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Personal protective equipment (PPE) reuse, first recommended in the context of the SARS-CoV-2 pandemic, can mitigate shortages in crisis situations and can greatly reduce the environmental impact of typically single-use PPE. Prior to safe reuse, PPE must be sanitized and contaminating pathogens-in current circumstances viruses in particular-must be inactivated. However, many established decontamination procedures are not equitable and remain unavailable in low-resource settings. In mid-2020, an interdisciplinary consortium of researchers first studied the potential of implementing cheap and easy-to-use antimicrobial photodynamic inactivation (aPDI) using methylene blue as photosensitizer to decontaminate face masks and filtering facepiece respirators. In this perspective piece, we describe the development of this novel method, discuss recent advances, and offer insights into how equitable PPE decontamination via methylene blue-based aPDI may be integrated into circular economy policies in the healthcare sector.
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Antiinfecciosos , COVID-19 , Dispositivos de Protección Respiratoria , Humanos , COVID-19/prevención & control , Azul de Metileno , Descontaminación/métodos , Equipo de Protección Personal , Atención a la SaludRESUMEN
OBJECTIVES: Brick kiln workers in Nepal are a neglected population who are exposed to high respirable silica concentrations, and few use interventions to reduce exposure. We aimed to characterise the prevalence of respiratory personal protective equipment (PPE) use, understand knowledge and attitudes towards kiln dust and respiratory PPE and identify factors associated with respiratory PPE use. METHODS: We conducted a cross-sectional study in Bhaktapur, Nepal. We used simple random selection to identify 10 out of 64 total kilns and stratified random sampling of 30 households to enrol workers aged ≥14 years within selected kilns. Field workers surveyed participants using structured questionnaires. Our primary outcome was to characterise the prevalence of current respiratory PPE use and secondary outcomes were summaries of knowledge, attitudes and practice of PPE use. RESULTS: We surveyed 83 workers (mean age 30.8 years, 77.1% male). Of these, 28.9% reported current respiratory PPE use at work, 3.6% heard of silicosis prior to the survey and 24.1% correctly identified the best respiratory PPE (N95, compared with surgical masks and barrier face coverings) for reducing dust exposure. Respiratory PPE users had higher income (mean monthly household income US$206 vs US$145; p=0.04) and education levels (25% vs 5.1% completed more than primary school; p=0.02) compared with non-users. CONCLUSIONS: Respiratory PPE use was low. Workers had poor knowledge of kiln dust health effects and proper respiratory PPE. We highlight important barriers to PPE use, particularly knowledge gaps, which can guide future investigations to reduce the silicosis burden among brick kiln workers.
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Polvo , Conocimientos, Actitudes y Práctica en Salud , Exposición Profesional , Equipo de Protección Personal , Dióxido de Silicio , Humanos , Nepal/epidemiología , Masculino , Adulto , Femenino , Estudios Transversales , Exposición Profesional/prevención & control , Equipo de Protección Personal/estadística & datos numéricos , Encuestas y Cuestionarios , Silicosis/epidemiología , Silicosis/prevención & control , Dispositivos de Protección Respiratoria/estadística & datos numéricos , Persona de Mediana Edad , Adulto Joven , Materiales de ConstrucciónRESUMEN
BACKGROUND: The COVID-19 pandemic has posed significant challenges to healthcare systems worldwide, including an increase in out-of-hospital cardiac arrests (OHCA). Healthcare providers are now required to use personal protective equipment (PPE) during cardiopulmonary resuscitation (CPR). Additionally, mechanical CPR devices have been introduced to reduce the number of personnel required for resuscitation. This study aimed to compare the outcomes of CPR performed with a mechanical device and the outcomes of manual CPR performed by personnel wearing PPE. METHODS: This multicenter observational study utilized data from the Korean Cardiac Arrest Research Consortium registry. The study population consisted of OHCA patients who underwent CPR in emergency departments (EDs) between March 2020 and June 2021. Patients were divided into two equal propensity score matched groups: mechanical CPR group (n = 421) and PPE-equipped manual CPR group (n = 421). Primary outcomes included survival rates and favorable neurological outcomes at discharge. Total CPR duration in the ED was also assessed. RESULTS: There were no significant between-group differences with respect to survival rate at discharge (mechanical CPR: 7.4% vs PPE-equipped manual CPR: 8.3%) or favorable neurological outcomes (3.3% vs. 3.8%, respectively). However, the mechanical CPR group had a longer duration of CPR in the ED compared to the manual CPR group. CONCLUSION: This study found no significant differences in survival rates and neurological outcomes between mechanical CPR and PPE-equipped manual CPR in the ED setting. However, a longer total CPR duration was observed in the mechanical CPR group. Further research is required to explore the impact of PPE on healthcare providers' performance and fatigue during CPR in the context of the pandemic and beyond.
