Thermal discomfort caused by personal protective equipment in healthcare workers during the delta COVID-19 pandemic in Guangzhou, China: A case study
Thermal discomfort caused by personal protective equipment in healthcare workers during the delta COVID-19 pandemic in Guangzhou, China: A case study
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DOI：
10.1016/j.csite.2022.101971
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发表时间：
2022-04-06
影响因子：
6.8
通讯作者：
Fang Z
中科院分区：
文献类型：
--
作者：
Zhu Y;Qiao S;Wu W;Li Y;Jian H;Lin S;Tang T;Zheng Z;Mao Y;Chen X;Fang Z
与上一次COVID-19疫情相比，于二零二一年炎热的夏季，大部分前线医护人员在户外环境下为居民进行核酸检测，而非在医院照顾COVID-19患者。因此，有必要调查个人防护装备（PPE）引起的热不适的发生率和特点。于2021年6月12日至16日，在广州市11个行政区的医院进行了一项横断面调查，以评估HCW的热不适。采用单因素和Logistic回归分析探讨与热不适相关的危险因素。共收到有效问卷3658份。穿戴PPE后热不适和湿不适水平分别从2.91 ± 1.19增加到3.61 ± 0.72和从0.98 ± 1.36增加到3.06 ± 1.1（p < 0.01）。“非常热”和“不舒服的潮湿”的感觉是最受穿戴PPE影响的，分别从31%增加到69.1%和从9.1%增加到45.7%。热不适水平显著增加（3.75 ± 0.57 vs.3.33 ± 0.89，p < 0.01）和潮湿不适水平舒适组与不舒适组之间的平均值分别为3.33 ± 0.95和2.54 ± 1.19，p < 0.01，伴随着类似的“非常热”和“令人不舒服的潮湿”的感觉模式。对于一般热相关症状，最常见的新发症状是多汗（80%），其次是呼吸困难（55.2%）和过度脱水（46.8%），而面部肿胀（74%）与局部热相关症状相关，其次是手部浸渍糜烂（56.7%）和视力损害（49.3%）。在多变量分析中，环境的表观温度（≥35 °C）、在负压救护车和户外工作、在此期间继续穿戴PPE 1-3天、年龄>40岁以及既往抗击大流行的经历与热不适独立相关（p < 0.01）。32.3%的受访者在取下PPE后立即考虑饮用冰水/另一种饮料，其次是25%的人缩短穿戴PPE的时间，19.1%的人去厕所。很大一部分参与者期待修改服装（72.9%）和面罩（53.4%）的材料以散热和通风，以及防雾护目镜（60.2%），在PPE中添加水合设备（53.4%），并使用柔软材料以减少压力（40%）。在夏季环境中，热不适是常见的，并且会降低与PPE相关的健康生理学。这表明，迫切需要修改目前的工作方法，以提高卫生保健工作者的应变能力，并加强他们在大流行期间的服务。
In contrast to the previous COVID-19 pandemic, most frontline healthcare workers (HCWs) worked on residents’ nucleic acid tests in outdoor environments, instead of taking care of COVID-19 patients in hospitals during the hot summer of 2021. Therefore, it is necessary to investigate the prevalence and characteristics of thermal discomfort caused by personal protective equipment (PPE). A cross-sectional survey was conducted online at hospitals from 11 administrative regions of Guangzhou for the assessment of thermal discomfort among HCWs from June 12–16, 2021. Univariate and logistic regression analyses were used to explore the risk factors associated with thermal discomfort. A total of 3658 valid responses were collected. The thermal discomfort and humid discomfort levels increased from 2.91 ± 1.19 to 3.61 ± 0.72 and from 0.98 ± 1.36 to 3.06 ± 1.1 after wearing PPE, respectively (p < 0.01). Feelings of being “very hot” and “uncomfortably humid” were the most influenced by wearing PPE, increasing from 31% to 69.1% and from 9.1% to 45.7%, respectively. There were significant increases in the thermal discomfort level (3.75 ± 0.57 vs. 3.33 ± 0.89, p < 0.01) and the humid discomfort level (3.33 ± 0.95 vs. 2.54 ± 1.19, p < 0.01) between the comfortable group and uncomfortable group, accompanied by similar patterns in the feelings of being “very hot” and “uncomfortably humid.” For general thermal-related symptoms, the most common new-onset symptom was profuse sweating (80%) followed by labored breathing (55.2%) and excessive dehydration (46.8%), while facial swelling (74%) was associated with local thermal-related symptoms, followed by hand maceration erosion (56.7%) and visual impairment (49.3%). In the multivariate analysis, the apparent temperature of the environment (≥35 °C), working in negative-pressure ambulances and outdoors, continuing to wear PPE for 1–3 days during this period, being aged >40 years, and previous experiences fighting the pandemic were independently associated with thermal discomfort (p < 0.01). Immediately after PPE removal, 32.3% of respondents considered drinking ice water/another drink, followed by 25% shortening the duration of wearing PPE and 19.1% going to the toilet. A large proportion of the participants looked forward to modifications to the material of the suit (72.9%) and mask (53.4%) for heat dissipation and dehumidification, as well as anti-fogging goggles (60.2%), adding hydration equipment to PPE (53.4%), and using soft materials to reduce pressure (40%). Thermal discomfort is common and degrades health physiology related to PPE in summer environments. This suggests that modifications to the current working practices are urgently required to improve the resilience of HCWs and enhance their services during pandemics.
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DOI：
10.1016/j.jhin.2020.11.027
发表时间：
2021-03
期刊：
The Journal of hospital infection
影响因子：
--
作者：
Davey SL;Lee BJ;Robbins T;Randeva H;Thake CD
通讯作者：
Thake CD
影响因子：
3.7
作者：
Potter AW;Gonzalez JA;Xu X
通讯作者：
Xu X
DOI：
10.3390/ijerph17218100
发表时间：
2020-11-03
影响因子：
--
作者：
Lee J;Venugopal V;Latha PK;Alhadad SB;Leow CHW;Goh NY;Tan E;Kjellstrom T;Morabito M;Lee JKW
通讯作者：
Lee JKW
DOI：
10.1016/j.jamcollsurg.2009.11.001
发表时间：
2010-03-01
影响因子：
5.2
作者：
Fry, Donald E.;Harris, W. Edwin;Twomey, Carolyn L.
通讯作者：
Twomey, Carolyn L.
影响因子：
9.8
作者：
Morabito, Marco;Messeri, Alessandro;Marinaccioe, Alessandro
通讯作者：
Marinaccioe, Alessandro