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Barde P, Chitturi V, Sharma G, Parmar N, Kathrotia R, Parchwani D, Sharma VK. Effects of Wearing Personal Protective Equipment on Serum Cortisol Levels and Physiological Variables in Healthcare Workers: A Randomised Controlled Trial in a Simulated Pandemic Environment. Cureus 2024; 16:e61687. [PMID: 38975497 PMCID: PMC11223943 DOI: 10.7759/cureus.61687] [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] [Accepted: 06/04/2024] [Indexed: 07/09/2024] Open
Abstract
INTRODUCTION The COVID-19 pandemic has necessitated the widespread use of personal protective equipment (PPE), particularly in high-risk environments. Full-body PPE is favoured for its comprehensive protection against the virus but poses challenges to the body's thermoregulatory system as it inhibits air exchange. This randomised trial was undertaken to investigate the effects of wearing a commonly used gown-type full-body PPE kit in a simulated environment. METHODS Initially, 65 healthy males were recruited and randomly divided into two groups: a study group wearing a full-body PPE kit (gown-type, full-body PPE kit with trousers, a gown-type shirt with a hood, a shoe cover, an N95 face mask, and an optional face shield) and a control group without PPE. They remained seated for three hours while wearing the PPE kit. Room conditions mimicked non-air-conditioned hospital scenarios, with temperature and humidity recorded and ventilation provided through open doors and windows, along with ceiling fan cooling. Activities with minimal physical exertion were allowed, and access to the toilet was kept to a minimum. Subjects underwent assessments of heart rate, respiratory rate, temperature, blood pressure, heart rate variability (HRV), and blood samples for serum cortisol before donning the PPE kit and entering a simulated ICU/WARD environment and after doffing. RESULTS A total of 60 participants completed the study (30 in each group). Compared to the controls, serum cortisol levels significantly increased in the PPE groups, and HRV data indicated increased sympathetic activity in the PPE group. CONCLUSION Wearing a full-body PPE kit (gown-type upper garment with trousers) was found to have a significant impact on cortisol levels and physiological variables in a simulated environment. This suggests that in situations like the COVID-19 pandemic that warrant the use of such PPE kits, appropriate measures should be taken to provide better thermal stability for maintaining the well-being of healthcare workers.
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Affiliation(s)
- Pradip Barde
- Physiology, All India Institute of Medical Sciences Rajkot, Rajkot, IND
| | - Vinay Chitturi
- Physiology, All India Institute of Medical Sciences, Rajkot, Rajkot, IND
| | - Gaurav Sharma
- Physiology, All India Institute of Medical Sciences Rajkot, Rajkot, IND
| | - Naresh Parmar
- Physiology, All India Institute of Medical Sciences, Rajkot, Rajkot, IND
| | - Rajesh Kathrotia
- Physiology, All India Institute of Medical Sciences Rajkot, Rajkot, IND
| | - Deepak Parchwani
- Biochemistry, All India Institute of Medical Sciences, Rajkot, Rajkot, IND
| | - Vivek K Sharma
- Physiology, All India Institute of Medical Sciences Rajkot, Rajkot, IND
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Ülgüt R, Tomsic I, Chaberny IF, von Lengerke T. Human resource management to assist infection prevention and control professionals: a scoping review. J Hosp Infect 2024; 148:145-154. [PMID: 38679391 DOI: 10.1016/j.jhin.2024.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 04/09/2024] [Accepted: 04/11/2024] [Indexed: 05/01/2024]
Abstract
Infection prevention and control (IPC) professionals are key intermediaries between hospital managers and frontline staff. During the novel coronavirus disease pandemic, IPC professionals faced new challenges. Unfortunately, research on human resource management (HRM) to support IPC during and between pandemics is lacking. Therefore, this scoping review aimed to elucidate the existing knowledge on HRM measures in this context and thus contribute to the pandemic preparedness of healthcare facilities. It was conducted as part of the "PREparedness and PAndemic REsponse in Germany (PREPARED)" project within the Network University Medicine (NUM), using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) checklist. PubMed was searched without time restriction until 2023 (filter: English, German). Two reviewers assessed titles/abstracts and full texts, respectively. A total of nine publications were included, eight of which were published in the USA. All publications reported survey data (quantitative: six). Measures targeting personnel development and the qualification of IPC personnel were reported in six studies, i.e., almost two-thirds of the studies, of which five focused on the tasks of IPC professionals. In contrast, management of personnel costs and remuneration systems were reported less frequently (three studies), and only regarding issues around retention, compensation and dismissal. In conclusion, research gaps include trials on implementation and effectiveness of HRM for IPC. Given the increasing shortage of IPC professionals, HRM measures during and between pandemics become more important for establishing pandemic preparedness.
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Affiliation(s)
- R Ülgüt
- Hannover Medical School, Department of Medical Psychology, Hannover, Germany
| | - I Tomsic
- Hannover Medical School, Department of Medical Psychology, Hannover, Germany
| | - I F Chaberny
- Leipzig University Hospital, Institute of Hygiene, Hospital Epidemiology and Environmental Medicine, Leipzig, Germany; Christian-Albrecht University of Kiel and University Medical Center Schleswig-Holstein, Institute of Hospital Epidemiology and Environmental Hygiene, Kiel, Germany
| | - T von Lengerke
- Hannover Medical School, Department of Medical Psychology, Hannover, Germany.
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Teka G, Woldeab A, Dereje N, Eshetu F, Gizachew L, Tazu Z, Lisanwork L, Tigabu E, Gebeyehu A, Tayachew A, Biru M, Berkessa T, Keraleme A, Bikale F, Shure W, Agune A, Haile B, Addis B, Moges M, Gonta M, Hailemariam A, Binkley L, Nawaz S, Wang SH, Mekuria Z, Aklilu A, Aliy J, Lulseged S, Girmay A, Patrick A, Amare B, Delelegn H, Daves S, Yimer G, Abate E, Wossen M, Melaku Z, Gebreyes W, Williams DE, Abayneh A. Regional and temporal variations in COVID-19 cases and deaths in Ethiopia: Lessons learned from the COVID-19 enhanced surveillance and response. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0003175. [PMID: 38781131 PMCID: PMC11115226 DOI: 10.1371/journal.pgph.0003175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 04/08/2024] [Indexed: 05/25/2024]
Abstract
BACKGROUND The COVID-19 pandemic is one of the most devastating public health emergencies of international concern to have occurred in the past century. To ensure a safe, scalable, and sustainable response, it is imperative to understand the burden of disease, epidemiological trends, and responses to activities that have already been implemented. We aimed to analyze how COVID-19 tests, cases, and deaths varied by time and region in the general population and healthcare workers (HCWs) in Ethiopia. METHODS COVID-19 data were captured between October 01, 2021, and September 30, 2022, in 64 systematically selected health facilities throughout Ethiopia. The number of health facilities included in the study was proportionally allocated to the regional states of Ethiopia. Data were captured by standardized tools and formats. Analysis of COVID-19 testing performed, cases detected, and deaths registered by region and time was carried out. RESULTS We analyzed 215,024 individuals' data that were captured through COVID-19 surveillance in Ethiopia. Of the 215,024 total tests, 18,964 COVID-19 cases (8.8%, 95% CI: 8.7%- 9.0%) were identified and 534 (2.8%, 95% CI: 2.6%- 3.1%) were deceased. The positivity rate ranged from 1% in the Afar region to 15% in the Sidama region. Eight (1.2%, 95% CI: 0.4%- 2.0%) HCWs died out of 664 infected HCWs, of which 81.5% were from Addis Ababa. Three waves of outbreaks were detected during the analysis period, with the highest positivity rate of 35% during the Omicron period and the highest rate of ICU beds and mechanical ventilators (38%) occupied by COVID-19 patients during the Delta period. CONCLUSIONS The temporal and regional variations in COVID-19 cases and deaths in Ethiopia underscore the need for concerted efforts to address the disparities in the COVID-19 surveillance and response system. These lessons should be critically considered during the integration of the COVID-19 surveillance system into the routine surveillance system.
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Affiliation(s)
- Gizaw Teka
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Adane Woldeab
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
- The Ohio State University Global One Health initiative (GOHi), Addis Ababa, Ethiopia
| | | | - Frehywot Eshetu
- Division of Global Health Protection (DGHP), US Centers for Disease Control and Prevention (CDC), Addis Ababa, Ethiopia
| | - Lehageru Gizachew
- The Ohio State University Global One Health initiative (GOHi), Addis Ababa, Ethiopia
| | - Zelalem Tazu
- The Ohio State University Global One Health initiative (GOHi), Addis Ababa, Ethiopia
| | - Leuel Lisanwork
- The Ohio State University Global One Health initiative (GOHi), Addis Ababa, Ethiopia
| | - Eyasu Tigabu
- The Ohio State University Global One Health initiative (GOHi), Addis Ababa, Ethiopia
| | - Ayele Gebeyehu
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Adamu Tayachew
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Mengistu Biru
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | | | | | | | - Wolde Shure
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Admikew Agune
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Bizuwork Haile
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Beza Addis
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Muluken Moges
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Melaku Gonta
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | | | - Laura Binkley
- The Ohio State University Global One Health initiative (GOHi), Columbus, Ohio, United States of America
| | - Saira Nawaz
- The Ohio State University Global One Health initiative (GOHi), Columbus, Ohio, United States of America
| | - Shu-Hua Wang
- The Ohio State University Global One Health initiative (GOHi), Columbus, Ohio, United States of America
- Department of Internal Medicine, The Ohio State University, Columbus, Ohio, United States of America
| | - Zelalem Mekuria
- The Ohio State University Global One Health initiative (GOHi), Columbus, Ohio, United States of America
| | | | - Jemal Aliy
- ICAP at Columbia University, Addis Ababa, Ethiopia
| | | | - Abiy Girmay
- World Health Organization (WHO) Ethiopia Office, Addis Ababa, Ethiopia
| | - Abok Patrick
- World Health Organization (WHO) Ethiopia Office, Addis Ababa, Ethiopia
| | - Berhanu Amare
- Division of Global Health Protection (DGHP), US Centers for Disease Control and Prevention (CDC), Addis Ababa, Ethiopia
| | - Hulemenaw Delelegn
- Division of Global Health Protection (DGHP), US Centers for Disease Control and Prevention (CDC), Addis Ababa, Ethiopia
| | - Sharon Daves
- Division of Global Health Protection (DGHP), US Centers for Disease Control and Prevention (CDC), Addis Ababa, Ethiopia
| | - Getnet Yimer
- University of Pennsylvania, Perelman School of Medicine, Pennsylvania, Philadelphia, United States of America
| | - Ebba Abate
- The Ohio State University Global One Health initiative (GOHi), Addis Ababa, Ethiopia
| | - Mesfin Wossen
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | | | - Wondwossen Gebreyes
- The Ohio State University Global One Health initiative (GOHi), Columbus, Ohio, United States of America
- Department of Veterinary Preventive Medicine, The Ohio State University, Columbus, Ohio, United States of America
| | - Desmond E. Williams
- Division of Global Health Protection (DGHP), US Centers for Disease Control and Prevention (CDC), Addis Ababa, Ethiopia
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Evans S, Stimson J, Pople D, White PJ, Wilcox MH, Robotham JV. Impact of interventions to reduce nosocomial transmission of SARS-CoV-2 in English NHS Trusts: a computational modelling study. BMC Infect Dis 2024; 24:475. [PMID: 38714946 PMCID: PMC11075183 DOI: 10.1186/s12879-024-09330-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 04/18/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Prior to September 2021, 55,000-90,000 hospital inpatients in England were identified as having a potentially nosocomial SARS-CoV-2 infection. This includes cases that were likely missed due to pauci- or asymptomatic infection. Further, high numbers of healthcare workers (HCWs) are thought to have been infected, and there is evidence that some of these cases may also have been nosocomially linked, with both HCW to HCW and patient to HCW transmission being reported. From the start of the SARS-CoV-2 pandemic interventions in hospitals such as testing patients on admission and universal mask wearing were introduced to stop spread within and between patient and HCW populations, the effectiveness of which are largely unknown. MATERIALS/METHODS Using an individual-based model of within-hospital transmission, we estimated the contribution of individual interventions (together and in combination) to the effectiveness of the overall package of interventions implemented in English hospitals during the COVID-19 pandemic. A panel of experts in infection prevention and control informed intervention choice and helped ensure the model reflected implementation in practice. Model parameters and associated uncertainty were derived using national and local data, literature review and formal elicitation of expert opinion. We simulated scenarios to explore how many nosocomial infections might have been seen in patients and HCWs if interventions had not been implemented. We simulated the time period from March-2020 to July-2022 encompassing different strains and multiple doses of vaccination. RESULTS Modelling results suggest that in a scenario without inpatient testing, infection prevention and control measures, and reductions in occupancy and visitors, the number of patients developing a nosocomial SARS-CoV-2 infection could have been twice as high over the course of the pandemic, and over 600,000 HCWs could have been infected in the first wave alone. Isolation of symptomatic HCWs and universal masking by HCWs were the most effective interventions for preventing infections in both patient and HCW populations. Model findings suggest that collectively the interventions introduced over the SARS-CoV-2 pandemic in England averted 400,000 (240,000 - 500,000) infections in inpatients and 410,000 (370,000 - 450,000) HCW infections. CONCLUSIONS Interventions to reduce the spread of nosocomial infections have varying impact, but the package of interventions implemented in England significantly reduced nosocomial transmission to both patients and HCWs over the SARS-CoV-2 pandemic.
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Affiliation(s)
- Stephanie Evans
- Fungal, HCAI, AMU & Sepsis Division, UK Health Security Agency, London, AMR, UK.
- Statistics, Modelling and Economics, UK Health Security Agency, London, UK.
| | - James Stimson
- Fungal, HCAI, AMU & Sepsis Division, UK Health Security Agency, London, AMR, UK
- Statistics, Modelling and Economics, UK Health Security Agency, London, UK
| | - Diane Pople
- Fungal, HCAI, AMU & Sepsis Division, UK Health Security Agency, London, AMR, UK
- Statistics, Modelling and Economics, UK Health Security Agency, London, UK
| | - Peter J White
- Statistics, Modelling and Economics, UK Health Security Agency, London, UK
- MRC Centre for Global Infectious Disease Analysis, Imperial College London, London, UK
- NIHR Health Protection Research Unit in Modelling and Health Economics at Imperial College London in partnership with the UK Health Security Agency and London School of Hygiene and Tropical Medicine, London, UK
| | - Mark H Wilcox
- Healthcare-Associated Infections Research Group, Leeds Institute of Medical Research, University of Leeds, Leeds, LS1 9JT, UK
- Microbiology, Leeds Teaching Hospitals, Leeds, UK
| | - Julie V Robotham
- Fungal, HCAI, AMU & Sepsis Division, UK Health Security Agency, London, AMR, UK
- Statistics, Modelling and Economics, UK Health Security Agency, London, UK
- NIHR Health Protection Research Unit in Modelling and Health Economics at Imperial College London in partnership with the UK Health Security Agency and London School of Hygiene and Tropical Medicine, London, UK
- NIHR Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance at University of Oxford in partnership with the, UK Health Security Agency, Oxford, UK
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McGuinness SL, Eades O, Zhong S, Clifford S, Fisher J, Kelsall HL, Kirkman M, Russell G, Skouteris H, Leder K. A longitudinal qualitative exploration of victorian healthcare workers' and organisations' evolving views and experiences during COVID-19. BMC Health Serv Res 2024; 24:596. [PMID: 38715025 PMCID: PMC11077789 DOI: 10.1186/s12913-024-11067-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 04/30/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic has profoundly impacted individuals, society, and healthcare organisations worldwide. Recent international research suggests that concerns, needs, and experiences of healthcare workers (HCWs) have evolved throughout the pandemic. This longitudinal qualitative study explored the evolving views and experiences of Victorian healthcare workers (HCWs) and organisational key personnel during the coronavirus disease (COVID-19) pandemic. METHODS We recruited participants from the Coronavirus in Victorian Health and Aged care workers (COVIC-HA) study cohort. We conducted two rounds of semi-structured interviews with HCWs and organisational key personnel from three different healthcare settings (hospital, aged care and primary care) in Victoria, Australia, in May-July 2021 and May-July 2022. Data were analysed thematically using trajectory and recurrent cross-sectional approaches, guided by a temporal change framework. RESULTS Twelve HCWs and five key personnel from various professional roles participated in interviews at both timepoints. Expected themes derived from mid-2021 interviews (navigating uncertainty, maintaining service delivery, and addressing staff needs) evolved over time. Concerns shifted from personal health and safety to workforce pressures, contributing to HCW burnout and fatigue and ongoing mental health support needs. New themes emerged from mid-2022 interviews, including managing ongoing COVID-19 impacts and supporting the healthcare workforce into the future. Clear and consistent communication, stable guidelines and forward-looking organisational responses were considered crucial. CONCLUSIONS Our longitudinal qualitative study highlighted the evolving impact of the COVID-19 pandemic on HCWs' perceptions, health and wellbeing and uncovered long-term sector vulnerabilities. Analysing HCW experiences and key personnel insights over time and across different pandemic phases provided crucial insights for policymakers to protect the healthcare workforce. Findings emphasise the need for proactive strategies that prioritise HCWs' wellbeing and workforce sustainability. Policy makers must invest in HCW health and wellbeing initiatives alongside healthcare system improvements to ensure resilience and capacity to meet future challenges. TRIAL REGISTRATION This study was approved through the Victorian Streamlined Ethical Review Process (SERP: Project Number 68,086) and registered with ANZCTR (ACTRN12621000533897) on 6 May 2021.