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COVID-19 , Reanimación Cardiopulmonar , Servicios Médicos de Urgencia , Paro Cardíaco Extrahospitalario , Humanos , Reanimación Cardiopulmonar/métodos , Pandemias , COVID-19/epidemiología , Paro Cardíaco Extrahospitalario/terapiaRESUMEN
PURPOSE: As climate change accelerates, healthcare workers (HCW) are expected to be more frequently exposed to heat at work. Heat stress can be exacerbated by physical activity and unfavorable working requirements, such as wearing personal protective equipment (PPE). Thus, understanding its potential negative effects on HCW´s health and working performance is becoming crucial. Using wearable sensors, this study investigated the physiological effects of heat stress due to HCW-related activities. METHODS: Eighteen participants performed four experimental sessions in a controlled climatic environment following a standardized protocol. The conditions were (a) 22 °C, (b) 22 °C and PPE, (c) 27 °C and (d) 27 °C and PPE. An ear sensor (body temperature, heart rate) and a skin sensor (skin temperature) were used to record the participants´ physiological parameters. RESULTS: Heat and PPE had a significant effect on the measured physiological parameters. When wearing PPE, the median participants' body temperature was 0.1 °C higher compared to not wearing PPE. At 27 °C, the median body temperature was 0.5 °C higher than at 22 °C. For median skin temperature, wearing PPE resulted in a 0.4 °C increase and higher temperatures in a 1.0 °C increase. An increase in median heart rate was also observed for PPE (+ 2/min) and heat (+ 3/min). CONCLUSION: Long-term health and productivity risks can be further aggravated by the predicted temperature rise due to climate change. Further physiological studies with a well-designed intervention are needed to strengthen the evidence for developing comprehensive policies to protect workers in the healthcare sector.
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Trastornos de Estrés por Calor , Dispositivos Electrónicos Vestibles , Humanos , Equipo de Protección Personal , Temperatura Cutánea , Temperatura , Personal de Salud , Trastornos de Estrés por Calor/prevención & controlRESUMEN
BACKGROUND: Health systems worldwide struggled to obtain sufficient personal protective equipment (PPE) and ventilators during the COVID-19 pandemic due to global supply chain disruptions. Our study's aim was to create a proof-of-concept model that would simulate the effects of supply strategies under various scenarios, to ultimately help decision-makers decide on alternative supply strategies for future similar health system related crises. METHODS: We developed a system dynamics model that linked a disease transmission model structure (susceptible, exposed, infectious, recovered (SEIR)) with a model for the availability of critical supplies in hospitals; thereby connecting care demand (patients' critical care in hospitals), with care supply (available critical equipment and supplies). To inform the model structure, we used data on critical decisions and events taking place surrounding purchase, supply, and availability of PPE and ventilators during the first phase of the COVID-19 pandemic within the English national health system. We used exploratory modelling and analysis to assess the effects of uncertainties on different supply strategies in the English health system under different scenarios. Strategies analysed were: (i) purchasing from the world market or (ii) through direct tender, (iii) stockpiling, (iv) domestic production, (v) supporting innovative supply strategies, or (vi) loaning ventilators from the private sector. RESULTS: We found through our exploratory analysis that a long-lasting shortage in PPE and ventilators is likely to be apparent in various scenarios. When considering the worst-case scenario, our proof-of-concept model shows that purchasing PPE and ventilators from the world market or through direct tender have the greatest influence on reducing supply shortages, compared to producing domestically or through supporting innovative supply strategies. However, these supply strategies are affected most by delays in their shipment time or set-up. CONCLUSION: We demonstrated that using a system dynamics and exploratory modelling approach can be helpful in identifying the purchasing and supply chain strategies that contribute to the preparedness and responsiveness of health systems during crises. Our results suggest that to improve health systems' resilience during pandemics or similar resource-constrained situations, purchasing and supply chain decision-makers can develop crisis frameworks that propose a plan of action and consequently accelerate and improve procurement processes and other governance processes during health-related crises; implement diverse supplier frameworks; and (re)consider stockpiling. This proof-of-concept model demonstrates the importance of including critical supply chain strategies as part of the preparedness and response activities to contribute to health system resilience.
