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Protective equipment-related pressure ulcers in healthcare workers during COVID-19 pandemic: A systematic review. J Tissue Viability 2022; 31:213-220. [PMID: 35210162 PMCID: PMC8856964 DOI: 10.1016/j.jtv.2022.02.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 01/29/2022] [Accepted: 02/14/2022] [Indexed: 01/17/2023]
Abstract
AIM This systematic review was carried out to examine pressure ulcers in healthcare staff due to the use of protective equipment during COVID-19 pandemic and the precautions taken to prevent these injuries. METHOD Relevant studies were retrospectively searched. Seven English keywords identified from MESH were used while searching. The search was carried out in five international databases by trying various combinations of these words during February 15-25, 2021. This systematic review was updated by rescanning databases on December 20, 2021 and a total of 611 studies were attained. RESULTS 17 studies which met the study inclusion criteria, which were conducted mostly through online survey method in different study designs and which included a total of 24,889 healthcare professionals were examined. The incidence of PPE-related pressure ulcers was found to be between 30% and 92.8%. Grade I pressure ulcers were the most common (44.1%-82%). The incidence of skin problems except PPE-related pressure ulcers such as itching, redness and dry skin was found to be between 42.8-88.1%. Risk factors that frequently played a role in the development of PPE-related pressure ulcers and other skin problems were longer use of PPE and sweating. PPE-related pressure ulcers and other skin problems were more frequent over the nose (nasal bone/nasal bridge), ears, forehead and cheeks. PPE-related itching, redness and dry skin mostly occurred. Several dressing applications were found to be effective in the prevention of PPE-related pressure ulcers and other skin problems that might develop especially on the facial region. CONCLUSION PPE-related pressure ulcers and other skin problems were found to be higher among healthcare professionals. Data regarding the sealing of dressing applications against viral transmission in the prevention of PPE-related pressure ulcers and other skin problems are limited. It is estimated that future studies will be performed to prevent device-related pressure ulcers in healthcare workers. It is suggested that there is a need to conduct studies with larger samples where expert researchers make observations for pressure ulcers in order to determine the prevalence and incidence of PPE-related pressure ulcers.
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Mahalingam K, Surbhi, Balaji A, Ganesh R, Daniel RA, Aggarwal R, Soni KD, Singh AK, Khanna P, Gupta V, Trikha A. Is it a challenging task to work with personal protective equipment in a COVID-19 ICU: Findings from a hospital-based cross-sectional study from north India. J Family Med Prim Care 2022; 11:1935-1942. [PMID: 35800524 PMCID: PMC9254845 DOI: 10.4103/jfmpc.jfmpc_1937_21] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 12/07/2021] [Accepted: 12/11/2021] [Indexed: 01/25/2023] Open
Abstract
Introduction Amidst the coronavirus disease 2019 (COVID-19) pandemic, the use of personal protective equipment (PPE) is mandatory for healthcare workers to remain protected against infection. The present study was undertaken to evaluate challenges faced by the healthcare workers while using level 3 PPE. Methods This hospital-based study was conducted among resident doctors selected by convenience sampling method using a pretested, semi-structured, self-administered questionnaire after getting informed consent from the participants to collect data on the somatic, psychological, and technical problems faced while working in PPE. Bivariate and multivariable logistic regression was done between outcome variables and other independent variables to check for the association. Results Of the total, 252 resident doctors completed the survey, their age ranged from 22 to 36 years with 140 (55.6%) males and 112 (44.4%) females. One-twenty-nine (51.2%) residents were trained to work in ICU, 73 (29%) participants used PPE ≤10 times and the rest 179 (71%) used PPE more than 10 times. The difficulties faced were as follows: visual impairment (n = 244, 96.8%), headache (n = 226, 89.6%), breathing difficulty (n = 216, 85.7%), hearing impairment (n = 201, 79.8%), sweating (n = 242, 96%), and fear of being infected (n = 156,61.9%). Two-thirty-six (93.6%) participants felt that overall work quality reduced due to PPE. Headache, hunger, urge to micturate, anxiety, sleep disturbances, and need to change the timing of medication or diet were higher with increased duration of work with PPE. Conclusion A longer duration of work is associated with headache, hunger, anxiety, and sleep disturbances. More research has to be done to improve the PPE to reduce problems like visual impairment, skin irritation, sweating, and breathing difficulty.
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Affiliation(s)
- Karthikeyan Mahalingam
- Department of Ophthalmology, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Surbhi
- Department of Anaethesia and Critical Care, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Akshaya Balaji
- Department of Ophthalmology, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Ragul Ganesh
- Department of Psychiatry, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Roy Arokiam Daniel
- Department of Centre for Community Medicine, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Richa Aggarwal
- Department of Anaethesia and Critical Care, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Kapil Dev Soni
- Department of Anaethesia and Critical Care, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Akhil Kant Singh
- Department of Anaethesia and Critical Care, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Puneet Khanna
- Department of Anaethesia and Critical Care, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Viney Gupta
- Department of Ophthalmology, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Anjan Trikha
- Department of Anaethesia and Critical Care, All India Institute of Medical Sciences (AIIMS), New Delhi, India
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Scientific and Clinical Abstracts From WOCNext® 2022: Fort Worth, Texas ♦ June 5-8, 2022. J Wound Ostomy Continence Nurs 2022; 49:S1-S99. [PMID: 35639023 DOI: 10.1097/won.0000000000000882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Chowdhury S, Roy S, Iktidar MA, Rahman S, Liza MM, Islam AMK, Akhter S, Medha MB, Tasnim A, Gupta AD, Deb A, Chowdhury S, Hawlader MDH. Prevalence of dermatological, oral and neurological problems due to face mask use during COVID-19 and its associated factors among the health care workers of Bangladesh. PLoS One 2022; 17:e0266790. [PMID: 35413077 PMCID: PMC9004776 DOI: 10.1371/journal.pone.0266790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 03/27/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND When caring for COVID-19 patients, using personal protective equipment (PPE) may significantly lower the risk of infection of health care workers (HCWs). However, adverse responses due to PPE use have been observed during the 2003 SARS pandemic. This study will highlight the different adverse reactions caused by face mask use, one of the essential components of PPE in the HCWs, and identify the factors associated with these problems. METHODS This cross-sectional survey was conducted between September and October 2021. 404 HCWs were selected by snowball sampling from four randomly selected healthcare facilities of Bangladesh. Trained volunteers collected data by face-to-face interview using a pretested structured questionnaire. Data were analyzed using STATA (v.16) and summarized using frequency and relative frequency. Later, the chi-square test was used to explore bivariate relationships, and the binary logistic regression model was fit to identify the predictors. RESULTS The majority of the respondents were 26-36 years (70.30%), male (69.80%), and doctors (74.50%). 48.76% of the respondents had unfavorable skin responses beneath the face masks; female gender, physicians, professionals working more than 32 hours a week, wearing N95, and more than one mask were predictors of skin problem. 28.47% and 60.15% of all participants suffered from some form of oral and neurological problems, respectively. CONCLUSION Face mask use sequelae, especially skin, oral and neurological problems, are prevalent among health care workers. Therefore, necessary precautionary measures should be taken to safeguard our frontlines.
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Affiliation(s)
- Sreshtha Chowdhury
- Department of Public Health, North South University, Dhaka, Bangladesh
- Public Health Professional Development Society (PPDS), Dhaka, Bangladesh
| | - Simanta Roy
- Department of Public Health, North South University, Dhaka, Bangladesh
- Public Health Professional Development Society (PPDS), Dhaka, Bangladesh
| | - Mohammad Azmain Iktidar
- Department of Public Health, North South University, Dhaka, Bangladesh
- Public Health Professional Development Society (PPDS), Dhaka, Bangladesh
| | - Shahidur Rahman
- Chittagong Medical College and Hospital, Chattogram, Bangladesh
| | - Mowshomi Mannan Liza
- Department of Public Health, North South University, Dhaka, Bangladesh
- Public Health Professional Development Society (PPDS), Dhaka, Bangladesh
| | - A. M. Khairul Islam
- Department of Public Health, North South University, Dhaka, Bangladesh
- Public Health Professional Development Society (PPDS), Dhaka, Bangladesh
| | - Sharmin Akhter
- Department of Public Health, North South University, Dhaka, Bangladesh
- Public Health Professional Development Society (PPDS), Dhaka, Bangladesh
| | | | - Afia Tasnim
- Chittagong Medical College and Hospital, Chattogram, Bangladesh
| | | | - Auditia Deb
- Chittagong Medical College and Hospital, Chattogram, Bangladesh
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Ho WYB, Tan LYC, Zhao X, Wang D, Lim HLJ. Epidemiology of occupational dermatoses associated with personal protective equipment use in the COVID-19 pandemic: Risk factors and mitigation strategies for frontline healthcare workers. JAAD Int 2022; 8:34-44. [PMID: 35434662 PMCID: PMC8989739 DOI: 10.1016/j.jdin.2022.03.013] [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] [Indexed: 11/29/2022] Open
Abstract
Background Objectives Methods Results Conclusions
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Affiliation(s)
- Wen Yang Benjamin Ho
- National Skin Center, Singapore
- Correspondence to: Wen Yang Benjamin Ho, MBBS, MRCP, MMed, National Skin Center, 1 Mandalay Road, Singapore 308205, Singapore.
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Raju SP, Sachdev M, Khunger N, Madnani N. Mask Acne in Skin of Color: A Significant Dermatological Condition Amidst the COVID-19 Pandemic. THE JOURNAL OF CLINICAL AND AESTHETIC DERMATOLOGY 2022; 15:44-48. [PMID: 35465038 PMCID: PMC9017666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The COVID-19 pandemic has given rise to the need to use personal protective equipment such as masks, among healthcare professionals and the general public. Numerous facial dermatoses linked to the use of masks have been described, from which the term maskne or mask acne has emerged. Although prolonged mask usage has been necessary, and a vast majority of people develop various skin conditions, there is a lack of research on the effects of masks on skin. In this article, we review alterations in biochemical properties of skin associated with mask use in individuals with skin of color and the factors predisposing them to developing acne. Because masks are crucial in preventing the spread of COVID-19, we also elucidate some fundamental strategies such as gentle skin care measures, decreasing the duration of mask wear, and following appropriate protocols for mask re-use, which may prevent mask acne and its long-term effects.