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Affiliation(s)
- Sarah L McGuinness
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia.
- Alfred Health, Melbourne, VIC, Australia.
| | - Owen Eades
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
- Alfred Health, Melbourne, VIC, Australia
| | - Shannon Zhong
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
- Alfred Health, Melbourne, VIC, Australia
| | - Sharon Clifford
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - Jane Fisher
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - Helen L Kelsall
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - Maggie Kirkman
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - Grant Russell
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - Helen Skouteris
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - Karin Leder
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
- Royal Melbourne Hospital, Melbourne, VIC, Australia
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Pradhan S, Nimavat N, Mangrola N, Singh S, Lohani P, Mandala G, Kumar R, Sinha N, Singh SK. Guarding Our Guardians: Navigating Adverse Reactions in Healthcare Workers Amid Personal Protective Equipment (PPE) Usage During COVID-19. Cureus 2024; 16:e58097. [PMID: 38738112 PMCID: PMC11088754 DOI: 10.7759/cureus.58097] [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] [Accepted: 04/09/2024] [Indexed: 05/14/2024] Open
Abstract
The widespread utilization of personal protective equipment (PPE) during the COVID-19 pandemic has been crucial for reducing transmission risk among healthcare workers (HCWs) and the public. However, the extensive use of PPE has brought about potential adverse reactions, particularly among HCWs. This study aims to investigate the prevalence and characteristics of adverse skin reactions associated with PPE use among different categories of HCWs, including faculty, residents, and nursing officers (NOs), in a dedicated tertiary care COVID-19 hospital. The study design was a hospital-based cross-sectional analytical study conducted over one month, involving a total of 240 participants. The participants were required to complete a pre-tested semi-structured questionnaire that covered demographic information, PPE-related data, preventive measures, observed reactions, and self-management strategies. Results indicated that adverse skin reactions were common among HCWs, with reactions reported by all participants. The most commonly used PPE included N95 masks, goggles, gloves, face shields, isolation gowns, and medical protective clothing. Excessive sweating (60% residents, 21.1% NOs, and 16.25% faculties), facial rash, dry palms (>70% of HCWs), and itching were among the most prevalent adverse reactions. Urticarial lesions (28.5% among NOs), pressure marks and pain (100% on the cheek among all HCWs), fungal infections (18.5% among residents at the web space of fingers), and skin breakdown were also reported. Factors such as age, gender, pre-existing skin problems, and oily/acne-prone skin history were found to be significantly associated with adverse skin reactions. In conclusion, the findings highlight the common adverse reactions reported by HCWs during the use of different PPEs. Certain steps taken by HCWs for the prevention of adverse reactions due to PPE emphasize the importance of tailored preventive measures and strategies to mitigate these adverse reactions, such as proper PPE selection, well-fitting equipment, regular breaks, and appropriate skincare practices. These insights contribute to the development of guidelines for optimal PPE usage and support the well-being of HCWs in their essential roles.
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Affiliation(s)
- Swetalina Pradhan
- Dermatology, All India Institute of Medical Sciences Patna, Patna, IND
| | - Nirav Nimavat
- Community Medicine, Gujarat Adani Institute of Medical Science, Bhuj, IND
| | | | - Shruti Singh
- Pharmacology, All India Institute of Medical Sciences Patna, Patna, IND
| | - Pallavi Lohani
- Community Medicine, Madhubani Medical College, Madhubani, IND
| | - Gowthamm Mandala
- Biological Health Sciences, Purude University, West Lafayette, USA
| | - Rajesh Kumar
- Pharmacology, All India Institute of Medical Sciences Patna, Patna, IND
| | - Nishi Sinha
- Pharmacology, All India Institute of Medical Sciences Patna, Patna, IND
| | - Sunil Kumar Singh
- Pharmacology, All India Institute of Medical Sciences Patna, Patna, IND
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Ungar R, Gur-Arie R, Heriot GS, Jamrozik E. Burdens of infection control on healthcare workers: a scoping review. J Hosp Infect 2024; 146:76-81. [PMID: 38141665 DOI: 10.1016/j.jhin.2023.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 12/05/2023] [Accepted: 12/14/2023] [Indexed: 12/25/2023]
Abstract
INTRODUCTION Hospital-acquired infections (HAIs) pose a significant risk to patients, and are a major focus of infection prevention and control policies (IPC). One under-recognized reason for the generally poor compliance with IPC is that it is burdensome for healthcare workers (HCWs). AIM To identify the burdens of IPC for HCWs. METHODS PubMed and CINAHL were searched for studies published in English since 2000 regarding compliance with IPC and the burdens associated with compliance. After screening 1018 initial results, 25 articles were included in the final review. RESULTS Evidence was found for burdens including dermatological complications, headaches, sensory symptoms and time pressure. Tools designed to measure compliance with IPC have limitations, and rarely assess the burdens of compliance. A strong safety culture predicted positive compliance, while knowledge of the underlying rationale for IPC had a non-linear relationship with compliance. CONCLUSION Future research should clarify IPC-related burdens and how these may be minimized to achieve better compliance.
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Affiliation(s)
- R Ungar
- Melbourne Medical School, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Australia
| | - R Gur-Arie
- Center for Health Promotion and Disease Prevention, Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA
| | - G S Heriot
- Department of Infectious Diseases, University of Melbourne, Peter Doherty Institute for Infection and Immunity, Melbourne, Australia
| | - E Jamrozik
- Ethox Centre and Pandemic Sciences Institute, University of Oxford, Oxford, UK; Department of Medicine, Royal Melbourne Hospital, University of Melbourne, Melbourne, Australia; Monash Bioethics Centre, Monash University, Melbourne, Australia.
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Dempster P, Hutchinson A, Oldland E, Bouchoucha SL. Australian emergency nurses' experiences of working with personal protective equipment during the COVID-19 pandemic. A qualitative study. Australas Emerg Care 2024; 27:63-70. [PMID: 37679286 DOI: 10.1016/j.auec.2023.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Revised: 08/16/2023] [Accepted: 08/20/2023] [Indexed: 09/09/2023]
Abstract
INTRODUCTION The COVID-19 pandemic has exposed a need to understand the challenges associated with wearing Personal protective Equipment (PPE). The aim in this study was to explore emergency nurses' experiences early in the COVID-19 pandemic in Australia and the impact of PPE use on their practice. METHODS An explorative descriptive qualitative study was conducted between January 2022 and April 2022. Eighteen emergency nurses and six leaders participated. Semi-structured interviews (n = 21) and one focus group were conducted. Interview transcripts were analysed using Braun and Clarke's framework. RESULTS Two major themes were identified. The first theme was: (1) The shifting ground of the COVID-19 pandemic response. Associated sub-themes were: i) What's the go with PPE today? ii) In the beginning we were scrambling for masks; iii) Emergency is the true frontline. The second theme was: (2) Physical and emotional impacts of emergency nursing work. Sub-themes were: (i) Facing the fear of exposure; (ii) By the end of the shift I am just absolutely spent; iii) Discomfort of wearing PPE impacts on compliance. CONCLUSIONS Healthcare leaders need to secure PPE supply chains and evaluate the effectiveness and side-effects of different PPE designs to minimise occupational harms associated with prolonged PPE use.
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Affiliation(s)
- Penelope Dempster
- School of Nursing and Midwifery, Centre for Quality and Patient Safety Research in the Institute for Health Transformation, Deakin University, Geelong, Australia; Holmesglen Institute of TAFE.
| | - Ana Hutchinson
- School of Nursing and Midwifery, Centre for Quality and Patient Safety Research in the Institute for Health Transformation, Deakin University, Geelong, Australia; Centre for Quality and Patient Safety Research, Epworth Healthcare Partnership, Deakin University, Geelong, Australia; Centre for Innovation in Infectious Disease and Immunology Research (CIIDIR), Deakin University, Geelong, Australia
| | - Elizabeth Oldland
- School of Nursing and Midwifery, Centre for Quality and Patient Safety Research in the Institute for Health Transformation, Deakin University, Geelong, Australia
| | - Stéphane L Bouchoucha
- School of Nursing and Midwifery, Centre for Quality and Patient Safety Research in the Institute for Health Transformation, Deakin University, Geelong, Australia; Centre for Innovation in Infectious Disease and Immunology Research (CIIDIR), Deakin University, Geelong, Australia
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Petersen J, Müller H, Melzer M. [Perceived changes in the workload of home care nurses during the COVID-19 pandemic: Results of an online survey]. ZEITSCHRIFT FUR EVIDENZ, FORTBILDUNG UND QUALITAT IM GESUNDHEITSWESEN 2024; 184:26-33. [PMID: 38143226 DOI: 10.1016/j.zefq.2023.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 09/25/2023] [Accepted: 10/24/2023] [Indexed: 12/26/2023]
Abstract
BACKGROUND The COVID-19 pandemic posed major challenges to the health care system, particularly to nursing. Intensive care was often the focus of attention. However, home care nursing was also confronted with drastic changes, while it is largely unknown how the work situation changed for employees as a result of the pandemic - also depending on the sponsorship of home care nursing services. METHODS A nationwide online survey of home-care nurses was conducted in May and June 2022. The Intensification of Job Demands Scale (IDS) and an open question regarding changes in the work situation due to the pandemic were used among other instruments. RESULTS More than two-thirds of the 976 home-care nurses surveyed agreed with the respective statements regarding work intensification (e.g., taking fewer breaks, doing work activities at the same time, not having enough time). Additional factors for psychological workload during the pandemic primarily fell within the scope of work organization (e.g., staff absences due to illness and quarantine, vaccination related leaves and terminations, additional workload due to handling protective clothing). Employees of privately run care services experienced fewer COVID-19-related changes than home care nurses employed by non-profit providers. CONCLUSION In future crisis situations, good information management (e.g., uniform, consistent and comprehensible guidelines and recommendations for action) and ways to compensate for staff shortages should be created.
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Affiliation(s)
- Julia Petersen
- Bundesanstalt für Arbeitsschutz und Arbeitsmedizin, Dresden, Deutschland.
| | - Helene Müller
- Bundesanstalt für Arbeitsschutz und Arbeitsmedizin, Dresden, Deutschland
| | - Marlen Melzer
- Bundesanstalt für Arbeitsschutz und Arbeitsmedizin, Dresden, Deutschland
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10
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Hou X, He Y, Chen F, Li Y, Wu M, Chen K, Zhou Z. The relationship between the frequency of headaches associated with the personal protective equipment and its influencing factors is mediated by depression: A cross-sectional study. Heliyon 2024; 10:e24744. [PMID: 38317913 PMCID: PMC10839872 DOI: 10.1016/j.heliyon.2024.e24744] [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: 09/21/2023] [Revised: 12/03/2023] [Accepted: 01/12/2024] [Indexed: 02/07/2024] Open
Abstract
Background To evaluate the factors affecting personal protective equipment (PPE) associated with headaches in healthcare workers during the first hit of coronavirus disease 2019 (COVID-19) outbreak in China in order to provide evidence for improving the prevention and treatment of PPE-associated headaches in frontline medical personnel. Methods In this cross-sectional study, the baseline characteristics and the prevalence of the PPE-associated headaches among frontline healthcare workers at Wuhan Taikang Hospital were objectively evaluated by means of a questionnaire survey. We obtained predictors of PPE-associated headaches frequency by multiple regression analyses. The path analysis model was applied to determine the interrelationships between the variables related to PPE-associated headaches frequency. Results Among the 520 participants, 436 (83.85 %) reported PPE-associated headaches during the anti-epidemic period. Compare with non-PPE-associated headache, age, PHQ-9 score >10, nurses, and PSQI>5were statistically significant found in participants with PPE-associated headaches. Multivariable linear regression showed that the occupation(nurse), pre-existing primary headache diagnosis, headache intensity and depression were risk factors for the frequency of PPE-associated headaches. The path analysis model observed that direct effects from occupation (nurse), pre-existing primary headache diagnosis, headache intensity and depression on the frequency of PPE-associated headaches. Depression indirectly mediated the effects of headache intensity and sleep quality on headache frequency. (All P < 0.05). Conclusion This study provided a path analysis model that illustrates the relationships between PPE-associated headaches frequency and its related factors among healthcare workers during the COVID-19 pandemic. It is crucial to the management of PPE-associated headaches to reduce its consequences for frontline healthcare workers.
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Affiliation(s)
- Xianhua Hou
- Department of Neurology, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
- Wuhan Taikang Tongji Hospital, Wuhan, China
| | - Yuxuan He
- Department of Neurology, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Fei Chen
- Department of Neurology, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Yang Li
- Department of Neurology, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
- Wuhan Taikang Tongji Hospital, Wuhan, China
| | - Min Wu
- Department of Neurology, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Kangning Chen
- Department of Neurology, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
- Wuhan Taikang Tongji Hospital, Wuhan, China
| | - Zhenhua Zhou
- Department of Neurology, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
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11
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Sansone V, Miraglia del Giudice G, Della Polla G, Angelillo IF. Impact of the COVID-19 pandemic on behavioral changes in healthcare workers in Italy. Front Public Health 2024; 12:1335953. [PMID: 38384871 PMCID: PMC10879601 DOI: 10.3389/fpubh.2024.1335953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 01/09/2024] [Indexed: 02/23/2024] Open
Abstract
Introduction During the COVID-19 pandemic, adherence to wearing face mask and washing hands procedures and achieving high COVID-19 vaccine coverage among healthcare workers (HCWs) were essential to minimize morbidity and possible death and limit the transmission of the virus. The objectives of the cross-sectional survey were to explore the influence of COVID-19 on the use of preventive measures and vaccination willingness among HCWs in the southern part of Italy and the associated factors. Methods The survey was carried out from 15 June 2023 to 15 July 2023 among 521 HCWs who worked in three randomly selected public hospitals. All data were collected through a self-administered questionnaire. Results HCWs had a positive change in the use of preventive measures if they did not often/always use them before the pandemic, but they are using in the current epidemiologic context and they were willing to use in a future epidemic situation. A positive change in the adherence to face mask-wearing (24.6%) was more likely among those with at least 5 years of university degree, nurses/midwives, and who had worked in COVID-19 wards. A positive change in alcohol-based hand rubbing (3.1%) was more likely in HCWs in Emergency/Critical/Infectious Diseases wards compared with medical wards. HCWs who were more likely to believe that the COVID-19 vaccine should be mandatory for them (58.1%) had at least 5 years of university degree, in Emergency/Critical/Infectious Diseases wards compared with surgical and medical wards, had received more than three doses of this vaccine, were more concerned to get infected during their activity, and had received information from scientific journals. HCWs more willing to receive the COVID-19 vaccine every year (39.8%) were males, physicians, those in Emergency/Critical/Infectious Diseases wards compared with medical wards, who had received more than three doses of this vaccine, who believed that this vaccine should be mandatory for HCWs, and who needed additional information. Discussion The survey showed that the COVID-19 pandemic had an impact on the use of preventive measures among HCWs, not necessarily for the improvement or increase. Educational messages on the importance of these measures regarding the promotion and recommendation of the vaccine need to be investigated and applied among HCWs in order to reduce vaccination gaps and the spread of the infection.
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12
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Gohil SK, Septimus E, Sands KE, Blanchard EJ, Moody J, de St. Maurice A, Yokoe D, Kwon J, Grein J, Cohen S, Uslan D, Vasudev M, Mauricio A, Mabalot S, Coady MH, Sljivo S, Smith K, Carver B, Poland R, Perlin J, Platt R, Huang SS. Coronavirus disease 2019 (COVID-19) infection prevention practices that exceed Centers for Disease Control and Prevention (CDC) guidance: Balancing extra caution against impediments to care. Infect Control Hosp Epidemiol 2023; 44:2074-2077. [PMID: 37260365 PMCID: PMC10755143 DOI: 10.1017/ice.2023.89] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 03/21/2023] [Accepted: 03/25/2023] [Indexed: 06/02/2023]
Abstract
In a survey of infection prevention programs, leaders reported frequent clinical and infection prevention practice modifications to avoid coronavirus disease 2019 (COVID-19) exposure that exceeded national guidance. Future pandemic responses should emphasize balanced approaches to precautions, prioritize educational campaigns to manage safety concerns, and generate an evidence-base that can guide appropriate infection prevention practices.
