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AbdulHussein A, Butt ZA, Dimitrov S, Cozzarin B. Factors Associated With Worsened Mental Health of Health Care Workers in Canada During the COVID-19 Pandemic: Cross-Sectional Survey Study. Interact J Med Res 2024; 13:e50064. [PMID: 38358785 PMCID: PMC10905361 DOI: 10.2196/50064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Revised: 11/26/2023] [Accepted: 01/12/2024] [Indexed: 02/16/2024] Open
Abstract
BACKGROUND Health care workers (HCWs) in Canada have endured difficult conditions during the COVID-19 pandemic. Many worked long hours while attending to patients in a contagious environment. This introduced an additional burden that may have contributed to worsened mental health conditions. OBJECTIVE In this study, we examine the factors associated with worsened mental health conditions of HCWs as compared to before the start of the pandemic. METHODS We use data from a survey of HCWs by Statistics Canada. A regression model is used to estimate the odds ratios (ORs) of worsened mental health after the start of the pandemic. The estimated odds ratio (OR) is associated with different independent variables that include demographics (age, sex, immigration status, and geographic area), occupational factors (work status, occupational group, and exposure category), and different access levels to personal protective equipment (PPE). RESULTS Of 18,139 eligible participants surveyed, 13,990 (77.1%) provided valid responses. We found that HCWs younger than 35 years old were more likely (OR 1.14, 95% CI 1.03-1.27; P=.01) to exhibit worsened mental health as compared to the reference group (35-44 years old). As for sex, male HCWs were less likely (OR 0.76, 95% CI 0.67-0.86; P<.001) to exhibit worsened mental health as compared to female HCWs. Immigrant HCWs were also less likely (OR 0.57, 95% CI 0.51-0.64; P<.001) to exhibit worsened mental health as compared to nonimmigrant HCWs. Further, HCWs working in Alberta had the highest likelihood of exhibiting worsened mental health as compared to HCWs working elsewhere (Atlantic provinces, Quebec, Manitoba, Saskatchewan, Ontario, British Columbia, and Northern Territories). Frontline workers were more likely (OR 1.26, 95% CI 1.16-1.38; P<.001) to exhibit worsened mental health than nonfrontline HCWs. Part-time HCWs were less likely (OR 0.85, 95% CI 0.76-0.93; P<.001) to exhibit worsened mental health than full-time HCWs. HCWs who reported encountering COVID-19 cases were more likely (OR 1.55, 95% CI 1.41-1.70; P<.001) to exhibit worsened mental health as compared to HCWs who reported no contact with the disease. As for PPE, HCWs who never had access to respirators, eye protection, and face shields are more likely to exhibit worsened mental health by 1.31 (95% CI 1.07-1.62; P<.001), 1.51 (95% CI 1.17-1.96; P<.001), and 1.41 (95% CI 1.05-1.92; P=.02) than those who always had access to the same PPE, respectively. CONCLUSIONS Different HCW groups experienced the pandemic differently based on their demographic and occupational backgrounds as well as access to PPE. Such findings are important to stakeholders involved in the planning of personalized support programs and aid mental health mitigation in future crises. Certain groups require more attention.
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Affiliation(s)
- Ali AbdulHussein
- Department of Management Science, Faculty of Engineering, University of Waterloo, Waterloo, ON, Canada
| | - Zahid Ahmad Butt
- School of Public Health Sciences, Faculty of Health, University of Waterloo, Waterloo, ON, Canada
| | - Stanko Dimitrov
- Department of Management Science, Faculty of Engineering, University of Waterloo, Waterloo, ON, Canada
| | - Brian Cozzarin
- Department of Management Science, Faculty of Engineering, University of Waterloo, Waterloo, ON, Canada
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Ashour DM, Elkitkat RS, Gabr H, Yosef M, Singh Grewal D, Saleh MI. Challenges of personal protective equipment use among ophthalmologists during the COVID-19 pandemic: A multicenter international study. Eur J Ophthalmol 2022; 32:1398-1405. [PMID: 34180262 PMCID: PMC9111902 DOI: 10.1177/11206721211028037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 06/05/2021] [Indexed: 01/03/2023]
Abstract
PURPOSE To explore the possible challenges and difficulties of using Personal Protective Equipment (PPE) in ophthalmic practice during the Coronavirus disease 2019 (COVID-19) pandemic. METHODS This is a multicenter, international survey among practicing ophthalmologists across different countries. The survey was conducted from September 9th to October 24th, 2020. It included a total of 23 questions that navigated through the currently adopted recommendations in different clinical situations. The survey also assessed the convenience of using various PPE in ophthalmic practice and addressed the clarity of the examination field while using various PPE during clinical or surgical procedures. RESULTS One hundred and seventy-two ophthalmologists completed the survey (101 from Egypt, 50 from the USA, and 21 from four other countries). The analysis of the responses showed that most ophthalmologists use face masks without significant problems during their examinations, while face shields followed by protective goggles were the most inconvenient PPE in the current ophthalmic practice. Moreover, most of the participants (133, 77.3%) noticed an increase in their examination time when using PPE. Furthermore, a considerable percentage of the respondents (70, 40.7%) stopped using one or more of the PPE due to inconvenience or discomfort. CONCLUSIONS Due to the unique nature of the ophthalmic examination, certain PPE are not ophthalmologist-friendly. Innovative PPE should be tailored for prompt, more convenient, and clearer ophthalmological practice.