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Affiliation(s)
- Sahana P Raju
- Dr. Raju is with the Department of Dermatology, Bangalore Medical College and Research Institute, India
- Dr. Sachdev is with the Department of Dermatology at Manipal Hospital in Bangalore, India
- Dr. Khunger is with the Department of Dermatology at VMMC & Safdarjung Hospital in New Delhi, India
- Dr. Madnani is with the Department of Dermatology at PD Hinduja National Hospital and Sir HN Reliance Foundation Hospital in Mumbai, India
| | - Mukta Sachdev
- Dr. Raju is with the Department of Dermatology, Bangalore Medical College and Research Institute, India
- Dr. Sachdev is with the Department of Dermatology at Manipal Hospital in Bangalore, India
- Dr. Khunger is with the Department of Dermatology at VMMC & Safdarjung Hospital in New Delhi, India
- Dr. Madnani is with the Department of Dermatology at PD Hinduja National Hospital and Sir HN Reliance Foundation Hospital in Mumbai, India
| | - Niti Khunger
- Dr. Raju is with the Department of Dermatology, Bangalore Medical College and Research Institute, India
- Dr. Sachdev is with the Department of Dermatology at Manipal Hospital in Bangalore, India
- Dr. Khunger is with the Department of Dermatology at VMMC & Safdarjung Hospital in New Delhi, India
- Dr. Madnani is with the Department of Dermatology at PD Hinduja National Hospital and Sir HN Reliance Foundation Hospital in Mumbai, India
| | - Nina Madnani
- Dr. Raju is with the Department of Dermatology, Bangalore Medical College and Research Institute, India
- Dr. Sachdev is with the Department of Dermatology at Manipal Hospital in Bangalore, India
- Dr. Khunger is with the Department of Dermatology at VMMC & Safdarjung Hospital in New Delhi, India
- Dr. Madnani is with the Department of Dermatology at PD Hinduja National Hospital and Sir HN Reliance Foundation Hospital in Mumbai, India
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George J, Verma R, Shafqat N. Physiological Hazard Assessment While Wielding Personal Protective Equipment (PPE) Among Health Care Workers. Cureus 2022; 14:e23510. [PMID: 35494999 PMCID: PMC9037050 DOI: 10.7759/cureus.23510] [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] [Accepted: 03/22/2022] [Indexed: 11/17/2022] Open
Abstract
Introduction Accurate use of personal protective equipment (PPE) is an essential part of infection prevention and control measures to protect health care workers and patients from various hazardous conditions. Health care workers caring for patients with potentially infectious health conditions are using PPE for long periods of time. However, long-term use of PPE can cause many physiological health hazards among health care workers. So, the current study was carried out to assess the general health problems and dermatological problems experienced by health care workers with PPE use. Materials and methods A descriptive cross-sectional survey has been carried out in two selected tertiary care hospitals in central India by recruiting 301 health care workers. Non-probability convenient sampling technique was used to select participants for the study. Sociodemographic Performa and structured questionnaires were used to collect data on demographic characteristics of the participants and various health problems experienced by health care workers with PPE use. Collected data were analyzed using appropriate descriptive and inferential statistics. Results The current study reported excessive sweating (86.4%), difficulty in reading (85%), dry mouth (80.7%), and breathing difficulty (74.1%) as the most common problem associated with PPE use. In addition to this, adverse reactions like headache, restlessness, and dizziness were reported by 70.1%, 64.5%, and 50.8%. Indentation and pain on the back of the ears (76.1%), skin soaking (67.1%), and excessive sweating (76.1%) were identified as the most common problems related to N-95 masks, gloves, and coverall use. Conclusion The current study revealed a higher incidence of various health problems with PPE use among health care workers. The findings of the study highlight the importance of developing various guidelines to reduce the negative impact of PPE use and implementing preventive measures to decrease health problems associated with PPE use.
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Proietti I, Borrelli I, Skroza N, Santoro PE, Gualano MR, Bernardini N, Mambrin A, Tolino E, Marchesiello A, Marraffa F, Michelini S, Rossi G, Volpe S, Ricciardi W, Moscato U, Potenza C. Adverse skin reactions to personal protective equipment (
PPE
) during
COVID
‐19 pandemic in Italian health care workers. Dermatol Ther 2022; 35:e15460. [PMID: 35306721 PMCID: PMC9111857 DOI: 10.1111/dth.15460] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 02/07/2022] [Accepted: 03/17/2022] [Indexed: 12/01/2022]
Abstract
To avoid exposure to SARS‐COV‐2, healthcare professionals must use personal protective equipment (PPE). Their use has been related to a series of adverse effects; the most frequent adverse events were headache, dyspnoea, and pressure injuries. Skin adverse effects are very common, including contact dermatitis, itching, erythema, and acneiform eruptions. The objective of this study is to evaluate the skin problems caused by personal protection equipment (PPE) in health care workers (HCWs) and to individuate eventual risk factors. From May to June 2020 a retrospective observational multi‐centric study conducted by an online survey sent by email, involving 10 hospital centers, was performed. We considered as independent variables gender and age, occupational group and sector, time of utilization, type and material of PPE. We tested 3 types of PPE: gloves, bonnet, and mask for different time of utilization (<1, 1–3, 3–6, >6 h). We performed a multiple logistic regression model to correlate them with skin adverse events occurrence. Among all the 1184 participants, 292 workers reported a dermatological pathology: 45 (15.41%) had psoriasis, 54 (18.49%) eczema, 38 (13.01%) acne, 48 (16.44%) seborrheic dermatitis, and 107 (36.64%) other. In our sample previous inflammatory dermatological conditions, female sex, prolonged use of PPE were significant risk factors for developing skin related adverse events considering all the PPE considered. The use of PPE is still mandatory in the hospital setting and skin adverse reactions still represent a global problem. Although data from Europe are limited, our study highlighted the importance of the problem of PPE skin reactions in a large sample of Italian healthcare professionals.
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Affiliation(s)
- Ilaria Proietti
- Department of Medico‐Surgical Sciences and Biotechnologies Sapienza University of Rome, Polo Pontino, Dermatology Unit “Daniele Innocenzi”, “A. Fiorini” Hospital, Terracina (LT) Italy
| | - Ivan Borrelli
- Department of Health Sciences and Public Health Università Cattolica del Sacro Cuore Rome Italy
| | - Nevena Skroza
- Department of Medico‐Surgical Sciences and Biotechnologies Sapienza University of Rome, Polo Pontino, Dermatology Unit “Daniele Innocenzi”, “A. Fiorini” Hospital, Terracina (LT) Italy
| | - Paolo Emilio Santoro
- Department of Woman and Child Health and Public Health Fondazione Policlinico Universitario A. Gemelli IRCCS Rome Italy
- Department of Health 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
| | - Nicoletta Bernardini
- Department of Medico‐Surgical Sciences and Biotechnologies Sapienza University of Rome, Polo Pontino, Dermatology Unit “Daniele Innocenzi”, “A. Fiorini” Hospital, Terracina (LT) Italy
| | - Alessandra Mambrin
- Department of Medico‐Surgical Sciences and Biotechnologies Sapienza University of Rome, Polo Pontino, Dermatology Unit “Daniele Innocenzi”, “A. Fiorini” Hospital, Terracina (LT) Italy
| | - Ersilia Tolino
- Department of Medico‐Surgical Sciences and Biotechnologies Sapienza University of Rome, Polo Pontino, Dermatology Unit “Daniele Innocenzi”, “A. Fiorini” Hospital, Terracina (LT) Italy
| | - Anna Marchesiello
- Department of Medico‐Surgical Sciences and Biotechnologies Sapienza University of Rome, Polo Pontino, Dermatology Unit “Daniele Innocenzi”, “A. Fiorini” Hospital, Terracina (LT) Italy
| | - Federica Marraffa
- Department of Medico‐Surgical Sciences and Biotechnologies Sapienza University of Rome, Polo Pontino, Dermatology Unit “Daniele Innocenzi”, “A. Fiorini” Hospital, Terracina (LT) Italy
| | - Simone Michelini
- Department of Medico‐Surgical Sciences and Biotechnologies Sapienza University of Rome, Polo Pontino, Dermatology Unit “Daniele Innocenzi”, “A. Fiorini” Hospital, Terracina (LT) Italy
| | - Giovanni Rossi
- Department of Medico‐Surgical Sciences and Biotechnologies Sapienza University of Rome, Polo Pontino, Dermatology Unit “Daniele Innocenzi”, “A. Fiorini” Hospital, Terracina (LT) Italy
| | - Salvatore Volpe
- Department of Medico‐Surgical Sciences and Biotechnologies Sapienza University of Rome, Polo Pontino, Dermatology Unit “Daniele Innocenzi”, “A. Fiorini” Hospital, Terracina (LT) Italy
| | - Walter Ricciardi
- Department of Health Sciences and Public Health Università Cattolica del Sacro Cuore Rome Italy
| | - Umberto Moscato
- Department of Woman and Child Health and Public Health Fondazione Policlinico Universitario A. Gemelli IRCCS Rome Italy
- Department of Health Sciences and Public Health Università Cattolica del Sacro Cuore Rome Italy
- Department of Public Health Sciences and Paediatrics University of Torino Torino Italy
| | - Concetta Potenza
- Department of Medico‐Surgical Sciences and Biotechnologies Sapienza University of Rome, Polo Pontino, Dermatology Unit “Daniele Innocenzi”, “A. Fiorini” Hospital, Terracina (LT) Italy
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Hu B. Recent Advances in Facemask Devices for In Vivo Sampling of Human Exhaled Breath Aerosols and Inhalable Environmental Exposures. Trends Analyt Chem 2022; 151:116600. [PMID: 35310778 PMCID: PMC8917876 DOI: 10.1016/j.trac.2022.116600] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Since the COVID-19 pandemic, the unprecedented use of facemasks has been requiring for wearing in daily life. By wearing facemask, human exhaled breath aerosols and inhaled environmental exposures can be efficiently filtered and thus various filtration residues can be deposited in facemask. Therefore, facemask could be a simple, wearable, in vivo, onsite and noninvasive sampler for collecting exhaled and inhalable compositions, and gain new insights into human health and environmental exposure. In this review, the recent advances in developments and applications of in vivo facemask sampling of human exhaled bacteria, viruses, proteins, and metabolites, and inhalable facemask contaminants and air pollutants, are reviewed. New features of facemask sampling are highlighted. The perspectives and challenges on further development and potential applications of facemask devices are also discussed.
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Affiliation(s)
- Bin Hu
- Institute of Mass Spectrometry and Atmospheric Environment, Guangdong Provincial Engineering Research Center for On-line Source Apportionment System of Air Pollution, Jinan University, Guangzhou 510632, China
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Dash G, Patro N, Dwari BC, Abhisekh K. Mask induced skin changes during Covid pandemic: A cross-sectional web-based survey among physicians in a tertiary care teaching hospital. J Cosmet Dermatol 2022; 21:1804-1808. [PMID: 35212140 PMCID: PMC9115254 DOI: 10.1111/jocd.14881] [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: 12/22/2021] [Revised: 01/24/2022] [Accepted: 02/17/2022] [Indexed: 11/28/2022]
Abstract
Background The COVID pandemic has affected the human race both physically and mentally. Mask use remains the standard way of preventing the spread of this virus. The continuous mask use has led to the emergence of various dermatoses like acne, pigmentation, and seborrhea in mask contact areas. The present survey has been undertaken to describe the various dermatoses encountered in the medical fraternity especially doctors, who are frequently exposed to prolonged mask use. Aims To estimate the frequency of various cutaneous manifestations seen among doctors following mask use via web‐based online questionnaire survey. Methods It was a cross‐sectional web‐based study conducted at a tertiary care teaching institute from June 2021 to August 2021. All the doctors of the hospital completing the questionnaire were included in the study with informed consent. Results A total of 178 participants completed the survey. The most common complaint was increased sweating (55.6%) followed by acne (34.3%) and oily skin (34.3%). Significant association was found between skin changes and duration (>6 h/day) of mask use, increasing number, and type of mask (N 95) used (p value <0.05). Conclusion The knowledge of various mask‐induced/aggravated dermatoses will help formulate proper precautionary protocols enhancing efficient mask usage for prolonged periods.