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COVID-19 , Resiliencia Psicológica , Humanos , Pandemias , COVID-19/epidemiología , Cuidados Críticos , Programas de GobiernoRESUMEN
Since 2020, the coronavirus disease 2019 (COVID-19) pandemic has seen many changes in our daily infection prevention behaviours so as to reduce healthcare-associated transmission of COVID-19 in patients and healthcare workers. In the early phases of the COVID-19 pandemic of 2020, there was much emphasis on compliant personal protective equipment utilization in the operating theatres (OTs) for COVID-19-positive patients. However, during this period, there was a lack of international validated protocols on the appropriate handling and subsequent storage of personal protective equipment in the context of aerosol-generating procedures in OTs for asymptomatic antigen rapid test (ART)-negative patients. Given the potential for transmission even with a negative ART due to the incubation period, our team developed a checklist of eye protection (e.g. goggles/face shield) and N95 mask handling and storage in non-isolation OTs for these patients. We sought to improve the compliance of best practices from 20% to 80% amongst junior anaesthetists in Singapore General Hospital so as to prevent infection transmission and cross-contamination in the OT through education and behaviour-changing interventions. This quality improvement project took place over 19 weeks from June to October 2020 by our team of anaesthetists and nurse clinicians in the non-isolation OT setting. To analyse the problem, we performed a root cause analysis to understand attitudes and beliefs driving their behaviour. The top 80% of cited root causes for non-compliance then guided prioritization of resources for subsequent behaviour-changing interventions. Using the comprehensive infection control checklist, we conducted several plan-do-study-act cycles while implementing this new checklist amongst junior anaesthetists. A total of 227 assessments of junior anaesthetists were made in the care of asymptomatic ART-negative patients. Compliance with correctly handling goggles post-intubation started out as 33.3% in Week 1, which improved to 78.5% by Week 19. Compliance with goggle storage and face shield disposal started out at 13.6% in Week 1 and increased to 78.6% by Week 19. We attributed this improvement to education and behaviour-changing interventions. This quality improvement project focusing on improving compliance with personal protective equipment utilization during the COVID-19 pandemic in the management of asymptomatic ART-negative patients in non-isolation OTs demonstrated the importance of interventions of education, persuasion, modelling, and training in effecting and sustaining organizational behaviour change in physicians and other healthcare personnel.
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Anestesistas , COVID-19 , Adhesión a Directriz , Equipo de Protección Personal , Humanos , COVID-19/epidemiología , COVID-19/prevención & control , Personal de Salud , Pandemias/prevención & control , SARS-CoV-2RESUMEN
INTRODUCTION: Facemasks are an important piece of personal protective equipment (PPE) to mitigate the spread of respiratory illnesses, but they can impede communication between patients and healthcare providers. The purpose of this scoping review is to identify effective communication practices while wearing facemasks. DESIGN: Scoping review using a systematic search of articles from the PubMed, CINAHL, and Embase databases. METHODS: The PEO (population, exposure, outcome) methodology was selected for this systematic scoping review. The population of interest (P) includes humans of all ages (children, adults, and older adults); the exposure of interest (E) is PPE that covers the mouth (i.e., facemasks); and the outcome of interest (O) is successful or unsuccessful communication practices. The Johns Hopkins Evidence-Based Practice for Nurses and Healthcare Professionals appraisal guidelines were used to determine the level and quality of the research. RESULTS: Thirty-nine articles met the inclusion criteria. Seventeen of these were high- or good-quality research studies, and the remaining 22 were non-research articles included with separate analysis as part of the scoping review. The 17 articles encompassed 2656 participants. The highest quality evidence indicated that standard surgical masks have the least impact on speech perception compared to other non-transparent mask types, and that recognizing emotions is less accurate with facemasks, necessitating compensatory actions (i.e., reducing extraneous noise, using a microphone to amplify voice, and employing clear speech). Evidence was contradictory regarding the use of transparent masks. Evidence was of limited quality for other non-verbal and verbal communication strategies. CONCLUSION: Awareness of communication challenges is crucial when wearing facemasks. More high-quality studies are needed to evaluate communication techniques when speakers are wearing facemasks. Basic strategies such as selecting an appropriate mask type, reducing extraneous noise, using microphones, verbalizing emotions, and employing clear speech appear to be beneficial. CLINICAL RELEVANCE: The findings of this scoping review highlight the importance of considering communication challenges while wearing facemasks in the healthcare settings. The review suggests that selecting an appropriate mask type, reducing extraneous noise, verbalizing emotions, and employing clear speech are some strategies that may be effective in mitigating the impact of facemasks on communication between patients and healthcare providers.