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Affiliation(s)
- Doaa Maamoun Ashour
- Department of Ophthalmology, Faculty of
Medicine, Ain Shams University, Cairo, Egypt
| | - Rania Serag Elkitkat
- Department of Ophthalmology, Faculty of
Medicine, Ain Shams University, Cairo, Egypt
- Watany Eye Hospital, Cairo, Egypt
- Watany Research and Development Center,
Cairo, Egypt
| | - Hesham Gabr
- Department of Ophthalmology, Faculty of
Medicine, Ain Shams University, Cairo, Egypt
- Department of Ophthalmology, Duke
University, Durham, NC, USA
| | - Mostafa Yosef
- Department of Community, Environmental
and Occupational Medicine, Ain Shams University, Cairo, Egypt
| | | | - Mohamed Ibrahim Saleh
- Department of Ophthalmology, Faculty of
Medicine, Ain Shams University, Cairo, Egypt
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Abstract
Introduction: The current pandemic of severe acute respiratory symptom coronavirus 2 (SARS-CoV-2) has had a major impact on individuals’ lives. Social isolation and the use of personal protective equipment - the latter being especially important for health care workers - emerged as two of the main methods of preventing the spread of the disease. The eye can represent a source of transmission through contaminated tears, as well as a source of infection for respiratory droplets or aerosol particles, which may come into contact with the ocular surface and migrate to the lungs and other parts of the body. Objectives: To investigate the risk of ocular transmission through a literature review and identify ways of preventing it. Methods: A search of the scientific literature was conducted in the PubMed and Cochrane databases, using a combination of the following keywords: “COVID-19,” “eye,” “personal protective equipment,” “SARS-CoV-2,” “protective goggles,” “face shields,” and “workers’ health.” Results: The mechanisms of ocular transmission have not been fully elucidated, but studies have demonstrated the presence of viral RNA in the conjunctival sac and aerosolized secretions of contaminated patients; these droplets may come into contact with the eyes of uninfected bystanders, entering the respiratory system through the nose and gaining access to the lungs. Conclusions: Studies show that the virus can be effectively transmitted through the eyes, underscoring the importance of protective goggles for health care workers or potential transmitters of the virus, in addition to the need for additional education measures to encourage hand hygiene and discourage touching of the eyes.
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Ionescu AC, Brambilla E, Manzoli L, Orsini G, Gentili V, Rizzo R. Efficacy of personal protective equipment against coronavirus transmission via dental handpieces. J Am Dent Assoc 2021; 152:631-640. [PMID: 34325779 PMCID: PMC7997726 DOI: 10.1016/j.adaj.2021.03.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Revised: 02/28/2021] [Accepted: 03/15/2021] [Indexed: 02/04/2023]
Abstract
BACKGROUND This laboratory study was done to evaluate the efficacy of personal protective equipment (PPE) and high-volume evacuation (HVE) against the spread of human coronavirus type 229E (HCoV-229E) during a standard dental procedure. METHODS Patient and operator manikins were used to recreate a dental setting inside a custom-built class III cabinet-like chamber. The mouth of the patient manikin was inoculated with an HCoV-229E suspension, the viral load of which was similar to that of asymptomatic people infected with severe acute respiratory syndrome coronavirus 2. The dental procedure was performed with an air turbine handpiece and HVE for 10 seconds. The efficacy of surgical masks, N95 (filtering facepiece class 2) and filtering facepiece class 3 respirators, and face shields was tested via quantitative real-time polymerase chain reaction. RESULTS The wide surface on which the inoculum was spread caused low contamination. Over the external surfaces of masks and respirators, when a face shield was not worn, viral loads ranged from 1.2 through 1.4 log10 mean gene copies per cm2. When the shield was worn, viral loads dropped below the detection limit (< 0.317 log10 gene copies/cm2) for all PPE. On the operator's forehead, viral loads were 0.6 through 0.8 log10 gene copies/cm2. Inside the operator manikin's mouth, viral loads were under the detection limit when using any PPE, with or without the shield. HVE did not significantly change viral loads. CONCLUSIONS All PPE combinations significantly reduced viral loads in the operator manikin's mouth to below the detection limit, but HVE did not decrease viral contamination. PRACTICAL IMPLICATIONS Although caution is suggested when removing and disposing of PPE to avoid self-contamination, the combination of PPE and face shields drastically decreases the risk of transmitting human coronavirus during aerosol-generating dental procedures.
