu Y, Lin Z, Chen Z, Zhang Y, Huang H, Chen R, Xia P, Zhang W, Du H. Psychological stress and coping strategies among frontline healthcare workers supporting patients with coronavirus disease 2019: a retrospective study and literature review. Ther Adv Respir Dis 2022; 16:17534666221130215. [PMID: 36476064 PMCID: PMC9742697 DOI: 10.1177/17534666221130215] [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] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) outbreak might have a psychological impact on frontline healthcare workers. However, the effectiveness of coping strategies was less reported. OBJECTIVES We aimed to investigate the sources of stress and coping strategies among frontline healthcare workers fighting against COVID-19. We also performed a literature review regarding the effects of coping methods on psychological health in this population. METHODS We included frontline healthcare workers who completed an online survey using self-made psychological stress questionnaires in a cross-sectional study. We evaluated the association between potential factors and high-stressed status using a logistic regression model. We performed the principal component analysis with varimax rotation for factor analysis. We also performed a systematic review of published randomized controlled studies that reported the effects of coping methods on psychological health in COVID-19 healthcare workers. RESULTS We included 107 [32 (29-36) years] respondents in the final analysis, with a response rate of 80.5%. A total of 41 (38.3%) respondents were high-stressed. Compared with the low-stressed respondents, those with high-stress were less likely to be male (46.3% versus 72.7%, p = 0.006), nurses (36.6% versus 80.3%, p < 0.001), and more likely to have higher professional titles (p = 0.008). The sources of high-stress in frontline healthcare workers were categorized into 'work factor', 'personal factor', and 'role factor'. A narrative synthesis of the randomized controlled studies revealed that most of the coping methods could improve the psychological stress in healthcare workers during the COVID-19 pandemic. CONCLUSION Our findings suggest that some frontline healthcare workers experienced psychological stress during the early pandemic. Effective coping strategies are required to help relieve the stress in this population.
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Affiliation(s)
| | | | - Yiming Xu
- The Third Clinical Medical College, Fujian Medical University, Fuzhou, China
| | - Zibei Lin
- The First Clinical Medical College, Fujian Medical University, Fuzhou, China
| | - Ziyang Chen
- The Second Clinical Medical College, Fujian Medical University, Fuzhou, China
| | - Yixian Zhang
- Department of Rehabilitation, Fujian Medical University Union Hospital, Fuzhou, China
| | - Huayao Huang
- Department of Rehabilitation, Fujian Medical University Union Hospital, Fuzhou, China
| | - Ronghua Chen
- Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, China
| | - Pincang Xia
- Fujian Center for Disease Control and Prevention, Fuzhou, China
| | - Wei Zhang
- Department of Neurology, Fujian Medical University Union Hospital, 29 Xinquan Road, Gulou District, Fuzhou, China
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21
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Gładyszewska-Fiedoruk K, Teleszewski TJ. Experimental studies of carbon dioxide concentration in the space under the face mask protecting against Covid-19 - Pilot studies. JOURNAL OF ENVIRONMENTAL HEALTH SCIENCE & ENGINEERING 2022; 20:1111-1119. [PMID: 35812773 PMCID: PMC9258009 DOI: 10.1007/s40201-022-00816-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 06/27/2022] [Indexed: 06/15/2023]
Abstract
Masks are the primary tool used to prevent the spread of COVID-19 in the current pandemic. The use of masks may result in some discomfort, which may be caused by the accumulation of carbon dioxide in the inner space of the mask. This paper presents tests of carbon dioxide concentration in the inner space of the mask during work at a computer, for various flat and convex masks. Five different masks were used in the tests. Convex masks showed a greater accumulation of carbon dioxide than flat masks. The concentration of carbon dioxide was also higher for masks made of more layers. The dependence of the average values of carbon dioxide concentrations under the masks for selected people depending on the BMI and the type of mask was determined, as well as the measurements of carbon dioxide concentrations without the mask. An increase in carbon dioxide concentration was observed with increasing BMI. The development of effective self-defense tools against the virus, including masks, is essential to contain the spread of COVID-19.
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Affiliation(s)
- Katarzyna Gładyszewska-Fiedoruk
- Institute of Environmental Engineering, Warsaw University of Life Sciences (SGGW), 166 Nowoursynowska Street, 02-776 Warsaw, Poland
| | - Tomasz Janusz Teleszewski
- Faculty of Civil Engineering and Environmental Sciences, Department of HVAC Engineering, Bialystok University of Technology, Wiejska 45E, 15-351 Białystok, Poland
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22
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Abu-Ismail L, Al-Shami K, Al-Shami M, Nashwan AJ. The effect of COVID-19 pandemic and wearing face masks on ophthalmology practice: What is known so far? A narrative review. Front Med (Lausanne) 2022; 9:1019434. [PMID: 36518743 PMCID: PMC9742357 DOI: 10.3389/fmed.2022.1019434] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 11/07/2022] [Indexed: 08/29/2023] Open
Abstract
Face masks, along with other preventive measures, can help slow the spread of COVID-19. Despite the positive effect of the mask in combating the virus, it has some negative effects on the human body that must be followed up on and reduced. In this study, we discuss the impact of wearing face masks on the eye and the common issues associated with using them. The literature search was conducted using electronic databases such as PubMed and Google Scholar. Only articles published in English were included. A total of 39 relevant articles were deemed eligible. After the duplicate articles were removed, the titles and abstracts of 20 papers underwent full-text screening. The review comprised both prospective and retrospective investigations, case reports, and a series of reporting ocular symptoms following the use of face masks. The COVID-19 pandemic affected ophthalmology practices in managing patients. New factors must be considered, especially when dealing with anti-VEGF injections, such as the risk of endophthalmitis, tests and symptoms of patients with glaucoma, and the emerging symptoms associated with the COVID-19 vaccination. The use of face masks and breathing aids seemed to influence the tear film.
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Affiliation(s)
- Luai Abu-Ismail
- Department of Ophthalmology, Islamic Hospital, Amman, Jordan
| | - Khayry Al-Shami
- Department of Clinical Medical Sciences, Faculty of Medicine, Yarmouk University, Irbid, Jordan
| | - Manar Al-Shami
- Department of Clinical Medical Sciences, Faculty of Medicine, Yarmouk University, Irbid, Jordan
- Princess Basma Hospital, Ministry of Health, Irbid, Jordan
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Chen X, Zhang C, Ibrahim S, Tao S, Xia X, Li Y, Li C, Yue F, Wang X, Bao S, Fan J. The impact of facemask on patients with COPD: A systematic review and meta-analysis. Front Public Health 2022; 10:1027521. [PMID: 36466486 PMCID: PMC9709116 DOI: 10.3389/fpubh.2022.1027521] [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: 08/25/2022] [Accepted: 10/17/2022] [Indexed: 11/17/2022] Open
Abstract
Background Since the emergence of COVID-19, mandatory facemask wearing has been implemented around the world to prevent viral transmission, however, the impact of wearing facemasks on patients with COPD was unclear. Methods The current study undertakes a systematic review and meta-analysis of a comprehensive literature retrieval from six databases, based on the pre-determined eligibility criteria, irrespective of language. The risk of bias was assessed using an established instrument. We primarily focused on analyzing ETCO2, SpO2, and heart and respiratory rates, and also considered the impacts on physiological and exercise performance. A descriptive summary of the data and possible meta-analysis was performed. Forest plots were generated to pool estimates based on each of the study outcomes. Results Of the 3,751 publications considered, six publications were selected for a systematic review and two publications were included for meta-analysis, however, the quality of these six studies was relatively low overall. In the case of inactivity, the facemask wearing COPD cohort had higher respiratory rates than that of the non-facemask wearing cohort (MD = 1.00 and 95% CI 0.47-1.53, P < 0.05). There was no significant difference in ETCO2 (MD = 0.10 and 95% CI -1.57-1.78, P > 0.05) and heart rate (MD = 0.40 and 95% CI -3.59-4.39, P > 0.05) nor SpO2 (MD = -0.40 and 95% CI -0.84-0.04, P > 0.05) between the COPD patients with and without facemasks. Furthermore, it was observed that the only significant differences between the COPD patients with and without facemasks undertaking different activities were FEV1 (%) (MD = 3.84 and 95% CI 0.14-7.54, P < 0.05), FEV1/FVC (%) (MD = 3.25 and 95% CI 0.71-5.79, P < 0.05), and blood lactate (MD = -0.90 and 95% CI -1.73 to -0.07, P < 0.05). Conclusion Wearing facemasks decreased the exercise performance of patients with COPD, however, it had minimal impact on physiological indexes. Further investigations will be performed on the high-quality data from randomized control studies. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=326265, identifier: CRD42022326265.