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Affiliation(s)
- Shruti K. Gohil
- Epidemiology & Infection Prevention Program, University of California Irvine Health (UC Irvine Health), Irvine, California
- Division of Infectious Diseases, University of California, Irvine School of Medicine, Irvine, California
| | - Edward Septimus
- Department of Population Medicine, Harvard Pilgrim Healthcare Institute, Harvard Medical School, Boston, Massachusetts
| | | | | | | | - Annabelle de St. Maurice
- Division of Pediatric Infectious Diseases, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, California
| | - Deborah Yokoe
- Division of Infectious Diseases, University of California San Francisco, San Francisco, California
| | - Jennie Kwon
- Division of Infectious Diseases, Washington University School of Medicine, St. Louis, Missouri
| | - Jonathan Grein
- Division of Infectious Diseases, Cedars Sinai Medical Center, Los Angeles, California
| | - Stuart Cohen
- Division of Infectious Diseases, University of California Davis, Davis, California
| | - Daniel Uslan
- Division of Infectious Diseases, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, California
| | - Milind Vasudev
- Division of Infectious Diseases, University of California, Irvine School of Medicine, Irvine, California
| | - Amarah Mauricio
- Division of Infectious Diseases, University of California, Irvine School of Medicine, Irvine, California
| | - Shannon Mabalot
- Infection Prevention, Sharp Metropolitan Medical Campus, San Diego, California
| | - Micaela H. Coady
- Department of Population Medicine, Harvard Pilgrim Healthcare Institute, Harvard Medical School, Boston, Massachusetts
| | - Selsebil Sljivo
- Department of Population Medicine, Harvard Pilgrim Healthcare Institute, Harvard Medical School, Boston, Massachusetts
| | | | | | | | | | - Richard Platt
- Department of Population Medicine, Harvard Pilgrim Healthcare Institute, Harvard Medical School, Boston, Massachusetts
| | - Susan S. Huang
- Epidemiology & Infection Prevention Program, University of California Irvine Health (UC Irvine Health), Irvine, California
- Division of Infectious Diseases, University of California, Irvine School of Medicine, Irvine, California
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13
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Yilmaz A, Seren İntepeler S. Opinions of emergency nurses in Turkey on their work environment during the COVID-19 pandemic and its relationship with their health: A qualitative study. Heliyon 2023; 9:e22716. [PMID: 38144309 PMCID: PMC10746406 DOI: 10.1016/j.heliyon.2023.e22716] [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: 10/15/2022] [Revised: 11/14/2023] [Accepted: 11/16/2023] [Indexed: 12/26/2023] Open
Abstract
Introduction COVID-19 patients being admitted to emergency service pose a high risk of exposure and infection to emergency nurses. Therefore, one of the primary responsibilities of hospital management is to provide an appropriate work environment for nurses. Aim To analyze the opinions of emergency nurses about their work environment, and to understand how the working environment is related to their health during the COVID-19 pandemic. Methods The study employed a qualitative descriptive research design and purposive sampling method. It was conducted in the emergency service of a state hospital in the central Anatolia region of Turkey, which was providing COVID-19 care at the time. The data were collected through semi-structured individual interviews held between January and February 2021. Each interview was conducted only once via WhatsApp video calls. Data collection was continued to reach data saturation (n:14). The data were analyzed using Colaizzi's seven-step content analysis. The Consolidated Criteria for Reporting Qualitative (COREQ) Studies checklist was followed in the study. Results Three themes emerged in the analysis of the data obtained from a total of 14 emergency nurses: (a) "Insufficient Physical Environment"; (b) "Inadequacies in Managerial Roles and Skills"; and (c) "The Effect of the Work Environment on Nurses' Health". It was determined that the work environment of emergency nurses was inadequate in terms of resting areas, ventilation and separation of clean and infected areas, and they stated that they had not received adequate support from their managers and encountered difficulties due to equipment shortage, particularly in the early stages of COVID-19. It was also determined that the work environment caused psychological and ergonomic health issues. Conclusions It is important to provide adequate managerial support and to make arrangements that resolve the physical and mental obstacles in improving the work environment of emergency nurses.
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Affiliation(s)
- Ayşegül Yilmaz
- Selcuk University Faculty of Health Sciences, Midwifery Department, Konya, Turkey
| | - Seyda Seren İntepeler
- Dokuz Eylul University Faculty of Nursing, Department of Nursing Management İzmir, Turkey
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14
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Gebreegziabher E, Bui D, Cummings KJ, Beckman J, Frederick M, Nguyen A, Chan E, Gibb K, Rodriguez A, Wong J, Majka C, Jain S, Vergara X. Temporal assessment of disparities in California COVID-19 mortality by industry: a population-based retrospective cohort study. Ann Epidemiol 2023; 87:S1047-2797(23)00169-2. [PMID: 37714416 DOI: 10.1016/j.annepidem.2023.09.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 08/28/2023] [Accepted: 09/09/2023] [Indexed: 09/17/2023]
Abstract
PURPOSE To assess changes in the COVID-19 mortality rate and disparities over variants or waves by industry. METHODS We identified COVID-19 deaths that occurred between January 2020 and May 2022 among California workers aged 18-64 years using death certificates, and estimated Californians at risk using the Current Population Survey. The waves in deaths were wave 1: March-June 2020, wave 2: July-November 2020, wave 3/Epsilon and Alpha variants: December 2020-May 2021, wave 4/Delta variant: June 2021-January 2022, and wave 5/Omicron variant: February-May 2022. We used Poisson regression to generate wave-specific mortality rate ratios (MRR) and included an interaction term between industry and wave in different models to assess significance of the change in MRR. RESULTS In all waves of the pandemic, healthcare, other services, manufacturing, transportation, and retail trade industries had higher mortality rates than the professional, scientific, and technical industry. The healthcare industry had the highest relative rate earlier in the pandemic, while other services, utilities, and accommodation and food services industries had substantial increases in MRR in later waves. CONCLUSIONS Industries that consistently had disproportionate COVID-19 mortality may have benefitted from protections that consider workers' increased exposure and vulnerability to severe outcomes.
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Affiliation(s)
- Elisabeth Gebreegziabher
- Occupational Health Branch, California Department of Public Health, Richmond; Heluna Health, City of Industry, CA.
| | - David Bui
- Occupational Health Branch, California Department of Public Health, Richmond; Heluna Health, City of Industry, CA.
| | - Kristin J Cummings
- Occupational Health Branch, California Department of Public Health, Richmond.
| | - John Beckman
- Occupational Health Branch, California Department of Public Health, Richmond; Public Health Institute, Oakland, CA.
| | - Matthew Frederick
- Occupational Health Branch, California Department of Public Health, Richmond; Public Health Institute, Oakland, CA.
| | - Alyssa Nguyen
- Infectious Diseases Branch, California Department of Public Health, Richmond.
| | - Elena Chan
- Occupational Health Branch, California Department of Public Health, Richmond; Public Health Institute, Oakland, CA.
| | - Kathryn Gibb
- Occupational Health Branch, California Department of Public Health, Richmond; Public Health Institute, Oakland, CA.
| | - Andrea Rodriguez
- Occupational Health Branch, California Department of Public Health, Richmond; Public Health Institute, Oakland, CA.
| | - Jessie Wong
- Occupational Health Branch, California Department of Public Health, Richmond; Public Health Institute, Oakland, CA.
| | - Claire Majka
- Occupational Health Branch, California Department of Public Health, Richmond; Public Health Institute, Oakland, CA.
| | - Seema Jain
- Infectious Diseases Branch, California Department of Public Health, Richmond.
| | - Ximena Vergara
- Occupational Health Branch, California Department of Public Health, Richmond; Heluna Health, City of Industry, CA.
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15
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Zhu F, Su H, Kong Y, Xu B, Lv Q, Lin J, Yi L, Xie J. Evaluation of dressings preventing facial medical device-related pressure injury in medical staff during the COVID-19 pandemic: A systematic review and network meta-analysis. J Clin Nurs 2023; 32:5988-5999. [PMID: 37082837 DOI: 10.1111/jocn.16721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 02/06/2023] [Accepted: 04/05/2023] [Indexed: 04/22/2023]
Abstract
AIM This study systematically compared the efficacy of various dressings that may prevent facial medical device-related pressure injury (MRDPI) in medical staff during the COVID-19 pandemic. BACKGROUND During the COVID-19 pandemic, medical staff who are required to wear masks, goggles and other personal protective equipment (PPE) are susceptible to facial MRDPI, which exacerbates working conditions. Dressings can effectively prevent or alleviate MRDPI, but it is unclear which dressings are most effective. DESIGN A systematic review and network meta-analysis, in accordance with PRISMA. METHODS A comprehensive literature search was conducted in four English and four Chinese databases to identify relevant studies published up to 8 September 2022. The selected studies were randomised controlled trials, with populations comprising medical staff who wore PPE during the COVID-19 pandemic and included an observation and control group. RESULTS The network meta-analysis of the 12 selected articles showed that foam dressing, hydrocolloid dressing and petrolatum gauze were better than conventional protection for preventing MRDPI. The surface under the cumulative ranking curve indicated that foam dressing was the best preventative. CONCLUSION Foam dressing is more effective than other dressings in preventing facial MRDPI in medical staff. When PPE must be worn for many hours, such as during the COVID-19 pandemic, medical staff can use foam dressings to prevent MRDPI. RELEVANCE TO CLINICAL PRACTICE The results support the use of dressings, especially foam dressings, to prevent MRDPI in healthcare workers. The appropriate dressings are recommended to prevent MRDPI associated with wearing PPE.
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Affiliation(s)
- Fangfang Zhu
- Nursing College, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Honghong Su
- Nursing College, Fuzhou Institute of Technology, Fuzhou, China
| | - Yue Kong
- Teaching and Research Department, Fuzong Clinical Medical College of Fujian Medical University (The 900th Hospital of Joint Logistic Support Force, PLA), Fuzhou, China
| | - Baoling Xu
- Nursing College, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Qian Lv
- Nursing College, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Jiamin Lin
- Nursing College, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Luanxing Yi
- Nursing College, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Jieling Xie
- Nursing College, Fujian University of Traditional Chinese Medicine, Fuzhou, China
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16
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Kalk A, Sturmberg J, Van Damme W, Brown GW, Ridde V, Zizi M, Paul E. Surfing Corona waves - instead of breaking them: Rethinking the role of natural immunity in COVID-19 policy. F1000Res 2023; 11:337. [PMID: 37576385 PMCID: PMC10412939 DOI: 10.12688/f1000research.110593.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/22/2023] [Indexed: 08/15/2023] Open
Abstract
In the first two years of the pandemic, COVID-19 response policies have aimed to break Corona waves through non-pharmaceutical interventions and mass vaccination. However, for long-term strategies to be effective and efficient, and to avoid massive disruption and social harms, it is crucial to introduce the role of natural immunity in our thinking about COVID-19 (or future "Disease-X") control and prevention. We argue that any Corona or similar virus control policy must appropriately balance five key elements simultaneously: balancing the various fundamental interests of the nation, as well as the various interventions within the health sector; tailoring the prevention measures and treatments to individual needs; limiting social interaction restrictions; and balancing the role of vaccinations against the role of naturally induced immunity. Given the high infectivity of SARS-CoV-2 and its differential impact on population segments, we examine this last element in more detail and argue that an important aspect of 'living with the virus' will be to better understand the role of naturally induced immunity in our overall COVID-19 policy response. In our eyes, a policy approach that factors natural immunity should be considered for persons without major comorbidities and those having 'encountered' the antigen in the past.
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Affiliation(s)
- Andreas Kalk
- Kinshasa Country Office, Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ), Kinshasa, Democratic Republic of the Congo
| | - Joachim Sturmberg
- Foundation President – International Society for Systems and Complexity Sciences for Health, Australia, Callaghan, Australia
- A/Prof of General Practice, College of Health, Medicine and Wellbeing, University of Newcastle, Australia, Callaghan, Australia
| | - Wim Van Damme
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Antwerp, Belgium
| | | | - Valéry Ridde
- CEPED, IRD-Université de Paris, ERL INSERM SAGESUD, Institute for Research on Sustainable Development (IRD), Paris, France
| | - Martin Zizi
- Aerendir Mobile Inc., Mountain View, California, USA
| | - Elisabeth Paul
- School of Public Health, Université libre de Bruxelles, Brussels, 1070, Belgium
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17
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Evrin T, Dabkowski M, Pruc M, Hernik J, Wieczorek W, Chabowski L, Wieczorek P, Chmielewski J, Feduniw S, Szarpak L. ETView SL versus Macintosh Direct Laryngoscope for Endotracheal Intubation Amid Simulated COVID-19 Cardiac Arrest: A Randomized Crossover Study. J Clin Med 2023; 12:5074. [PMID: 37568476 PMCID: PMC10419956 DOI: 10.3390/jcm12155074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 07/23/2023] [Accepted: 07/31/2023] [Indexed: 08/13/2023] Open
Abstract
Airway management procedures, such as endotracheal intubation (ETI), pose a significant risk of aerosol generation, requiring robust personal protective equipment (PPE) against aerosol-generating procedures (AGP). This study aimed to assess the impact of PPE-AGP on intubation success rates, time to intubation, and glottic visualization using ETView and a standard Macintosh laryngoscope (MAC). A total of 52 physicians participated in this prospective, observational, randomized crossover study conducted in a medical simulation setting. Participants included COVID-19 patients with cardiac arrest scenarios with and without PPE-AGP who were intubated with ETView and MAC. During intubation without PPE-AGP, ETView showed a similar first-pass success rate (FPS) but had a shorter intubation time and better glottal hydration compared to MAC. In scenario B (with PPE-AGP), ETView outperformed MAC in FPS, initiation time, and glottic visualization. The use of PPE-AGP had little impact on ETView's performance. However, it negatively affected the Macintosh laryngoscope, reducing FPS and glottic visibility. Participants found intubation with ETView easier in both scenarios. In conclusion, as compared to the Macintosh laryngoscope, ETView demonstrated higher performance under the circumstances of the simulation, especially when PPE-AGP was used.
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Affiliation(s)
- Togay Evrin
- Department of Emergency Medicine, Medical Faculty, Ufuk University, 06510 Ankara, Turkey
| | - Miroslaw Dabkowski
- Research Unit, Polish Society of Disaster Medicine, 05-806 Warsaw, Poland
| | - Michal Pruc
- Research Unit, Polish Society of Disaster Medicine, 05-806 Warsaw, Poland
- Department of Public Health, International Academy of Ecology and Medicine, 02000 Kyiv, Ukraine
| | - Jacek Hernik
- Institute of Outcomes Research, Maria Sklodowska-Curie Medical Academy, 00-136 Warsaw, Poland
| | - Wojciech Wieczorek
- Research Unit, Polish Society of Disaster Medicine, 05-806 Warsaw, Poland
- Department of Emergency Medicine, Medical University of Warsaw, 02-013 Warsaw, Poland
| | - Lukasz Chabowski
- Research Unit, Polish Society of Disaster Medicine, 05-806 Warsaw, Poland
- Department of Public Health, Odessa International Medical University, 12042 Odessa, Ukraine
| | - Pawel Wieczorek
- Research Unit, Polish Society of Disaster Medicine, 05-806 Warsaw, Poland
- Pediatric Intensive Care Unit (PICU), John Paul II Upper Silesian Health Centre in Katowice, 40-752 Katowice, Poland
| | - Jaroslaw Chmielewski
- Institute of Environmental Protection—National Research Institute (IEP-NRI), 02-170 Warsaw, Poland
- Department of Public Health, International European University, 03187 Kyiv, Ukraine
| | - Stepan Feduniw
- Department of Obstetrics, University Hospital Zurich, 8091 Zurich, Switzerland
- Department of Gynecology, University Hospital Zurich, 8091 Zurich, Switzerland
| | - Lukasz Szarpak
- Henry JN Taub Department of Emergency Medicine, Baylor College of Medicine, Houston, TX 77030, USA
- Research Unit, Maria Sklodowska-Curie Bialystok Oncology Center, 15-027 Bialystok, Poland
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Quaglio G, Done G, Cavallin F, Ojeda MG, Claes P. Experiences of health professionals in EU institutions during the Covid crisis. INTERNATIONAL JOURNAL OF DISASTER RISK REDUCTION : IJDRR 2023; 94:103810. [PMID: 37360249 PMCID: PMC10276498 DOI: 10.1016/j.ijdrr.2023.103810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 06/15/2023] [Accepted: 06/16/2023] [Indexed: 06/28/2023]
Abstract
We performed a quantitative and a qualitative study, addressing the experiences of health services of 16 European Union institutions during the Covid-19 pandemic. Among the 165 eligible subjects, 114 (69%) participated in the survey. The biggest problem reported was limitation of social contacts (53%). At work, the biggest problems were workload (50%) and shortage of staff (37%). The majority were positive about teamwork. Teleworking was seen positively by 81%. Most participants felt better prepared for future situations by their recent experience (94%). Participants underlined the importance of strengthening the collaboration with the local health systems (80%), as well as with medical services and internal services within their own institution (75%). The qualitative analysis also reported participants' fear of becoming infected, and of their family members getting sick. Similarly reported were the sense of isolation and anxiety, the excessive workload and work complexity, shortage of staff, and the benefits of teleworking. Study findings highlight: i) the need to strengthen mental health support to health personnel, not only during crisis situations; ii) the need for sufficient health workers, with swift recruitment strategies in times of crisis; iii) the importance of clear protocols to ensure no shortages of personal protective equipment (PPE); iv) the importance of teleworking, which represents an opportunity for major reorganisation of work within EU medical services; v) the need to strengthen collaboration with local health systems and the medical services of EU institutions.