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Perez-Mañanes R, José SGDS, Desco-Menéndez M, Sánchez-Arcilla I, González-Fernández E, Vaquero-Martín J, González-Garzón JP, Mediavilla-Santos L, Trapero-Moreno D, Calvo-Haro JA. Application of 3D printing and distributed manufacturing during the first-wave of COVID-19 pandemic. Our experience at a third-level university hospital. 3D Print Med 2021; 7:7. [PMID: 33683485 PMCID: PMC7938282 DOI: 10.1186/s41205-021-00097-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Accepted: 02/28/2021] [Indexed: 12/02/2022] Open
Abstract
Background 3D printing and distributed manufacturing represent a paradigm shift in the health system that is becoming critical during the COVID-19 pandemic. University hospitals are also taking on the role of manufacturers of custom-made solutions thanks to 3D printing technology. Case Presentation We present a monocentric observational case study regarding the distributed manufacturing of three groups of products during the period of the COVID-19 pandemic from 14 March to 10 May 2020: personal protective equipment, ventilatory support, and diagnostic and consumable products. Networking during this period has enabled the delivery of a total of 17,276 units of products manufactured using 3D printing technology. The most manufactured product was the face shields and ear savers, while the one that achieved the greatest clinical impact was the mechanical ventilation adapters and swabs. The products were manufactured by individuals in 57.3% of the cases, and our hospital acted as the main delivery node in a hub with 10 other hospitals. The main advantage of this production model is the fast response to stock needs, being able to adapt almost in real time. Conclusions The role of 3D printing in the hospital environment allows the reconciliation of in-house and distributed manufacturing with traditional production, providing custom-made adaptation of the specifications, as well as maximum efficiency in the working and availability of resources, which is of special importance at critical times for health systems such as the current COVID-19 pandemic.
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Affiliation(s)
- Rubén Perez-Mañanes
- Advanced Planning and 3D Manufacturing Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain. .,Department of Orthopaedic Surgery and Traumatology, Hospital General Universitario Gregorio Marañón, Madrid, Spain. .,Faculty of Medicine. Department of Surgery, Universidad Complutense, Madrid, Spain. .,Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.
| | - Sonia García-de San José
- Advanced Planning and 3D Manufacturing Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain.,Deputy Hospital Management, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Manuel Desco-Menéndez
- Advanced Planning and 3D Manufacturing Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain.,Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.,Department of Bioengineering and Aerospace Engineering, Universidad Carlos III, Madrid, Spain
| | - Ignacio Sánchez-Arcilla
- Advanced Planning and 3D Manufacturing Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain.,Department of Labour Risks Prevention, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Esmeralda González-Fernández
- Advanced Planning and 3D Manufacturing Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain.,Supply Management, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Javier Vaquero-Martín
- Department of Orthopaedic Surgery and Traumatology, Hospital General Universitario Gregorio Marañón, Madrid, Spain.,Faculty of Medicine. Department of Surgery, Universidad Complutense, Madrid, Spain.,Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - Javier Pascau González-Garzón
- Advanced Planning and 3D Manufacturing Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain.,Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.,Department of Bioengineering and Aerospace Engineering, Universidad Carlos III, Madrid, Spain
| | - Lydia Mediavilla-Santos
- Department of Orthopaedic Surgery and Traumatology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Diego Trapero-Moreno
- Advanced Planning and 3D Manufacturing Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - José Antonio Calvo-Haro
- Advanced Planning and 3D Manufacturing Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain.,Department of Orthopaedic Surgery and Traumatology, Hospital General Universitario Gregorio Marañón, Madrid, Spain.,Faculty of Medicine. Department of Surgery, Universidad Complutense, Madrid, Spain.,Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
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Wendling JM, Fabacher T, Pébaÿ PP, Cosperec I, Rochoy M. Experimental Efficacy of the Face Shield and the Mask against Emitted and Potentially Received Particles. Int J Environ Res Public Health 2021; 18:1942. [PMID: 33671300 PMCID: PMC7922468 DOI: 10.3390/ijerph18041942] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Revised: 02/09/2021] [Accepted: 02/10/2021] [Indexed: 01/03/2023]
Abstract
There is currently not sufficient evidence to support the effectiveness of face shields for source control. In order to evaluate the comparative barrier performance effect of face masks and face shields, we used an aerosol generator and a particle counter to evaluate the performance of the various devices in comparable situations. We tested different configurations in an experimental setup with manikin heads wearing masks (surgical type I), face shields (22.5 cm high with overhang under the chin of 7 cm and circumference of 35 cm) on an emitter or a receiver manikin head, or both. The manikins were face to face, 25 cm apart, with an intense particle emission (52.5 L/min) for 30 s. The particle counter calculated the total cumulative particles aspirated on a volume of 1.416 L In our experimental conditions, when the receiver alone wore a protection, the face shield was more effective (reduction factor = 54.8%), while reduction was lower with a mask (reduction factor = 21.8%) (p = 0.002). The wearing of a protective device by the emitter alone reduced the level of received particles by 96.8% for both the mask and face shield (p = NS). When both the emitter and receiver manikin heads wore a face shield, the protection allowed for better results in our experimental conditions: 98% reduction for the face shields versus 97.3% for the masks (p = 0.01). Face shields offered an even better barrier effect than the mask against small inhaled particles (<0.3 µm-0.3 to 0.5 µm-0.5 to 1 µm) in all configurations. Therefore, it would be interesting to include face shields as used in our experimental study as part of strategies to reduce transmission within the community setting.