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Affiliation(s)
- Xuwen Chen
- School of Public Health, Center for Laboratory and Simulation Training, Centre for Evidence-Based Medicine, Gansu University of Chinese Medicine, Lanzhou, China
| | - Changqing Zhang
- Department of Radiology, Gansu Provincial People's Hospital, Lanzhou, China
| | - Sani Ibrahim
- School of Public Health, Center for Laboratory and Simulation Training, Centre for Evidence-Based Medicine, Gansu University of Chinese Medicine, Lanzhou, China
| | - Shunyu Tao
- School of Public Health, The University of Sydney, Camperdown, NSW, Australia
| | - Xiaoli Xia
- Department of Geriatrics, Affiliated Hospital of Gansu University of Chinese Medicine, Lanzhou, China
| | - Yi Li
- Department of Respiratory Cadres, Gansu Provincial People's Hospital, Lanzhou, China
| | - Caiyun Li
- School of Public Health, Center for Laboratory and Simulation Training, Centre for Evidence-Based Medicine, Gansu University of Chinese Medicine, Lanzhou, China
| | - Feiyan Yue
- School of Public Health, Center for Laboratory and Simulation Training, Centre for Evidence-Based Medicine, Gansu University of Chinese Medicine, Lanzhou, China
| | - Xinhua Wang
- School of Public Health, Center for Laboratory and Simulation Training, Centre for Evidence-Based Medicine, Gansu University of Chinese Medicine, Lanzhou, China,Xinhua Wang
| | - Shisan Bao
- School of Public Health, Center for Laboratory and Simulation Training, Centre for Evidence-Based Medicine, Gansu University of Chinese Medicine, Lanzhou, China,Shisan Bao
| | - Jingchun Fan
- School of Public Health, Center for Laboratory and Simulation Training, Centre for Evidence-Based Medicine, Gansu University of Chinese Medicine, Lanzhou, China,*Correspondence: Jingchun Fan
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Guan X, Lin J, Han J, Gao X, Zhang Y, Hu B, Guidoin R, Wang L. Prolonged Use of Surgical Masks and Respirators Affects the Protection and Comfort for Healthcare Workers. MATERIALS (BASEL, SWITZERLAND) 2022; 15:ma15227918. [PMID: 36431403 PMCID: PMC9696921 DOI: 10.3390/ma15227918] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Revised: 11/01/2022] [Accepted: 11/07/2022] [Indexed: 05/24/2023]
Abstract
This study explored the ideal period for wearing masks to prevent the physiological and psychological problems associated with long-term face mask use during respiratory infections by healthcare workers. Breathing simulators, surgical masks (SM) and medical respirators (PM) were prepared for two to eight hours. Changes in the comfort of masks (facial skin temperature, breathing resistance, and moisture permeability) and protection (filtration efficiency, resistance to blood penetration, and colony count) were assessed. The results demonstrated that the masks offered efficient liquid-particle filtering even after eight hours of use. However, the number of bacterial colonies using PM and SM grew significantly after two and four hours, respectively. Concerning comfort, the inspiratory resistance of masks rose dramatically after two hours, whereas the moisture permeability declined considerably after four hours. In addition, skin temperature had a significant increase within two hours, which may result in facial discomfort. When conditions permitted, the hospital staff was instructed to replace their masks every two hours.
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Affiliation(s)
- Xiaoning Guan
- Key Laboratory of Textile Science and Technology, Ministry of Education, College of Textiles, Donghua University, Shanghai 201620, China
- Key Laboratory of Textile Industry for Biomedical Textile Materials and Technology, Donghua University, Shanghai 201620, China
| | - Jing Lin
- Key Laboratory of Textile Science and Technology, Ministry of Education, College of Textiles, Donghua University, Shanghai 201620, China
- Key Laboratory of Textile Industry for Biomedical Textile Materials and Technology, Donghua University, Shanghai 201620, China
| | - Jiaxiang Han
- Key Laboratory of Textile Science and Technology, Ministry of Education, College of Textiles, Donghua University, Shanghai 201620, China
- Key Laboratory of Textile Industry for Biomedical Textile Materials and Technology, Donghua University, Shanghai 201620, China
| | - Xiaodong Gao
- Department of Hospital Infection Management, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Ying Zhang
- Key Laboratory of Textile Science and Technology, Ministry of Education, College of Textiles, Donghua University, Shanghai 201620, China
- Key Laboratory of Textile Industry for Biomedical Textile Materials and Technology, Donghua University, Shanghai 201620, China
| | - Bijie Hu
- Department of Hospital Infection Management, Zhongshan Hospital, Fudan University, Shanghai 200032, China
- Department of Infectious Diseases, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Robert Guidoin
- LOEX, Division of Regenerative Medicine, Centre de Recherche du CHU, Université Laval, Quebec City, QU G1V 0A6, Canada
- Department of Surgery, Faculty of Medicine, Université Laval, Quebec City, QU G1V 0A6, Canada
| | - Lu Wang
- Key Laboratory of Textile Science and Technology, Ministry of Education, College of Textiles, Donghua University, Shanghai 201620, China
- Key Laboratory of Textile Industry for Biomedical Textile Materials and Technology, Donghua University, Shanghai 201620, China
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Sahebi A, Hasheminejad N, Shohani M, Yousefi A, Tahernejad S, Tahernejad A. Personal protective equipment-associated headaches in health care workers during COVID-19: A systematic review and meta-analysis. Front Public Health 2022; 10:942046. [PMID: 36311638 PMCID: PMC9605797 DOI: 10.3389/fpubh.2022.942046] [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: 05/12/2022] [Accepted: 09/20/2022] [Indexed: 01/25/2023] Open
Abstract
Introduction Health Care Workers (HCWs) use Personal Protective Equipment (PPE) during the COVID-19 pandemic to protect themselves and prevent the transmission of the disease. The use of PPE, especially respiratory masks, has adverse consequences, including headaches, which have been secondary and unusual. The aim of the present systematic review and meta-analysis study was to investigate the prevalence of PPE-associated headaches in HCWs during COVID-19 pandemic. Methods The present review study was performed based on the PRISMA guideline. The protocol of the present study was registered in PROSPERO with the code CRD42022304437. Valid data resources such as Scopus, PubMed, Web of Science, Science Direct, Google Scholar, Embase were used to identify and extract relevant studies. The searches were conducted between the beginning of 2020 and the end of January 2022. A random effects model was used for meta-analysis and I 2 index was used to investigate between-study heterogeneity. Data were analyzed using STATA ver. 14. Results A total of 539 articles were first identified through initial search and finally 26 final studies were selected to undergo the meta-analysis phase. According to the results of meta-analysis, the prevalence of headache after and before the use of PPE was 48.27% (95% CI: 40.20-56.34, I 2 = 99.3%, p = 0 < 001) and 30.47% (95% CI: 20.47-40.47, I 2 = 97.3%, p = 0 < 001), respectively. Conclusion The results of the present study showed that the prevalence of PPE-associated headache in HCWs was relatively high, so, the use of PPE during COVID-19 pandemic can be considered as one of the causes of headache. Therefore, management strategies such as regular screening of HCWs for headaches and regular rest periods without the use of PPE can be effective in reducing the prevalence of headaches.
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Affiliation(s)
- Ali Sahebi
- Non-Communicable Diseases Research Center, Ilam University of Medical Sciences, Ilam, Iran
| | - Naser Hasheminejad
- Department of Occupational Health Engineering and Safety at Work, School of Public Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Masoumeh Shohani
- Department of Nursing, School of Nursing and Midwifery, Ilam University of Medical Sciences, Ilam, Iran
| | - Atefeh Yousefi
- Department of Neurology, Shohadaye Tajrish Hospital, Shahid Beheshti University of Medical Science, Tehran, Iran
| | - Somayeh Tahernejad
- Health in Disasters and Emergencies Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran,*Correspondence: Somayeh Tahernejad
| | - Azadeh Tahernejad
- Department of Health in Disasters and Emergencies, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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26
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Bharatha A, Krishnamurthy K, Cohall D, Rahman S, Forde CA, Corbin-Harte R, Ojeh N, Kabir R, Parsa AD, Rabbi AMF, Majumder MAA. Personal protective equipment (PPE) related adverse skin reactions among healthcare workers at the main COVID-19 isolation center in Barbados. Front Public Health 2022; 10:978590. [PMID: 36304246 PMCID: PMC9592812 DOI: 10.3389/fpubh.2022.978590] [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: 06/28/2022] [Accepted: 09/12/2022] [Indexed: 01/25/2023] Open
Abstract
Background The use of personal protective equipment (PPE) reduces the risk of transmission of infectious agents significantly among healthcare workers (HCWs). The study aimed to investigate the prevalence and characteristics of PPE-related adverse skin reactions among HCWs working at the main COVID-19 isolation center in Barbados. Methods A cross-sectional web-based online survey was conducted during April to June 2021 which recorded demographic information, details of PPE use and adverse skin reactions including severity and duration of onset of symptoms. Results Most of the respondents used PPE for consecutive days (77.9%), 1-6 h/day (59.2%), and more than a year (62.5%). Fewer than half of the participants (45.6%) experienced adverse skin reactions from the use of PPE. The reactions were mostly observed in the cheeks (40.4%) and nose bridges (35.6%). Females had more reactions than their male counterparts (p = 0.003). The use of N95 masks and a combination of surgical and N95 masks produced adverse effects predominantly in the ears (60%) and cheeks (56.4%). Binary logistic regression showed that female HCWs (OR = 5.720 95% CI: 1.631, 20.063), doctors (OR = 5.215 95% CI: 0.877, 31.002), and longer duration of PPE use (>1 year) (OR = 2.902 95% CI: 0.958, 8.787) caused a significantly higher prevalence of adverse skin reactions. Conclusion The PPE-related skin reactions were common among HCWs which mainly occurred due to prolonged use. Preventive measures inclusive of appropriate training of HCWs on the use of PPE are recommended to minimize these adverse events.