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Affiliation(s)
- Gaurav Dash
- Department of Dermatology, Hitech hospital, Bhubaneswar
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Aloweni F, Bouchoucha SL, Hutchinson A, Ang SY, Toh HX, Bte Suhari NA, Bte Sunari RN, Lim SH. Health care workers' experience of personal protective equipment use and associated adverse effects during the COVID-19 pandemic response in Singapore. J Adv Nurs 2022; 78:2383-2396. [PMID: 35170075 PMCID: PMC9111733 DOI: 10.1111/jan.15164] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 10/28/2021] [Accepted: 11/27/2021] [Indexed: 12/15/2022]
Abstract
Aim One of the greatest challenges in responding to the COVID‐19 pandemic is preventing staff exposure and infection by ensuring consistent and effective use of personal protective equipment (PPE). This study explored health care workers' experience of prolonged PPE use in clinical practice settings and their concerns regarding PPE supply, effectiveness and training needs. Design A descriptive cross‐sectional design was adopted in this study. Methods Health care workers (N = 592) from an acute care hospital completed an online survey from July to September 2020 assessing: (i) usage frequencies, side effects and interference with patient care; and (ii) perceptions of access to PPE, likelihood of exposure to infection and adequacy of PPE training. Results PPE‐related side effects were reported by 319 (53.8%) participants, the majority being nurses (88.4%) and those working in high‐risk areas such as the emergency department (39.5%), respiratory wards (acute 22.3% and non‐acute 23.8%) and COVID‐19 isolation ward (13.8%). The average time wearing PPE per shift was 6.8 h (SD 0.39). The most commonly reported symptoms were from donning N95 masks and included: pressure injuries (45.5%), mask‐induced acne (40.4%) and burning/pain (24.5%). Some 31.3% expressed that PPE‐related side effects had negatively affected their work. The odds of having PPE‐associated side effects was higher in women (OR 2.10, 95% CI [1.29–03.42], p = .003) and those working in high‐risk wards (OR 3.12, 95% CI [2.17–4.60], p < .001]. Most (90.1%) agreed that PPE supplies were readily available, sufficient for all (86.1%) and there was sufficient training in correct PPE use (93.6%). Only 13.7% of participants reported being ‘highly confident’ of overall PPE protection. Conclusions Prevention and management of PPE‐related adverse effects is vital to: preserve the integrity of PPE, improve adherence and minimize viral transmission. Impact The high incidence of PPE‐associated pressure injuries and perception that PPE use can interfere with clinical care should inform future development of PPE products, and strategies to better equip health care workers to prevent and manage PPE‐related side effects.
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Affiliation(s)
- Fazila Aloweni
- Division of Nursing, Singapore General Hospital, Singapore, Singapore
| | - Stéphane L Bouchoucha
- Associate Head of School (International), Centre for Quality and Patient Safety Research in the Institute for Health Transformation, Deakin University Geelong, School of Nursing and Midwifery, Victoria, Australia
| | - Ana Hutchinson
- Centre for Quality and Patient Safety Research in the Institute for Health Transformation, Epworth Health/Deakin University Partnership, School of Nursing and Midwifery Geelong, Victoria, Australia
| | - Shin Yuh Ang
- Division of Nursing, Singapore General Hospital, Singapore, Singapore
| | - Hui Xian Toh
- Division of Nursing, Singapore General Hospital, Singapore, Singapore
| | | | | | - Siew Hoon Lim
- Division of Nursing, Singapore General Hospital, Singapore, Singapore
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Moore Z, Moore D, McEvoy NL, Avsar P, O'Connor T, Budri A, Curley G, Walsh S, Burke F, Porter‐Armstrong A, Chaboyer W, Rice J, Patton D. Preventing facial pressure injuries among health care staff working in diverse COVID-19 care environments. Int Wound J 2022; 19:1677-1685. [PMID: 35146927 PMCID: PMC9111615 DOI: 10.1111/iwj.13768] [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: 11/22/2021] [Revised: 01/20/2022] [Accepted: 01/24/2022] [Indexed: 02/03/2023] Open
Abstract
The aim of this study was to determine the impact of a specially designed care bundle on the development of facial pressure injuries among frontline health care workers wearing personal protective equipment (PPE) during the COVID-19 pandemic. This was a mixed methods study. First, a pre-posttest observational design was employed to evaluate the impact of the pre-piloted intervention, a care bundle including skin cleansing and hydration, protective material use, facemask selection and skin inspection, developed in line with international best practice guidelines. Data were collected using survey methodology. Frontline COVID-19 staff working in acute, community and ambulance services were invited to participate. Then, judgemental and volunteer sampling was used to select participants to undertake semi-structured interviews to elicit feedback on their perceptions of the care bundle. The sample included 120 acute hospital staff, 60 Ambulance staff, 24 Community Hub staff and 20 COVID-19 testing centre staff. A survey response rate of 61% was realised (n = 135/224). Of the participants, 32% (n = 43) had a facial pressure ulcer (FPI) pre-intervention and 13% (n = 18) developed an FPI while using the care bundle. The odds ratio (OR) was 0.33 (95% CI: 0.18 to 0.61; P = .0004), indicating a 77% reduction in the odds of FPI development with use of the care bundle. Analysis of the qualitative data from 22 interviews identified three key themes, the context for the care bundle, the ease of use of the care bundle and the care bundle as a solution to FPI development. The care bundle reduced the incidence of FPI among the participants and was found to be easy to use. Implementation of skin protection for frontline staff continues to be important given the persistently high incidence of COVID-19 and the ongoing need to wear PPE for protracted durations.
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Affiliation(s)
- Zena Moore
- Skin Wounds and Trauma Research CentreRCSI University of Medicine and Health SciencesDublinIreland,School of Nursing and MidwiferyRCSI University of Medicine and Health SciencesDublinIreland,Fakeeh College of Health SciencesJeddahSaudi Arabia,School of Nursing and MidwiferyGriffith UniversityQueenslandAustralia,Faculty of Medicine, Nursing and Health SciencesMonash UniversityMonashAustralia,Department of Public HealthFaculty of Medicine and Health Sciences, Ghent UniversityGhentBelgium,Lida InstituteShanghaiChina,University of WalesCardiffUK,National Health and Medical Research Council Centre of Research Excellence in Wiser Wound CareMenzies Health Institute QueenslandQueenslandAustralia
| | | | - Natalie L. McEvoy
- School of Nursing and MidwiferyRCSI University of Medicine and Health SciencesDublinIreland,Beaumont HospitalDublinIreland
| | - Pinar Avsar
- Skin Wounds and Trauma Research CentreRCSI University of Medicine and Health SciencesDublinIreland,School of Nursing and MidwiferyRCSI University of Medicine and Health SciencesDublinIreland
| | - Tom O'Connor
- Skin Wounds and Trauma Research CentreRCSI University of Medicine and Health SciencesDublinIreland,School of Nursing and MidwiferyRCSI University of Medicine and Health SciencesDublinIreland,Fakeeh College of Health SciencesJeddahSaudi Arabia,School of Nursing and MidwiferyGriffith UniversityQueenslandAustralia,Lida InstituteShanghaiChina
| | - Aglecia Budri
- Skin Wounds and Trauma Research CentreRCSI University of Medicine and Health SciencesDublinIreland,School of Nursing and MidwiferyRCSI University of Medicine and Health SciencesDublinIreland
| | - Gerard Curley
- Beaumont HospitalDublinIreland,RCSI University of Medicine and Health SciencesDublinIreland
| | - Simone Walsh
- Skin Wounds and Trauma Research CentreRCSI University of Medicine and Health SciencesDublinIreland,School of Nursing and MidwiferyRCSI University of Medicine and Health SciencesDublinIreland
| | - Frank Burke
- School of Nursing and MidwiferyRCSI University of Medicine and Health SciencesDublinIreland
| | | | - Wendy Chaboyer
- School of Nursing and MidwiferyRCSI University of Medicine and Health SciencesDublinIreland,School of Nursing and MidwiferyGriffith UniversityQueenslandAustralia,National Health and Medical Research Council Centre of Research Excellence in Wiser Wound CareMenzies Health Institute QueenslandQueenslandAustralia
| | | | - Declan Patton
- Skin Wounds and Trauma Research CentreRCSI University of Medicine and Health SciencesDublinIreland,School of Nursing and MidwiferyRCSI University of Medicine and Health SciencesDublinIreland,Fakeeh College of Health SciencesJeddahSaudi Arabia,School of Nursing and MidwiferyGriffith UniversityQueenslandAustralia,Faculty of Science, Medicine and HealthUniversity of WollongongAustralia
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Maskne: The Epidemic within the Pandemic: From Diagnosis to Therapy. J Clin Med 2022; 11:jcm11030618. [PMID: 35160071 PMCID: PMC8836723 DOI: 10.3390/jcm11030618] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 01/17/2022] [Accepted: 01/24/2022] [Indexed: 02/04/2023] Open
Abstract
Maskne, a newly coined term deriving from the contraction of mask-related acne, is a form of mechanical acne resulting from continuous textile–skin adherence and friction. Prolonged mask use heats up the face environment, thus modifying skin microbiota and sebum production. Although effective prevalence is unknown, since the pandemic began and the prolonged use of masks was extended to the general population, maskne has been a frequent topic of consultation among dermatologists. This term has been successfully introduced into common language, with more than 200,000 hashtags on social media, where it is also possible to find “home remedies” that can worsen this dermatosis. The aim of this paper is to discuss the pathogenesis, address clinicians on the correct differential diagnoses among facial dermatoses, and move towards the correct therapy.
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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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65
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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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Silva LFMD, Almeida AGDA, Pascoal LM, Santos Neto M, Lima FET, Santos FS. Skin injuries due to Personal Protective Equipment and preventive measures in the COVID-19 context: an integrative review. Rev Lat Am Enfermagem 2022. [PMID: 35476010 PMCID: PMC9019902 DOI: 10.1590/1518-8345.5636.3522] [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] [Indexed: 11/22/2022] Open
Abstract
Objective to identify the diverse scientific evidence on the types of skin lesions caused due to the use of Personal Protective Equipment in health professionals during the COVID-19 pandemic and to verify the recommended prevention measures. Method this is an integrative review carried out in the MEDLINE, CINAHL, LILACS, SCOPUS, Science Direct, Web of Science and SciELO databases. The search was conducted in a paired manner, constituting a sample of 17 studies categorized according to the types of skin lesions and preventive measures. Results the main types of skin lesions related to mask use were stage 1 pressure ulcers, acne and cutaneous depression. Regarding the use of glasses and face shields, the most frequent were stage 1 and 2 pressure ulcers. Xerosis and irritant contact dermatitis occurred due to using gloves and protective clothing, respectively. The main preventive measures recommended were using hydrocolloid or foam dressing in the pressure regions, moisturizers and emollients. Conclusion a considerable number of skin lesions associated with using the equipment were noticed, and the data obtained can guide the professionals in identifying risks and promoting preventive measures to avoid their occurrence.
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Malathy PA, Daniel SJ, Venkatesan S, Priya BY. A Clinico Epidemiological Study of Adverse Cutaneous Manifestations on Using Personal Protective Equipment Among Health Care Workers During Covid Pandemic in a Tertiary Care Centre. Indian J Dermatol 2022; 67:478. [PMID: 36578707 PMCID: PMC9792000 DOI: 10.4103/ijd.ijd_1157_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Background COVID-19 (Coronavirus Disease 2019) pandemic was caused by a novel coronavirus. The frontline health care workers (HCW), wearing personal protective equipment (PPE) for a longer duration can result in a spectrum of adverse skin reactions. Recognizing occupationally induced adverse skin manifestations from PPE is necessary to avoid skin damage and risk of infections and to maintain compliance. Aim This study aimed to determine the prevalence, clinical characteristics of adverse cutaneous manifestations due to PPE, and also the contributing epidemiological factors among HCW in a tertiary care institute. Materials and Methods This cross-sectional study was conducted for a period of one month. Four hundred fifteen health care workers who used PPE continuously for >4 hours voluntarily participated in this study. By using a self-administered online questionnaire, the information and clinical photographs were collected. Results The prevalence of adverse skin manifestations was 62.1% (258). The prevalence was more common in females. Mask-related facial skin problems were most commonly reported. Of 74 participants with pre-existing acne lesions, 35 (8.4%) reported acne flare-ups after using PPE. Increased sweating (22.6%) and itching (11%) were the most commonly noted symptoms. Conclusion This study provides an insight into the prevalence of adverse skin reactions due to prolonged PPE usages, such as N95 masks and latex gloves in particular. Hence dermatological screening of HCW at regular intervals is inevitable to facilitate early management and prevent inadvertent protocol breaches. Further, it proposes the importance of raising proper safety measures to effectively reduce the COVID positivity rate among HCW by minimizing and preventing occupationally induced dermatosis.