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Affiliation(s)
- Gianluca Quaglio
- Medical Preparedness and Crisis Management Unit (MPCMU), Directorate-General for Personnel (DG PERS), European Parliament, Brussels, Belgium
| | - Georgeta Done
- Medical Service, Directorate-General for Personnel (DG PERS), European Parliament, Luxembourg
| | | | - Maria Gil Ojeda
- Medical Preparedness and Crisis Management Unit (MPCMU), Directorate-General for Personnel (DG PERS), European Parliament, Brussels, Belgium
| | - Petra Claes
- Medical Preparedness and Crisis Management Unit (MPCMU), Directorate-General for Personnel (DG PERS), European Parliament, Brussels, Belgium
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19
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Marra AR, Miraglia JL, Malheiro DT, Guozhang Y, Teich VD, Victor EDS, Pinho JRR, Cypriano A, Vieira LW, Polonio M, Ornelas RH, de Oliveira SM, Borges FA, Oler SCC, Ricardo VCV, Maezato AM, Callado GY, Schettino GDPP, de Oliveira KG, Santana RAF, Malta FDM, Amgarten D, Boechat AL, Kobayashi T, Salinas JL, Edmond MB, Rizzo LV. Longer-term effectiveness of a heterologous coronavirus disease 2019 (COVID-19) vaccine booster in healthcare workers in Brazil. ANTIMICROBIAL STEWARDSHIP & HEALTHCARE EPIDEMIOLOGY : ASHE 2023; 3:e104. [PMID: 37396193 PMCID: PMC10311693 DOI: 10.1017/ash.2023.173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 04/05/2023] [Accepted: 04/07/2023] [Indexed: 07/04/2023]
Abstract
Objective To compare the long-term vaccine effectiveness between those receiving viral vector [Oxford-AstraZeneca (ChAdOx1)] or inactivated viral (CoronaVac) primary series (2 doses) and those who received an mRNA booster (Pfizer/BioNTech) (the third dose) among healthcare workers (HCWs). Methods We conducted a retrospective cohort study among HCWs (aged ≥18 years) in Brazil from January 2021 to July 2022. To assess the variation in the effectiveness of booster dose over time, we estimated the effectiveness rate by taking the log risk ratio as a function of time. Results Of 14,532 HCWs, coronavirus disease 2019 (COVID-19) was confirmed in 56.3% of HCWs receiving 2 doses of CoronaVac vaccine versus 23.2% of HCWs receiving 2 doses of CoronaVac vaccine with mRNA booster (P < .001), and 37.1% of HCWs receiving 2 doses of ChAdOx1 vaccine versus 22.7% among HCWs receiving 2 doses of ChAdOx1 vaccine with mRNA booster (P < .001). The highest vaccine effectiveness with mRNA booster was observed 30 days after vaccination: 91% for the CoronaVac vaccine group and 97% for the ChAdOx1 vaccine group. Vacine effectiveness declined to 55% and 67%, respectively, at 180 days. Of 430 samples screened for mutations, 49.5% were SARS-CoV-2 delta variants and 34.2% were SARS-CoV-2 omicron variants. Conclusions Heterologous COVID-19 vaccines were effective for up to 180 days in preventing COVID-19 in the SARS-CoV-2 delta and omicron variant eras, which suggests the need for a second booster.
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Affiliation(s)
- Alexandre R. Marra
- Hospital Israelita Albert Einstein, São Paulo, Brazil
- Department of Internal Medicine, University of Iowa, Iowa City, Iowa, United States
| | | | | | - Yang Guozhang
- Hospital Israelita Albert Einstein, São Paulo, Brazil
| | | | | | | | | | | | - Miria Polonio
- Hospital Israelita Albert Einstein, São Paulo, Brazil
| | | | | | | | | | | | | | | | | | | | | | | | | | | | - Takaaki Kobayashi
- Department of Internal Medicine, University of Iowa, Iowa City, Iowa, United States
| | | | - Michael B. Edmond
- West Virginia University School of Medicine, Morgantown, West Virginia, United States
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20
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McGrath BA, Shelton CL, Gardner A, Coleman R, Lynch J, Alexander PG, Cooper G. Bubble-PAPR: a phase 1 clinical evaluation of the comfort and perception of a prototype powered air-purifying respirator for use by healthcare workers in an acute hospital setting. BMJ Open 2023; 13:e066524. [PMID: 37156585 PMCID: PMC10174029 DOI: 10.1136/bmjopen-2022-066524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/10/2023] Open
Abstract
OBJECTIVES We aimed to design and produce a low-cost, ergonomic, hood-integrated powered air-purifying respirator (Bubble-PAPR) for pandemic healthcare use, offering optimal and equitable protection to all staff. We hypothesised that participants would rate Bubble-PAPR more highly than current filtering face piece (FFP3) face mask respiratory protective equipment (RPE) in the domains of comfort, perceived safety and communication. DESIGN Rapid design and evaluation cycles occurred based on the identified user needs. We conducted diary card and focus group exercises to identify relevant tasks requiring RPE. Lab-based safety standards established against British Standard BS-EN-12941 and EU2016/425 covering materials; inward particulate leakage; breathing resistance; clean air filtration and supply; carbon dioxide elimination; exhalation means and electrical safety. Questionnaire-based usability data from participating front-line healthcare staff before (usual RPE) and after using Bubble-PAPR. SETTING Overseen by a trial safety committee, evaluation progressed sequentially through laboratory, simulated, low-risk, then high-risk clinical environments of a single tertiary National Health Service hospital. PARTICIPANTS 15 staff completed diary cards and focus groups. 91 staff from a range of clinical and non-clinical roles completed the study, wearing Bubble-PAPR for a median of 45 min (IQR 30-80 (15-120)). Participants self-reported a range of heights (mean 1.7 m (SD 0.1, range 1.5-2.0)), weights (72.4 kg (16.0, 47-127)) and body mass indices (25.3 (4.7, 16.7-42.9)). OUTCOME MEASURES Preuse particulometer 'fit testing' and evaluation against standards by an independent biomedical engineer.Primary:Perceived comfort (Likert scale).Secondary: Perceived safety, communication. RESULTS Mean fit factor 16 961 (10 participants). Bubble-PAPR mean comfort score 5.64 (SD 1.55) vs usual FFP3 2.96 (1.44) (mean difference 2.68 (95% CI 2.23 to 3.14, p<0.001). Secondary outcomes, Bubble-PAPR mean (SD) versus FFP3 mean (SD), (mean difference (95% CI)) were: how safe do you feel? 6.2 (0.9) vs 5.4 (1.0), (0.73 (0.45 to 0.99)); speaking to other staff 7.5 (2.4) vs 5.1 (2.4), (2.38 (1.66 to 3.11)); heard by other staff 7.1 (2.3) vs 4.9 (2.3), (2.16 (1.45 to 2.88)); speaking to patients 7.8 (2.1) vs 4.8 (2.4), (2.99 (2.36 to 3.62)); heard by patients 7.4 (2.4) vs 4.7 (2.5), (2.7 (1.97 to 3.43)); all p<0.01. CONCLUSIONS Bubble-PAPR achieved its primary purpose of keeping staff safe from airborne particulate material while improving comfort and the user experience when compared with usual FFP3 masks. The design and development of Bubble-PAPR were conducted using a careful evaluation strategy addressing key regulatory and safety steps. TRIAL REGISTRATION NUMBER NCT04681365.
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Affiliation(s)
- Brendan A McGrath
- Acute Intensive Care Unit, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK
- Manchester Academic Critical Care, Division of Infection, Immunity and Respiratory Medicine, Manchester Academic Health Science Centre, Manchester, UK
| | - Clifford L Shelton
- Department of Anaesthesia, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK
- Lancaster Medical School, Lancaster University, Lancaster, UK
| | - Angela Gardner
- Acute Intensive Care Unit, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK
| | - Ruth Coleman
- Acute Intensive Care Unit, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK
| | - James Lynch
- Acute Intensive Care Unit, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK
| | - Peter G Alexander
- Acute Intensive Care Unit, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK
- Manchester Academic Critical Care, Division of Infection, Immunity and Respiratory Medicine, Manchester Academic Health Science Centre, Manchester, UK
| | - Glen Cooper
- The University of Manchester School of Mechanical Aerospace and Civil Engineering, Manchester, UK
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21
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Laxmidhar R, Desai C, Patel P, Laxmidhar F. Adverse Effects Faced by Healthcare Workers While Using Personal Protective Equipment During the COVID-19 Pandemic in Civil Hospital, Ahmedabad. Cureus 2023; 15:e38485. [PMID: 37273298 PMCID: PMC10237251 DOI: 10.7759/cureus.38485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/03/2023] [Indexed: 06/06/2023] Open
Abstract
Background Healthcare workers (HCWs) were compelled to use personal protective equipment (PPE) during the COVID-19 pandemic to prevent cross-transmission. One of the most significant challenges in responding to the COVID-19 pandemic is the consistent and effective use of PPE to avoid staff exposure and infection. This study aimed to detect and evaluate the adverse effects of PPE and determine the associated risk factors. Methodology This cross-sectional study included 186 randomly selected HCWs at Civil Hospital, Ahmedabad, from May 2022 to July 2022. An anonymous self-administered questionnaire was used for data collection, and data analysis was done using descriptive statistics. Results PPE-related adverse effects were noted among 147 HCWs, with a prevalence of 79.03%. Data analysis showed that factors significantly associated with PPE adverse effects in HCWs were age group 20-40 years (chi-squared (χ2) = 4.119, p = 0.04) and female gender (χ2 = 7.153, p = 0.007). Overall, 30.8% of participants had tested positive while on duty during the pandemic. Similarly, adverse effects were associated with PPE use of more than four hours per day and more than three days per week (χ2 = 5.477, p = 0.02 and χ2 = 6.488, p = 0.01, respectively). The majority of HCWs expressed indentation and pain on the back of the ear (52.7%) and pressure-related injury (39.8%) as adverse effects after wearing masks; skin soaking in sweat (54.83%) due to gloves; profuse sweating due to gown (64.28%); fogging (65.26%) due to googles and face-shield; and discomfort (61.29%). Conclusions The prevalence of adverse effects related to wearing PPE was alarmingly high among HCWs. The major risk factors were age, female sex, and duration of use. Although the majority of healthcare personnel have received vaccinations, the use of PPE has not altered, and severe skin reactions continue to be a global issue with no known solution. To further understand the problem, national data for the impacted healthcare professionals could be helpful. Furthermore, workplace prevention programs are necessary.
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Affiliation(s)
- Rosy Laxmidhar
- Infectious Diseases, Byramjee Jeejeebhoy (BJ) Medical College, Civil Hospital Asarwa, Ahmedabad, IND
| | - Chetna Desai
- Pharmacology, Byramjee Jeejeebhoy (BJ) Medical College, Civil Hospital Asarwa, Ahmedabad, IND
| | - Prakruti Patel
- Pharmacology, Byramjee Jeejeebhoy (BJ) Medical College, Civil Hospital Asarwa, Ahmedabad, IND
| | - Fehmida Laxmidhar
- Infectious Diseases, Smt. Nathiba Hargovandas Lakhmichand (NHL) Municipal Medical College, Ahmedabad, IND
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22
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Alkhalaf A, Aljaroudi E, Al-Hulami M, Gaffar B, Almas K. Efficacy of Surgical Masks Versus N95 Respirators for the Prevention of COVID-19 in Dental Settings: A Systematic Review. Cureus 2023; 15:e37631. [PMID: 37200654 PMCID: PMC10186565 DOI: 10.7759/cureus.37631] [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] [Accepted: 04/15/2023] [Indexed: 05/20/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2. (SARS-CoV-2). It spreads mainly through saliva droplets or nasal discharge. Dentists are among the professionals with the greatest risk of contracting and transmitting COVID-19. We compared the efficacy of surgical masks versus N95 respirators in preventing COVID-19 infection in dental settings. PubMed, Scopus, Web of Science, and Cochrane Library databases were searched. Search terms corresponded to a predefined PICOS (patient/population, intervention, comparison, and outcomes) question. The risk of bias was evaluated using AMSTAR-2 (A Measurement Tool to Assess Systematic Reviews-2), ROBIS (Risk of Bias in Systematic Reviews), and Health Evidence tools. A total of 191 articles were screened, and nine of them were further evaluated for eligibility, of which five articles (fulfilled the selection criteria) and were included in this study. Two studies concluded that surgical masks could provide equivalent protection to N95 respirators. Another study found that N95 respirators were superior to surgical masks. The fourth study found that better protection can be achieved when using surgical masks by the aerosol source than when the recipient uses an N95 respirator, while the last study concluded that surgical masks or N95 respirators alone do not provide full protection. Thus, according to this systematic review, N95 respirators provide better protection against COVID-19 infection compared to surgical masks.
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Affiliation(s)
- Ali Alkhalaf
- Dentistry, College of Dentistry, Imam Abdulrahman bin Faisal University, Dammam, SAU
| | - Essa Aljaroudi
- Dentistry, College of Dentistry, Imam Abdulrahman bin Faisal University, Dammam, SAU
| | - Mohammed Al-Hulami
- Dentistry, College of Dentistry, Imam Abdulrahman bin Faisal University, Dammam, SAU
| | - Balgis Gaffar
- Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman bin Faisal University, Dammam, SAU
| | - Khalid Almas
- Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman bin Faisal University, Dammam, SAU
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23
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Renza M, Peřan D, Sýkora R, Stern M, Zvoníček V, Waldauf P, Duška F. Influence of additional personal protective equipment on team performance in simulation-based emergency scenarios: a randomised controlled trial. Br J Anaesth 2023; 130:e494-e496. [PMID: 36935308 PMCID: PMC10028374 DOI: 10.1016/j.bja.2023.02.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 02/21/2023] [Accepted: 02/21/2023] [Indexed: 03/21/2023] Open
Affiliation(s)
- Metoděj Renza
- Department of Anaesthesia and Intensive Care Medicine, Charles University, Third Faculty of Medicine and FNKV University Hospital, Prague, Czech Republic
| | - David Peřan
- Department of Anaesthesia and Intensive Care Medicine, Charles University, Third Faculty of Medicine and FNKV University Hospital, Prague, Czech Republic; Emergency Medical Services of the Karlovy Vary Region, Karlovy Vary, Czech Republic
| | - Roman Sýkora
- Department of Anaesthesia and Intensive Care Medicine, Charles University, Third Faculty of Medicine and FNKV University Hospital, Prague, Czech Republic; Emergency Medical Services of the Karlovy Vary Region, Karlovy Vary, Czech Republic
| | - Michael Stern
- Department of Anaesthesia and Intensive Care Medicine, Charles University, Third Faculty of Medicine and FNKV University Hospital, Prague, Czech Republic
| | - Václav Zvoníček
- Department of Anaesthesia and Intensive Care Medicine, Charles University, Third Faculty of Medicine and FNKV University Hospital, Prague, Czech Republic
| | - Petr Waldauf
- Department of Anaesthesia and Intensive Care Medicine, Charles University, Third Faculty of Medicine and FNKV University Hospital, Prague, Czech Republic
| | - František Duška
- Department of Anaesthesia and Intensive Care Medicine, Charles University, Third Faculty of Medicine and FNKV University Hospital, Prague, Czech Republic.