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Comunicación , Máscaras , Equipo de Protección Personal , Humanos , Personal de SaludRESUMEN
BACKGROUND: An increase in the workload and use of personal protective equipment by healthcare workers was observed during the COVID-19 pandemic. Due to the connections between craniocervical structures, symptoms such as neck pain and temporomandibular symptoms could be influenced by the use of PPE. AIMS: To assess the prevalence of craniocervical pain, sleep quality, physical activity, and depressive symptoms and relationship among craniocervical symptoms in healthcare workers before and during the COVID-19 pandemic in Brazil. DESIGN: Cross-sectional study. PARTICIPANTS: Healthcare workers. SETTINGS: An online questionnaire included a self-report of craniocervical pain intensity [orofacial pain, neck pain, and headache (Numerical Rating Scale)], sleep quality (Pittsburgh Sleep Quality Index), depressive symptoms (Patient Health Questionnaire two items) and physical activity (self-report). METHODS: The sample analysis was performed by descriptive statistics, the paired t-test was used to compare symptoms intensity before and during the pandemic. The relationship between dependent and independent samples was assessed through McNemar test, Pearson's chi-squared test, and Student's independent t-test. A value of p < .05 was adopted as statistical significance. RESULTS: Overall, 147 participants replied the questionnaires. Headache, neck pain, and orofacial pain complaints increased during the pandemic in healthcare workers (p < 0.001). Craniocervical pain was correlated with poor sleep quality, probable depression, and physical activity during the pandemic (p < 0.05). CONCLUSION: Healthcare workers self-reported more craniocervical pain during the COVID-19 pandemic compared to before the pandemic. In addition, poor sleep quality, depressive symptoms, and physical inactivity were associated with craniocervical symptoms during this period.
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COVID-19 , Depresión , Ejercicio Físico , Personal de Salud , Dolor de Cuello , Calidad del Sueño , Humanos , COVID-19/epidemiología , COVID-19/psicología , Masculino , Estudios Transversales , Femenino , Personal de Salud/estadística & datos numéricos , Personal de Salud/psicología , Brasil/epidemiología , Adulto , Depresión/epidemiología , Depresión/psicología , Dolor de Cuello/epidemiología , Dolor de Cuello/psicología , Encuestas y Cuestionarios , Ejercicio Físico/psicología , Persona de Mediana Edad , Pandemias , Cefalea/epidemiología , Cefalea/psicología , Autoinforme , SARS-CoV-2 , Equipo de Protección Personal/estadística & datos numéricos , PrevalenciaRESUMEN
Using data from the 2022 Korea Community Health Survey (nâ =â 13â 320), this study investigated helmet use and related factors among Korean adults using personal mobility devices, without distinguishing between private and hired users. Among mobility device users, 32.1% responded that they always wore a helmet. The proportion of helmet use was 35.2% among men, 25.8% among women, 29.2% among those aged 19-44 years, 42.3% among those aged 45-64 years and 26.6% among those aged 65 years or older. Furthermore, those who drank less frequently and were physically active were more likely to wear helmets. Moreover, people who always wore a seat belt when driving a car or sitting in the rear seat and people who always wore a helmet when riding a motorcycle were more likely to wear a helmet while using electric personal mobility devices. Approximately one-third of users always wore a helmet. The helmet-wearing rate was related to general characteristics such as gender and education level, and to safety behaviors such as wearing a seat belt when driving a car, sitting in the rear seat of a car, or when riding a motorcycle. In addition to considering personal characteristics investigated in this study, the helmet-wearing rate should be improved through policies or systems at the national or regional levels.