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Affiliation(s)
- Ambadasu Bharatha
- Faculty of Medical Sciences, The University of the West Indies, Cave Hill Campus, Bridgetown, Barbados
| | - Kandamaran Krishnamurthy
- PICU Consultant, Queen Elizabeth Hospital, Bridgetown, Barbados,*Correspondence: Kandamaran Krishnamurthy
| | - Damian Cohall
- Faculty of Medical Sciences, The University of the West Indies, Cave Hill Campus, Bridgetown, Barbados
| | - Sayeeda Rahman
- American University of Integrative Sciences, School of Medicine, Bridgetown, Barbados
| | - Corey A. Forde
- Infection Prevention and Control/Infectious Diseases Programs, The Queen Elizabeth Hospital, Bridgetown, Barbados
| | - Rhea Corbin-Harte
- Isolation Facilities Client Relations and Activities, Bridgetown, Barbados
| | - Nkemcho Ojeh
- Faculty of Medical Sciences, The University of the West Indies, Cave Hill Campus, Bridgetown, Barbados
| | - Russell Kabir
- Faculty of Health Education, Medicine and Social Care, Anglia Ruskin University, Chelmsford, United Kingdom
| | - Ali Davod Parsa
- Faculty of Health, Education, Medicine and Social Care, Anglia Ruskin University, Cambridge, United Kingdom
| | | | - Md Anwarul Azim Majumder
- Faculty of Medical Sciences, The University of the West Indies, Cave Hill Campus, Bridgetown, Barbados
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Wyer M, Barratt R, Hor SY, Ferguson PE, Gilbert GL. Exploring healthcare workers' perspectives of video feedback for training in the use of powered air purifying respirators (PAPR) at the onset of the COVID-19 pandemic. BMC MEDICAL EDUCATION 2022; 22:688. [PMID: 36151565 PMCID: PMC9502944 DOI: 10.1186/s12909-022-03742-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 09/07/2022] [Indexed: 05/10/2023]
Abstract
BACKGROUND With the advent of COVID-19, many healthcare workers (HWs) in Australia requested access to powered air purifying respirators (PAPR) for improved respiratory protection, comfort and visibility. The urgency of the response at our hospital required rapid deployment of innovative training to ensure the safe use of PAPRs, in particular, a video-feedback training option to prepare HWs for PAPR competency. AIM To explore the feasibility, acceptability, and utility of video-feedback in PAPR training and competency assessment. METHODS Semi-structured interviews were conducted with 12 HWs, including clinicians from Intensive Care, Anaesthetics and Respiratory Medicine, at a large teaching hospital in Australia. FINDINGS Participants believed that the use of video-feedback in PAPR training was feasible, acceptable and useful. They described a variety of benefits to learning and retention, from a variety of ways in which they engaged with the personal video-feedback. Participants also described the impact of reviewing personalised practice footage, compared to generic footage of an ideal performance. CONCLUSION By conceptualising video-feedback using a pedagogical approach, this study contributes to knowledge around optimising methods for training HWs in PPE use, particularly when introducing a new and complex PPE device during an infectious disease outbreak.
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Affiliation(s)
- Mary Wyer
- Sydney Institute for Infectious Diseases, The University of Sydney, Level 6 Block K Westmead Hospital, Westmead, NSW 2145 Australia
- New South Wales Biocontainment Centre, Westmead Hospital, Cnr Darcy and Hawkesbury Rds, Westmead, Australia
| | - Ruth Barratt
- Sydney Institute for Infectious Diseases, The University of Sydney, Level 6 Block K Westmead Hospital, Westmead, NSW 2145 Australia
- New South Wales Biocontainment Centre, Westmead Hospital, Cnr Darcy and Hawkesbury Rds, Westmead, Australia
- Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW Australia
| | - Su-yin Hor
- Centre for Health Services Management, Faculty of Health, University of Technology Sydney, Sydney, NSW Australia
| | - Patricia E. Ferguson
- Sydney Institute for Infectious Diseases, The University of Sydney, Level 6 Block K Westmead Hospital, Westmead, NSW 2145 Australia
- New South Wales Biocontainment Centre, Westmead Hospital, Cnr Darcy and Hawkesbury Rds, Westmead, Australia
- Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW Australia
- Department of Infectious Diseases, Westmead hospital, Cnr Darcy and Hawkesbury Rds, Westmead, Australia
| | - Gwendolyn L. Gilbert
- Sydney Institute for Infectious Diseases, The University of Sydney, Level 6 Block K Westmead Hospital, Westmead, NSW 2145 Australia
- Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW Australia
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Mahmud R, Joy KMNI, Rassel MA, Monayem FB, Datta PK, Hossain MS, Hoque MM, Habib SMHR, Munna NH, Ahmed M, Sayeed SKJB, Rahman M, Chowdhury AH, Hossain MZ, Ahmed KGU, Miah MT, Rahman MM. Health hazards related to using masks and/or personal protective equipment among physicians working in public hospitals in Dhaka: A cross-sectional study. PLoS One 2022; 17:e0274169. [PMID: 36107841 PMCID: PMC9477277 DOI: 10.1371/journal.pone.0274169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 08/24/2022] [Indexed: 11/18/2022] Open
Abstract
Background
Wearing masks or personal protective equipment (PPE) has become an integral part of the occupational life of physicians due to the coronavirus disease 2019 (COVID-19) pandemic. Most physicians have been developing various health hazards related to the use of different protective gears. This study aimed to determine the burden and spectrum of various health hazards associated with using masks or PPE and their associated risk factors.
Methods
This cross-sectional survey was conducted in Dhaka Medical College from March 01–May 30, 2021, among physicians from different public hospitals in Dhaka, Bangladesh. We analyzed the responses of 506 physicians who completed case record forms through Google forms or hard copies.
Findings
The mean (SD) age of the respondents was 35.4 [7.7], and 69.4% were men. Approximately 40% were using full PPE, and 55% were using N-95 masks. A total of 489 (96.6%) patients experienced at least one health hazard. The reported severe health hazards were syncope, severe dyspnea, severe chest pain, and anaphylaxis. Headache, dizziness, mood irritation, chest pain, excessive sweating, panic attack, and permanent facial disfigurement were the minor health hazards reported. Extended periods of work in the COVID-19-unit, reuse of masks, diabetes, obesity, and mental stress were risk factors for dyspnea. The risk factors for headaches were female sex, diabetes, and previous primary headaches. Furthermore, female sex and reusing masks for an extended period (> 6 h) were risk factors for facial disfigurement. The risk factors for excessive sweating were female sex and additional evening office practice for an extended period.
Conclusions
Healthcare workers experienced several occupational hazards after using masks and PPE. Therefore, an appropriate policy is required to reduce such risks.
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Affiliation(s)
- Reaz Mahmud
- Department of Neurology, Dhaka Medical College, Dhaka, Bangladesh
- * E-mail: ,
| | | | - Mohammad Aftab Rassel
- Department of Neurology, National Institute of Neurosciences and Hospital, Dhaka, Bangladesh
| | | | | | | | | | | | - Nazmul Hoque Munna
- Assistant professor, Department of Neurology, Mugda Medical College, Dhaka, Bangladesh
| | - Mohiuddin Ahmed
- Department of Neurology, Dhaka Medical College, Dhaka, Bangladesh
| | | | - Motlabur Rahman
- Department of Medicine, Dhaka Medical College, Dhaka, Bangladesh
| | | | | | | | - Md. Titu Miah
- Department of Medicine, Dhaka Medical College, Dhaka, Bangladesh
| | - Md. Mujibur Rahman
- Department of Medicine, Bangabandhu Sheikh Mujib Medical University, Dhaka. Bangladesh
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Discomfort and Pain Related to Protective Mask-Wearing during COVID-19 Pandemic. J Pers Med 2022; 12:jpm12091443. [PMID: 36143228 PMCID: PMC9501271 DOI: 10.3390/jpm12091443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 08/30/2022] [Accepted: 08/31/2022] [Indexed: 11/21/2022] Open
Abstract
The SARS-CoV-2 pandemic made the use of facemasks mandatory to prevent contact with the virus. Recent studies have revealed that intensive use of facemasks significantly exacerbated pre-existing headaches and triggered de novo headaches. In our experience, some subjects also complain of symptoms of neuropathic pain in the head/facial regions. Until now, the relationship between neuropathic pain and facemasks has not been documented. The aim of the study is to investigate the occurrence of neuropathic pain related to facemask use. It is a cross-sectional survey using a questionnaire, developed following a commonly accepted outcome research methodology. Participants, both health care and non-health care workers, responded to items included in the questionnaire about the type of facemasks, time and manner of wearing them, side effects such as skin lesions, symptoms of neuropathic pain, etc.
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30
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Kaur M, Kumar A, Kaur S, Nagar PK, Nagi M, Thakur V, Khan R. Adverse Effects of Personal Protective Equipment and Their Self-Practiced Preventive Strategies among the Covid-19 Frontline Health Care Workers. Hosp Top 2022:1-12. [PMID: 35983853 DOI: 10.1080/00185868.2022.2112523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
BACKGROUND Owing to the highly contagious nature of SARS-CoV-2, the use of personal protective equipment (PPE) among the healthcare workers (HCWs) is mandatory. However, PPE associated adverse effects are also there. OBJECTIVE To study the adverse effects associated with PPE and their preventive measures amongst the HCWs. MATERIAL AND METHODS A descriptive study was conducted among 200 HCWs working in a Covid center of a tertiary care center. The participants were sent the questionnaires online. Some of them not having smart phones were interviewed telephonically. Their information profile, the various adverse effects associated with PPE, and the preventive measures being practiced by them were noted. Data was analyzed using descriptive and inferential statistics. RESULTS Total 97% HCWs reported adverse effects with hazmat suit; 96% with N 95 mask; 92% with goggle and 78% with gloves. The adverse effects associated with the prolonged use of the mask were erythema; erosions and scar at the nasal bridge; ear pain; difficulty in breathing; and headache. Sixty-seven percent of the participants had sweating with the use of gloves, which led to cutaneous exfoliation such as dry hands (55%) and skin itching (43%). Moisturizers and natural oils were used to prevent the dryness of hands. For the pressure related injury over the nasal bridge due to N95 mask, participants used to apply Band-Aid (adhesive bandage) and cotton dressing. CONCLUSION Adverse skin reactions related to PPE are common among HCWs. Comprehensive assessment of the skin condition and awareness on adverse skin reactions should be advocated.