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24
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Baklouti M, Ben Ayed H, Maamri H, Ketata N, Rhila F, Yaich S, Karray R, Jdidi J, Mejdoub Y, Kassis M, Feki H, Dammak J. Adverse effects of personnel protective equipment among first line COVID-19 healthcare professionals: A survey in Southern Tunisia. Infect Dis Health 2023; 28:10-18. [PMID: 35927168 PMCID: PMC9276802 DOI: 10.1016/j.idh.2022.06.001] [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: 05/06/2022] [Revised: 06/24/2022] [Accepted: 06/26/2022] [Indexed: 01/25/2023]
Abstract
BACKGROUND Health care professionals (HCP) were obliged to wear personal protective equipment (PPE) during pandemic in order to minimize the risk of transmission of the emerging virus. The objective of the study was to estimate the prevalence of adverse effects related to the wear of PPE among HCP and to determinate their predictive factors. METHODS This was a cross-sectional study including a representative sample of 300 randomized HCP at Hedi Chaker University Hospital Sfax, Tunisia, during the period August-September 2021. Data collection was carried out by an anonymous self-administered questionnaire. RESULTS PPE related adverse effects were noted among 87 HCP with a prevalence of 57.2%. Multivariate analysis showed that factors independently associated with PPE adverse effects were female gender (Adjusted Odds Ratio (AOR) = 1.8; p = 0.048), chronic diseases (AOR = 0.29; p = 0.001) and previous infection with COVID-19 (AOR = 0.46; p = 0.004). Frequent use of bleach or other disinfection product without protection and use of hot water at work were independently associated with a high risk of adverse effects ((AOR = 2.22; p = 0.003) and (AOR = 2.83; p = 0.005), respectively). Similarly, a duration of use of PPE>4 h per day (AOR = 1.98; p = 0.039), as well as use of visors and/or glasses (AOR = 1.84; p = 0.045) were independently associated with PPE related adverse effects. CONCLUSION The prevalence of adverse effects related to the wear of PPE was alarmingly high among HCP. Multiple risk factors were highlighted, notably professional aspects. Adequate and repetitive training for caregivers on the correct use of PPE remain essential to manage this problem.
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Affiliation(s)
- Mouna Baklouti
- Preventive Medicine and Hygiene Department, Habib Bourguiba University Hospital, University of Sfax, Sfax, Tunisia.
| | - Houda Ben Ayed
- Preventive Medicine and Hygiene Department, Hedi Chaker University Hospital, University of Sfax, Sfax, Tunisia
| | - Hanen Maamri
- Community Health and Epidemiology Department, Hedi Chaker University Hospital, University of Sfax, Sfax, Tunisia
| | - Nouha Ketata
- Preventive Medicine and Hygiene Department, Hedi Chaker University Hospital, University of Sfax, Sfax, Tunisia
| | - Firas Rhila
- Preventive Medicine and Hygiene Department, Habib Bourguiba University Hospital, University of Sfax, Sfax, Tunisia
| | - Sourour Yaich
- Community Health and Epidemiology Department, Hedi Chaker University Hospital, University of Sfax, Sfax, Tunisia
| | - Raouf Karray
- Community Health and Epidemiology Department, Hedi Chaker University Hospital, University of Sfax, Sfax, Tunisia
| | - Jihene Jdidi
- Community Health and Epidemiology Department, Hedi Chaker University Hospital, University of Sfax, Sfax, Tunisia
| | - Yosra Mejdoub
- Community Health and Epidemiology Department, Hedi Chaker University Hospital, University of Sfax, Sfax, Tunisia
| | - Mondher Kassis
- Preventive Medicine and Hygiene Department, Habib Bourguiba University Hospital, University of Sfax, Sfax, Tunisia
| | - Habib Feki
- Preventive Medicine and Hygiene Department, Hedi Chaker University Hospital, University of Sfax, Sfax, Tunisia
| | - Jamel Dammak
- Community Health and Epidemiology Department, Hedi Chaker University Hospital, University of Sfax, Sfax, Tunisia
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25
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Zhu Z, Li K, Zhang G, Jin H, Zhu Z, Wang P. Decision Method of Optimal Needle Insertion Angle for Dorsal Hand Intravenous Robot. SENSORS (BASEL, SWITZERLAND) 2023; 23:848. [PMID: 36679644 PMCID: PMC9864605 DOI: 10.3390/s23020848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 01/05/2023] [Accepted: 01/06/2023] [Indexed: 06/17/2023]
Abstract
In the context of COVID-19, the research on various aspects of the venipuncture robot field has become increasingly hot, but there has been little research on robotic needle insertion angles, primarily performed at a rough angle. This will increase the rate of puncture failure. Furthermore, there is sometimes significant pain due to the patients' differences. This paper investigates the optimal needle entry angle decision for a dorsal hand intravenous injection robot. The dorsal plane of the hand was obtained by a linear structured light scan, which was used as a basis for calculating the needle entry angle. Simulation experiments were also designed to determine the optimal needle entry angle. Firstly, the linear structured optical system was calibrated and optimized, and the error function was constructed and solved iteratively by the optimization method to eliminate measurement error. Besides, the dorsal hand was scanned to obtain the spatial point clouds of the needle entry area, and the least squares method was used to fit it to obtain the dorsal hand plane. Then, the needle entry angle was calculated based on the needle entry area plane. Finally, the changes in the penetration force under different needle entry angles were analyzed to determine the optimal needle insertion angle. According to the experimental results, the average error of the optimized structured light plane position was about 0.1 mm, which meets the needs of the project, and a large angle should be properly selected for needle insertion during the intravenous injection.
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Affiliation(s)
- Zihan Zhu
- School of Information Science and Electrical Engineering, Shandong Jiaotong University, Jinan 250357, China
| | - Kefeng Li
- School of Information Science and Electrical Engineering, Shandong Jiaotong University, Jinan 250357, China
| | - Guangyuan Zhang
- School of Information Science and Electrical Engineering, Shandong Jiaotong University, Jinan 250357, China
| | - Hualei Jin
- School of Information Science and Electrical Engineering, Shandong Jiaotong University, Jinan 250357, China
| | - Zhenfang Zhu
- School of Information Science and Electrical Engineering, Shandong Jiaotong University, Jinan 250357, China
| | - Peng Wang
- School of Information Science and Electrical Engineering, Shandong Jiaotong University, Jinan 250357, China
- Institute of Automation, Shandong Academy of Sciences, Jinan 250013, China
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26
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Harris ML, McLeod A, Titler MG. Health Experiences of Nurses during the COVID-19 Pandemic: A Mixed Methods Study. West J Nurs Res 2023; 45:443-454. [PMID: 36625341 PMCID: PMC9834626 DOI: 10.1177/01939459221148825] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
This study characterizes the impact of the COVID-19 pandemic on the mental and physical health of nurses. Qualitative data (collected using semi-structured interviews) were integrated with quantitative data (collected concurrently using the SF-12 Health Survey). Nurses (N = 30) compared their health prior to and during the first pandemic wave (March-May 2020). Interviews were analyzed thematically; descriptive statistics and t-tests compared pre-pandemic to current SF-12 scores. Qualitative findings demonstrated an impact on nurses' mental health expressed as isolation, loss, intense emotions, and feelings of being expendable. Impact on nurses' physical health included exhaustion, personal protective equipment skin breakdown, limited breaks from work, and virus exposure. Quantitative results show nurses' experienced declines in overall mental health (p < .001), and multiple physical health domains: role limitations due to physical problems (p < .0001), bodily pain (p < .0001), and general health (p < .0001). Promotion of nurses' well-being and safety, as well as education in emergency preparedness, must be given precedence to protect nurses' health.
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Affiliation(s)
- Melissa L. Harris
- Center of Innovation to Accelerate
Discovery and Practice Transformation (ADAPT), Durham VA Health Care System, Durham,
NC, USA,Clinical and Translational Science
Institute, Duke University, Durham, NC, USA,University of Michigan School of
Nursing, Ann Arbor, MI, USA,Melissa L. Harris, Clinical and
Translational Science Institute, Duke University, 710 W. Main St. Durham NC
27701, USA.
| | - Anne McLeod
- University of Michigan School of
Nursing, Ann Arbor, MI, USA,University of Michigan, Michigan
Medicine, Transplant Center, Ann Arbor, MI, USA
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27
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Jain VM, Parihar SRS, Acharya S, Acharya S. Effects of wearing personal protective equipment (PPE) and its role in affecting the work efficiency of dentists during the COVID-19 pandemic. Work 2023; 76:3-10. [PMID: 36872823 DOI: 10.3233/wor-220083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2023] Open
Abstract
BACKGROUND The risk of exposure to COVID-19 infection through droplets/aerosol in dental clinics has renewed focus on the utility and possible adverse effects of using personal protective equipment (PPE) on dentists. OBJECTIVE To obtain information from a cross-section of dentists regarding their PPE usage and to evaluate the possible risk factors that can influence their work efficiency. METHODS A 31-item cross-sectional survey with a structured multiple-choice questionnaire was designed. Social media and emails were used to circulate the questionnaire among dental professionals worldwide. A total of 317 respondents returned the completed forms. RESULTS A total of 184 (55%) participants reported getting soaking wet while wearing PPE at the end of the working hours (approximately eight hours of working). Many respondents (n = 286, 90%) reported that the use of PPE resulted in reduced visibility of the operating field. The majority of respondents (84%) felt that their overall work efficiency had reduced after using PPE. Binary logistic regression had shown that two significant factors that were associated with reduced work efficiency included, pre-existing systemic illness and getting soaking wet from wearing a PPE. CONCLUSION Definite protocols should be introduced that mandate the doffing of PPE for every patient, in a separate well-ventilated area where the skin can recuperate from the heat and pressure points caused by the PPE. Dentists should take greater care in choosing the appropriate PPE to prevent exacerbation of pre-existing illnesses, which may reduce their work efficiency.
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Affiliation(s)
- Vedushi M Jain
- Manipal College of Dental Sciences, Manipal Academy of Higher Education (MAHE), Manipal, India
| | | | - Shruthi Acharya
- Department of Oral Medicine and Radiology, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education (MAHE), Manipal, India
| | - Shashidhar Acharya
- Department of Public Health Dentistry, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education (MAHE), Manipal, India
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28
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Alshehi MMH, Ilesanmi RE, Dabou EAR. Physical Burden and Perceived Stress of Personal Protective Equipment During COVID-19 Pandemic: A Retrospective Study in the United Arab Emirates. SAGE Open Nurs 2023; 9:23779608231186754. [PMID: 37457618 PMCID: PMC10345910 DOI: 10.1177/23779608231186754] [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: 04/02/2023] [Revised: 06/18/2023] [Accepted: 06/20/2023] [Indexed: 07/18/2023] Open
Abstract
Introduction Over the course of the COVID-19 pandemic, personal protective equipment (PPE) has become necessary. According to published research, PPE-related physical impacts were probably underreported during the pandemic. Objective To examine the physical burden and perceived stress associated with prolonged PPE wearing among nurses during the COVID-19 pandemic in the United Arab Emirates (UAE). Methods This was a cross-sectional retrospective study of 209 nurses working in two hospitals in the UAE. A convenience sampling technique was applied, and the data were collected using an online questionnaire. Data collection was completed within three months (April 2022 to June 2022). The completed questionnaires were analyzed using SPSS version 21. Chi-square statistics was used to test the association of categorical variables at a 5% level of significance. Results A total of 209 nurses had a mean age of 38.4 ± 8.7 years. More than 65.1% wore PPE continuously for 4 hrs per day. The most common physical burdens reported were difficulty in breathing (62.2%), excessive thirst (41.6%), and facial itchiness (39.2%). Most participants (95.2%) reported high-stress levels. There was no significant association between the level of stress and the duration of wearing PPE (p = .43 > .05). However, the authors found a statistically significant association between breathing difficulty with face masks and the duration of wearing them (p < .05). In addition, itchiness/rash related to gloves was significantly associated with wearing duration (p < .05). Conclusion Findings show that nurses experienced adverse effects from PPE use, which increased with the number of hours of wearing. Further studies with a larger sample size will allow for generalization of the study results.
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Affiliation(s)
| | - Rose Ekama Ilesanmi
- RAK College of Nursing, RAK Medical and Health Sciences University, Ras Al-Khaimah, United Arab Emirates
| | - Eman Abdelaziz Rashad Dabou
- RAK College of Nursing, RAK Medical and Health Sciences University, Ras Al-Khaimah, United Arab Emirates
- Medical–Surgical Nursing Department, Faculty of Nursing, Alexandria University, Alexandria, Egypt
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29
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Needlestick and sharp injuries among healthcare workers prior to and during the coronavirus disease 2019 (COVID-19) pandemic. Infect Control Hosp Epidemiol 2022; 43:1966-1968. [PMID: 34895375 PMCID: PMC8692850 DOI: 10.1017/ice.2021.498] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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Öz TK, Cader FA, Dakhil ZA, Parapid B, Kadavath S, Bond R, Chieffo A, Gimelli A, Mihailidou AS, Ramu B, Cavarretta E, Michos ED, Kaya E, Buchanan L, Patil M, Aste M, Alasnag M, Babazade N, Burgess S, Manzo-Silberman S, Paradies V, Thamman R. International consensus statement on challenges for women in cardiovascular practice and research in the COVID-19 era. Minerva Cardiol Angiol 2022; 70:641-651. [PMID: 35212510 DOI: 10.23736/s2724-5683.22.05935-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
The challenges to academic and professional development and career advancement of women in cardiology (WIC), imposed by the pandemic, not only impinge the female cardiologists' "leaky pipeline" but also make the "leakiness" more obvious. This consensus document aims to highlight the pandemic challenges WIC face, raise awareness of the gender equity gap, and propose mitigating actionable solutions derived from the data and experiences of an international group of female cardiovascular clinicians and researchers. This changing landscape has led to the need for highly specialized cardiologists who may have additional training in critical care, imaging, advanced heart failure, or interventional cardiology. Although women account for most medical school graduates, the number of WIC, particularly in mentioned sub-specialties, remains low. Moreover, women have been more affected by systemic issues within these challenging work environments, limiting their professional progression, career advancement, and economic potential. Therefore, it is imperative that tangible action points be noted and undertaken to ensure the representation of women in leadership, advocacy, and decision-making, and increase diversity in academia. Strategies to mitigate the negative impacts of the pandemic need to be taken during this COVID-19 pandemic to ensure WIC have a place in the field of Cardiology.
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Affiliation(s)
- Tuğba Kemaloğlu Öz
- Department of Cardiology, Liv Hospital Ulus, Istanbul, Turkey.,Faculty of Medicine, Istinye University, Istanbul, Turkey
| | - F Aaysha Cader
- Department of Cardiology, Ibrahim Cardiac Hospital and Research Institute, Dhaka, Bangladesh
| | - Zainab A Dakhil
- Ibn Al-Bitar Cardiac Center, Department of Cardiology, Al-Kindy College of Medicine, University of Baghdad, Baghdad, Iraq
| | - Biljana Parapid
- Department of Internal Medicine, School of Medicine University of Belgrade, Belgrade, Serbia
| | - Sabeeda Kadavath
- Structural Interventional Cardiology, Vanderbilt University, Nashville, TN, USA
| | - Rachel Bond
- Division of Cardiology, Dignity Health Department of Medicine, Creighton University, Chandler, AZ, USA
| | - Alaide Chieffo
- Interventional Cardiology Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Alessia Gimelli
- Nuclear Cardiology Unit, Fondazione Toscana G. Monasterio, Pisa, Italy
| | - Anastasia S Mihailidou
- Royal North Shore Hospital, Northern Sydney Local Health District, Kolling Institute, Macquarie University, Sydney, Australia
| | - Bhavadharini Ramu
- Unit of Advanced Heart Failure and Cardiac Transplantation, Division of Cardiology, Department of Medicine, Medical University of South Carolina, Charleston, SC, USA
| | - Elena Cavarretta
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University, Latina, Italy.,Mediterranea Cardiocentro, Naples, Italy
| | - Erin D Michos
- Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Esra Kaya
- Department of Cardiology, Clinic of Heart, Lung, and Vessel Disease, Rikshospitalet, Oslo University Hospital, Oslo, Norway
| | - Louise Buchanan
- Department of Cardiology, North Cumbria Integrated Care NHS Foundation Trust, Carlisle, UK
| | - Mansi Patil
- Department of Medicine, Asha Kiran JHC Hospital, Maharastra, India
| | - Milena Aste
- Arrhythmologic Center, Department of Cardiology, ASL4 Chiavarese, Ospedali del Tigullio, Lavagna, Genoa, Italy
| | - Mirvat Alasnag
- Cardiac Center, King Fahd Armed Forces Hospital, Jeddah, Saudi Arabia
| | - Nigar Babazade
- Department of Cardiology, New Clinic, Heart Valve Center, Baku, Azerbaijan
| | - Sonya Burgess
- Nepean Public Hospital, Sydney Southwest Private Hospital, Southwest Cardiology and Penrith Specialist Group, Sydney, Australia
| | - Stéphane Manzo-Silberman
- Coronary Care Unit, Department of Interventional Cardiology, Lariboisière Hospital, APHP, Paris University, Paris, France
| | - Valeria Paradies
- Department of Cardiology, Maasstad Hospital, Rotterdam, the Netherlands
| | - Ritu Thamman
- Section of Cardiology, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA -
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Sahebi A, Hasheminejad N, Shohani M, Yousefi A, Tahernejad S, Tahernejad A. Personal protective equipment-associated headaches in health care workers during COVID-19: A systematic review and meta-analysis. Front Public Health 2022; 10:942046. [PMID: 36311638 PMCID: PMC9605797 DOI: 10.3389/fpubh.2022.942046] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 09/20/2022] [Indexed: 01/25/2023] Open
Abstract
Introduction Health Care Workers (HCWs) use Personal Protective Equipment (PPE) during the COVID-19 pandemic to protect themselves and prevent the transmission of the disease. The use of PPE, especially respiratory masks, has adverse consequences, including headaches, which have been secondary and unusual. The aim of the present systematic review and meta-analysis study was to investigate the prevalence of PPE-associated headaches in HCWs during COVID-19 pandemic. Methods The present review study was performed based on the PRISMA guideline. The protocol of the present study was registered in PROSPERO with the code CRD42022304437. Valid data resources such as Scopus, PubMed, Web of Science, Science Direct, Google Scholar, Embase were used to identify and extract relevant studies. The searches were conducted between the beginning of 2020 and the end of January 2022. A random effects model was used for meta-analysis and I 2 index was used to investigate between-study heterogeneity. Data were analyzed using STATA ver. 14. Results A total of 539 articles were first identified through initial search and finally 26 final studies were selected to undergo the meta-analysis phase. According to the results of meta-analysis, the prevalence of headache after and before the use of PPE was 48.27% (95% CI: 40.20-56.34, I 2 = 99.3%, p = 0 < 001) and 30.47% (95% CI: 20.47-40.47, I 2 = 97.3%, p = 0 < 001), respectively. Conclusion The results of the present study showed that the prevalence of PPE-associated headache in HCWs was relatively high, so, the use of PPE during COVID-19 pandemic can be considered as one of the causes of headache. Therefore, management strategies such as regular screening of HCWs for headaches and regular rest periods without the use of PPE can be effective in reducing the prevalence of headaches.