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Dispositivos de Protección de la Cabeza , Humanos , Dispositivos de Protección de la Cabeza/estadística & datos numéricos , Masculino , Femenino , República de Corea , Adulto , Persona de Mediana Edad , Anciano , Adulto Joven , Cinturones de Seguridad/estadística & datos numéricos , Encuestas EpidemiológicasRESUMEN
Personal protective equipment (PPE) has been universally recognized for its role in protecting workers from injuries and illnesses. Smart PPE integrates Internet of Things (IoT) technologies to enable continuous monitoring of workers and their surrounding environment, preventing undesirable events, facilitating rapid emergency response, and informing rescuers of potential hazards. This work presents a smart PPE system with a sensor node architecture designed to monitor workers and their surroundings. The sensor node is equipped with various sensors and communication capabilities, enabling the monitoring of specific gases (VOC, CO2, CO, O2), particulate matter (PM), temperature, humidity, positional information, audio signals, and body gestures. The system utilizes artificial intelligence algorithms to recognize patterns in worker activity that could lead to risky situations. Gas tests were conducted in a special chamber, positioning capabilities were tested indoors and outdoors, and the remaining sensors were tested in a simulated laboratory environment. This paper presents the sensor node architecture and the results of tests on target risky scenarios. The sensor node performed well in all situations, correctly signaling all cases that could lead to risky situations.
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Dispositivos Electrónicos Vestibles , Lugar de Trabajo , Humanos , Equipo de Protección Personal , Algoritmos , Internet de las Cosas , Inteligencia Artificial , Material Particulado/análisis , HumedadRESUMEN
Personal protective equipment (PPE) has long been a high priority in dental aerosol-producing treatments. Since COVID-19 pandemic, its importance has increased yet again. While importance of PPE in preventing transmission and thus possible infection of pathogens is well known, contamination potential of PPE after treatment itself is less investigated. This review aims to give an overview of the current literature and contamination potential (viral, blood, bacterial) of components of protective equipment itself. The literature search was performed using the Medline database; furthermore, a hand search was conducted. Last search took place on 23 November 2022. Two categories of hygiene-related keywords were formed (category A: mask, face shield, goggles, eyewear, personal protective equipment; category B: contamination, aerosol). Each keyword from one category was combined with all keywords from the other one. In addition, the keyword "dental" was always added. First, a title and abstract screening was performed. Afterward, a full-text analysis was followed for the included studies. A total of 648 search hits were found in the Medline database. 47 were included after title and abstract screening. 22 studies were excluded after full-text analysis, 25 studies were included. The hand search resulted in 4 studies that were included. Bacterial contamination of PPE after treatment has been adequately studied, contamination with blood less. Microorganisms mainly originate from the oral and cutaneous flora; however, a transmission of potential pathogens like Staphylococcus aureus or Escherichia coli was also described. Studies showing transmission pathways starting from PPE and its various components are lacking. No measures have yet been described that fully protect the protective equipment from contamination. There is growing awareness that PPE itself can be a source of pathogen transmission, and thus possible infection. Therefore, not only wearing of protective clothing, but also conscious handling of it is crucial for transmission and possible infection prevention. However, studies showing transmission pathways starting from PPE and its various components are lacking. Several studies have investigated what measures can be taken to protect the protective equipment itself. So far, none of the methods evaluated can prevent contamination of PPE.
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COVID-19 , Pandemias , Humanos , Pandemias/prevención & control , Transmisión de Enfermedad Infecciosa de Paciente a Profesional/prevención & control , Aerosoles y Gotitas Respiratorias , Equipo de Protección Personal , COVID-19/prevención & controlRESUMEN
Exposure to polycyclic aromatic hydrocarbons (PAHs) of high molecular weight from chimney soot can cause cancer among chimney sweepers. These sweepers may also be exposed to high concentrations of nanosized particles, which can cause significant inflammatory responses due to their relatively greater surface area per mass. In this study, the authors aimed to assess the exposure profiles of airborne personal exposure to gaseous and particulate PAHs, and real-time samples of the particle number concentrations (PNCs), particle sizes, and lung-deposited surface areas (LDSAs), for chimney sweepers in Norway. Additionally, the authors aimed to assess the task-based exposure concentrations of PNCs, sizes, and LDSAs while working on different tasks. The results are based on personal samples of particulate PAHs (n = 68), gaseous PAHs (n = 28), and real-time nanoparticles (n = 8) collected from 17 chimney sweepers. Samples were collected during a "typical work week" of chimney sweeping and fire safety inspections, then during a "massive soot" week, where larger sweeping missions took place. Significantly higher PAH concentrations were measured during the "massive soot" week compared to the "typical work week," however, the time-weighted average (TWA) (8-hr) of all gaseous and particulate PAHs ranged from 0.52 to 4.47 µg/m3 and 0.49 to 2.50 µg/m3, respectively, well below the Norwegian occupational exposure limit (OEL) of 40 µg/m3. The PNCs were high during certain activities, such as emptying the vacuum cleaner. Additionally, during 2 days of sweeping in a waste sorting facility, the TWAs of the PNCs were 3.6 × 104 and 7.1 × 104 particles/cm3 on the first and second days, respectively, which were near and above the proposed nano reference limit TWA value of 4.0 × 104 particles/cm3 proposed by the International Workshop on Nano Reference Values. The corresponding TWAs of the LDSAs were 49.5 and 54.5 µm2/cm3, respectively. The chimney sweepers seemed aware of the potential health risks associated with exposure, and suitable personal protective equipment was used. However, the PNCs reported for the activities show that when the activities change or increase, the PNCs' TWAs can become unacceptably high.