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Affiliation(s)
| | - Ashok Kumar
- National Institute of Nursing Education, PGIMER, Chandigarh, India
| | - Sukhpal Kaur
- National Institute of Nursing Education, PGIMER, Chandigarh, India
| | | | - Manisha Nagi
- National Institute of Nursing Education, PGIMER, Chandigarh, India
| | - Vishal Thakur
- Department of Dermatology, Venereology & Leprology, Himalayan Institute of Medical Sciences, Uttarakhand, India
| | - Reshma Khan
- Nursing Department, PGIMER, Chandigarh, India
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31
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Mao Y, Zhu Y, Guo Z, Zheng Z, Fang Z, Chen X. Experimental investigation of the effects of personal protective equipment on thermal comfort in hot environments. BUILDING AND ENVIRONMENT 2022; 222:109352. [PMID: 35782230 PMCID: PMC9239730 DOI: 10.1016/j.buildenv.2022.109352] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 06/21/2022] [Accepted: 06/26/2022] [Indexed: 05/16/2023]
Abstract
Since the outbreak of COVID-19, wearing personal protective equipment (PPE) has become increasingly common, especially for healthcare workers performing nucleic acid sample collection. A field experiment and questionnaire survey were conducted in a semi-open transition space of a university building in Guangzhou, southern China. Thirty-two subjects wore PPE to simulate nucleic acid sample collection, during which thermal parameters were recorded and subjective questionnaires were completed. The relationship between thermal sensation and thermal index was analyzed to determine the neutral temperature and comfort temperature zones. Subjects had higher requirements for thermal environment parameters when wearing PPE than when not wearing PPE, and were found to have statistically significant differences in thermal perception when wearing and not wearing PPE. Wearing PPE significantly raised the subjects' thermal and humidity sensations and restricted their airflow. Wearing PPE resulted in thermal discomfort for the subjects and a high unacceptability rate for environmental thermal parameters. The subjects wore PPE for an acceptable duration of approximately 1.5 h. The neutral operative temperatures were significantly lower when wearing PPE than when not wearing PPE, and the deviation from the neutral temperature was 9.7 °C. The neutral operative temperature was 19.5 °C and the comfort temperature zone was 17.4-21.5 °C when subjects wore PPE, demonstrating that subjects who wore PPE preferred lower temperatures. These results suggest that people who wear PPE for work, especially outdoors, should receive more attention to ensure thermal comfort and safety.
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Affiliation(s)
- Yudong Mao
- School of Civil Engineering, Guangzhou University, Guangzhou, China
| | - Yongcheng Zhu
- The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Zhisheng Guo
- School of Civil Engineering, Guangzhou University, Guangzhou, China
| | - Zhimin Zheng
- School of Civil Engineering, Guangzhou University, Guangzhou, China
| | - Zhaosong Fang
- School of Civil Engineering, Guangzhou University, Guangzhou, China
| | - Xiaohui Chen
- The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
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Kugelman D, Weppler CG, Warren CF, Lajam CM. Occupational Hazards of Orthopedic Surgery Exposures: Infection, Smoke, and Noise. J Arthroplasty 2022; 37:1470-1473. [PMID: 35304300 DOI: 10.1016/j.arth.2022.03.034] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 02/23/2022] [Accepted: 03/08/2022] [Indexed: 02/02/2023] Open
Abstract
The orthopedic environment exposes surgeons and staff to infection, surgical smoke, and high levels of noise. It is helpful to understand how exposure increases the risk for adverse health consequences. Protective equipment, safety protocols, and instrument modification can reduce exposure to hazards. When modifications to practice are made, they must be evaluated to ensure they do not introduce new hazards or impede the use of instruments. Despite evidence of risk, protective measures are seldom employed in orthopedic practice. Wider implementation of protection for clinicians may not occur unless the same hazards are shown to impact patient outcomes.
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Affiliation(s)
- David Kugelman
- Orthopedic Surgery, NYU Langone Grossman School of Medicine, Chief Orthopedic Safety Officer, NYU Langone Health, New York, New York
| | - Campbell G Weppler
- Orthopedic Surgery, NYU Langone Grossman School of Medicine, Chief Orthopedic Safety Officer, NYU Langone Health, New York, New York
| | - Cooper F Warren
- Orthopedic Surgery, NYU Langone Grossman School of Medicine, Chief Orthopedic Safety Officer, NYU Langone Health, New York, New York
| | - Claudette M Lajam
- Orthopedic Surgery, NYU Langone Grossman School of Medicine, Chief Orthopedic Safety Officer, NYU Langone Health, New York, New York
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Radha K, George G, Varghese A, Joseph J, Vijayanarayanan N. Prevalence of Physical and Psychological Impacts of Wearing Personal Protective Equipment on Health Care Workers During COVID-19: A Systematic Review and Meta-Analysis. Indian J Occup Environ Med 2022; 26:140-150. [PMID: 36408432 PMCID: PMC9674076 DOI: 10.4103/ijoem.ijoem_32_22] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 02/12/2022] [Accepted: 03/12/2022] [Indexed: 06/16/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has necessitated the use of personal protective equipment (PPE) among the frontline health care workers (HCWs). Even though PPE helps in preventing infection, it poses significant physical and psychological impacts at varying levels. Correspondingly, multiple independent studies have brought out the PPE-associated problems. However, there exists a lacuna on comprehensive information of global prevalence related to the same. AIM To estimate the prevalence and risk factors of PPE among HCWs during COVID-19 across the globe. DESIGN Systematic review and meta-analysis. METHOD The review was undertaken as per the protocol registered in PROSPERO CRD42021272216 following Preferred Reporting Items for Systematic Reviews and Meta-Analysis(PRISMA) guidelines. Two independent reviewers have undertaken the search strategy, study selection, and methodological quality assessment. Discrepancies were addressed by the third reviewer. Heterogeneity was addressed through I2 statistics and forest plots generated by open meta-software. RESULTS A total of 16 articles conducted across 6 different countries among 10,182 HCWs were included in the review. The pooled prevalence of skin lesions, headache, sweating, breathing difficulty, vision difficulty, thirst/dry mouth, fatigue, and communication difficulty, anxiety, fear were 57 (47-66%), 51 (37-64%), 75 (56-90%), 44 (23-68%), 61 (21-94%), 54 (30-77%), 67 (58-76%), 74 (47-94%), 28 (24-33%), 14 (10-17%), respectively. Moreover, the various risk factors included are the use of PPE for >6 h and young females. In addition, the medical management of new-onset problems created an additional burden on the frontline health care personnel (HCP). CONCLUSION The frontline HCWs encountered physical and psychological problems at varying levels as a result of wearing PPE which needs to be addressed to prevent the inadequate use of PPE leading to infections.
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Affiliation(s)
- K Radha
- Faculty, College of Nursing, Bhopal Memorial Hospital and Research Centre, ICMR, Bhopal, Madhya Pradesh, India
| | - Gigini George
- Faculty, College of Nursing, Bhopal Memorial Hospital and Research Centre, ICMR, Bhopal, Madhya Pradesh, India
| | - Abin Varghese
- Faculty, College of Nursing, All India Institute of Medical Sciences, Nagpur, Maharashtra, India
| | - Jaison Joseph
- Department of Psychiatric Nursing, College of Nursing, Pt. B. D. Sharma University of Health Sciences, Rohtak, Haryana, India
| | - N Vijayanarayanan
- Department of Medical Surgical Nursing, RD Memorial College of Nursing, Bhopal, Madhya Pradesh, India
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Pasli S, Imamoglu M, Beser MF, Sahin AS, Ilhan E, Yadigaroglu M. Examination of the Effects of 4-Hour Nonvalved Filtering Facepiece Respirator Use on Blood Gas Values of Health Care Professionals: A Before and After Study. J Emerg Nurs 2022; 48:423-429.e1. [PMID: 35550305 PMCID: PMC9704115 DOI: 10.1016/j.jen.2022.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 03/07/2022] [Accepted: 03/13/2022] [Indexed: 12/14/2022]
Abstract
INTRODUCTION The use of personal protective equipment increased rapidly during the COVID-19 pandemic that began in 2019. The purpose of this study was to examine the effects of uninterrupted 4-hour use of internationally certified nonvalved filtering facepiece respirators on venous blood gas in health care workers during the COVID-19 pandemic. METHODS A before-after design included venous blood gas analyses collected at the beginning of shifts before nonvalved filtering facepiece respirator had been put on and after 4-hour uninterrupted use of nonvalved filtering facepiece respirator. RESULTS In this study, 33 volunteer health care workers took part. In terms of blood gas values, mean pCO2 values were 47.63 (SD = 5.16) before and 47.01 (SD = 5.07) after nonvalved filtering facepiece respirator use, mean HCO3 values were 23.68 (SD = 1.10) in first blood gas analysis and 24.06 (SD = 1.31) in second blood gas analysis, and no significant difference was observed between before and after the use of nonvalved filtering facepiece respirator (t = 0.67, P = .50, t = -2.0, P = .054, respectively). The only significant difference in parameters investigated between the groups was in pH levels, at pH = 7.35 (SD = 0.29) before and pH = 7.36 (SD = 0.20) after nonvalved filtering facepiece respirator use (t = -2.26, P = .03). CONCLUSION Continuous nonvalved filtering facepiece respirator use for 4 hours was not associated with clinician impairment in blood gas and peripheral SpO2 levels during nonexertional clinical ED work.