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Affiliation(s)
- Ali Sahebi
- Non-Communicable Diseases Research Center, Ilam University of Medical Sciences, Ilam, Iran
| | - Naser Hasheminejad
- Department of Occupational Health Engineering and Safety at Work, School of Public Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Masoumeh Shohani
- Department of Nursing, School of Nursing and Midwifery, Ilam University of Medical Sciences, Ilam, Iran
| | - Atefeh Yousefi
- Department of Neurology, Shohadaye Tajrish Hospital, Shahid Beheshti University of Medical Science, Tehran, Iran
| | - Somayeh Tahernejad
- Health in Disasters and Emergencies Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran,*Correspondence: Somayeh Tahernejad
| | - Azadeh Tahernejad
- Department of Health in Disasters and Emergencies, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Bharatha A, Krishnamurthy K, Cohall D, Rahman S, Forde CA, Corbin-Harte R, Ojeh N, Kabir R, Parsa AD, Rabbi AMF, Majumder MAA. Personal protective equipment (PPE) related adverse skin reactions among healthcare workers at the main COVID-19 isolation center in Barbados. Front Public Health 2022; 10:978590. [PMID: 36304246 PMCID: PMC9592812 DOI: 10.3389/fpubh.2022.978590] [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: 06/28/2022] [Accepted: 09/12/2022] [Indexed: 01/25/2023] Open
Abstract
Background The use of personal protective equipment (PPE) reduces the risk of transmission of infectious agents significantly among healthcare workers (HCWs). The study aimed to investigate the prevalence and characteristics of PPE-related adverse skin reactions among HCWs working at the main COVID-19 isolation center in Barbados. Methods A cross-sectional web-based online survey was conducted during April to June 2021 which recorded demographic information, details of PPE use and adverse skin reactions including severity and duration of onset of symptoms. Results Most of the respondents used PPE for consecutive days (77.9%), 1-6 h/day (59.2%), and more than a year (62.5%). Fewer than half of the participants (45.6%) experienced adverse skin reactions from the use of PPE. The reactions were mostly observed in the cheeks (40.4%) and nose bridges (35.6%). Females had more reactions than their male counterparts (p = 0.003). The use of N95 masks and a combination of surgical and N95 masks produced adverse effects predominantly in the ears (60%) and cheeks (56.4%). Binary logistic regression showed that female HCWs (OR = 5.720 95% CI: 1.631, 20.063), doctors (OR = 5.215 95% CI: 0.877, 31.002), and longer duration of PPE use (>1 year) (OR = 2.902 95% CI: 0.958, 8.787) caused a significantly higher prevalence of adverse skin reactions. Conclusion The PPE-related skin reactions were common among HCWs which mainly occurred due to prolonged use. Preventive measures inclusive of appropriate training of HCWs on the use of PPE are recommended to minimize these adverse events.
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Affiliation(s)
- Ambadasu Bharatha
- Faculty of Medical Sciences, The University of the West Indies, Cave Hill Campus, Bridgetown, Barbados
| | - Kandamaran Krishnamurthy
- PICU Consultant, Queen Elizabeth Hospital, Bridgetown, Barbados,*Correspondence: Kandamaran Krishnamurthy
| | - Damian Cohall
- Faculty of Medical Sciences, The University of the West Indies, Cave Hill Campus, Bridgetown, Barbados
| | - Sayeeda Rahman
- American University of Integrative Sciences, School of Medicine, Bridgetown, Barbados
| | - Corey A. Forde
- Infection Prevention and Control/Infectious Diseases Programs, The Queen Elizabeth Hospital, Bridgetown, Barbados
| | - Rhea Corbin-Harte
- Isolation Facilities Client Relations and Activities, Bridgetown, Barbados
| | - Nkemcho Ojeh
- Faculty of Medical Sciences, The University of the West Indies, Cave Hill Campus, Bridgetown, Barbados
| | - Russell Kabir
- Faculty of Health Education, Medicine and Social Care, Anglia Ruskin University, Chelmsford, United Kingdom
| | - Ali Davod Parsa
- Faculty of Health, Education, Medicine and Social Care, Anglia Ruskin University, Cambridge, United Kingdom
| | | | - Md Anwarul Azim Majumder
- Faculty of Medical Sciences, The University of the West Indies, Cave Hill Campus, Bridgetown, Barbados
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Westermann C, Zielinski N, Altenburg C, Dulon M, Kleinmüller O, Kersten JF, Nienhaus A. Prevalence of Adverse Skin Reactions in Nursing Staff Due to Personal Protective Equipment during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12530. [PMID: 36231831 PMCID: PMC9566727 DOI: 10.3390/ijerph191912530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 09/23/2022] [Accepted: 09/27/2022] [Indexed: 06/16/2023]
Abstract
In order to prevent the nosocomial transmission of the SARS-CoV-2 virus, it has become necessary for health workers to increase their use of personal protective equipment (PPE). The aim of the study was to investigate the prevalence and influencing factors for adverse skin reactions (ASR) due to occupational PPE use among nursing staff in Germany during the COVID-19 pandemic. The study uses a mixed methods design. A focus group was created with experts from the field of healthcare, and an online survey was then carried out among nursing staff. Influencing factors were identified using multivariate logistic regression via odds ratios (ORs) with 95% confidence intervals (CIs). A total of 2274 nursing staff took part in the survey, with 1967 included in the analysis. The prevalence of ASR was 61%, with 94% affecting at least one area of the face. Statistically significant factors of influence were Filtering Face Peace (FFP) mask wearing duration of ≥4 h, a history of contact allergies, and being female and young. A pre-existing skin disease had a protective effect. The prevalence of PPE-related ASR underlines the necessity for targeted preventive measures for nursing staff during pandemic situation.
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Affiliation(s)
- Claudia Westermann
- Department of Occupational Medicine, Hazardous Substances and Public Health, Institution for Statutory Accident Insurance and Prevention in the Healthcare and Welfare Services, 22089 Hamburg, Germany
| | - Nika Zielinski
- Institute for Health Services Research in Dermatology and Nursing, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany
| | - Christiane Altenburg
- Department of Occupational Medicine, Hazardous Substances and Public Health, Institution for Statutory Accident Insurance and Prevention in the Healthcare and Welfare Services, 22089 Hamburg, Germany
| | - Madeleine Dulon
- Department of Occupational Medicine, Hazardous Substances and Public Health, Institution for Statutory Accident Insurance and Prevention in the Healthcare and Welfare Services, 22089 Hamburg, Germany
| | - Olaf Kleinmüller
- Institute for Health Services Research in Dermatology and Nursing, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany
| | - Jan Felix Kersten
- Institute for Health Services Research in Dermatology and Nursing, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany
| | - Albert Nienhaus
- Department of Occupational Medicine, Hazardous Substances and Public Health, Institution for Statutory Accident Insurance and Prevention in the Healthcare and Welfare Services, 22089 Hamburg, Germany
- Institute for Health Services Research in Dermatology and Nursing, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany
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Colas A, Baudet A, Regad M, Conrath E, Colombo M, Florentin A. An unprecedented and large-scale support mission to assist residential care facilities during the COVID-19 pandemic. Infect Prev Pract 2022; 4:100234. [PMID: 35873804 PMCID: PMC9287467 DOI: 10.1016/j.infpip.2022.100234] [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: 02/17/2022] [Accepted: 07/10/2022] [Indexed: 01/08/2023] Open
Abstract
Background In March 2020, COVID-19 cases occurred in residential care facilities. To assist these facilities, the regional health agency of the Meurthe-et-Moselle administrative district ordered a support mission. Methods Infection prevention and control mobile teams were formed under the coordination of the infection prevention and control department (IPCD) of a university hospital. Teams went to residential care facilities for the elderly, to facilities for people with disabilities (FPD) and independent living communities (ILC). They visited the facilities and met with the management and the ward staff to assess the situation and to identify any potential support needs. Results Over two non-consecutive weeks, 104 residential care facilities were visited (9025 residents). If urgent needs were identified, the IPCD was directly informed by the teams to initiate an extensive assistance operation. Thereby, additional staff and equipment were provided for every facility in need. Although most of them had implemented good management to face the pandemic, four emergency field support operations took place in facilities with uncontrolled outbreaks. Conclusions This is the first reported support action for residential care facilities during the pandemic in France. As no major outbreaks were noticed later, this mission was deemed a success and met the residential care facilities' needs for support. Many facilities have expressed the need to cooperate with infection prevention and control specialists in the future, both during outbreaks, also in routine daily practice. This report highlights the need to maintain support for residential care facilities and to implement a permanent collaboration between hospitals and residential care facilities.
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Affiliation(s)
- Anaïs Colas
- CHRU-Nancy, F-54505 Vandœuvre-lès-Nancy, France.,Université de Lorraine, Faculté de Médecine, F-54505 Vandœuvre-lès-Nancy, France
| | - Alexandre Baudet
- CHRU-Nancy, F-54505 Vandœuvre-lès-Nancy, France.,Université de Lorraine, Faculté d'odontologie, F-54505 Vandœuvre-lès-Nancy, France.,Université de Lorraine, APEMAC, équipe MICS, F-54000 Nancy, France
| | - Marie Regad
- CHRU-Nancy, F-54505 Vandœuvre-lès-Nancy, France.,Université de Lorraine, Faculté de Médecine, F-54505 Vandœuvre-lès-Nancy, France.,Université de Lorraine, APEMAC, équipe MICS, F-54000 Nancy, France
| | | | | | - Arnaud Florentin
- CHRU-Nancy, F-54505 Vandœuvre-lès-Nancy, France.,Université de Lorraine, Faculté de Médecine, F-54505 Vandœuvre-lès-Nancy, France.,Université de Lorraine, APEMAC, équipe MICS, F-54000 Nancy, France
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LeBlanc K, Woo K, Wiesenfeld L, Bresnai-Harris J, Heerschap C, Butt B, Chaplain V, Wiesenfeld S. Impact of prolonged PPE use on Canadian health professionals. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2022; 31:S30-S36. [PMID: 35980915 DOI: 10.12968/bjon.2022.31.15.s30] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
AIM To explore the impact that prolonged use of personal protective equipment (PPE) has on the skin integrity of Canadian health professionals. METHOD A descriptive, pan-Canadian, cross-sectional, online survey was carried out to explore the type and prevalence of PPE-related skin injury among Canadian health professionals. Convenience sampling was used to disseminate the online survey link to health professionals. RESULTS There were responses from 757 health professionals. Masks worn included surgical masks (90%), a combination of surgical or N95/KN95 masks (7.7%) and an N95/KN95 mask alone (2.7%). Responses showed 84.6% of providers always wear a mask while at work with 38.5% wearing the same mask all shift; 90% of participants wore protective eye wear. Complications included soreness or pressure injuries behind the ears (70%), new or worsening acne (52%), a runny nose or sneezing (45%), itching (39%), and dry skin (37%). Hand issues included dry skin (53%), red skin (30%), itching (26%), broken skin (20%), rash (16%), and dermatitis (11%) - 51% of respondents did not moisturise their hands. Complications related to gown use included itching (6%), moisture-associated skin damage (5.5%), feeling claustrophobic (4.5%), and new or worsening acne (3%). Increased perspiration due to PPE was experienced in 87.5% of respondents. Some 43% of respondents noted their mental health became worse due to wearing PPE for prolonged periods. CONCLUSION These findings should be used in the development of guidelines to prevent and manage PPE-related skin injuries among health professionals. Education for professionals should focus on skin protection, prevention of PPE-related skin complications and support for mental health issues.
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Affiliation(s)
- Kimberley LeBlanc
- Academic Chair, Wound, Ostomy and Continence Institute, Ottawa, Ontario, Canada/Advanced Practice Nurse, KDS Professional Consulting, Ottawa
| | - Kevin Woo
- Nurse Specialized in Wound, Ostomy and Continence, Queen's University, Kingston, Ontario, Canada
| | - Lorne Wiesenfeld
- Vice Dean, Postgraduate Medical Education, Department of Emergency Medicine, University of Ottawa, Ontario, Canada
| | | | - Corey Heerschap
- Nurse Specialized in Wound, Ostomy and Continence, Royal Victoria Regional Health Centre, Barrie, Ontario, Canada
| | - Britney Butt
- Nurse Specialized in Wound, Ostomy and Continence, North York General Hospital, Toronto, Ontario, Canada
| | - Valérie Chaplain
- Nurse Specialized in Wound, Ostomy and Continence, Montfort Hospital, Ottawa, Ontario, Canada
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Jokubaitis M, Timofejavaitė R, Braschinsky M, Zvaune L, Leheste AR, Gribuste L, Mattila P, Strautmane S, Dapkutė A, Ryliškienė K. Risk factors for development of personal protective equipment induced headache: e-survey of medical staff in Baltic states. BMC Health Serv Res 2022; 22:1016. [PMID: 35948960 PMCID: PMC9363870 DOI: 10.1186/s12913-022-08412-5] [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: 04/11/2022] [Accepted: 07/27/2022] [Indexed: 11/17/2022] Open
Abstract
Background The COVID-19 pandemic led to an unprecedented increase in the use of personal protective equipment (PPE) among medical personnel. The goal of this study was to determine the risk factors and frequency of PPE-induced headache during the COVID-19 pandemic. Methods From January 25 to March 1, 2021, an anonymous online survey was undertaken in the Baltic states. Results In total, 2132 individuals participated. 52.3% experienced a PPE-induced headache. Usual onset time was between 2–3 h, lasting up to 1 h after PPE removal. The most common localization was in temporal and frontal regions. Headache usually occurred 2 to 3 days per week with an average pain score of 5.04 ± 1.80 points. Higher risk was associated with discomfort/pressure OR = 11.55, heat stress OR = 2.228, skin conditions OR = 1.784, long PPE use (duration 10-12 h) OR = 2,18, headache history prior PPE use OR = 1.207. Out of 52.3% respondents with PPE-induced headache, 45.5% developed de novo headache, whereas 54.5% had headache history. Statistically significant differences of PPE-induced headache between respective groups included severity (4.73 vs 5.29), duration (≥ 6 h 6.7% vs 8.2%), accompanying symptoms (nausea (19.3% vs 25.7%), photophobia (19.1% vs 25.7%), phonophobia (15.8% vs 23.5%), osmophobia (5.3% vs 12.0%)) and painkiller use (43.0% vs 61.7%). Conclusions Over half of the medical personnel reported headache while using PPE. The risk was higher in individuals with headache history, increased duration of PPE use and discomfort while using PPE. Predisposed individuals reported PPE-induced headache which persisted longer, was more intense and debilitating than in the respondents with de novo headache. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-08412-5.