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Contaminantes Atmosféricos , Exposición Profesional , Hidrocarburos Policíclicos Aromáticos , Hidrocarburos Policíclicos Aromáticos/análisis , Hollín , Gases , Exposición Profesional/análisis , Polvo/análisis , Pulmón/química , Contaminantes Atmosféricos/análisis , Material Particulado/análisis , Monitoreo del Ambiente/métodosRESUMEN
During the COVID-19 pandemic, dental face shields were recommended to protect the eyes. This study aimed to examine to what extent face shield and mask contamination differ when a pre-procedural mouth rinsing with Chlorhexidine (CHX) is conducted before treatment. In this prospective, randomized study, three groups of subjects were formed (rinsing with 0.1% CHX, water, or no rinsing (control) before aerosol-producing treatments). After each of the 301 treatments, the practitioner's face shield was swabbed with eSwab and the mask was brought into contact with agar plates. Sampling was done from the exterior surface only. Samples were cultured for 48 h at 35 °C under aerobic and anaerobic conditions. Bacteria were classified by phenotypic characteristics, biochemical test methods, and matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS). Colony-forming units were counted and mean values were compared (WSR, H-test, U-test, p < 0.05). Within each subject group, face shields showed significantly more contamination than surgical masks (control group: 350 CFU, 50 CFU; intervention water: 270 CFU, 40 CFU; intervention CHX: 250 CFU, 30 CFU). Comparison of face shields of the different subject groups did not reveal any statistically significant differences. However, CHX resulted in a statistically significant bacterial reduction on surgical masks compared to the water and control group (control: 50 CFU, intervention water: 40 CFU, intervention CHX: 30 CFU). Contamination of face shields and surgical masks was highest in the control group, followed by the water group, and lowest in the intervention group with CHX. Streptococcus spp. and Staphylococcus spp. dominated, representing the oral and cutaneous flora. Contamination of masks worn with or without face shields did not differ. Presumably, face shields intercept first splashes and droplets, while the masks were mainly exposed to bioaerosol mist. Consequently, face shields protect the facial region and surroundings from splashes and droplets, but not the mask itself. A pre-procedural mouth rinse with CHX had no statistically significant reducing effect on contamination of the face shield, but a statistically significant reducing effect was observed on contamination of the mask.
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Pandemias , Aerosoles y Gotitas Respiratorias , Humanos , Clorhexidina/farmacología , Equipos de Seguridad , Bacterias , Agua/farmacologíaRESUMEN
The COVID-19 pandemic created an unprecedented increase in the usage of personal protective equipment (PPE) in the healthcare industry, especially in the form of face coverings. Subsequently, guidelines related to breathability and wear comfort were published by the Centers for Disease Control (CDC) as an influx of various new materials entered the PPE market. This study evaluated a proprietary, novel, zinc-ion embedded fiber with the ability to deactivate bacteria and viruses, including SARS-COV-2, for its wear comfort in a nonwoven disposable mask in comparison to a commercially available surgical face mask which served as the control. Ten healthy, full-time, career, firefighters participated in this study wearing both masks in a randomized fashion. A medical task simulation (MTS) protocol was developed to replicate nursing task metabolic rates, per the compendium of physical activities, via a graded treadmill walking exercise. Participant ratings including ease of mask fit, overall mask comfort, facial comfort, breathability, and facial temperature sensation were recorded before, during, and after the 50-minute protocol in a controlled environmental chamber. The 100% nylon, zinc ion mask was rated as slightly cooler at the beginning of the trial (at 0.8 vs. 1.3), than the commercially available polypropylene mask. The polypropylene mask also reached a perceived mask facial comfort (MFC) rating of 1.6 just 35 min into the protocol whereas the zinc ion mask did not reach a rating of slight discomfort until the end of the exercise. Findings indicate the novel zinc-ion embedded mask was as comfortable, if not more so, than the commercially available nonwoven mask with more favorable ratings for longer durations. Not only do the zinc properties provide enhanced protection, but they maintain, if not improve, wearer comfort.