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Affiliation(s)
- Sinan Pasli
- For correspondence, write: Sinan Pasli, Department of Emergency
Medicine, Karadeniz Technical University, Trabzon 61080,
Turkey
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Dominguez-Moreno R, Venegas-Gómez VA, Zepeda-Gutiérrez LA, De La Rosa-Cuevas JJ, Hernández-Félix JH, Martos-Armendariz EO, Chiquete E, Vega-Boada F, Flores-Silva F, Cantú-Brito C. Headache related to personal protective equipment in healthcare workers during COVID-19 pandemic in Mexico: baseline and 6-month follow-up. Int Arch Occup Environ Health 2022; 95:1945-1954. [PMID: 35716173 PMCID: PMC9206092 DOI: 10.1007/s00420-022-01895-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Accepted: 05/26/2022] [Indexed: 11/30/2022]
Abstract
Background and aim Headaches related to the use of personal protective equipment (PPE) could affect performance at work in healthcare personnel. Our aim was to describe the prevalence and risk factors for headaches related to PPE, in the personnel of a specialized coronavirus disease 2019 (COVID-19) tertiary hospital. Methods In this cross-sectional survey study, we invited healthcare workers from COVID-19 referral center in Mexico (May 22–June 19, 2020) to answer a standardized structure questionnaire on characteristics of new-onset PPE-related headache or exacerbation of primary headache disorder. Participants were invited regardless of whether they had a current headache to avoid selection bias. This is the primary analysis of these data. Results Two hundred and sixty-eight subjects were analyzed, 181/268 (67.5%) women, 177/268 (66%) nurses, mean age 28 years. The prevalence of PPE-related headache was 210/268 (78.4%). Independent risk factors were occupation other than physician (OR 1.59, 95% CI 1.20–2.10), age > 30 years (OR 2.54, 95% CI 1.25–5.14), and female sex (OR 3.58, 95% CI 1.86–6.87). In the 6-month follow-up, 13.1% of subjects evolve to chronic headache, with stress as predictive risk factor. Conclusion The frequency of PPE-associated headache is high, and a subgroup could evolve to chronic headache. More studies are necessary to improve the knowledge about this condition.
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Affiliation(s)
- Rogelio Dominguez-Moreno
- Department of Neurology, National Institute of Medical Sciences and Nutrition Salvador Zubirán, Ciudad de Mexico, México.
| | - Venny A Venegas-Gómez
- Department of Internal Medicine, National Institute of Medical Sciences and Nutrition Salvador Zubirán, Ciudad de Mexico, México
| | - Luis Asdruval Zepeda-Gutiérrez
- Department of Internal Medicine, National Institute of Medical Sciences and Nutrition Salvador Zubirán, Ciudad de Mexico, México
| | - Juan José De La Rosa-Cuevas
- Department of Neurology, National Institute of Medical Sciences and Nutrition Salvador Zubirán, Ciudad de Mexico, México
| | - Jorge Humberto Hernández-Félix
- Department of Neurology, National Institute of Medical Sciences and Nutrition Salvador Zubirán, Ciudad de Mexico, México
| | - Edgar Omar Martos-Armendariz
- Department of Neurology, National Institute of Medical Sciences and Nutrition Salvador Zubirán, Ciudad de Mexico, México
| | - Erwin Chiquete
- Department of Neurology, National Institute of Medical Sciences and Nutrition Salvador Zubirán, Ciudad de Mexico, México
| | - Felipe Vega-Boada
- Department of Neurology, National Institute of Medical Sciences and Nutrition Salvador Zubirán, Ciudad de Mexico, México
| | - Fernando Flores-Silva
- Department of Neurology, National Institute of Medical Sciences and Nutrition Salvador Zubirán, Ciudad de Mexico, México
| | - Carlos Cantú-Brito
- Department of Neurology, National Institute of Medical Sciences and Nutrition Salvador Zubirán, Ciudad de Mexico, México
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Effect of Wearing Surgical Face Masks on Gas Detection from Respiration Using Photoacoustic Spectroscopy. Molecules 2022; 27:molecules27113618. [PMID: 35684554 PMCID: PMC9182023 DOI: 10.3390/molecules27113618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 06/01/2022] [Accepted: 06/02/2022] [Indexed: 11/17/2022] Open
Abstract
Wearing surgical face masks is among the measures taken to mitigate coronavirus disease (COVID-19) transmission and deaths. Lately, concern was expressed about the possibility that gases from respiration could build up in the mask over time, causing medical issues related to the respiratory system. In this research study, the carbon dioxide concentration and ethylene in the breathing zone were measured before and immediately after wearing surgical face masks using the photoacoustic spectroscopy method. From the determinations of this study, the C2H4 was established to be increased by 1.5% after one hour of wearing the surgical face mask, while CO2 was established to be at a higher concentration of 1.2% after one hour of wearing the surgical face mask, when the values were correlated with the baseline (control).
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Schutzmaske und Kopfschmerz. PSYCHOPRAXIS. NEUROPRAXIS 2022. [PMCID: PMC9009278 DOI: 10.1007/s00739-022-00811-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 10/29/2022]
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Qi G, Yuan P, Qi M, Hu X, Shi S, Shi X. Influencing factors of high PTSD among medical staff during COVID-19: evidences from both meta-analysis and subgroup analysis. Saf Health Work 2022; 13:269-278. [PMID: 35784492 PMCID: PMC9233879 DOI: 10.1016/j.shaw.2022.06.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 06/11/2022] [Accepted: 06/16/2022] [Indexed: 11/25/2022] Open
Abstract
Background PTSD (Post-traumatic stress disorder, PTSD) had a great impact on health care workers during the COVID-19 (Corona Virus Disease 2019, COVID-19). Better knowledge of the prevalence of PTSD and its risk factors is a major public health problem. This study was conducted to assess the prevalence and important risk factors of PTSD among medical staff during the COVID-19. Methods The databases were searched for studies published during the COVID-19, and a PRISMA (preferred reporting items for systematic review and meta-analysis) compliant systematic review (PROSPERO-CRD 42021278970) was carried out to identify articles from multiple databases reporting the prevalence of PTSD outcomes among medical staff. Proportion random effect analysis, I2 statistic, quality assessment, subgroup analysis, and sensitivity analysis were carried out. Results A total of 28 cross-sectional studies and the PTSD results of doctors and nurses were summarized from 14 and 27 studies: the prevalences were 31% (95% CI [confidence interval, CI]: 21%–40%) and 38% (95% CI: 30%–45%) in doctors and nurses, respectively. The results also showed seven risks (p < 0.05): long working hours, isolation wards, COVID-19 symptoms, nurses, women, fear of infection, and pre-existing mental illness. Two factors were of borderline significance: higher professional titles and married. Conclusion Health care workers have a higher prevalence of PTSD during COVID-19. Health departments should provide targeted preventive measures for medical staff away from PTSD.
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Affiliation(s)
- Guojia Qi
- Department of Epidemiology and Health Statistics, School of Public Health, Zunyi Medical University, Zunyi, Guizhou, China
| | - Ping Yuan
- Department of Epidemiology and Health Statistics, School of Public Health, Zunyi Medical University, Zunyi, Guizhou, China
| | - Miao Qi
- Department of Epidemiology and Health Statistics, School of Public Health, Zunyi Medical University, Zunyi, Guizhou, China
| | - Xiuli Hu
- Department of Epidemiology and Health Statistics, School of Public Health, Zunyi Medical University, Zunyi, Guizhou, China
| | - Shangpeng Shi
- Department of Quality Management, The Third Affiliated Hospital of Zunyi Medical University (The First People’s Hospital of Zunyi), Zunyi, Guizhou, China
| | - Xiuquan Shi
- Department of Epidemiology and Health Statistics, School of Public Health, Zunyi Medical University, Zunyi, Guizhou, China
- Center for Injury Research and Policy & Center for Pediatric Trauma Research, The Research Institute at Nationwide Children’s Hospital, The Ohio State University College of Medicine, Columbus, OH, USA
- Corresponding author. Department of Epidemiology and Health Statistics, School of Public Health, Zunyi Medical University, Zunyi 563006, Guizhou, China.