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Affiliation(s)
- Priyavathani A. Malathy
- From the Department of Dermatology, Madras Medical College and RGGGH, Chennai, Tamil Nadu, India
| | - Samuel J. Daniel
- From the Department of Dermatology, Madras Medical College and RGGGH, Chennai, Tamil Nadu, India
| | - S Venkatesan
- From the Department of Dermatology, Madras Medical College and RGGGH, Chennai, Tamil Nadu, India
| | - B Yuva Priya
- From the Department of Dermatology, Madras Medical College and RGGGH, Chennai, Tamil Nadu, India,Address for correspondence: Dr. Yuva Priya B, Department of Dermatology, Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu - 600 003, India. E-mail:
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68
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Silva LFMD, Almeida AGDA, Pascoal LM, Santos Neto M, Lima FET, Santos FS. Lesões de pele por Equipamentos de Proteção Individual e medidas preventivas no contexto da COVID-19: revisão integrativa. Rev Lat Am Enfermagem 2022; 30:e3551. [DOI: 10.1590/1518-8345.5636.3551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 01/10/2022] [Indexed: 11/22/2022] Open
Abstract
Resumo Objetivo identificar as evidências científicas sobre os tipos de lesões de pele ocasionadas pelo uso de Equipamento de Proteção Individual em profissionais de saúde durante a pandemia da COVID-19 e verificar as medidas de prevenção recomendadas. Método trata-se de uma revisão integrativa realizada nas bases de dados MEDLINE, CINAHL, LILACS, SCOPUS, Science Direct, Web of Science e no banco de dados SciELO. A busca foi realizada de forma pareada, constituindo uma amostra de 17 estudos categorizados quanto aos tipos de lesões de pele e às medidas preventivas. Resultados os principais tipos de lesões de pele relacionados ao uso de máscara foram lesão por pressão estágio 1, acne e depressão cutânea. Quanto ao uso de óculos e protetor facial, as mais frequentes foram lesão por pressão estágios 1 e 2. Xerose e dermatites de contato irritante ocorreram devido ao uso de luvas e roupas de proteção, respectivamente. As principais medidas preventivas recomendadas foram o uso de curativo de hidrocoloide ou espuma nas regiões de pressão, hidratantes e emolientes. Conclusão observou-se um número considerável de lesões de pele associadas ao uso dos equipamentos e os dados obtidos podem direcionar os profissionais na identificação de riscos e promoção de medidas preventivas para evitar sua ocorrência.
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Silva LFMD, Almeida AGDA, Pascoal LM, Santos Neto M, Lima FET, Santos FS. Lesiones cutáneas por Equipos de Protección Individual y medidas preventivas en el contexto del COVID-19: revisión integradora*. Rev Lat Am Enfermagem 2022. [DOI: 10.1590/1518-8345.5636.3550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumen Objetivo identificar que evidencia científica hay sobre los tipos de lesiones cutáneas provocadas por el uso de Equipos de Protección Individual en los profesionales sanitarios durante la pandemia del COVID-19 y verificar las medidas de prevención recomendadas. Método se trata de una revisión integradora realizada en las bases de datos MEDLINE, CINAHL, LILACS, SCOPUS, Science Direct, Web of Science y la biblioteca electrónica SciELO. La búsqueda se realizó de forma pareada, la muestra estuvo conformada por 17 estudios categorizados según los tipos de lesiones cutáneas y medidas preventivas. Resultados los principales tipos de lesiones cutáneas relacionadas con el uso de mascarillas fueron las lesiones por presión estadio 1, el acné y la depresión cutánea. En cuanto al uso de gafas y pantalla facial, las más frecuentes fueron las lesiones por presión estadios 1 y 2. Se detectó xerosis y dermatitis irritante de contacto por el uso de guantes y ropa de protección, respectivamente. Las principales medidas preventivas recomendadas fueron el uso de apósitos de hidrocoloide o espuma en las regiones de presión, humectantes y emolientes. Conclusión hubo un número considerable de lesiones cutáneas asociadas al uso de equipos y los datos obtenidos pueden orientar a los profesionales para que identifiquen los riesgos y promuevan medidas preventivas para evitar su aparición.
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70
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Algaadi S, A Almulhim Y, Y Alobaysi Y, Alosaimi A, S Alshehri M. Effects of the face mask on the skin during the COVID-19 pandemic in Saudi Arabia. ADVANCES IN HUMAN BIOLOGY 2022. [DOI: 10.4103/aihb.aihb_64_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
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71
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Vieira Esteves C, Gushiken de Campos W, Jin É, Lemos CA. Contact cheilitis due to continuous respiratory protection for COVID-19. Oral Dis 2021; 28 Suppl 2:2568-2569. [PMID: 34914158 DOI: 10.1111/odi.14106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 11/10/2021] [Accepted: 12/14/2021] [Indexed: 11/26/2022]
Affiliation(s)
- Camilla Vieira Esteves
- Department of Stomatology, School of Dentistry, University of Sao Paulo, São Paulo, Brazil
| | | | - Érica Jin
- Private Practice, Jin Clinic, São Paulo, Brazil
| | - Celso Augusto Lemos
- Department of Stomatology, School of Dentistry, University of Sao Paulo, São Paulo, Brazil
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Affiliation(s)
| | - Lora Dagi Glass
- Department of Ophthalmology, Columbia University Medical Center, New York, New York
| | - Pamela L Scheinman
- Department of Dermatology, Brigham and Women's Hospital, Chestnut Hill, Massachusetts.,Dermatology and Skin Care Associates, Wellesley, Massachusetts
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73
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Skiveren JG, Ryborg MF, Nilausen B, Bermark S, Philipsen PA. Adverse skin reactions among health care workers using face personal protective equipment during the coronavirus disease 2019 pandemic: A cross-sectional survey of six hospitals in Denmark. Contact Dermatitis 2021; 86:266-275. [PMID: 34865243 PMCID: PMC9302995 DOI: 10.1111/cod.14022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 11/26/2021] [Accepted: 11/27/2021] [Indexed: 10/25/2022]
Abstract
BACKGROUND Health care workers (HCWs) report frequent adverse skin reactions (ASRs) due to face personal protective equipment (F-PPE) use during the coronavirus disease 2019 (COVID-19) pandemic. OBJECTIVES To describe self-reported ASRs among HCWs using F-PPE; investigate background factors, such as chronic skin diseases and skin types (dry, oily, combination, sensitive), and determine whether HCWs took preventive methods against ASRs. METHODS An online questionnaire was distributed to 22 993 HCWs at hospitals. RESULTS The prevalence of ASRs was 61.9% based on 10 287 responders. Different types of F-PPE caused different reactions. The most common ASRs from surgical masks were spots and pimples (37.2%) and from FFP3 masks was red and irritated skin (27.3%). A significantly higher proportion of HCWs with chronic skin diseases had ASRs (71.6%) than those without chronic skin diseases (59.7%) (P < .001). Some skin types were more prone to ASRs (sensitive skin [78.8%] vs dry skin [54.3%]; P = .001). HCWs using F-PPE for >6 hours versus <3 hours per day had a four times higher ASR risk (P = <.001). Nearly all HCWs used preventive and/or counteractive methods (94.2%). CONCLUSIONS It is important to consider background factors, such as chronic skin diseases and skin types, to prevent and counteract ASRs due to F-PPE use. HIGHLIGHTS Daily long-term use of face protective equipment increased the risk of adverse skin reaction by four times. Health care workers (HCWs) with chronic skin diseases had significantly more skin reactions than those without. Sensitive skin types were more prone to skin reactions. The skin reactions were higher in HCWs in intensive care units than HCWs in in-patient clinics.
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Affiliation(s)
- Jette G Skiveren
- Department of Dermatology and Copenhagen Wound Healing Centre, Bispebjerg University Hospital, Copenhagen, Denmark
| | - Malene F Ryborg
- Department of Dermatology and Copenhagen Wound Healing Centre, Bispebjerg University Hospital, Copenhagen, Denmark
| | - Britt Nilausen
- Department of Dermatology and Copenhagen Wound Healing Centre, Bispebjerg University Hospital, Copenhagen, Denmark
| | - Susan Bermark
- Department of Dermatology and Copenhagen Wound Healing Centre, Bispebjerg University Hospital, Copenhagen, Denmark
| | - Peter A Philipsen
- Department of Dermatology and Copenhagen Wound Healing Centre, Bispebjerg University Hospital, Copenhagen, Denmark
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74
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Santis MD, Barcali E, Bardacci Y, Rasero L, Bambi S, Bocchi L. Design of a wearable device for physiological parameter monitoring in a COVID setting. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2021; 2021:7352-7355. [PMID: 34892796 DOI: 10.1109/embc46164.2021.9630379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The study focuses on the realization of an accurate device for the detection of different physiological parameters. It has been realized a simple portable system containing the necessary electronics and ensuring the monitoring of the blood oxygenation, the body temperature, the air quality, the respiratory rate and the ECG. The main processing unit consists in a Raspberry Pi Zero W connected to the Healthy Pi4. The latter provides the interface for the clinical pulse-oxymeter while the measures of temperature and quality air are provided using the I2C protocol. The Bluetooth module is finally used to provide the ECG and blood rate data. The collected data are elaborated using Matlab and Python. To evaluate the accuracy of the realized device some experimental tests have been conducted on different subjects, comparing subjects working in Covid area with others resting at home. In both cases the monitoring time was 4 hours. Results have shown good performances of the system, detecting accurately the differences of the parameters values between the two situations. The usability of the device was assessed by administering a questionnaire to the healthcare personnel involved in the experimentation. The outcome shows a good usability of the system as well as an acceptable dressing time.
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Yaqoob S, Saleem A, Jarullah FA, Asif A, Essar MY, Emad S. Association of Acne with Face Mask in Healthcare Workers Amidst the COVID-19 Outbreak in Karachi, Pakistan. Clin Cosmet Investig Dermatol 2021; 14:1427-1433. [PMID: 34675578 PMCID: PMC8504703 DOI: 10.2147/ccid.s333221] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 09/28/2021] [Indexed: 12/11/2022]
Abstract
Background In the wake of coronavirus (COVID-19) global alert, people have begun to practice safety measures in order to reduce the exposure to life-threatening disease. The largest at risk population is undoubtedly the frontline healthcare workers (HCWs) who are using personal protective equipment (PPE), essentially face masks, to battle against this deadly virus. This study was conducted with the prime intention to reveal an association between face mask and acne and measure the prevalence of acne amongst HCWs amidst COVID-19 outbreak in Karachi. Furthermore, this study aimed to identify the type of mask generating acne, locate the common sites, assess the severity and establish an association of mask use with the skin type. Methods This cross-sectional study was carried out at Medicare Cardiac and General Hospital, Jinnah Medical College Hospital, Jinnah Postgraduate Medical Centre and Jamal Noor Hospital located in Karachi, Pakistan. A total of 348 HCWs were interviewed, of which only 193 met the inclusion criteria. All information was recorded on a predesigned proforma and analyzed using SPSS 25.0. Results Among 193 participants, acne was prevalent in 103 (53.4%) participants with maximum cases reported in female HCWs, and in doctors (p<0.05). Out of 73 HCWs using N-95 masks, 46 (44.7%) developed acne, with a p-value of 0.036. Skin type and past history of acne also yielded statistically significant results. Among all the skin types, HCWs with oily skin (64, 62.1%) were prone to face resurgence of acne or new-onset acne. The most common sites of eruption of acne were along the cheeks (45.1%) followed by the nose (40.9%). Majority of the population suffered from mild acne. Moderate and severe acne eruption was particularly observed in those wearing N-95 and surgical masks. Conclusion The use of face masks is associated with high rates of acne eruption. Disseminating the guidelines and indications of World Health Organization (WHO) regarding proper use of mask, encouraging awareness among HCWs and following proper doffing and donning protocol as endorsed by Centers for Disease Control and Prevention (CDC) will possibly minimize the adverse reactions.