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Antiinfecciosos , COVID-19 , Dispositivos de Protección Respiratoria , Humanos , COVID-19/prevención & control , SARS-CoV-2 , Pandemias/prevención & control , Zinc , Polipropilenos , Atención a la SaludRESUMEN
The objective was to study the interaction of the components of a complex liquid mixture on the permeation parameters of its constituents. A firearm cleaning solvent, Hoppes No. 9 Gun Bore Cleaner, was selected to challenge two varieties of disposable nitrile gloves, the thinnest (Kimberly-Clark Lavender) and thickest (Kimberly-Clark Blue), using the closed-loop ASTM F739 cell without recirculation and n-decane collection followed by quantitation of the permeated compounds using capillary gas chromatography-mass spectrometry. The thicker Blue glove resisted the permeation of Hoppe's relative to the thinner Lavender glove as shown by 3.2 times more mass permeated by the Lavender glove at 60 min despite the same standardized breakthrough times (7.5 ± 2.5 min). The kerosene fraction permeated faster at a much higher rate than expected. The Kimberly-Clark disposable nitrile glove chemical resistance guide lists a breakthrough time for kerosene of 82 min for Sterling disposable nitrile glove material. However, for Hoppe's the kerosene components appeared at the standardized breakthrough time. Mixture components that were reported by the glove manufacturer to quickly permeate the disposable nitrile material, such as ethanol, did not permeate at a rate slower than expected, indicative of a possible carrier function. A semiquantitative risk assessment confirmed the unacceptability of both gloves. Persons using personal protective equipment, such as gloves, may not be afforded the expected resistance to chemical permeation when chemicals are in a suitable mixture, hence enhancing the risk of exposure. More research is needed to produce better glove testing measures to ensure the safety of workers.
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Armas de Fuego , Guantes Protectores , Nitrilos , Permeabilidad , Solventes , Nitrilos/química , Exposición Profesional/prevención & control , Exposición Profesional/análisis , Humanos , Ensayo de Materiales , Cromatografía de Gases y Espectrometría de MasasRESUMEN
Structural firefighters are exposed to a complex set of contaminants and combustion byproducts, including volatile organic compounds (VOCs). Additionally, recent studies have found structural firefighters' skin may be exposed to multiple chemical compounds via permeation or penetration of chemical byproducts through or around personal protective equipment (PPE). This mannequin-based study evaluated the effectiveness of four different PPE conditions with varying contamination control measures (incorporating PPE interface design features and particulate blocking materials) to protect against ingress of several VOCs in a smoke exposure chamber. We also investigated the effectiveness of long-sleeve base layer clothing to provide additional protection against skin contamination. Outside gear air concentrations were measured from within the smoke exposure chamber at the breathing zone, abdomen, and thigh heights. Personal air concentrations were collected from mannequins under PPE at the same general heights and under the base layer at abdomen and thigh heights. Sampled contaminants included benzene, toluene, styrene, and naphthalene. Results suggest that VOCs can readily penetrate the ensembles. Workplace protection factors (WPFs) were near one for benzene and toluene and increased with increasing molecular weight of the contaminants. WPFs were generally lower under hoods and jackets compared to under pants. For all PPE conditions, the pants appeared to provide the greatest overall protection against ingress of VOCs, but this may be due in part to the lower air concentrations toward the floor (and cuffs of pants) relative to the thigh-height outside gear concentrations used in calculating the WPFs. Providing added interface control measures and adding particulate-blocking materials appeared to provide a protective benefit against less-volatile chemicals, like naphthalene and styrene.