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Affiliation(s)
| | | | - Mark Braschinsky
- Neurology Clinic, Tartu University Hospital, Tartu, Estonia.,Department of Neurology and Neurosurgery, University of Tartu, Tartu, Tartu, Estonia
| | - Linda Zvaune
- Department of Neurology and Neurosurgery, Riga East Clinical University Hospital, Riga, Latvia
| | | | - Laura Gribuste
- Department of Neurology, Pauls Stradins Clinical University Hospital, Riga, Latvia
| | - Paula Mattila
- Faculty of Medicine, University of Tartu, Tartu, Estonia
| | - Sintija Strautmane
- Department of Neurology, Pauls Stradins Clinical University Hospital, Riga, Latvia.,Faculty of Residency, Riga Stradins University, Riga, Latvia
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Loibner M, Barach P, Wolfgruber S, Langner C, Stangl V, Rieger J, Föderl-Höbenreich E, Hardt M, Kicker E, Groiss S, Zacharias M, Wurm P, Gorkiewicz G, Regitnig P, Zatloukal K. Resilience and Protection of Health Care and Research Laboratory Workers During the SARS-CoV-2 Pandemic: Analysis and Case Study From an Austrian High Security Laboratory. Front Psychol 2022; 13:901244. [PMID: 35936273 PMCID: PMC9353000 DOI: 10.3389/fpsyg.2022.901244] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 06/10/2022] [Indexed: 11/25/2022] Open
Abstract
The SARS-CoV-2 pandemic has highlighted the interdependency of healthcare systems and research organizations on manufacturers and suppliers of personnel protective equipment (PPE) and the need for well-trained personnel who can react quickly to changing working conditions. Reports on challenges faced by research laboratory workers (RLWs) are rare in contrast to the lived experience of hospital health care workers. We report on experiences gained by RLWs (e.g., molecular scientists, pathologists, autopsy assistants) who significantly contributed to combating the pandemic under particularly challenging conditions due to increased workload, sickness and interrupted PPE supply chains. RLWs perform a broad spectrum of work with SARS-CoV-2 such as autopsies, establishment of virus cultures and infection models, development and verification of diagnostics, performance of virus inactivation assays to investigate various antiviral agents including vaccines and evaluation of decontamination technologies in high containment biological laboratories (HCBL). Performance of autopsies and laboratory work increased substantially during the pandemic and thus led to highly demanding working conditions with working shifts of more than eight hours working in PPE that stressed individual limits and also the ergonomic and safety limits of PPE. We provide detailed insights into the challenges of the stressful daily laboratory routine since the pandemic began, lessons learned, and suggest solutions for better safety based on a case study of a newly established HCBL (i.e., BSL-3 laboratory) designed for autopsies and research laboratory work. Reduced personal risk, increased resilience, and stress resistance can be achieved by improved PPE components, better training, redundant safety measures, inculcating a culture of safety, and excellent teamwork.
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Affiliation(s)
- Martina Loibner
- Diagnostic and Research Institute of Pathology, Medical University of Graz, Graz, Austria
| | - Paul Barach
- Diagnostic and Research Institute of Pathology, Medical University of Graz, Graz, Austria
- College of Population Health, Thomas Jefferson University, Philadelphia, PA, United States
- School of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Stella Wolfgruber
- Diagnostic and Research Institute of Pathology, Medical University of Graz, Graz, Austria
| | - Christine Langner
- Diagnostic and Research Institute of Pathology, Medical University of Graz, Graz, Austria
| | - Verena Stangl
- Diagnostic and Research Institute of Pathology, Medical University of Graz, Graz, Austria
| | - Julia Rieger
- Diagnostic and Research Institute of Pathology, Medical University of Graz, Graz, Austria
| | | | - Melina Hardt
- Diagnostic and Research Institute of Pathology, Medical University of Graz, Graz, Austria
| | - Eva Kicker
- Diagnostic and Research Institute of Pathology, Medical University of Graz, Graz, Austria
| | - Silvia Groiss
- Diagnostic and Research Institute of Pathology, Medical University of Graz, Graz, Austria
| | - Martin Zacharias
- Diagnostic and Research Institute of Pathology, Medical University of Graz, Graz, Austria
| | - Philipp Wurm
- Diagnostic and Research Institute of Pathology, Medical University of Graz, Graz, Austria
| | - Gregor Gorkiewicz
- Diagnostic and Research Institute of Pathology, Medical University of Graz, Graz, Austria
| | - Peter Regitnig
- Diagnostic and Research Institute of Pathology, Medical University of Graz, Graz, Austria
| | - Kurt Zatloukal
- Diagnostic and Research Institute of Pathology, Medical University of Graz, Graz, Austria
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Peters MDJ. N95 respirators for health care workers: the importance of fit, comfort, and usability. Med J Aust 2022; 217:83-84. [PMID: 35712849 PMCID: PMC9349611 DOI: 10.5694/mja2.51618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 05/10/2022] [Accepted: 05/16/2022] [Indexed: 11/17/2022]
Affiliation(s)
- Micah DJ Peters
- University of South Australia and Rosemary Bryant AO Research Centre Adelaide SA
- Australian Nursing and Midwifery Federation (Federal Office) Melbourne VIC
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Togha M, Hashemi SM, Yamani N, Martami F, Salami Z. A Review on Headaches Due to COVID-19 Infection. Front Neurol 2022; 13:942956. [PMID: 35911910 PMCID: PMC9327440 DOI: 10.3389/fneur.2022.942956] [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: 05/13/2022] [Accepted: 06/20/2022] [Indexed: 11/13/2022] Open
Abstract
Since December 2019, the time when the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was spotted, numerous review studies have been published on COVID-19 and its neuro invasion. A growing number of studies have reported headaches as a common neurological manifestation of COVID-19. Although several hypotheses have been proposed regarding the association between headache and the coronavirus, no solid evidence has been presented for the mechanism and features of headache in COVID-19. Headache also is a common complaint with the omicron variant of the virus. COVID-19 vaccination also is a cause of new-onset headaches or aggravation of the previous headache in migraine or tension headache sufferers. In this review study, the types of headaches reported in previous studies and their possible pathogenic mechanisms are outlined. To accomplish this objective, various types of headaches are classified and their patterns are discussed according to ICHD-3 diagnostic criteria, including, headaches attributed to systemic viral infection, viral meningitis or encephalitis, non-infectious inflammatory intracranial disease, hypoxia and/or hypercapnia, cranial or cervical vascular disorder, increased cerebrospinal fluid (CSF) pressure, refractive error, external-compression headache, and cough headache. Then, their pathogeneses are categorized into three main categories, direct trigeminal involvement, vascular invasion, and inflammatory mediators. Furthermore, persistent headache after recovery and the predictors of intensity is further investigated. Post-vaccination headache is also discussed in this review.
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Affiliation(s)
- Mansoureh Togha
- Headache Department, Iranian Center of Neurological Researches, Institute of Neuroscience, Tehran University of Medical Sciences, Tehran, Iran
- Headache Department, Neurology Ward, Sina Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyedeh Melika Hashemi
- Headache Department, Iranian Center of Neurological Researches, Institute of Neuroscience, Tehran University of Medical Sciences, Tehran, Iran
| | - Nooshin Yamani
- Neurology Department, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Fahimeh Martami
- Headache Department, Iranian Center of Neurological Researches, Institute of Neuroscience, Tehran University of Medical Sciences, Tehran, Iran
| | - Zhale Salami
- Headache Department, Iranian Center of Neurological Researches, Institute of Neuroscience, Tehran University of Medical Sciences, Tehran, Iran
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Radha K, George G, Varghese A, Joseph J, Vijayanarayanan N. Prevalence of Physical and Psychological Impacts of Wearing Personal Protective Equipment on Health Care Workers During COVID-19: A Systematic Review and Meta-Analysis. Indian J Occup Environ Med 2022; 26:140-150. [PMID: 36408432 PMCID: PMC9674076 DOI: 10.4103/ijoem.ijoem_32_22] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 02/12/2022] [Accepted: 03/12/2022] [Indexed: 06/16/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has necessitated the use of personal protective equipment (PPE) among the frontline health care workers (HCWs). Even though PPE helps in preventing infection, it poses significant physical and psychological impacts at varying levels. Correspondingly, multiple independent studies have brought out the PPE-associated problems. However, there exists a lacuna on comprehensive information of global prevalence related to the same. AIM To estimate the prevalence and risk factors of PPE among HCWs during COVID-19 across the globe. DESIGN Systematic review and meta-analysis. METHOD The review was undertaken as per the protocol registered in PROSPERO CRD42021272216 following Preferred Reporting Items for Systematic Reviews and Meta-Analysis(PRISMA) guidelines. Two independent reviewers have undertaken the search strategy, study selection, and methodological quality assessment. Discrepancies were addressed by the third reviewer. Heterogeneity was addressed through I2 statistics and forest plots generated by open meta-software. RESULTS A total of 16 articles conducted across 6 different countries among 10,182 HCWs were included in the review. The pooled prevalence of skin lesions, headache, sweating, breathing difficulty, vision difficulty, thirst/dry mouth, fatigue, and communication difficulty, anxiety, fear were 57 (47-66%), 51 (37-64%), 75 (56-90%), 44 (23-68%), 61 (21-94%), 54 (30-77%), 67 (58-76%), 74 (47-94%), 28 (24-33%), 14 (10-17%), respectively. Moreover, the various risk factors included are the use of PPE for >6 h and young females. In addition, the medical management of new-onset problems created an additional burden on the frontline health care personnel (HCP). CONCLUSION The frontline HCWs encountered physical and psychological problems at varying levels as a result of wearing PPE which needs to be addressed to prevent the inadequate use of PPE leading to infections.
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Affiliation(s)
- K Radha
- Faculty, College of Nursing, Bhopal Memorial Hospital and Research Centre, ICMR, Bhopal, Madhya Pradesh, India
| | - Gigini George
- Faculty, College of Nursing, Bhopal Memorial Hospital and Research Centre, ICMR, Bhopal, Madhya Pradesh, India
| | - Abin Varghese
- Faculty, College of Nursing, All India Institute of Medical Sciences, Nagpur, Maharashtra, India
| | - Jaison Joseph
- Department of Psychiatric Nursing, College of Nursing, Pt. B. D. Sharma University of Health Sciences, Rohtak, Haryana, India
| | - N Vijayanarayanan
- Department of Medical Surgical Nursing, RD Memorial College of Nursing, Bhopal, Madhya Pradesh, India
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Nyberg A, Rajaleid K, Demmelmaier I. The Work Environment during Coronavirus Epidemics and Pandemics: A Systematic Review of Studies Using Quantitative, Qualitative, and Mixed-Methods Designs. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116783. [PMID: 35682365 PMCID: PMC9180570 DOI: 10.3390/ijerph19116783] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 05/27/2022] [Accepted: 05/28/2022] [Indexed: 02/05/2023]
Abstract
We aimed to provide an overview of how work environment and occupational health are affected, and describe interventions designed to improve the work environment during epidemics and pandemics. The guidelines on Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) were followed. The databases Cinahl, Medline, PsycInfo, and Web of Science were searched for population: working population; exposure: coronavirus epidemic or pandemic; and outcome: work environment, in articles published until October 2020. Quality assessment was based on a modified version of the Mixed Methods Appraisal Tool (MMAT). After deduplication 3711 articles remained, of which 530 were selected for full-text screening and 119 for quality assessment. After the exclusion of studies that were low quality, 95 remained, of which 85 focused on healthcare personnel and 10 on employees in other industries; 73 used quantitative methods and 22 used qualitative or mixed methods; the majority were based on cross-sectional data. Healthcare staff experienced increased job demands, poor leadership, and lack of resources (personal protective equipment, personnel, and competence). High demands and work with infected patients were associated with negative mental health outcomes. There was a lack of studies assessing interventions, studies from industries other than healthcare, and studies of high quality.
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Affiliation(s)
- Anna Nyberg
- Department of Public Health and Caring Sciences, Uppsala University, P.O. Box 564, SE-751 22 Uppsala, Sweden;
- Correspondence: ; Tel.: +46-8-708-234318
| | - Kristiina Rajaleid
- Stress Research Institute, Department of Psychology, Stockholm University, SE-106 91 Stockholm, Sweden;
| | - Ingrid Demmelmaier
- Department of Public Health and Caring Sciences, Uppsala University, P.O. Box 564, SE-751 22 Uppsala, Sweden;
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Kunstler B, Newton S, Hill H, Ferguson J, Hore P, Mitchell BG, Dempsey K, Stewardson AJ, Friedman D, Cole K, Sim MR, Ferguson B, Burns P, King N, McGloughlin S, Dicks M, McCarthy S, Tam B, Hazelton B, McGurgan C, McDonald S, Turner T. P2/N95 respirators & surgical masks to prevent SARS-CoV-2 infection: Effectiveness & adverse effects. Infect Dis Health 2022; 27:81-95. [PMID: 35151628 PMCID: PMC8769935 DOI: 10.1016/j.idh.2022.01.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 01/03/2022] [Accepted: 01/05/2022] [Indexed: 12/19/2022]
Abstract
BACKGROUND Millions of people have acquired and died from SARS-CoV-2 infection during the COVID-19 pandemic. Healthcare workers (HCWs) are required to wear personal protective equipment (PPE), including surgical masks and P2/N95 respirators, to prevent infection while treating patients. However, the comparative effectiveness of respirators and masks in preventing SARS-CoV-2 infection and the likelihood of experiencing adverse events (AEs) with wear are unclear. METHODS Searches were carried out in PubMed, Europe PMC and the Cochrane COVID-19 Study Register to 14 June 2021. A systematic review of comparative epidemiological studies examining SARS-CoV-2 infection or AE incidence in HCWs wearing P2/N95 (or equivalent) respirators and surgical masks was performed. Article screening, risk of bias assessment and data extraction were duplicated. Meta-analysis of extracted data was carried out in RevMan. RESULTS Twenty-one studies were included, with most having high risk of bias. There was no statistically significant difference in respirator or surgical mask effectiveness in preventing SARS-CoV-2 infection (OR 0.85, [95%CI 0.72, 1.01]). Healthcare workers experienced significantly more headaches (OR 2.62, [95%CI 1.18, 5.81]), respiratory distress (OR 4.21, [95%CI 1.46, 12.13]), facial irritation (OR 1.80, [95%CI 1.03, 3.14]) and pressure-related injuries (OR 4.39, [95%CI 2.37, 8.15]) when wearing respirators compared to surgical masks. CONCLUSION The existing epidemiological evidence does not enable definitive assessment of the effectiveness of respirators compared to surgical masks in preventing infection. Healthcare workers wearing respirators may be more likely to experience AEs. Effective mitigation strategies are important to ensure the uptake and correct use of respirators by HCWs.