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Lv F, Xiong Q, Min S, Chen J, Ren L, Zhu Z, Shen Y, Huang F, Hu J, Li J. Safety and Comfort of Wearing Medical Masks in Adult Surgical Patients After General Anesthesia During the COVID-19 Epidemic: A Retrospective, Observational Cohort Study. J Perianesth Nurs 2022; 37:351-356. [PMID: 35227589 PMCID: PMC8062440 DOI: 10.1016/j.jopan.2021.04.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Revised: 04/05/2021] [Accepted: 04/06/2021] [Indexed: 01/31/2023]
Abstract
OBJECTIVE This study assessed oxygen saturation variation and comfort in adult surgical patients wearing masks in PACU during the COVID-19 epidemic. DESIGN Retrospective observation was applied in this study. METHODS One hundred thirty-seven patients wearing no medical masks (Group A, aged from 20 to 87) and 136 patients wearing medical masks (Group B, aged from 18 to 91) were selected in this retrospective study after extubation in PACU. After extubation their pulse oxygen saturation, noninvasive mean blood pressure and heart rate were recorded at two different time points (treated with 40% O2 oxygen therapy for 10 minutes and breathing room air for 10 minutes). The comfort, arterial blood gas data, complications and duration of patients were also reviewed in PACU. FINDINGS There were no significant differences in the pulse oxygen saturation between the two groups after inhaling 40% O2 or air. Compared with Group A, patients in Group B have lower comfort (6 [4-7] vs 7 [6-8]; P < .001), with shortened duration after extubation in PACU (50 [45-55] vs 56 [48-60]; P < .001). No significant differences were found in heart rate, noninvasive mean blood pressure, arterial blood gas data and complications. And no hypoxemia and respiratory adverse events happened in two groups. CONCLUSIONS Wearing medical masks does not reduce oxygen saturation in adult surgical patients during recovery from general anesthesia. The discomfort caused by masks is the concern in PACU.
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Affiliation(s)
| | | | - Su Min
- Address correspondence to Su Min, Department of Anaesthesiology, the First Affiliated Hospital of Chongqing Medical University, 1 Youyi Road, Yuzhong District, Chongqing 400016, China
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Manookian A, Dehghan Nayeri N, Shahmari M. Physical problems of prolonged use of personal protective equipment during the COVID-19 pandemic: A scoping review. Nurs Forum 2022; 57:874-884. [PMID: 35575417 PMCID: PMC9347983 DOI: 10.1111/nuf.12735] [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: 06/02/2021] [Revised: 04/23/2022] [Accepted: 04/27/2022] [Indexed: 11/29/2022]
Abstract
Background It is widely believed that using personal protective equipment (PPE) provides high levels of protection for healthcare workers (HCWs) in the fight against coronavirus disease (COVID‐19). However, the long‐term use of PPE is inconvenient for HCWs and may cause physical discomfort. These factors could result in poor compliance and disrupt the health and safety of HCWs, which may negatively affect the patient's safety. Objective This study aimed to investigate the literature for the purpose of collecting convincing evidence of HCWs' physical problems associated with PPE use during the COVID‐19 pandemic. Methods This scoping review was conducted using PubMed, Embase, ProQuest, Science Direct, Springer, Biomed Central, and Google Scholar to identify the related literature. Results HCWs have experienced various physical disorders including skin, respiratory, musculoskeletal, nervous, urinary, and circulatory system problems that are associated with PPE in various body systems. Among these, skin problems were the most frequent physical problems. Conclusions The literature demonstrated the adverse impacts of using PPE on HCWs. Therefore, healthcare policymakers should take the appropriate measures to improve the work environment during the COVID‐19 pandemic, which could consequently prevent and mitigate the adverse effects of using PPE.
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Affiliation(s)
- Arpi Manookian
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.,USERN Care (TUMS) Office, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Nahid Dehghan Nayeri
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehraban Shahmari
- Department of Medical-Surgical, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
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Doğan A, Karasu F, Yilmaz L. The effects of nurses' use of personal protective equipment on their vital signs during the COVID-19 pandemic. Work 2022; 71:843-850. [PMID: 35253717 DOI: 10.3233/wor-211232] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND In order for nurses to provide the desired/expected care during the COVID-19 pandemic, the personal protective equipment (PPE) they use should not cause additional damage. OBJECTIVE The current study examined the effect of nurses' use of PPE on their vital signs during the COVID-19 pandemic. METHODS The present study was executed in a public hospital located in Turkey between October 2020 and December 2020 with a total of 112 nurses, 54 of them were serving in COVID-19 clinics, and 58 of them were working in other clinics. The data of the study was collected by using the introductory information form, the vital signs measurement, and the Visual Analogue Scale. The numbers, percentages, means, standard deviation, Chi-square, ANOVA, Mann-Whitney U and Wilcoxon tests were used to analyze the data. RESULTS The mean scores of SpO2, respiratory rate, body temperature, heart rate and blood pressure measurements of the nurses in the experimental group were compared before and after putting on the PPE. It was found that the difference between the two averages was statistically significant (p < 0.05). CONCLUSION It was found that the use of PPE for a long time causes a decrease in SpO2, increase in respiratory rate, pulse and blood pressure, as well as the aches in face, ear, nose and head.
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Affiliation(s)
- Aysel Doğan
- Department of Nursing, Faculty of Health Sciences, Toros University, Mersin, Turkey
| | - Fatma Karasu
- Department of Nursing, Faculty of Health Sciences, Kilis 7 Aralık University, Kilis, Turkey
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Kunstler B, Newton S, Hill H, Ferguson J, Hore P, Mitchell BG, Dempsey K, Stewardson AJ, Friedman D, Cole K, Sim MR, Ferguson B, Burns P, King N, McGloughlin S, Dicks M, McCarthy S, Tam B, Hazelton B, McGurgan C, McDonald S, Turner T. P2/N95 respirators & surgical masks to prevent SARS-CoV-2 infection: Effectiveness & adverse effects. Infect Dis Health 2022; 27:81-95. [PMID: 35151628 PMCID: PMC8769935 DOI: 10.1016/j.idh.2022.01.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 01/03/2022] [Accepted: 01/05/2022] [Indexed: 12/19/2022]
Abstract
BACKGROUND Millions of people have acquired and died from SARS-CoV-2 infection during the COVID-19 pandemic. Healthcare workers (HCWs) are required to wear personal protective equipment (PPE), including surgical masks and P2/N95 respirators, to prevent infection while treating patients. However, the comparative effectiveness of respirators and masks in preventing SARS-CoV-2 infection and the likelihood of experiencing adverse events (AEs) with wear are unclear. METHODS Searches were carried out in PubMed, Europe PMC and the Cochrane COVID-19 Study Register to 14 June 2021. A systematic review of comparative epidemiological studies examining SARS-CoV-2 infection or AE incidence in HCWs wearing P2/N95 (or equivalent) respirators and surgical masks was performed. Article screening, risk of bias assessment and data extraction were duplicated. Meta-analysis of extracted data was carried out in RevMan. RESULTS Twenty-one studies were included, with most having high risk of bias. There was no statistically significant difference in respirator or surgical mask effectiveness in preventing SARS-CoV-2 infection (OR 0.85, [95%CI 0.72, 1.01]). Healthcare workers experienced significantly more headaches (OR 2.62, [95%CI 1.18, 5.81]), respiratory distress (OR 4.21, [95%CI 1.46, 12.13]), facial irritation (OR 1.80, [95%CI 1.03, 3.14]) and pressure-related injuries (OR 4.39, [95%CI 2.37, 8.15]) when wearing respirators compared to surgical masks. CONCLUSION The existing epidemiological evidence does not enable definitive assessment of the effectiveness of respirators compared to surgical masks in preventing infection. Healthcare workers wearing respirators may be more likely to experience AEs. Effective mitigation strategies are important to ensure the uptake and correct use of respirators by HCWs.
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Affiliation(s)
- Breanne Kunstler
- BehaviourWorks Australia, Monash Sustainable Development Institute, Monash University, 8 Scenic Boulevard, Clayton, Melbourne, VIC, 3800, Australia.