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Affiliation(s)
- Sadia Yaqoob
- Department of Medicine, Jinnah Medical and Dental College, Karachi, Pakistan
| | - Amna Saleem
- Department of Medicine, Jinnah Medical and Dental College, Karachi, Pakistan
| | | | - Areeba Asif
- Department of Medicine, Jinnah Medical and Dental College, Karachi, Pakistan
| | - Mohammad Yasir Essar
- Department of Dentistry, Kabul University of Medical Sciences, Kabul, Afghanistan
| | - Shaista Emad
- Department of Biochemistry, Sohail University, Karachi, Pakistan
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Maingard J, Mont'Alverne FJ, Chandra R. Staff and physician protection in neurointervention during the coronavirus disease-2019 pandemic: A summary review and recommendations. Interv Neuroradiol 2021; 27:24-29. [PMID: 34669523 PMCID: PMC8575980 DOI: 10.1177/15910199211035307] [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] [Indexed: 01/28/2023] Open
Abstract
The coronavirus disease-2019 pandemic, caused by the novel severe acute respiratory distress syndrome coronavirus 2, has to date resulted in an estimated global death toll of more than 1.5 million with more than 69 million reported cases worldwide. It has become increasingly clear that delivery of effective neurointerventional clinical care means maintaining an able and safe workforce in a rapidly changing environment. Staff and physician protection has become increasingly topical and relevant within the angiography suite both in peripheral and cardiac intervention and in neurointervention. The following review outlines the types of personal protective equipment relevant to neurointerventional care, summarises society guidelines and makes recommendations for the provision of safe care to both staff and patients.
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Affiliation(s)
- Julian Maingard
- NeuroInterventional Radiology Unit, 2538Monash Health, Australia.,School of Medicine, Deakin University, Australia.,Monash Imaging, Monash University, Australia.,Faculty of Medicine, Nursing and Health Sciences, 365090Monash University, Australia
| | - Francisco J Mont'Alverne
- Interventional Neuroradiology Unit, Neurology Department, 365090Hospital Geral de Fortaleza, Brazil
| | - Ronil Chandra
- NeuroInterventional Radiology Unit, 2538Monash Health, Australia.,Monash Imaging, Monash University, Australia.,Faculty of Medicine, Nursing and Health Sciences, 365090Monash University, Australia
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77
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Özkesici Kurt B. The course of acne in healthcare workers during the COVID-19 pandemic and evaluation of possible risk factors. J Cosmet Dermatol 2021; 20:3730-3738. [PMID: 34637186 PMCID: PMC8662215 DOI: 10.1111/jocd.14530] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Revised: 08/16/2021] [Accepted: 10/05/2021] [Indexed: 12/19/2022]
Abstract
Background There are a limited number of publications reporting an increase in acne in the COVID‐19 outbreak. Objective The study aimed to evaluate the course and the clinical features of acne and possible risk factors during the COVID‐19 pandemic in healthcare workers. Method A total of 172 physicians (female, n = 159, male; n = 13, mean age = 35.03 ± 5.27 years) who had acne in any period of their life were included in the study. A self‐administered online questionnaire was applied. Results During the COVID‐19 pandemic, 45.35% of the participants reported that their acne complaints increased, 27.33% reported relapses, and 7.56% reported occurrence for the first time. Newly formed acne was reported most frequently on the chin (78.26%). The number of female participants, smoking, increased stress, and the rate of surgical mask use were found to be higher in the group whose acne occurred for the first time, relapsed, or increased than in the group whose acne complaints were unchanged or decreased (p < 0.05). In the group whose acne relapsed or increased, adult‐onset acne, presence of scar, and use of systemic acne treatment before the COVID‐19 pandemic were more common than in the group whose acne complaints were unchanged or decreased (p < 0.05). Conclusion Almost half of the participants reported an increase in acne. More than a third of the participants reported that their acne relapsed or they had acne for the first time. In addition to the use of surgical masks, factors such as increased stress, smoking, adult‐onset acne, presence of scar, and previous systemic acne treatment were found to be responsible for acne development.
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Affiliation(s)
- Birgül Özkesici Kurt
- Clinic of Dermatology, Adıyaman Training and Research Hospital, Adıyaman, Turkey
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78
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Priya K, Vaishali PNA, Rajasekaran S, Balaji D, Navin RBN. Assessment of Effects on Prolonged Usage of Face Mask by ENT Professionals During Covid-19 Pandemic. Indian J Otolaryngol Head Neck Surg 2021; 74:3173-3177. [PMID: 34642631 PMCID: PMC8500263 DOI: 10.1007/s12070-021-02902-4] [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: 05/31/2021] [Accepted: 10/02/2021] [Indexed: 11/27/2022] Open
Abstract
The protection efficacy of face masks during this covid 19 pandemic has been well documented. The changes in human nasal functions after wearing facemask for prolonged period is not known. The aim of this study is to determine the effects of prolonged usage of facemask by ENT professionals during covid 19 pandemic. It is a cross sectional study conducted in department of ENT in Chettinad Hospital and Research Institute, Kelambakkam. A self-constructed questionnaire containing 21 queries regarding the effects of prolonged use of face mask, after being analysed by the experts of our institution were distributed to 124 ENT professionals all over India. People who are ENT by professionals can participate in this study. Participation is voluntary. Study period was from March 2020 to December 2020. All answered questionnaires were sent for statistical analysis. 63.71% experienced difficulty in breathing while wearing face mask, 37.10% experienced dry nose, 46.77% experienced dry mouth. The most common modality of prevention in an OPD setup was face mask with face shield (31.45%). About 80.65% people believed there are side effects due to wearing mask. Since facemasks are essential to protect us from COVID-19, certain strategies can be followed to reduce the discomfort due to its prolonged usage such as encouraging nasal breathing, taking short breaks from wearing mask in a safe environment and to maintain hydration.
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Affiliation(s)
- K. Priya
- Department of ENT, Chettinad Hospital and Research Institute, Chennai, India
| | | | - S. Rajasekaran
- Department of ENT, Chettinad Hospital and Research Institute, Chennai, India
| | - D. Balaji
- Department of ENT, Chettinad Hospital and Research Institute, Chennai, India
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79
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Kaul S, Kaur I, Jakhar D. Facial Mask-related Acne and Acneiform Eruption During the Coronavirus Disease 2019 Pandemic: A Case Series. THE JOURNAL OF CLINICAL AND AESTHETIC DERMATOLOGY 2021; 14:32-34. [PMID: 34976287 PMCID: PMC8711614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Use of a facial mask is a necessity during the current pandemic. The associated occlusion with extended daily use can lead to physiological changes in the skin with resultant irritation, itching, and infections. This can lead to exacerbation of pre-existing dermatoses or induction of irritant dermatitis or bacterial folliculitis. We observed several patients with previously controlled acne vulgaris who developed a flare. Also, in those without a history of pre-existing acne, an acneiform eruption was noted. The majority of patients were women who had pre-existing acne and needed to wear a N95 respirator or a surgical mask for several hours a day, every day. A few suggested simple preventative measures provided herein might help this vulnerable population.
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Affiliation(s)
- Subuhi Kaul
- Dr. Kaul is with the Department of Internal Medicine, John H. Stroger Hospital of Cook County in Chicago, Illinois
- Drs. Kaur and Jakhar are with the Department of Dermatology, North Delhi Municipal Corporation Medical College and Hindu Rao Hospital in New Delhi, India
| | - Ishmeet Kaur
- Dr. Kaul is with the Department of Internal Medicine, John H. Stroger Hospital of Cook County in Chicago, Illinois
- Drs. Kaur and Jakhar are with the Department of Dermatology, North Delhi Municipal Corporation Medical College and Hindu Rao Hospital in New Delhi, India
| | - Deepak Jakhar
- Dr. Kaul is with the Department of Internal Medicine, John H. Stroger Hospital of Cook County in Chicago, Illinois
- Drs. Kaur and Jakhar are with the Department of Dermatology, North Delhi Municipal Corporation Medical College and Hindu Rao Hospital in New Delhi, India
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80
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Galanis P, Vraka I, Fragkou D, Bilali A, Kaitelidou D. Impact of personal protective equipment use on health care workers' physical health during the COVID-19 pandemic: A systematic review and meta-analysis. Am J Infect Control 2021; 49:1305-1315. [PMID: 33965463 PMCID: PMC8102386 DOI: 10.1016/j.ajic.2021.04.084] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Revised: 04/27/2021] [Accepted: 04/28/2021] [Indexed: 01/29/2023]
Abstract
BACKGROUND During the coronavirus disease 2019 (COVID-19) pandemic, health care workers (HCWs) have been obliged to wear personal protective equipment (PPE). We assessed the impact of PPE use on HCWs' physical health and we examined factors related to a greater risk of adverse events due to PPE use. METHODS We applied the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines and the Cochrane criteria. We searched PubMed, Medline, Scopus, ProQuest, CINAHL, and medRxiv from January 1, 2020 to December 27, 2020. RESULTS Our review included 14 studies with 11,746 HCWs. The estimated overall prevalence of adverse events among HCWs was 78% with a range from 42.8% to 95.1% among studies. Among others, the following factors were related to the risk of adverse events among HCWs due to PPE use: obesity, diabetes mellitus, smoking, pre-existing headache, longer duration of shifts wearing PPE, increased consecutive days with PPE, and increased exposure to confirmed or suspected COVID-19 patients. CONCLUSIONS The frequency of adverse events among HCWs due to PPE use is very high. Healthcare facilities should take the necessary precautions and change the working conditions during the COVID-19 pandemic to prevent adverse events associated with PPE use and minimize harm to HCWs.
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Affiliation(s)
- Petros Galanis
- Faculty of Nursing, Center for Health Services Management and Evaluation, National and Kapodistrian University of Athens, Athens, Greece.
| | - Irene Vraka
- Department of Radiology, P & A Kyriakou Children's Hospital, Athens, Greece
| | - Despoina Fragkou
- Faculty of Nursing, Center for Health Services Management and Evaluation, National and Kapodistrian University of Athens, Athens, Greece
| | - Angeliki Bilali
- Hospital Waste Management Unit, P & A Kyriakou Children's Hospital, Athens, Greece
| | - Daphne Kaitelidou
- Faculty of Nursing, Center for Health Services Management and Evaluation, National and Kapodistrian University of Athens, Athens, Greece
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81
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Lansiaux E, Tchagaspanian N, Arnaud J, Durand P, Changizi M, Forget J. Side-Effects of Public Health Policies Against Covid-19: The Story of an Over-Reaction. Front Public Health 2021; 9:696818. [PMID: 34589461 PMCID: PMC8473612 DOI: 10.3389/fpubh.2021.696818] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 05/24/2021] [Indexed: 12/23/2022] Open
Affiliation(s)
| | | | - Juliette Arnaud
- Global Variations, Genève, Switzerland.,Ecole Normale Supérieure, Paris, France
| | | | | | - Joachim Forget
- Global Variations, Genève, Switzerland.,Assemblée Nationale, Paris, France
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82
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Häussl A, Ehmann E, Pacher A, Knödl K, Huber T, Neundlinger L, Osmanovic A, Plank-Straner A, Walter P, Schüssler S, Schoberer D. Psychological, physical, and social effects of the COVID-19 pandemic on hospital nurses. Int Nurs Rev 2021; 68:482-492. [PMID: 34582576 PMCID: PMC8653222 DOI: 10.1111/inr.12716] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 08/24/2021] [Indexed: 11/28/2022]
Abstract
Aim The study aim was to explore the physical, mental, and social effects of the COVID‐19 pandemic on Austrian nurses working in hospitals. Background The COVID‐19 pandemic required nurses to work extremely hard and over long periods, which can have physical, psychological, and social consequences. Methods This study was carried out using a qualitative descriptive design and data was collected through individual interviews using an interview guide. A qualitative content analysis was conducted taking both deductive and inductive approaches. Findings Eighteen nurses (average age of 34.7 years) participated in the study. Their general attitude and feelings regarding working during the COVID‐19 pandemic in the hospital setting were positive. Several behavioral changes in the nurses’ daily working and private daily lives were reported. Psychological impacts included the fear of infecting someone at home, insomnia, and sadness. Headaches, diarrhea, muscle tension, skin redness, and increased sweating were identified as the most common physical impacts. In terms of social impact, all nurses mentioned social isolation and the increased use of (new) media. Conclusions Working with people suffering from COVID‐19 had psychological and physical effects on caregivers. Caregivers felt socially isolated in their private environments; however, they often compensated for this isolation by using social media. Implications for nursing and implications for nursing policy Staff perceived the provision of sufficient information, regular team meetings, and the employer's positive reinforcement as supportive, enhancing their feelings of security. We recommend providing more psychological support and making structural adjustments in daily clinical practice to counteract the negative effects of working during a pandemic.