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Contaminantes Ocupacionales del Aire , Bomberos , Naftalenos , Exposición Profesional , Ropa de Protección , Compuestos Orgánicos Volátiles , Compuestos Orgánicos Volátiles/análisis , Exposición Profesional/prevención & control , Exposición Profesional/análisis , Contaminantes Ocupacionales del Aire/análisis , Humanos , Benceno/análisis , Tolueno/análisis , Equipo de Protección Personal , Estireno/análisis , Maniquíes , Humo/análisis , Lugar de TrabajoRESUMEN
This scoping review aimed to identify and summarise evidence on the comfort and functional performance of police officer personal protective equipment (PPE). The Arksey and O'Malley (2005) five-stage framework for scoping reviews was followed. PubMed, CINAHL, Scopus, and Web of Science were searched, and 35 articles were included in the review. The findings show that increased police PPE mass increases heart rate, metabolic energy expenditure, and perceived exertion in response to exercise. Unisex armour designs cause increased discomfort for females with larger bra sizes. PPE reduces joint-specific range of motion, with the design and location impairing movement more than mass. Jumping and sprinting performance is decreased with heavy PPE but unaffected by lighter protection, while agility is compromised with most forms of protection. Future research is needed on the fit and function of PPE for specialist police units, such as mounted police, along with further investigations on how fit can affect functional performance.
This paper identifies and reviews existing evidence on the comfort and functional performance of police officer personal protective equipment (PPE). This is significant because it summarises and categorises key concepts that underpin research in this area, whilst highlighting gaps in the current knowledge and areas for future research.
RESUMEN
Firefighters wear personal protective equipment to protect them from the thermal and chemical environment in which they operate. The self-contained breathing apparatus (SCBA) provides isolation of the airway from the hazardous fireground. National standards limit SCBA weight, however, integration of additional features could result in an SCBA exceeding the current limit. The purpose of this study was to examine the effects of increased SCBA weight on firefighters' physiological responses, work output, dynamic stability, and comfort. Completion of simulated firefighting activities induced a strong physiological response. Peak oxygen consumption was higher with the lightest SCBA than the heaviest SCBA. Few other physiological differences were noted as SCBA weight increased. Importantly, increased SCBA weight resulted in significantly more negative perceptions by the firefighters and a trend towards significance for the duration of work time prior to reaching volitional fatigue. These results should be considered when assessing changes to existing SCBA weight limits.
Increased SCBA weight above existing national standards resulted in negative perceptions by the firefighters, but not significant physiological changes after two simulated bouts of firefighting activity. SCBA weight had a nearly significant impact on the time firefighters worked before reaching volitional fatigue, with heavier SCBA trending towards decreased working time.
RESUMEN
The recent pandemic has shown that protecting the general population from hazardous substances or pathogens can be a challenging and urgent task. The key element to adequate protection is appropriately sized, well-fitted and sufficiently distributed personal protective equipment (PPE). While these conditions are followed for adult PPE wearers, they are less considered when it comes to protecting subadults. In this study, the assessment of the fit and design improvements of a 3D-printed facial half mask for subadult wearers (4-18 years) is designed. The target population was represented by 1137 subadults, aged 4.06-18.94 years, for whom 3D face models were acquired. The half mask tested, which was originally provided in one subadult size, did not fit appropriately the target population. This finding prompted the creation of four size categories using the age-dependent distribution of the centroid size calculated from 7 facial landmarks. For each size category, a modified half-mask virtual design was created, including resizing and reshaping, and fit was evaluated visually and numerically using averaged and random 3D face representatives.Practitioner summary: The reason for this study was to describe procedures which led to design improvement of an existing half-mask and provide respiratory protection for subadults. To address this, fit was assessed using an innovative metric approach. Four sizes were then created based on centroid size, resulting in improved fit and design.Abbreviations: CH: cheilion landmark; CS: centroid size; EX: exocanthion landmark; GN: gnathion landmark; N: nasion landmark; PPE: personal protective equipment; PR: pronasale landmark; RPE: respiratory protective equipment.
3D human face dataset was used for modifying and validating protective equipment for subadultsTo ensure optimal protection for subadults, four size categories were proposed based on 3D face landmarks and centroid sizeModified half-mask design fit was validated virtually using a visual and numerical approach.
RESUMEN
The novel personal protection equipment based on a face mask equipped with a nanofiber filter functionalized with povidone iodine has been developed and tested in a clinical trial. This nanofiber filter was characterized with a low flow resistance and, thus, allowed comfortable breathing. The performed study proved that the novel nanofiber filter with incorporated povidone-iodine was characterized with a slow release of iodine which minimized side effects but kept disinfection efficiency. Our clinical study performed on 207 positively tested SARS-CoV-2 patients wearing the PPE for 4-8 hours daily for 1 to 4 days has shown that even the iodine amount as low as 0.00028 ppm was sufficient to significantly decrease the reproduction number and, very importantly, to protect against severe course of disease.