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Affiliation(s)
- Breanne Kunstler
- BehaviourWorks Australia, Monash Sustainable Development Institute, Monash University, 8 Scenic Boulevard, Clayton, Melbourne, VIC, 3800, Australia.
| | - Skye Newton
- Adelaide Health Technology Assessment (AHTA), School of Public Health, University of Adelaide, Australia
| | - Hayley Hill
- Adelaide Health Technology Assessment (AHTA), School of Public Health, University of Adelaide, Australia
| | - John Ferguson
- Division of Medicine, John Hunter Hospital, Newcastle Regional Mail Centre, NSW, 2310, Australia
| | - Phillipa Hore
- Department of Anaesthesia and Acute Pain Medicine, St Vincent's Hospital, Victoria Parade, Fitzroy, VIC, 3065, Australia
| | - Brett G. Mitchell
- The University of Newcastle, School of Nursing and Midwifery, Level 9, 77a Holden St, Gosford Hospital, Gosford, NSW, Australia, 2250
| | - Kathy Dempsey
- The Clinical Excellence Commission, 1 Reserve Road, St Leonards, NSW, Australia, 2065
| | - Andrew J. Stewardson
- Department of Infectious Diseases, The Alfred and Central Clinical School, Monash University, 85 Commercial Rd, Melbourne, VIC, Australia, 3004
| | - Deborah Friedman
- Deputy Chief Health Officer, Victorian Department of Health Melbourne, VIC, Australia, 3004
| | - Kate Cole
- Cole Health Pty Ltd, Balmain, NSW, Australia, 2041
| | - Malcolm R. Sim
- Monash Centre for Occupational & Environmental Health (MonCOEH), School of Public Health & Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, 553 St Kilda Rd, Melbourne, VIC, Australia, 3004
| | - Bridget Ferguson
- Central Queensland University, School of Nursing, Midwifery and Social Sciences; 554-700 Yaamba Rd, Norman Gardens, QLD, 4701, Australia
| | - Penelope Burns
- Academic Unit of General Practice, ANU Medical School, The Australian National University, Building 4, Hospital Road, Garran, ACT, 2605, Australia
| | - Nicole King
- North Shore Private Hospital, 3 Westbourne St, St Leonard's, 2065, Australia
| | - Steven McGloughlin
- Alfred Health and School of Public Health and Preventive Medicine, Monash University, Level 4, 553 St Kilda Road, Melbourne, VIC, Australia, 3004
| | - Melanie Dicks
- Ernst & Young, 121 Marcus Clarke Street, Canberra, ACT, Australia, 2601
| | - Sally McCarthy
- Prince of Wales Clinical School, Faculty of Medicine, University of New South Wales, Sydney, NSW, 2052, Australia
| | - Barry Tam
- Health Infrastructure NSW, 60 Day Road, Cheltenham, NSW, 2119, Australia
| | - Briony Hazelton
- PathWest Laboratory Medicine, QEII Medical Centre, Hospital Avenue, Nedlands, WA, Australia, 6009
| | - Cherylynn McGurgan
- Royal Melbourne Hospital Emergency Department, 300 Grattan Street, Parkville, VIC, Australia, 3050
| | - Steve McDonald
- Cochrane Australia, School of Public Health and Preventive Medicine, Monash University, Level 4, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - Tari Turner
- Cochrane Australia, School of Public Health and Preventive Medicine, Monash University, Level 4, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
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Wichmann D, Schempf U, Göpel S, Stüker D, Fusco S, Königsrainer A, Malek NP, Werner CR. Analysis of the effects of the first and second/third waves of the COVID-19 pandemic on an Interdisciplinary Endoscopy Unit in a German 'hotspot' area: a single-center experience. Therap Adv Gastroenterol 2022; 15:17562848221086753. [PMID: 35340756 PMCID: PMC8949732 DOI: 10.1177/17562848221086753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 02/23/2022] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Since December 2019, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has posed a pandemic threat to global health. We are now in the fourth wave of this pandemic. As the pandemic developed, the requirements and therapeutic endoscopic procedures for SARS-CoV-2-positive patients underwent changes. METHODS Analysis of implications for an endoscopy unit during the first and second/third waves of the COVID-19 pandemic with a focus on COVID-19-related process changing. Addressed are number of SARS-CoV-2-positive patients and endoscopic examinations performed in patients who tested positive for SARS-CoV-2 during the various waves, adherence to scheduled examinations, rotation of staff to COVID-dedicated structures and, finally, impact of vaccination on infection rate among endoscopic staff. RESULTS During the first wave, 10 SARS-CoV-2-positive in-house patients underwent a total of 22 gastrointestinal (GI) endoscopic procedures. During the second and third waves, 59 GI endoscopies were performed in 38 patients. While in the first wave, GI bleeding was the main indication for endoscopy (82%), in the second and third waves the main indication for endoscopy was endoscopic insertion of deep feeding tubes (78%; p < 0.001). During the first wave, 5 (17%) of 29 Interdisciplinary Endoscopy Unit (IEU) staff members were moved to designated COVID wards, which was not necessary during the following waves. Lack of protective clothing was critical during the first wave, but not in the later waves. Screening tests for patients and staff were widely available after the first wave, and IEU staff was vaccinated during the second wave. CONCLUSION Strategies to ensure safe endoscopies with respect to preventing transmission of SARS-CoV-2 from patients to staff were effective. Organizational adjustments allowed the routine program to continue unaffected. Indications for GI endoscopies changed over time: during the first wave, GI endoscopies were performed for life-threatening indications, whereas later supportive procedures were the main indication.
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Affiliation(s)
- Dörte Wichmann
- Department of General, Visceral and Transplant Surgery, University Hospital Tübingen, Tübingen, Germany
| | - Ulrike Schempf
- Department of Gastroenterology, Hepatology, Gastrointestinal Oncology, Geriatrics and Infectious diseases, University Hospital Tübingen, Tübingen, Germany
| | - Siri Göpel
- Department of Gastroenterology, Hepatology, Gastrointestinal Oncology, Geriatrics and Infectious diseases, University Hospital Tübingen, Tübingen, Germany
| | - Dietmar Stüker
- Department of General, Visceral and Transplant Surgery, University Hospital Tübingen, Tübingen, Germany
| | - Stefano Fusco
- Department of Gastroenterology, Hepatology, Gastrointestinal Oncology, Geriatrics and Infectious diseases, University Hospital Tübingen, Tübingen, Germany
| | - Alfred Königsrainer
- Department of General, Visceral and Transplant Surgery, University Hospital Tübingen, Tübingen, Germany
| | - Nisar P. Malek
- Department of Gastroenterology, Hepatology, Gastrointestinal Oncology, Geriatrics and Infectious diseases, University Hospital Tübingen, Tübingen, Germany
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Resuello TEM, Puyat MCA. Mask-induced facial dermatoses during the COVID-19 pandemic: A cross-sectional study in a tertiary medical center in the Philippines. JAAD Int 2022; 7:121-123. [PMID: 35291232 PMCID: PMC8913279 DOI: 10.1016/j.jdin.2022.03.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Tina Elaine M. Resuello
- Correspondence to: Tina Elaine M. Resuello, MD, Department of Dermatology, Rizal Medical Center, Pasig Boulevard, Pasig 1600, Philippines
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Ng CYH, Lim NA, Bao LXY, Quek AML, Seet RCS. Mitigating SARS-CoV-2 Transmission in Hospitals: A Systematic Literature Review. Public Health Rev 2022; 43:1604572. [PMID: 35296115 PMCID: PMC8906284 DOI: 10.3389/phrs.2022.1604572] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 01/19/2022] [Indexed: 11/25/2022] Open
Abstract
Objectives: Hospital outbreaks of SARS-CoV-2 infection are dreaded but preventable catastrophes. We review the literature to examine the pattern of SARS-CoV-2 transmission in hospitals and identify potential vulnerabilities to mitigate the risk of infection. Methods: Three electronic databases (PubMed, Embase and Scopus) were searched from inception to July 27, 2021 for publications reporting SARS-CoV-2 outbreaks in hospital. Relevant articles and grey literature reports were hand-searched. Results: Twenty-seven articles that described 35 SARS-CoV-2 outbreaks were included. Despite epidemiological investigations, the primary case could not be identified in 37% of outbreaks. Healthcare workers accounted for 40% of primary cases (doctors 17%, followed by ancillary staff 11%). Mortality among infected patients was approximately 15%. By contrast, none of the infected HCWs died. Several concerning patterns were identified, including infections involving ancillary staff and healthcare worker infections from the community and household contacts. Conclusion: Continuous efforts to train-retrain and enforce correct personal protective equipment use and regular routine screening tests (especially among ancillary staff) are necessary to stem future hospital outbreaks of SARS-CoV-2.
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Affiliation(s)
- Chester Yan Hao Ng
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Nicole-Ann Lim
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Lena X. Y. Bao
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Amy M. L. Quek
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Raymond C. S. Seet
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Healthy Longevity Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- *Correspondence: Raymond C. S. Seet,
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Hildebrandt A, Hökelekli O, Uflacker L, Rudolf H, Paulussen M, Gatermann SG. Seroprevalence of SARS-CoV-2 Antibodies in Employees of Three Hospitals of a Secondary Care Hospital Network in Germany and an Associated Fire Brigade: Results of a Repeated Cross-Sectional Surveillance Study Over 1 Year. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042402. [PMID: 35206589 PMCID: PMC8878380 DOI: 10.3390/ijerph19042402] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 02/06/2022] [Accepted: 02/15/2022] [Indexed: 02/06/2023]
Abstract
Healthcare workers (HCWs) are playing a vital role in the current SARS-CoV-2 pandemic. This study investigated how infection spreads within three local hospitals and an associated fire brigade in Germany by testing employees for the presence of SARS-CoV-2 IgG antibodies over one year. The three observational periods corresponded to the initial three pandemic waves: first wave: June–September 2020, second wave: October 2020–January 2021, and third wave: February–June 2021. We analysed 3285 serum samples of 1842 employees, which represents 65.7% of all employees. Altogether, 13.2% employees were seropositive: 194/1411 HCWs (13.7%) and 49/431 non-HCWs (11.4%) with a clear increase of seroprevalence from the first (1.1%) to the second (13.2%) and third (29.3%) pandemic wave. HCWs presumably had an additional occupational risk for infection in the second and third wave due to an increase of infection pressure with more COVID-19 patients treated, showing possible weak points in the recommended infection prevention strategy.
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Affiliation(s)
- Anke Hildebrandt
- St. Vincenz Hospital, Department of Internal Medicine I, 45711 Datteln, Germany
- Institute of Medical Microbiology, University Hospital Münster, 48149 Münster, Germany
| | - Oktay Hökelekli
- St. Vincenz Hospital, Department of Internal Medicine I, 45711 Datteln, Germany
| | - Lutz Uflacker
- St. Vincenz Hospital, Department of Internal Medicine I, 45711 Datteln, Germany
| | - Henrik Rudolf
- Institute for Biostatistics and Informatics in Medicine and Ageing Research, University Medical Center Rostock, 18057 Rostock, Germany
| | - Michael Paulussen
- Vestische Kinder- und Jugendklinik, Witten/Herdecke University, 45711 Datteln, Germany
| | - Sören G Gatermann
- National Reference Center for Multidrug-Resistant Gram-Negative Bacteria, Ruhr University Bochum, 44801 Bochum, Germany
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Physiotherapy management for COVID-19 in the acute hospital setting and beyond: an update to clinical practice recommendations. J Physiother 2022; 68:8-25. [PMID: 34953756 PMCID: PMC8695547 DOI: 10.1016/j.jphys.2021.12.012] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 11/25/2021] [Accepted: 12/13/2021] [Indexed: 12/15/2022] Open
Abstract
This document provides an update to the recommendations for physiotherapy management for adults with coronavirus disease 2019 (COVID-19) in the acute hospital setting. It includes: physiotherapy workforce planning and preparation; a screening tool for determining requirement for physiotherapy; and recommendations for the use of physiotherapy treatments and personal protective equipment. New advice and recommendations are provided on: workload management; staff health, including vaccination; providing clinical education; personal protective equipment; interventions, including awake proning, mobilisation and rehabilitation in patients with hypoxaemia. Additionally, recommendations for recovery after COVID-19 have been added, including roles that physiotherapy can offer in the management of post-COVID syndrome. The updated guidelines are intended for use by physiotherapists and other relevant stakeholders caring for adult patients with confirmed or suspected COVID-19 in the acute care setting and beyond.
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Fleischmann E, Fellendorf F, Schönthaler EM, Lenger M, Hiendl L, Bonkat N, Wagner-Skacel J, Bengesser S, Angel HF, Seitz RJ, Reininghaus EZ, Dalkner N. Believing processes around COVID-19 vaccination: An exploratory study investigating workers in the health sector. Front Psychiatry 2022; 13:993323. [PMID: 36213920 PMCID: PMC9532762 DOI: 10.3389/fpsyt.2022.993323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 08/30/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The processes underlying believing have been labeled "creditions", which are important brain functions between emotion and cognition. Creditions are influenced by both internal and external factors, one of which is the coronavirus disease 2019 (COVID-19) pandemic and the vaccination against the disease. METHODS To investigate believing processes shortly before the implementation of a mandatory vaccination in Austria, both vaccinated and unvaccinated workers in the health sector (WHS) were surveyed in December 2021/January 2022. In total, 1,062 vaccinated and 97 unvaccinated WHS (920 females) completed the online survey. Beliefs were assessed using the parameters of the credition model (narrative, certainty, emotion, and mightiness) with regard to (1) the COVID-19 pandemic in general, and (2) the vaccination. Type of emotion and narrative were divided into positive, negative, and indifferent. Moreover, the congruence between emotion and narrative was calculated. RESULTS The vaccination rate of the sample was 91.6%, with a significantly higher percentage of men being in the group of vaccinated (21.1%) as compared to unvaccinated individuals (12.4%). Pertaining beliefs about the COVID-19 vaccination, unvaccinated WHS reported more negative and less positive emotions as well as content of narrative than vaccinated WHS. In addition, they showed higher levels of certainty as well as mightiness while believing and felt less sufficiently informed about governmental and workplace-related COVID-19 measures. The groups did not differ in the type of emotion or content of narrative in their beliefs about the pandemic in general. CONCLUSION In conclusion, unvaccinated WHS had more negative and less positive emotions and thoughts than vaccinated WHS in their beliefs about the COVID-19 vaccination and their motivations for not having received it. They were more certain about their beliefs and felt stronger negative emotions in their beliefs compared to vaccinated individuals. Providing unvaccinated WHS with adequate information might be helpful in reducing their mental burden.
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Affiliation(s)
- Eva Fleischmann
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz, Austria
| | - Frederike Fellendorf
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz, Austria
| | - Elena M Schönthaler
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz, Austria
| | - Melanie Lenger
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz, Austria
| | - Lena Hiendl
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz, Austria
| | - Nina Bonkat
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz, Austria
| | - Jolana Wagner-Skacel
- Department of Medical Psychology and Psychotherapy, Medical University of Graz, Graz, Austria
| | - Susanne Bengesser
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz, Austria
| | - Hans-Ferdinand Angel
- Department of Catechetics and Religious Education, Karl-Franzens-University of Graz, Graz, Austria
| | - Rüdiger J Seitz
- Department of Neurology, Medical Faculty, Centre of Neurology and Neuropsychiatry, LVR-Klinikum Düsseldorf, Heinrich-Heine-University of Düsseldorf, Düsseldorf, Germany
| | - Eva Z Reininghaus
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz, Austria
| | - Nina Dalkner
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz, Austria
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Daud A, Hussein IM, Zhang PC, Ahmed Y, Trac J, Vujovic N, Rizvi SF, Kuzyk PR. 3D-Printed Personal Protective Face Shields During the COVID-19 Pandemic: A Survey of Canadian Frontline Workers. Cureus 2021; 13:e18141. [PMID: 34692348 PMCID: PMC8526080 DOI: 10.7759/cureus.18141] [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] [Accepted: 09/20/2021] [Indexed: 11/05/2022] Open
Abstract
Background During the coronavirus disease 2019 pandemic, three-dimensional (3D) printing was utilized to rapidly produce face shields for frontline workers in response to an acute shortage of personal protective equipment (PPE). In this study, we examine the perceived utility and performance of 3D-printed (3DP) face shields through a survey of frontline workers in Ontario, Canada. Methodology Frontline workers who received community-produced 3DP face shields from the Canadian initiative "3DPPE GTHA" (March-December 2020) were invited to participate in the study. The survey response rate was 54.3%. Of 63 respondents, 39 were patient-facing and 24 were community-facing frontline workers. Participants were asked to rate performance measures in 10 categories on a five-point Likert scale. Data were categorized by organization and frontline worker type, and a t-test was used to determine statistically significant differences among subgroups. Results The mean preference for 3DP face shields among respondents was 3.2 out of 5 (95% confidence interval [CI]: 2.1-4.3). Community-facing respondents reported significantly greater overall utility scores for 3DP face shields (3.58, 95% CI: 3.38-3.79) compared to respondents working in a patient-facing profession (2.95, 95% CI: 2.77-3.13; p < 0.05). However, no differences were reported in portability and compatibility with other PPE. Respondents from organizations with large service volumes reported significantly lower overall utility scores (2.67, 95% CI: 2.44-2.89) than respondents in organizations with smaller service volumes (3.45, 95% CI: 3.28-3.62; p < 0.05). Conclusions Community-facing frontline workers and those from smaller service volume organizations endorse higher utility for 3DP face shields than patient-facing frontline workers. Despite this, frontline workers generally rate 3DP face shields positively. 3DP face shields are a viable option for personal and community use and can be used to supplement supply in a community setting.
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Affiliation(s)
- Anser Daud
- Faculty of Medicine, University of Toronto, Toronto, CAN.,Granovsky Gluskin Division of Orthopaedic Surgery, Sinai Health System, Toronto, CAN
| | - Isra M Hussein
- Faculty of Medicine, University of Toronto, Toronto, CAN
| | - Peter Chengming Zhang
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, CAN.,Rotman School of Management, University of Toronto, Toronto, CAN
| | - Yousuf Ahmed
- Faculty of Medicine, University of Toronto, Toronto, CAN
| | - Jessica Trac
- Faculty of Medicine, University of Toronto, Toronto, CAN
| | - Nina Vujovic
- Faculty of Medicine, University of Toronto, Toronto, CAN
| | - Syed F Rizvi
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, CAN
| | - Paul R Kuzyk
- Division of Orthopaedic Surgery, University of Toronto, Toronto, CAN.,Granovsky Gluskin Division of Orthopaedic Surgery, Sinai Health System, Toronto, CAN
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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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