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Affiliation(s)
- Alfred Häussl
- Institute of Nursing Science Medical University of Graz, Graz, Austria
| | - Eva Ehmann
- Institute of Nursing Science Medical University of Graz, Graz, Austria
| | - Angelika Pacher
- Institute of Nursing Science Medical University of Graz, Graz, Austria
| | - Katrin Knödl
- Institute of Nursing Science Medical University of Graz, Graz, Austria
| | - Teresa Huber
- Institute of Nursing Science Medical University of Graz, Graz, Austria
| | - Lydia Neundlinger
- Institute of Nursing Science Medical University of Graz, Graz, Austria
| | - Asmir Osmanovic
- Institute of Nursing Science Medical University of Graz, Graz, Austria
| | | | - Petra Walter
- Institute of Nursing Science Medical University of Graz, Graz, Austria
| | - Sandra Schüssler
- Institute of Nursing Science Medical University of Graz, Graz, Austria
| | - Daniela Schoberer
- Institute of Nursing Science Medical University of Graz, Graz, Austria
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83
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Abdali S, Yu J. Occupational Dermatoses Related to Personal Protective Equipment Used During the COVID-19 Pandemic. Dermatol Clin 2021; 39:555-568. [PMID: 34556245 PMCID: PMC8165076 DOI: 10.1016/j.det.2021.05.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The recent coronavirus disease 2019 (COVID-19) pandemic has led to the dramatic increase in use of personal protective equipment (PPE) among health care providers and the general public. Herein the authors discuss the various occupational dermatoses including allergic and irritant contact dermatitis, acne, seborrheic dermatitis, and rosacea related to frequent handwashing, disinfecting of surfaces, and prolonged wear of various PPE including face masks, gloves, and gowns. The authors provide an overview of published PPE-associated occupational dermatoses during the COVID-19 pandemic and also discuss prevention strategies and treatment options to help patients with these complaints.
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Affiliation(s)
- Selli Abdali
- Philadelphia College of Osteopathic Medicine, Philadelphia, PA 19131, USA
| | - JiaDe Yu
- Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, 50 Staniford St, Boston, MA 02114, USA.
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84
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Delanghe L, Cauwenberghs E, Spacova I, De Boeck I, Van Beeck W, Pepermans K, Claes I, Vandenheuvel D, Verhoeven V, Lebeer S. Cotton and Surgical Face Masks in Community Settings: Bacterial Contamination and Face Mask Hygiene. Front Med (Lausanne) 2021; 8:732047. [PMID: 34540873 PMCID: PMC8446422 DOI: 10.3389/fmed.2021.732047] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 08/09/2021] [Indexed: 11/13/2022] Open
Abstract
During the current COVID-19 pandemic, the use of face masks has become increasingly recommended and even mandatory in community settings. To evaluate the risk of bacterial cross-contamination, this study analyzed the bacterial bioburden of disposable surgical masks and homemade cotton masks, and surveyed the habits and face mask preferences of the Flemish population. Using culture approaches and 16S rRNA gene amplicon sequencing, we analyzed the microbial community on surgical and/or cotton face masks of 13 healthy volunteers after 4 h of wearing. Cotton and surgical masks contained on average 1.46 × 105 CFU/mask and 1.32 × 104 CFU/mask, respectively. Bacillus, Staphylococcus, and Acinetobacter spp. were mostly cultured from the masks and 43% of these isolates were resistant to ampicillin or erythromycin. Microbial profiling demonstrated a consistent difference between mask types. Cotton masks mainly contained Roseomonas, Paracoccus, and Enhydrobacter taxa and surgical masks Streptococcus and Staphylococcus. After 4 h of mask wearing, the microbiome of the anterior nares and the cheek showed a trend toward an altered beta-diversity. According to dedicated questions in the large-scale Corona survey of the University of Antwerp with almost 25,000 participants, only 21% of responders reported to clean their cotton face mask daily. Laboratory results indicated that the best mask cleaning methods were boiling at 100°C, washing at 60°C with detergent or ironing with a steam iron. Taken together, this study suggests that a considerable number of bacteria, including pathobionts and antibiotic resistant bacteria, accumulate on surgical and even more on cotton face masks after use. Based on our results, face masks should be properly disposed of or sterilized after intensive use. Clear guidelines for the general population are crucial to reduce the bacteria-related biosafety risk of face masks, and measures such as physical distancing and increased ventilation should not be neglected when promoting face mask use.
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Affiliation(s)
- Lize Delanghe
- Department of Bioscience Engineering, University of Antwerp, Antwerp, Belgium
| | - Eline Cauwenberghs
- Department of Bioscience Engineering, University of Antwerp, Antwerp, Belgium
| | - Irina Spacova
- Department of Bioscience Engineering, University of Antwerp, Antwerp, Belgium
| | - Ilke De Boeck
- Department of Bioscience Engineering, University of Antwerp, Antwerp, Belgium
| | - Wannes Van Beeck
- Department of Bioscience Engineering, University of Antwerp, Antwerp, Belgium
| | - Koen Pepermans
- Faculty of Social Sciences, University of Antwerp, Antwerp, Belgium
| | - Ingmar Claes
- Department of Bioscience Engineering, University of Antwerp, Antwerp, Belgium
| | - Dieter Vandenheuvel
- Department of Bioscience Engineering, University of Antwerp, Antwerp, Belgium
| | - Veronique Verhoeven
- Department of Primary and Interdisciplinary Care (FAMPOP), University of Antwerp, Antwerp, Belgium
| | - Sarah Lebeer
- Department of Bioscience Engineering, University of Antwerp, Antwerp, Belgium
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85
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Cretu S, Dascalu M, Georgescu SR, Salavastru CM. Personal protective equipment use and face acne in health care providers during the COVID-19 pandemic in Romania: A new occupational acne type? J Eur Acad Dermatol Venereol 2021; 36:e18-e20. [PMID: 34547135 PMCID: PMC8657521 DOI: 10.1111/jdv.17679] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 08/31/2021] [Accepted: 09/16/2021] [Indexed: 01/10/2023]
Affiliation(s)
- S Cretu
- Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.,Dermatology PhD Student, Dermatology Research Unit, Colentina Clinical Hospital, Bucharest, Romania
| | - M Dascalu
- Department of Computer Science, Polytechnic University of Bucharest, Bucharest, Romania
| | - S R Georgescu
- Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.,Dermatology Department, "Victor Babes" Clinical Hospital for Infectious Diseases, Bucharest, Romania
| | - C M Salavastru
- Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.,Pediatric Dermatology Department, Colentina Clinical Hospital, Bucharest, Romania
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86
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Abstract
The emergence of the coronavirus disease 2019 pandemic has led to a change in the whole world order. The key actors and occupational groups most at risk during this period have been health care professionals. In this pandemic, we, as dermatologists, also have many responsibilities regarding patients, ourselves, and society. Dermatologists have to protect themselves, their families, and their patients while working in pandemic services and outpatient clinics, as well as in their practices. One of their roles is to inform the public about protective measures for cutaneous side effects associated with the intensive use of disinfectants and long-term use of masks. In hospitals, only emergency patients had been admitted for treatment in all units during the pandemic, and elective operations and procedures were delayed. In this context, it is very important to determine what procedures will be carried out during this period in the follow up and treatment of chronic dermatologic diseases, as well as what interventional and cosmetic procedures may performed. Guidelines issued by various medical societies have made valuable contributions. The benefits and associated issues of teledermatology have pros and cons. Finally, one of the issues to ponder in the long term seems to be how we should pursue online education.
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Affiliation(s)
- Ayse Serap Karadag
- Department of Dermatology, Ataşehir Memorial Hospital, Istanbul, Turkey.
| | - Melek Aslan Kayıran
- Department of Dermatology, Istanbul Medeniyet University, School of Medicine, Goztepe Prof Dr Süleyman Yalçın City Hospital, Istanbul, Turkey
| | - Uwe Wollina
- Department of Dermatology and Allergology, Städtisches Klinikum Dresden Academic Teaching Hospital of the Technical University, Freidrichstrasse, Dresden, Germany
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87
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Keng BMH, Gan WH, Tam YC, Oh CC. Personal protective equipment-related occupational dermatoses during COVID-19 among health care workers: A worldwide systematic review. JAAD Int 2021; 5:85-95. [PMID: 34485949 PMCID: PMC8407949 DOI: 10.1016/j.jdin.2021.08.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/18/2021] [Indexed: 12/22/2022] Open
Abstract
Background Occupational dermatoses caused by personal protective equipment (PPE) in the ongoing COVID-19 pandemic are emerging occupational health challenges that must be promptly and effectively addressed to ease burden on our health care workers. Objective A systematic review was conducted to determine common PPE-related dermatoses, affected body sites, and implicated occupational contactants. We further proposed solutions to mitigate this problem. Methods Online databases were searched for articles on PPE-related dermatoses in health care workers during the COVID-19 pandemic written in English and published from January 1, 2020, to January 30, 2021. Results Sixteen studies, including a total of 3958 participants, were included. The most common dermatoses were xerosis, pressure-related erythema, and contact dermatitis, mainly affecting the face and hands. The most widely implicated contactants were increased frequency of hand hygiene, gloves, N95 masks, and goggles. Proposed solutions were categorized as individual self-care, protection of the workforce, and long-term preventive measures. Conclusion Through measures such as regular basic skin care education, early access to specialty clinics via telemedicine, and designing of better-fit PPE, the challenges posed by PPE-related occupational dermatoses can be significantly reduced.
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Affiliation(s)
| | - Wee Hoe Gan
- Department of Occupational and Environmental Medicine, Singapore General Hospital, Singapore, Singapore.,Duke-NUS Medical School, Singapore, Singapore.,Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Yew Chong Tam
- Education Resource Centre, Singapore General Hospital, Singapore, Singapore
| | - Choon Chiat Oh
- Duke-NUS Medical School, Singapore, Singapore.,Department of Dermatology, Singapore General Hospital, Singapore, Singapore
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88
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Thatiparthi A, Liu J, Martin A, Wu JJ. Adverse Effects of COVID-19 and Face Masks: A Systematic Review. THE JOURNAL OF CLINICAL AND AESTHETIC DERMATOLOGY 2021; 14:S39-S45. [PMID: 34980966 PMCID: PMC8562946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
BACKGROUND Due to the public health risk associated with SARS-CoV-2 (COVID-19) infection, universal use of face masks has been recommended to protect against viral spread. Adverse facial reactions from the utilization of masks in the general public are poorly characterized in literature. OBJECTIVE We aimed to provide a systematic review of studies reporting adverse facial reactions associated with use of face masks during the COVID-19 pandemic. METHODS PubMed and Cochrane databases were searched using the following search terms: "masks" AND "skin reactions, facial dermatosis, rash, acne, atopic dermatitis, rosacea, OR seborrheic dermatitis." METHODS A total of 954 cases of dermatological adverse effects were reported. Over 17 different adverse facial reactions were found, including the top 10 in order: itch (370, 38.8%), indentation/ear pain (102, 10.7%), discomfort (90, 9.4%), erythema (72, 7.5%), dryness (62, 6.5%), rash (60, 6.3%), scarring (42, 4.4%), desquamation (22, 2.3%), pain (19, 2.0%), burning (19, 2.0%), and wheals (7, 0.7%). Face masks can increase acne (n=44), rosacea (n=14), and seborrheic dermatitis (n=9). LIMITATIONS Publication bias of articles, with limited studies available regarding this topic. CONCLUSION Wearing face masks to protect from COVID-19 can increase adverse facial dermatoses and exacerbate underlying dermatology conditions; however, several preventative measures may be taken.
