Effective factors on not using the N95 respirators among health care workers: Application of Fuzzy Delphi and Fuzzy Analytic Hierarchy Process (FAHP)

Patient safety implications of wearing a face mask for prevention in the era of COVID-19 pandemic: a systematic review and consensus recommendations

In the past, the use of face masks in western countries was essentially limited to occupational health. Now, because of the COVID-19 pandemic, mask-wearing has been recommended as a public health intervention. As potential side effects and some contraindications are emerging, we reviewed the literature to assess the impact of them in daily life on patient safety and to provide appropriate guidelines and recommendations. We performed a systematic review of studies investigating physiological impact, safety, and risk of masks in predefined categories of patients, which have been published in peer-reviewed journals with no time and language restrictions. Given the heterogeneity of studies, results were analyzed thematically. We used PRISMA guidelines to report our findings. Wearing a N95 respirator is more associated with worse side effects than wearing a surgical mask with the following complications: breathing difficulties (reduced FiO₂, SpO₂^, PaO₂ increased ETCO₂, PaCO₂), psychiatric symptoms (panic attacks, anxiety) and skin reactions. These complications are related to the duration of use and/or disease severity. Difficulties in communication is another issue to be considered especially with young children, older person and people with hearing impairments. Even if benefits of wearing face masks exceed the discomfort, it is recommended to take an "air break" after 1-2 h consecutively of mask-wearing. However, well-designed prospective studies are needed. The COVID-19 pandemic could represent a unique opportunity for collecting large amount of real-world data.

Prioritizing the Potential Smartification Measures by Using an Integrated Decision Support System with Sustainable Development Goals (a Case Study in Southern Italy)

With the increasing population of cities, expanding roads as one of the essential urban infrastructures is a necessary task; therefore, adverse effects such as increased fuel consumption, pollution, noise, and road accidents are inevitable. One of the most efficient ways to mitigate congestion-related adverse effects is to introduce effective intelligent transportation systems (ITS), using advanced technologies and mobile communication protocols to make roads smarter and reduce negative impacts such as improvement in fuel consumption and pollution, and reduction of road accidents, which leads to improving quality of life. Smart roads might play a growing role in the improved safety of road transportation networks. This study aims to evaluate and rank the potential smartification measures for the road network in Calabria, in southern Italy, with sustainable development goals. For this purpose, some potential smartification measures were selected. Experts in the field were consulted using an advanced procedure: four criteria were considered for evaluating these smartification measures. The Integrated fuzzy decision support system (FDSS), namely the fuzzy Delphi analytic hierarchy process (FDAHP) with the fuzzy technique for order performance by similarity to ideal solution (FTOPSIS) were used for evaluating and ranking the potential smartification measures. The results demonstrated that the repetition of signals in the vehicle has the highest rank, and photovoltaic systems spread along the road axis has the lowest rank to use as smartification measures in the roads of the case study.

Prevalence of positive TST among healthcare workers in high-burden TB setting in Peru

Background

Tuberculosis (TB) transmission has long been recognized as an important occupational hazard for healthcare workers (HCWs). HCWs have a 5.8% annual risk of exposure and three times greater risk of developing active TB than the general population.

Methods

We conducted an observational cross-sectional study between September 2014 and March 2015 among HCWs in a high-burden TB setting in Lima to estimate the prevalence of positive Tuberculin Skin Test (TST) and to investigate factors associated with a positive TST.

Results

Two hundred forty participants were included in the analysis; TST was administered to 190 (79.2%) while the rest were exempt due to a previous positive TST result, history of TB, or test refusal. A positive TST result was found among 56.2% of participants to whom the TST was applied (95% CI: 49.22–63.55%). When considering those who had a previous positive TST result and those with a history of TB, the prevalence of a positive TST result was 64.3% (95% CI: 57.8–70.3%). No significant differences were observed between clinical/paramedical and administrative staff in the health center. The use of N95 masks during work hours was reported by 142 (69.9%) participants. Prevalence ratios (PR) show that workers with more than 120 months as a HCW were 1.44 times more likely to be TST positive. The multivariate analysis found that HCWs with over 10 years of service were 1.52 times more likely to be TST positive.

Conclusion

This study supports previous reports that TB infection is an occupational hazard for HCWs. Prevention of TB transmission through control measures, as well as timely diagnosis of LTBI in this particular high-risk group, is critical for individual and public health.