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Affiliation(s)
| | - Thibaut Fabacher
- Department of Public Health, GMRC, CHRU, F-67000 Strasbourg, France;
| | | | | | - Michaël Rochoy
- General Medicine Department, University Lille, CERIM, ULR 2694, F-59000 Lille, France
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Mittal S, Mohan A, Madan K, Boppana TK, Tiwari P, Hadda V. Face shields for prevention of SARS-CoV-2 in community - need of the hour. Adv Respir Med 2021; 89:83. [PMID: 33471352 DOI: 10.5603/ARM.a2020.0185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 10/03/2020] [Indexed: 11/25/2022]
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Abstract
COVID-19 has challenged most everyone in every facet of life. In the beginning of the pandemic shutdown, schools had to make decisions quickly often with limited planning. For students who were deaf or hard of hearing, communication access during instruction was the urgent focus of teachers of the deaf/hard of hearing and educational audiologists. The move from the classroom to home resulted in both predictable and unpredictable challenges as well as some unexpected benefits. Based on numerous conversations with these professionals as well as parents, the challenges encountered with online learning and solutions that were implemented to support students are reported.
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Affiliation(s)
- Cheryl DeConde Johnson
- The ADE-Vantage-Audiology, Deaf Education Vantage Consulting Services, Leadville, Colorado.,College of Education, Disabilities and Psychoeducational Studies, University of Arizona, Tucson, Arizona
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Affiliation(s)
- James D Cherry
- Department of Pediatrics, David Geffen School of Medicine at the University of California–Los Angeles, Los Angeles, California, USA,Correspondence: James D. Cherry, Department of Pediatrics, David Geffen School of Medicine at UCLA, 10833 Le Conte Ave., MDCC 22–442, Los Angeles, CA 90095–1752 ()
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Britton J, Eadie E, Turner D. An investigation of different types of eyewear and face shields in protecting patients and operators from the harmful effects of ultraviolet radiation. Photodermatol Photoimmunol Photomed 2019; 35:246-254. [PMID: 30932222 DOI: 10.1111/phpp.12459] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/25/2019] [Indexed: 11/27/2022]
Abstract
BACKGROUND Phototherapy and photochemotherapy are commonly used treatment modalities for a range of chronic skin conditions. Whilst undergoing ultraviolet radiation exposure, patients can wear personal protective equipment. Face shields in combination with other forms of skin cover may be worn to provide both skin and eye protection. There are a number of different types of eyewear and face shields available for purchase. Some of these have clear identifications that show the levels of protection provided whilst others may not have any. METHODS A series of similar experiments has been undertaken independently at two phototherapy treatment centres-Chapel Allerton Hospital, Leeds and Ninewells Hospital, Dundee-to investigate the effectiveness of different face shields and eye protection that are available for purchase in the United Kingdom (UK). Two similar examples of one face shield were tested at both centres, and another was transferred between the units. RESULTS Not all examples of the face shields and protective eyewear provided the wearer full protection between 300 nanometres and 400 nanometres (nm). Cost and conformance to different standards was not always a good indicator. Some inexpensive examples tested also met British Association of Dermatology protective sunglasses guidelines. CONCLUSIONS It is incumbent on all centres to check the properties of protective face shields and eyewear provided to patients and operators to guard against the effects from ultraviolet radiation. There is no correlation between price of the protective equipment and level of protection offered, and there may be opportunity for cost savings.
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Affiliation(s)
- Jason Britton
- Medical Physics Department, Leeds General Infirmary, Leeds, UK
| | - Ewan Eadie
- Photobiology unit, Ninewells Hospital, Dundee, UK
| | - David Turner
- Dermatology Department, Chapel Allerton Hospital, Leeds, UK
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