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Affiliation(s)
- Akshitha Thatiparthi
- Ms. Thatiparthi is with the College of Osteopathic Medicine of the Pacific, Western University of Health Sciences in Pomona, California
- Mr. Liu is with the Keck School of Medicine, University of Southern California in Los Angeles, California
- Ms. Martin is with the School of Medicine, University of California in Riverside, California
- Dr. Wu is with the Dermatology Research and Education Foundation in Irvine, California
| | - Jeffrey Liu
- Ms. Thatiparthi is with the College of Osteopathic Medicine of the Pacific, Western University of Health Sciences in Pomona, California
- Mr. Liu is with the Keck School of Medicine, University of Southern California in Los Angeles, California
- Ms. Martin is with the School of Medicine, University of California in Riverside, California
- Dr. Wu is with the Dermatology Research and Education Foundation in Irvine, California
| | - Amylee Martin
- Ms. Thatiparthi is with the College of Osteopathic Medicine of the Pacific, Western University of Health Sciences in Pomona, California
- Mr. Liu is with the Keck School of Medicine, University of Southern California in Los Angeles, California
- Ms. Martin is with the School of Medicine, University of California in Riverside, California
- Dr. Wu is with the Dermatology Research and Education Foundation in Irvine, California
| | - Jashin J Wu
- Ms. Thatiparthi is with the College of Osteopathic Medicine of the Pacific, Western University of Health Sciences in Pomona, California
- Mr. Liu is with the Keck School of Medicine, University of Southern California in Los Angeles, California
- Ms. Martin is with the School of Medicine, University of California in Riverside, California
- Dr. Wu is with the Dermatology Research and Education Foundation in Irvine, California
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89
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Jakhar D, Grover C, Kaur I, Das A, Kaul S. COVID-19 and Healthcare Worker: What We Need to Know. Indian J Dermatol 2021; 66:264-271. [PMID: 34446949 PMCID: PMC8375534 DOI: 10.4103/ijd.ijd_462_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
COVID-19 pandemic has challenged and overwhelmed most healthcare institutions and healthcare workers, across the world. Despite being unprepared for this pandemic, frontline workers have worked relentlessly to provide the much-needed care to these patients. Doctors from different branches of medicine, including dermatologists, came forward and played a substantial role in mitigating the impact of this pandemic on the general population. Sadly, in the process, these healthcare workers faced many personal, social, psychological, economic, and health-related issues. The psychological burden and health-related issues received due attention in the main-stream news as well as scientific research papers. With most frontline workers isolated from their families, social media became the new platform to reduce the sense of isolation and share their anxiety, insomnia, and fatigue. This article is aimed at highlighting various challenges faced by healthcare workers during the ongoing COVID-19 pandemic.
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Affiliation(s)
- Deepak Jakhar
- Consultant Dermatologist, Dermosphere Clinic, University College of Medical Sciences and GTB Hospital, New Delhi, India
| | - Chander Grover
- Department of Dermatology and STD, University College of Medical Sciences and GTB Hospital, New Delhi, India
| | - Ishmeet Kaur
- Department of Dermatology, North Delhi Municipal Corporation Medical College and Hindu Rao Hospital, New Delhi, India
| | - Anupam Das
- Department of Dermatology, KPC Medical College and Hospital, Kolkata, West Bengal, India
| | - Subuhi Kaul
- Department of Internal Medicine, John H Stroger Hospital of Cook County, Chicago, Illinois, USA
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90
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Altun E, Topaloglu Demir F. Occupational facial dermatoses related to mask use in healthcare professionals. J Cosmet Dermatol 2021; 21:2535-2541. [PMID: 34450685 PMCID: PMC8662203 DOI: 10.1111/jocd.14415] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Accepted: 08/17/2021] [Indexed: 01/24/2023]
Abstract
Background Mask use can lead to facial dermatoses due to factors, such as hyperhydration, seborrhea, high humidity caused by sweating, and the occlusive effect of the mask. Aim We investigated mask‐related facial dermatoses in healthcare personnel who, since the beginning of the COVID‐19 pandemic, had to wear a mask for long hours. Methods In this study, healthcare professionals working at Medipol Mega University Hospital since the beginning of the pandemic were screened for facial dermatoses between December 2020 and February 2021 with a dermatological examination and interview. Results Of the 101 healthcare professionals, 51 (50.5%) were doctors and 50 (49.5%) nurses, and 36 (35.6%) were male and 65 (64.4%) were female. All the participants had been actively working at the hospital for 35–46 weeks since the beginning of the pandemic and wearing N95 or surgical masks for an average of 6–13 h a day. During the dermatological examination, the most common facial dermatosis was acne, which was observed in 55.4% (n = 56) of the cases. Of the 56 acne cases, 41.1% (n = 23) had acne in their history, while 58.9% (n = 33) had new‐onset acne. Being female, using a N95 surgical mask compared to surgical mask, and the daily average duration of mask use were determined as risk factors for acne development due to mask use. Conclusions The use of masks, more frequently N95, caused both an increase in existing acne and the development of new acne.
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Affiliation(s)
- Ece Altun
- Department of Dermatology and Venereology, Istanbul Medipol University, Istanbul, Turkey
| | - Filiz Topaloglu Demir
- Department of Dermatology and Venereology, Istanbul Medipol University, Istanbul, Turkey
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91
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Healthcare Workers' Experiences and Views of Using Surgical Masks and Respirators, and Their Attitudes on the Sustainability: A Semi-Structured Survey Study during COVID-19. NURSING REPORTS 2021; 11:615-628. [PMID: 34968337 PMCID: PMC8608101 DOI: 10.3390/nursrep11030059] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 07/29/2021] [Accepted: 07/30/2021] [Indexed: 02/05/2023] Open
Abstract
A universal mask use was instituted in healthcare during COVID-19 pandemic in 2020. The extensive growth in the consumption of surgical masks and respirators brought new challenges. Healthcare workers had to get accustomed to wearing the facemasks continuously, raising concerns on the patient, occupational, and environmental safety. The aim of this study is to describe frontline healthcare workers and other authorities’ views and experiences on continuous use of surgical masks and respirators (facemasks) and their attitudes towards environmental and sustainability issues. A cross-sectional web-based survey was conducted in Finland during the COVID-19 pandemic in autumn 2020. The respondents(N = 120) were recruited via social media, and the data were collected using a purpose-designed questionnaire. Descriptive statistics and inductive content analysis were used to analyze the quantitative data and qualitative data, respectively. The healthcare workers perceived their own and patient safety, and comfortability of facemasks as important, but according to their experiences, these properties were not evident with the current facemasks. They considered protection properties more important than environmental values. However, biodegradability and biobased material were seen as desired properties in facemasks. Based on the results, the current facemasks do not meet users’ expectations well enough. Especially the design, breathability, and sustainability issues should be taken more into account.
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92
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Huang C, Sun Q, Jiang D, Zhang X, Chen C, Yan D, Liu X, Zhou Y, Ding C, Lan L, Wu J, Li L, Li A, Liu X, Yang S. Characteristics of facial skin problems and microbiome variation during wearing masks for fighting against COVID-19. J Eur Acad Dermatol Venereol 2021; 35:e853-e855. [PMID: 34363249 PMCID: PMC8446999 DOI: 10.1111/jdv.17580] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 07/29/2021] [Indexed: 01/22/2023]
Affiliation(s)
- C Huang
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Q Sun
- Department of Dermatology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - D Jiang
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - X Zhang
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - C Chen
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - D Yan
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - X Liu
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Y Zhou
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - C Ding
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - L Lan
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - J Wu
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - L Li
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - A Li
- Physician Health Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Department of Henan Gene Hospital, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - X Liu
- Department of Dermatology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - S Yang
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
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93
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Salati H, Khamooshi M, Vahaji S, Christo FC, Fletcher DF, Inthavong K. N95 respirator mask breathing leads to excessive carbon dioxide inhalation and reduced heat transfer in a human nasal cavity. PHYSICS OF FLUIDS (WOODBURY, N.Y. : 1994) 2021; 33:081913. [PMID: 34552313 PMCID: PMC8450908 DOI: 10.1063/5.0061574] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 08/06/2021] [Indexed: 05/16/2023]
Abstract
Face masks and respirators are used to filter inhaled air, which may contain airborne droplets and high particulate matter (PM) concentrations. The respirators act as a barrier to the inhaled and exhaled air, which may change the nasal airflow characteristics and air-conditioning function of the nose. This study aims to investigate the nasal airflow dynamics during respiration with and without an N95 respirator driven by airflow through the nasal cavity to assess the effect of the respirator on breathing conditions during respiration. To achieve the objective of this study, transient computational fluid dynamics simulations have been utilized. The nasal geometry was reconstructed from high-resolution Computed Tomography scans of a healthy 25-year-old female subject. The species transport method was used to analyze the airflow, temperature, carbon dioxide (CO2), moisture content (H2O), and temperature distribution within the nasal cavity with and without an N95 respirator during eight consecutive respiration cycles with a tidal volume of 500 ml. The results demonstrated that a respirator caused excessive CO2 inhalation by approximately 7 × greater per breath compared with normal breathing. Furthermore, heat and mass transfer in the nasal cavity was reduced, which influences the perception of nasal patency. It is suggested that wearers of high-efficiency masks that have minimal porosity and low air exchange for CO2 regulation should consider the amount of time they wear the mask.
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Affiliation(s)
| | - Mehrdad Khamooshi
- Mechanical and Automotive Engineering, School of Engineering, RMIT University, Bundoora, Australia
| | - Sara Vahaji
- School of Engineering, Faculty of Science Engineering and Built Environment, Deakin University, Victoria, Australia
| | - Farid C. Christo
- School of Engineering, Faculty of Science Engineering and Built Environment, Deakin University, Victoria, Australia
| | - David F. Fletcher
- School of Chemical and Biomolecular Engineering, The University of Sydney, NSW 2006 Australia
| | - Kiao Inthavong
- Mechanical and Automotive Engineering, School of Engineering, RMIT University, Bundoora, Australia
- Author to whom correspondence should be addressed:
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94
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Kim DH, Lee DH. Riehl's melanosis caused by occupational exposure to personal protective equipment. Contact Dermatitis 2021; 85:720-721. [PMID: 34322879 DOI: 10.1111/cod.13954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 07/23/2021] [Accepted: 07/26/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Dong Hyo Kim
- Department of Dermatology, Seoul National University College of Medicine, Seoul, South Korea
| | - Dong Hun Lee
- Department of Dermatology, Seoul National University College of Medicine, Seoul, South Korea
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95
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Stefaniak AA, Krajewski PK, Białynicki-Birula R, Nowicka D, Szepietowski JC. Is Face and Mask Touching a Real Struggle During the COVID-19 Pandemic? A Prospective Study Among Medical Students. Front Med (Lausanne) 2021; 8:663873. [PMID: 34395466 PMCID: PMC8358140 DOI: 10.3389/fmed.2021.663873] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 06/29/2021] [Indexed: 12/16/2022] Open
Abstract
There are limited data in the literature on the frequency of face- and mask-touching behavior as a potential vector for the self-inoculation and transmission of the novel coronavirus. In this prospective study, we assessed the facial touching behavior of 204 medical students. One hundred thirty-four subjects (65.68%) during the 15-min observation at least once touched the area of the mask (38.23%), eyes (38.23%), or other parts of the facial zone (49.02%). The mean number of touches was 11.98 ± 16.33 per hour. The results of our study reveal that there is no significant association between mask wearing and gender; however, there might be a tendency for people with eyeglasses to touch the area near the eyes more often.