| | - Skye Newton
- Adelaide Health Technology Assessment (AHTA), School of Public Health, University of Adelaide, Australia
| | - Hayley Hill
- Adelaide Health Technology Assessment (AHTA), School of Public Health, University of Adelaide, Australia
| | - John Ferguson
- Division of Medicine, John Hunter Hospital, Newcastle Regional Mail Centre, NSW, 2310, Australia
| | - Phillipa Hore
- Department of Anaesthesia and Acute Pain Medicine, St Vincent's Hospital, Victoria Parade, Fitzroy, VIC, 3065, Australia
| | - Brett G. Mitchell
- The University of Newcastle, School of Nursing and Midwifery, Level 9, 77a Holden St, Gosford Hospital, Gosford, NSW, Australia, 2250
| | - Kathy Dempsey
- The Clinical Excellence Commission, 1 Reserve Road, St Leonards, NSW, Australia, 2065
| | - Andrew J. Stewardson
- Department of Infectious Diseases, The Alfred and Central Clinical School, Monash University, 85 Commercial Rd, Melbourne, VIC, Australia, 3004
| | - Deborah Friedman
- Deputy Chief Health Officer, Victorian Department of Health Melbourne, VIC, Australia, 3004
| | - Kate Cole
- Cole Health Pty Ltd, Balmain, NSW, Australia, 2041
| | - Malcolm R. Sim
- Monash Centre for Occupational & Environmental Health (MonCOEH), School of Public Health & Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, 553 St Kilda Rd, Melbourne, VIC, Australia, 3004
| | - Bridget Ferguson
- Central Queensland University, School of Nursing, Midwifery and Social Sciences; 554-700 Yaamba Rd, Norman Gardens, QLD, 4701, Australia
| | - Penelope Burns
- Academic Unit of General Practice, ANU Medical School, The Australian National University, Building 4, Hospital Road, Garran, ACT, 2605, Australia
| | - Nicole King
- North Shore Private Hospital, 3 Westbourne St, St Leonard's, 2065, Australia
| | - Steven McGloughlin
- Alfred Health and School of Public Health and Preventive Medicine, Monash University, Level 4, 553 St Kilda Road, Melbourne, VIC, Australia, 3004
| | - Melanie Dicks
- Ernst & Young, 121 Marcus Clarke Street, Canberra, ACT, Australia, 2601
| | - Sally McCarthy
- Prince of Wales Clinical School, Faculty of Medicine, University of New South Wales, Sydney, NSW, 2052, Australia
| | - Barry Tam
- Health Infrastructure NSW, 60 Day Road, Cheltenham, NSW, 2119, Australia
| | - Briony Hazelton
- PathWest Laboratory Medicine, QEII Medical Centre, Hospital Avenue, Nedlands, WA, Australia, 6009
| | - Cherylynn McGurgan
- Royal Melbourne Hospital Emergency Department, 300 Grattan Street, Parkville, VIC, Australia, 3050
| | - Steve McDonald
- Cochrane Australia, School of Public Health and Preventive Medicine, Monash University, Level 4, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - Tari Turner
- Cochrane Australia, School of Public Health and Preventive Medicine, Monash University, Level 4, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
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CEYLAN G, EMİR F. Uzun süreli N95 (FFP2) maske kullanımının kan oksijen satürasyonuna ve diş hekimi konforuna etkisinin değerlendirilmesi. ACTA ODONTOLOGICA TURCICA 2022. [DOI: 10.17214/gaziaot.994450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Karsli E, Yilmaz A, Kemancı A, Canacik O, Ozen M, Seyit M, Şahin L, Oskay A, Sabirli R, Turkcuer I. The effect of N95 respirators on vital parameters, PETCO 2, among healthcare providers at the pandemic clinics. Ir J Med Sci 2022; 192:853-860. [PMID: 35415774 PMCID: PMC9005163 DOI: 10.1007/s11845-022-03013-x] [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: 03/08/2022] [Accepted: 04/08/2022] [Indexed: 01/25/2023]
Abstract
BACKGROUND Wearing face shields and masks, which used to have very limited public use before the COVID-19 outbreak, has been highly recommended by organizations, such as CDC and WHO, during this pandemic period. AIMS The aim of this prospective study is to scrutinize the dynamic changes in vital parameters, change in end tidal CO2 (PETCO2) levels, the relationship of these changes with taking a break, and the subjective complaints caused by respiratory protection, while healthcare providers are performing their duties with the N95 mask. METHODS The prospective cohort included 54 healthcare workers (doctors, nurses, paramedics) who worked in the respiratory unit of the emergency department (ED) and performed their duties by wearing valved N95 masks and face shields. The vital parameters and PETCO2 levels were measured at 0-4th-5th and 9th hours of the work-shift. RESULTS Only the decrease in diastolic BP between 0 and 9 h was statistically significant (p = 0.038). Besides, mean arterial pressure (MAP) values indicated a significant decrease between 0-9 h and 5-9 h (p = 0.024 and p = 0.049, respectively). In terms of the vital parameters of the subjects working with and without breaks, only PETCO2 levels of those working uninterruptedly increased significantly at the 4th hour in comparison to the beginning-of-shift baseline levels (p = 0.003). CONCLUSION Although the decrease in systolic blood pressure (SBP) and MAP values is assumed to be caused by increased fatigue due to workload and work pace as well as increase in muscle activity, the increase in PETCO2 levels in the ED healthcare staff working with no breaks between 0 and 4 h should be noted in terms of PPE-induced hypoventilation.
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Affiliation(s)
- Emre Karsli
- Department of Emergency Medicine, Faculty of Medicine, Tınaztepe University, Izmir, Turkey
| | - Atakan Yilmaz
- Department of Emergency Medicine, Faculty of Medicine, Pamukkale University, Denizli, Turkey
| | - Aykut Kemancı
- Department of Emergency Medicine, Tavsanli Doc Dr. Mustafa Kalemli State Hospital, Kutahya, Turkey
| | - Omer Canacik
- Department of Emergency Medicine, Memorial Sisli Hospital, Istanbul, Turkey
| | - Mert Ozen
- Department of Emergency Medicine, Faculty of Medicine, Pamukkale University, Denizli, Turkey
| | - Murat Seyit
- Department of Emergency Medicine, Faculty of Medicine, Pamukkale University, Denizli, Turkey
| | - Levent Şahin
- Department of Emergency Medicine, Kafkas University Faculty of Medicine, Kars, Turkey
| | - Alten Oskay
- Department of Emergency Medicine, Faculty of Medicine, Pamukkale University, Denizli, Turkey
| | - Ramazan Sabirli
- Department of Emergency Medicine, Bakircay University Faculty of Medicine Cigli Training and Research Hospital, 35620, Izmir, Turkey.
| | - Ibrahim Turkcuer
- Department of Emergency Medicine, Faculty of Medicine, Pamukkale University, Denizli, Turkey
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Litwinowicz K, Choroszy M, Ornat M, Wróbel A, Waszczuk E. Bayesian network meta-analysis of face masks' impact on human physiology. Sci Rep 2022; 12:5823. [PMID: 35388100 PMCID: PMC8985742 DOI: 10.1038/s41598-022-09747-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 02/28/2022] [Indexed: 12/21/2022] Open
Abstract
Several concerns regarding the safety of face masks use have been propounded in public opinion. The objective of this review is to examine if these concerns find support in the literature by providing a comprehensive overview of physiological responses to the use of face masks. We have performed a systematic review, pairwise and network meta-analyses to investigate physiological responses to the use of face masks. The study has been registered with PROSPERO (C RD42020224791). Obtained results were screened using our exclusion and inclusion criteria. Meta-analyses were performed using the GeMTC and meta R packages. We have identified 26 studies meeting our inclusion and exclusion criteria, encompassing 751 participants. The use of face masks was not associated with significant changes in pulsoxymetrically measured oxygen saturation, even during maximal-effort exercises. The only significant physiological responses to the use of face masks during low-intensity activities were a slight increase in heart rate, mildly elevated partial pressure of carbon dioxide (not meeting criteria for hypercarbia), increased temperature of facial skin covered by the mask, and subsequent increase of the score in the rating of heat perception, with N95 filtering facepiece respirators having a greater effect than surgical masks. In high-intensity conditions, the use of face masks was associated with decreased oxygen uptake, ventilation, and RR. Face masks are safe to use and do not cause significant alterations in human physiology. The increase in heart rate stems most likely from increased respiratory work required to overcome breathing resistance. The increase in carbon dioxide is too small to be clinically relevant. An increased rating of heat perception when using face masks results from higher temperature of facial skin covered by the mask.
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Affiliation(s)
- Kamil Litwinowicz
- Department of Biochemistry and Immunochemistry, Wroclaw Medical University, Wrocław, Poland.
| | - Marcin Choroszy
- Department of Microbiology, Wroclaw Medical University, Wrocław, Poland
| | - Maciej Ornat
- Department of Human Morphology and Embryology, Wroclaw Medical University, Wrocław, Poland
| | - Anna Wróbel
- Department of Psychotherapy and Psychosomatic Diseases, Wroclaw Medical University, Wrocław, Poland
| | - Ewa Waszczuk
- Department of Gastroenterology and Hepatology, Wroclaw Medical University, Wrocław, Poland
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Roberts M, Thygerson SM, Beard JD, Clark C, Montague E. Occupational safety and health guidelines in relation to COVID‐19 risk, death risk, and case‐fatality proportion: An international, ecological study. Health Sci Rep 2022; 5:e539. [PMID: 35308414 PMCID: PMC8919368 DOI: 10.1002/hsr2.539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 01/24/2022] [Accepted: 02/08/2022] [Indexed: 11/21/2022] Open
Abstract
Background Coronavirus disease 2019 (COVID‐19) began in 2019 with several unknown factors. The World Health Organization (WHO) subsequently developed COVID‐19 occupational safety and health (OSH) guidelines to reduce occupational COVID‐19 transmission. Many countries also developed their own COVID‐19 OSH guidelines, but whether these guidelines included WHO's guidelines and whether including WHO's guidelines in countries' COVID‐19 OSH guidelines reduced COVID‐19 transmission is unknown. Objectives The objectives of our study were to (1) compare the COVID‐19 OSH guidelines of several countries to WHO's OSH guidelines, (2) estimate associations between characteristics of countries and their OSH guidelines and the number of WHO's OSH guidelines included in countries' OSH guidelines, and (3) estimate associations between WHO's OSH guidelines included in countries' OSH guidelines and COVID‐19 risk, death risk, and case‐fatality proportion. Methods This study represents international, ecological research of 36 countries from all six world health regions. Countries' COVID‐19 OSH guidelines were compared with WHO's OSH guidelines. Linear regression models adjusted for potential confounders were used to estimate associations of interest. Results The median number of WHO's 15 COVID‐19 OSH guidelines included in countries' COVID‐19 OSH guidelines was eight. Countries' COVID‐19 OSH guidelines focused on workers included significantly more of WHO's COVID‐19 OSH guidelines than countries' COVID‐19 OSH guidelines focused on general populations. Including “provide personal protective equipment for workers” and “create workplace policy for wearing personal protective equipment” in countries' COVID‐19 OSH guidelines were significantly related to decreased COVID‐19 risk, death risk, and/or case‐fatality proportion. Conclusions Countries' COVID‐19 OSH guidelines should include WHO's guidelines, focus on workers, and include “provide personal protective equipment for workers” and “create workplace policy for wearing personal protective equipment.”