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Affiliation(s)
- Aleksandra A Stefaniak
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Wroclaw, Poland
| | - Piotr K Krajewski
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Wroclaw, Poland
| | - Rafał Białynicki-Birula
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Wroclaw, Poland
| | - Danuta Nowicka
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Wroclaw, Poland
| | - Jacek C Szepietowski
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Wroclaw, Poland
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96
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Damiani G, Gironi LC, Pacifico A, Cristaudo A, Malagoli P, Allocco F, Bragazzi NL, Linder DM, Santus P, Buja A, Savoia P, Pigatto PD. Masks use and facial dermatitis during COVID-19 outbreak: is there a difference between CE and non-CE approved masks? Multi-center, real-life data from a large Italian cohort. Ital J Dermatol Venerol 2021; 156:220-225. [PMID: 33960753 DOI: 10.23736/s2784-8671.21.06895-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND During the recent COVID-19 outbreak, masks became mandatory and shortages frequent, therefore the prevalence of non-CE (European Conformity Mark) approved masks increased in the general population. We aimed to quantify the prevalence of mask-related cutaneous side effects and the differences between CE and non-CE approved masks. METHODS In this multicenter prospective observational study conducted from March 20, 2020 to May 12, 2020(during and after quarantine), patients attending emergency departments for a dermatological consult were clinically assessed and their masks were inspected to detect CE marks and UNI (Italian National Unification Entity) norms. Patients with history of facial dermatoses or under current treatment for facial dermatoses were excluded. RESULTS We enrolled 412 patients (318 during quarantine and 94 after quarantine). CE-approved masks were observed 52.8% vs. 24.5%, whilst subsets of non-CE approved masks were 9.7% vs. 14.9% (Personal protective equipment (PPE)-masks), 16.4% vs. 12.8% (surgical masks [SM]), and 21.1% vs. 47.9%(non-PPE) and (non-SM masks), respectively during and after quarantine. Remarkably, non-CE-approved masks resulted in patients displaying a statistically significant higher incidence of facial dermatoses and irritant contact dermatitis compared to CE-approved masks, and these differences were mainly driven by non-PPE non-SM masks. Comparing quarantine and after quarantine periods, no statistically significant differences were found for CE-approved masks, whilst differences were detected in non-CE-approved masks regarding incidence of facial dermatoses (P<0.0001)and irritant contact dermatitis (P=0.0041). CONCLUSIONS Masks are essential to prevent COVID-19 but at the same time higher awareness regarding mask specifications should be promoted in the general population. Non-PPE and non-SM masks should undergo more rigorous testing to prevent the occurrence of cutaneous side effects and future patients' lawsuit damages.
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Affiliation(s)
- Giovanni Damiani
- Department of Clinical Dermatology, IRCCS Galeazzi Orthopedic Institute, Milan, Italy - .,Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy -
| | - Laura C Gironi
- Maggiore della Carità University Hospital, Novara, Italy
| | - Alessia Pacifico
- Department of Clinical Dermatology, IRCCS S. Gallicano Dermatological Institute, Rome, Italy
| | - Antonio Cristaudo
- Department of Clinical Dermatology, IRCCS S. Gallicano Dermatological Institute, Rome, Italy
| | - Piergiorgio Malagoli
- Unit of Dermatology, Hospital of San Donato Milanese, San Donato Milanese, Milan, Italy
| | | | - Nicola L Bragazzi
- Department of Mathematics and Statistics, Laboratory for Industrial and Applied Mathematics (LIAM), York University, Toronto, ON, Canada
| | - Dennis M Linder
- Department of Dermatology, University Hospital, Padua, Italy
| | - Pierachille Santus
- Respiratory Unit, Department of Biomedical And Clinical Sciences (DIBIC), University of Milan, Luigi Sacco University Hospital, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Alessandra Buja
- Department of Cardiological, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | - Paola Savoia
- Department of Health Sciences, University of Eastern Piedmont, Novara, Italy
| | - Paolo Dm Pigatto
- Department of Clinical Dermatology, IRCCS Galeazzi Orthopedic Institute, Milan, Italy.,Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
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97
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Wan X, Lu Q, Sun D, Wu H, Jiang G. Skin Barrier Damage due to Prolonged Mask Use among Healthcare Workers and the General Population during the COVID-19 Pandemic: A Prospective Cross-Sectional Survey in China. Dermatology 2021; 238:218-225. [PMID: 34237729 PMCID: PMC8339038 DOI: 10.1159/000517219] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Accepted: 05/13/2021] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) has resurged in localized areas in China. Individuals wear masks to prevent the spread of droplets. However, skin barrier damage occurs because of the prolonged use of masks. OBJECTIVE To investigate the prevalence and associated risk factors of skin injuries among healthcare workers (HCWs) and the general population during the COVID-19 outbreak. METHODS A multicenter cross-sectional study of skin barrier damage caused by wearing masks was conducted using an online questionnaire between December 10 and December 31, 2020. Data regarding demographics, characteristics of facial skin damage, and information on masks were registered. Multivariate logistic regression was used to analyze factors associated with skin barrier damage, and odds ratios (OR) with 95% confidence intervals (CI) were used to establish correlation strength. RESULTS A total of 1,538 responses were retrieved from 1,700 questionnaires (response rate, 90.47%), and 1,409 questionnaires were valid (effective response rate, 91.61%). The respondents comprised 567 HCWs (40.24%) and 842 individuals from the general population (59.76%). The prevalence of skin injuries was 46.03% among HCWs and 46.20% among the general population. History of chronic skin disease (OR, 6.01; 95% CI, 4.75-7.75), type of mask used (OR, 2.77; 95% CI, 1.95-3.93), daily wearing time (OR, 1.57; 95% CI, 1.36-1.82), and mask replacement cycle (OR, 0.76; 95% CI, 0.68-0.86) were associated with skin barrier damage. CONCLUSION There was a high incidence of skin barrier damage due to prolonged mask use among HCWs and the general population, and treatment and prevention were inadequate. Attention needs to be given to strengthening comprehensive health education and popularization of science.
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Affiliation(s)
- Xiao Wan
- Department of Dermatology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Quansheng Lu
- Department of Dermatology, People's Hospital of Jiawang District of Xuzhou, Xuzhou, China
| | - Dandan Sun
- Department of Dermatology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Hong Wu
- Department of General Surgery, Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Guan Jiang
- Department of Dermatology, Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
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98
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Bambi S, Giusti GD, Galazzi A, Mattiussi E, Comisso I, Manici M, Rosati M, Lucchini A. Pressure Injuries Due to Personal Protective Equipment in COVID-19 Critical Care Units. Am J Crit Care 2021; 30:287-293. [PMID: 33912903 DOI: 10.4037/ajcc2021178] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
BACKGROUND Caring for patients with COVID-19 requires wearing a full set of personal protective equipment (PPE) to avoid contamination. Personal discomfort has been associated with use of PPE, and anecdotal reports describe pressure injuries related to wearing PPE. OBJECTIVES To investigate the occurrence of device-related pressure injuries due to wearing PPE among Italian nurses caring for patients with COVID-19 in critical care settings. METHODS This descriptive study used an online survey investigating both the demographic characteristics of respondents and complications related to wearing PPE, including the development of pressure injuries. RESULTS A total of 266 nurses throughout Italy completed the survey; 32% of respondents were men. Nurses' median age was 36 years (range 22-59 years), and the median time spent working in their current clinical setting (an intensive care or high-dependency unit) was 3 years (range 0-32 years). Personal protective equipment was worn for a median duration of 5 hours (range 2-12 hours). While wearing PPE, 92.8% of nurses experienced pain and 77.1% developed device-related pressure injuries, mainly on the nose, ears, and forehead. Pain was more frequent among nurses with such injuries. Transparent dressings, emollient cream, and no dressing were associated with development of device-related pressure injury. CONCLUSIONS Pressure injuries related to PPE represent an important adverse effect for nurses caring for patients with COVID-19. This topic deserves study to determine adequate solutions for preventing and treating such injuries and their potential influence on nurses' work tolerance.
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Affiliation(s)
- Stefano Bambi
- Stefano Bambi is a staff nurse in the medical and surgical intensive care unit, Careggi University Hospital, Florence, Italy
| | - Gian Domenico Giusti
- Gian Domenico Giusti is a staff nurse in the intensive care unit, Perugia University Hospital, Perugia, Italy, and a nurse educator in the Department of Experimental Medicine, School of Nursing, University of Perugia, Perugia, Italy
| | - Alessandro Galazzi
- Alessandro Galazzi is a clinical nurse educator in the Healthcare Professions Department, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Elisa Mattiussi
- Elisa Mattiussi is a nurse educator in the Department of Medical Sciences, School of Nursing, University of Udine, Udine, Italy; and a staff nurse in the Department of Anaesthesia and Intensive Care, Azienda Sanitaria Universitaria Friuli Centrale, University Hospital of Udine, Udine, Italy
| | - Irene Comisso
- Irene Comisso is a staff nurse in the Clinica di Anestesia e Rianimazione, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy
| | - Matteo Manici
- Matteo Manici is a staff nurse in the postsurgical intensive care unit, University Hospital of Parma, Parma, Italy
| | - Moris Rosati
- Moris Rosati is a staff nurse in the Anestesia e Rianimazione DEA e dei Trapianti, Azienda ospedaliero-universitaria Senese, Siena, Italy
| | - Alberto Lucchini
- Alberto Lucchini is a nurse coordinator in the general intensive care unit, ASST Monza, San Gerardo Hospital, University of Milano-Bicocca, Monza, Italy
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Pandey V, Misra N, Greeshma R, Astha A, Jeyavel S, Lakshmana G, Rajkumar E, Prabhu G. Techno Trend Awareness and Its Attitude Towards Social Connectedness and Mitigating Factors of COVID-19. Front Psychol 2021; 12:637395. [PMID: 34113286 PMCID: PMC8185047 DOI: 10.3389/fpsyg.2021.637395] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 04/01/2021] [Indexed: 11/18/2022] Open
Abstract
While COVID-19 has taken a toll on many professions and livelihood of all walks of lives, technology has amplified its intrusion to ease the necessities. Innovative technology, therefore, has improved the glitches and provided the software to adhere to these new normal. However, individuals' awareness and attitude toward the advancements of these technological trends need to be addressed. Although the government has taken measures to prevent and curb the growing cases for COVID-19 with the help of technology, the support from the individuals would depend mostly on their level of awareness and the attitude toward those measures. The present qualitative study explored the techno trend awareness, perception and attitudes of techno experts and technical professionals toward social connectedness and mitigating factors of COVID-19. Besides, it also explained individuals' shift toward virtual interaction to maintain social connections during the pandemic. The thematic analysis generated four prominent themes. Social Connectedness, emphasized on the emotional connections that created a positive feeling of belongingness. Technological Advancement provided three sub-themes highlighting perception, techno trend awareness and desirable attitudes toward the mitigation of COVID-19. The categories under Treatment and Preventive Measures indicated the enhanced self-care of individuals and also the tendencies to minimize the spread of diseases. The emergence of the theme Inclination toward Indigenous Knowledge, which is an important finding, indicated the techno-experts inclination toward the indigenous knowledge amid vague scientific shreds of evidence.
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Affiliation(s)
- Vijyendra Pandey
- Department of Psychology, Central University of Karnataka, Gulbarga, India
| | - Neelam Misra
- Department of Microbiology, Gulbarga University, Gulbarga, India
| | - Rajgopal Greeshma
- Department of Psychology, Central University of Karnataka, Gulbarga, India
| | - Arora Astha
- Department of Psychology, Central University of Karnataka, Gulbarga, India
| | | | | | - Eslavath Rajkumar
- Department of Psychology, Central University of Karnataka, Gulbarga, India
| | - G Prabhu
- Department of Psychology, Central University of Karnataka, Gulbarga, India
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100
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