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Affiliation(s)
- Morgan Roberts
- Department of Public Health Brigham Young University Provo Utah USA
| | | | - John D. Beard
- Department of Public Health Brigham Young University Provo Utah USA
| | - Camille Clark
- Department of Public Health Brigham Young University Provo Utah USA
| | - Emma Montague
- Department of Public Health Brigham Young University Provo Utah USA
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Plaut S. Scoping review and interpretation of myofascial pain/fibromyalgia syndrome: An attempt to assemble a medical puzzle. PLoS One 2022; 17:e0263087. [PMID: 35171940 PMCID: PMC8849503 DOI: 10.1371/journal.pone.0263087] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 01/11/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Myofascial Pain Syndrome (MPS) is a common, overlooked, and underdiagnosed condition and has significant burden. MPS is often dismissed by clinicians while patients remain in pain for years. MPS can evolve into fibromyalgia, however, effective treatments for both are lacking due to absence of a clear mechanism. Many studies focus on central sensitization. Therefore, the purpose of this scoping review is to systematically search cross-disciplinary empirical studies of MPS, focusing on mechanical aspects, and suggest an organic mechanism explaining how it might evolve into fibromyalgia. Hopefully, it will advance our understanding of this disease. METHODS Systematically searched multiple phrases in MEDLINE, EMBASE, COCHRANE, PEDro, and medRxiv, majority with no time limit. Inclusion/exclusion based on title and abstract, then full text inspection. Additional literature added on relevant side topics. Review follows PRISMA-ScR guidelines. PROSPERO yet to adapt registration for scoping reviews. FINDINGS 799 records included. Fascia can adapt to various states by reversibly changing biomechanical and physical properties. Trigger points, tension, and pain are a hallmark of MPS. Myofibroblasts play a role in sustained myofascial tension. Tension can propagate in fascia, possibly supporting a tensegrity framework. Movement and mechanical interventions treat and prevent MPS, while living sedentarily predisposes to MPS and recurrence. CONCLUSIONS MPS can be seen as a pathological state of imbalance in a natural process; manifesting from the inherent properties of the fascia, triggered by a disrupted biomechanical interplay. MPS might evolve into fibromyalgia through deranged myofibroblasts in connective tissue ("fascial armoring"). Movement is an underemployed requisite in modern lifestyle. Lifestyle is linked to pain and suffering. The mechanism of needling is suggested to be more mechanical than currently thought. A "global percutaneous needle fasciotomy" that respects tensegrity principles may treat MPS/fibromyalgia more effectively. "Functional-somatic syndromes" can be seen as one entity (myofibroblast-generated-tensegrity-tension), sharing a common rheuma-psycho-neurological mechanism.
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Affiliation(s)
- Shiloh Plaut
- School of Medicine, St. George’s University of London, London, United Kingdom
- * E-mail:
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Oliveira R, Plácido M, Pereira L, Machado S, Parreira E, Gil-Gouveia R. Headaches and the use of personal protective equipment in the general population during the COVID-19 pandemic. Cephalalgia 2022; 42:608-617. [PMID: 35166146 DOI: 10.1177/03331024211067787] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Headaches associated with personal protective equipment were reported in health-care workers in previous epidemiological studies. METHODS National web-based survey advertised by the Portuguese Headache Society and National Headache and Migraine patient´s organization between September-December 2020 screening for personal protective equipment usage pattern, pre-existing and de novo headaches after the onset of the COVID-19 pandemic, and its relation to personal protective equipment use. RESULTS Of 5064 participants, 90.6% (4562/5034) were women, mean age was 37.2 ± 11 years. Most questions had a completion rate above 87% (non-completion rate ranging from 0-12.7%). Twenty percent were health-care professionals (993/5046). Surgical and cloth masks were the most common personal protective equipment type, whereas protective eyewear and FFP2/FFP3 masks were mostly used by health-care professionals. About 97% (1814/1870) of migraine and headache participants reported aggravation of pre-existing headaches with personal protective equipment use, and 56% (2476/4420) had de novo headaches. Participants with de novo headaches had a higher frequency of pre-existing migraine (1118/1226, 91.2% vs 1408/1600, 88%, P = .042), and wore personal protective equipment for longer periods of time (7 ± 2 h 42 vs 6 ± 2 h 54 min per day, P < .001). In multivariate analysis longer mean duration of personal protective equipment use (OR of 1.1, 95% CI 1-1.2) and previous migraine (OR of 1.2, 95% CI 1-1.4) were predictors of developing de novo headaches. CONCLUSIONS Almost all participants with pre-existing headache reported worsening of their headaches, and more than half of the study population developed de novo headaches following personal protective equipment use. Duration of personal protective equipment usage and pre-existing migraine were the strongest predictors of de novo headaches.
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Affiliation(s)
- Renato Oliveira
- Department of Neurology, 199396Hospital da Luz Lisboa, Hospital da Luz Lisboa, Lisbon, Portugal.,Hospital da Luz Headache Center, Lisbon Portugal
| | - Madalena Plácido
- MiGRA Portugal - Portuguese Migraine and Headache Patients, Lisbon, Portugal
| | - Liliana Pereira
- Department of Neurology, Hospital Garcia de Orta, Lisbon, Portugal
| | - Sara Machado
- Hospital da Luz Headache Center, Lisbon Portugal.,Department of Neurology, Hospital Prof. Doutor Fernando Fonseca, Lisbon, Portugal
| | - Elsa Parreira
- Department of Neurology, 199396Hospital da Luz Lisboa, Hospital da Luz Lisboa, Lisbon, Portugal.,Hospital da Luz Headache Center, Lisbon Portugal.,Department of Neurology, Hospital Prof. Doutor Fernando Fonseca, Lisbon, Portugal
| | - Raquel Gil-Gouveia
- Department of Neurology, 199396Hospital da Luz Lisboa, Hospital da Luz Lisboa, Lisbon, Portugal.,Hospital da Luz Headache Center, Lisbon Portugal
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Santoro PE, Borrelli I, Gualano MR, Proietti I, Skroza N, Rossi MF, Amantea C, Daniele A, Ricciardi W, Potenza C, Moscato U. The Dermatological Effects and Occupational Impacts of Personal Protective Equipment on a Large Sample of Healthcare Workers During the COVID-19 Pandemic. Front Public Health 2022; 9:815415. [PMID: 35141194 PMCID: PMC8818717 DOI: 10.3389/fpubh.2021.815415] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 12/23/2021] [Indexed: 12/14/2022] Open
Abstract
Introduction Working during the Sars-CoV-2 pandemic healthcare workers (HCWs) had to wear Personal Protective Equipment (PPEs) for extended periods of time, leading to an increase in dermatological reactions. The study evaluates the prevalence of adverse skin reactions to PPEs among Italian healthcare workers during the COVID-19 pandemic, and aims to determine whether prolonged PPEs usage poses a significant occupational health risk, by measuring the loss of work days and the eligibility of workers that requested health surveillance due to dermatological PPEs reactions. Materials and Methods An online ad hoc questionnaire was administered to a sample of Italian HCWs. Questions verted on sociodemographic characteristics, PPEs usage, and occupational well-being. Descriptive analyses and logistic regressions were performed to explore possible associations between variables. Results Two types of PPEs, Gloves and Masks, were tested. The sample included 1,223 interviewed HCWs, 1,184 gave their consent for participation. A total of 90 medical surveillance visits were requested due to PPEs related dermatological issues: in 30 cases were recognized limitations in working duties and in one case the worker was deemed not fit to keep working. Furthermore, 25 workers had a loss of occupational days due to dermatological issues. A statistically significant correlation was observed with being a nurse or midwife (OR = 1.91, IC = 1.38–2.63, p < 0.001), and being female (OR = 2.04, IC = 1.49–2.78, p < 0.001), which acted as risk factors. Discussion The enhanced protection measures put in place during the COVID-19 pandemic, highlight the importance of occupational dermatology. This study could contribute to assess the issue, aiming to develop better prevention strategies in the workplace in order to improve well-being of HCWs and reduce the impact of dermatological adverse reactions to PPEs.
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Affiliation(s)
- Paolo Emilio Santoro
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli Istituto di Ricovero e Cura a Carattere Scientifico, Rome, Italy
- Department of Life Sciences and Public Health, Section of Occupational Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Ivan Borrelli
- Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Maria Rosaria Gualano
- Department of Public Health Sciences and Paediatrics, University of Torino, Torino, Italy
- *Correspondence: Maria Rosaria Gualano
| | - Ilaria Proietti
- Dermatology Unit “Daniele Innocenzi”, “A. Fiorini” Hospital, Terracina, Italy
| | - Nevena Skroza
- Dermatology Unit “Daniele Innocenzi”, “A. Fiorini” Hospital, Terracina, Italy
| | - Maria Francesca Rossi
- Department of Life Sciences and Public Health, Section of Occupational Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Carlotta Amantea
- Department of Life Sciences and Public Health, Section of Occupational Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Alessandra Daniele
- Department of Life Sciences and Public Health, Section of Occupational Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Walter Ricciardi
- Department of Life Sciences and Public Health, Section of Hygiene, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Concetta Potenza
- Dermatology Unit “Daniele Innocenzi”, “A. Fiorini” Hospital, Terracina, Italy
| | - Umberto Moscato
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli Istituto di Ricovero e Cura a Carattere Scientifico, Rome, Italy
- Department of Life Sciences and Public Health, Section of Occupational Health, Università Cattolica del Sacro Cuore, Rome, Italy
- Department of Life Sciences and Public Health, Section of Hygiene, Università Cattolica del Sacro Cuore, Rome, Italy
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50
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Sharma R, Abrol S. Dermatological manifestations among health care workers following COVID-19 precaution taking measures. Indian J Dermatol 2022; 67:86-87. [PMID: 35656252 PMCID: PMC9154165 DOI: 10.4103/ijd.ijd_345_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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