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AlEdani EM, Gurramkonda J, Chaudhri S, Amin A, Panjiyar BK, Al-Taie DS, Nath TS. COVID-19-Related Risk Factors for Developing Occupational Contact Dermatitis Along With Its Incidence, Prevention, and Management: A Systematic Review. Cureus 2024; 16:e68441. [PMID: 39360055 PMCID: PMC11445976 DOI: 10.7759/cureus.68441] [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] [Received: 11/12/2023] [Accepted: 09/02/2024] [Indexed: 10/04/2024] Open
Abstract
Occupational contact dermatitis (OCD) is an eczematous local inflammatory skin irritation caused by repeated use of hand sanitizer and other chemical substances. Occupational irritant contact dermatitis (OICD) and occupational allergic contact dermatitis (OACD) are the two variants of CD that cannot be identified clinically. Hand dermatitis (HD) is typically assessed as a clinical consequence because it affects the hands most frequently at work as per epidemiological studies on OCD. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 standards were followed when conducting this umbrella review. We used the search terms "Occupational Contact Dermatitis AND COVID-19" to search for the most pertinent papers in full text on the databases PubMed/MedLine, ScienceDirect, and PubMed Central (PMC). Additionally, the reference section of the papers was used to find more articles. A total of 11,646 results were found, and eight papers remained after applying the inclusion criteria (full-text papers, English language, studies published in the previous 10 years, involving humans, and only systematic reviews). After completing the title and abstract screening, we obtained five papers. Next, the full-text screening and AMSTAR quality check were completed, yielding the same five papers. After searching ScienceDirect, five papers that met the inclusion criteria were included, and six papers were selected from the references, yielding a total of 11 papers. The causes of occupational dermatitis from protective face masks are discussed in this review. We anticipate an increase in the incidence of occupational dermatitis linked to face mask use given that a large segment of healthcare workers (HCWs) wear protective face masks. To understand the prevalence and available therapies for mask-related occupational dermatitis, further well-designed research is required.
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Affiliation(s)
- Esraa M AlEdani
- Dermatology, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Jahnavi Gurramkonda
- Neurological Surgery, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Shaan Chaudhri
- Psychiatry, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Amina Amin
- General Surgery, Shifa International Hospital, Islamabad, PAK
| | - Binay K Panjiyar
- Research Fellowship, Ventolini's Lab, Texas Tech University Health Sciences Center, Odessa, USA
- Research, Harvard Medical School, Boston, USA
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Dhuha S Al-Taie
- Otolaryngology - Head and Neck Surgery, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
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Michaels BS, Ayers T, Brooks-McLaughlin J, McLaughlin RJ, Sandoval-Warren K, Schlenker C, Ronaldson L, Ardagh S. Potential for Glove Risk Amplification via Direct Physical, Chemical, and Microbiological Contamination. J Food Prot 2024; 87:100283. [PMID: 38679200 DOI: 10.1016/j.jfp.2024.100283] [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: 09/06/2023] [Revised: 04/17/2024] [Accepted: 04/22/2024] [Indexed: 05/01/2024]
Abstract
This review focuses on the potential direct physical, chemical, and microbiological contamination from disposable gloves when utilized in food environments, inclusive of the risks posed to food products as well as worker safety. Unrecognized problems endemic to glove manufacturing were magnified during the COVID-19 pandemic due to high demand, increased focus on PPE performance, availability, supply chain instability, and labor shortages. Multiple evidence-based reports of contamination, toxicity, illness, deaths, and related regulatory action linked to contaminated gloves in food and healthcare have highlighted problems indicative of systemic glove industry shortcomings. The glove manufacturing process was diagramed with sources and pathways of contamination identified, indicating weak points with documented occurrences detailed. Numerous unsafe ingredients can introduce chemical contaminants, potentially posing risks to food and to glove users. Microbial hazards present significant challenges to overall glove safety as contaminants appear to be introduced via polluted water sources or flawed glove manufacturing processes, resulting in increased risks within food and healthcare environments. Frank and opportunistic pathogens along with food spoilage organisms can be introduced to foods and wearers. When the sources and pathways of glove-borne contamination were explored, it was found that physical failures play a pivotal role in the release of sweat build-up, liquefaction of chemical residues, and incubation of microbial contaminants from hands and gloves. Thus, with glove physical integrity issues, including punctures in new, unused gloves that can develop into significant rips and tears, not only can direct physical food contamination occur but also chemical and microbiological contamination can find their way into food. Enhanced regulatory requirements for Acceptable Quality Limits of food-grade gloves, and the establishment of appropriate bioburden standards would enhance safety in food applications. Based on the information provided, together with a false sense of security associated with glove use, the unconditional belief in glove chemical and microbiological purity may be unfounded.
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Affiliation(s)
- Barry S Michaels
- B. Michaels Group Inc., 487 West River Road, Palatka, FL 32177, USA.
| | - Troy Ayers
- Eurofins Microbiology Laboratories Inc., Des Moines, IA 50321, USA
| | | | | | | | | | - Lynda Ronaldson
- Eagle Protect PBC, South Lake Tahoe, CA 96150, USA; Eagle Protect Ltd. Christchurch 8011, New Zealand
| | - Steve Ardagh
- Eagle Protect PBC, South Lake Tahoe, CA 96150, USA; Eagle Protect Ltd. Christchurch 8011, New Zealand
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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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Clynick M, Holness DL. New causes of occupational allergic contact dermatitis. Curr Opin Allergy Clin Immunol 2024; 24:51-57. [PMID: 38037883 DOI: 10.1097/aci.0000000000000961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2023]
Abstract
PURPOSE OF REVIEW Occupational allergic contact dermatitis (OACD) is an important work-related skin disease. Information about the causative agents comes from many sources, including patch test databases, registries, case series and case reports. This review summarizes new information about common causative allergens and diagnosis. RECENT FINDINGS Common causes of OACD include rubber components, epoxies and preservatives. New exposure sources for these allergens continue to be described. Often these exposure sources are related to the changing world around us, such as allergens related to smartphones and technology, and personal protective equipment-related exposures during the COVID-19 pandemic. New allergens are also being described, some of which are related to known allergens (e.g. a new epoxy or acrylate component).Accurate diagnosis is critical to effective management of OACD, which may include removing the worker from exposure to the causative allergen. Safety data sheets may not contain complete information and patch testing with specialized series of allergens and workplace materials may be necessary. SUMMARY This review provides current evidence about causes of OACD and important aspects of diagnosis. This is important for clinical practice to ensure cases of OACD are not missed.
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Affiliation(s)
- Meghan Clynick
- Department of Medicine, St Michael's Hospital, Unity Health Toronto
- Department of Medicine
| | - Dorothy Linn Holness
- Department of Medicine, St Michael's Hospital, Unity Health Toronto
- Department of Medicine
- Dalla Lana School of Public Health, University of Toronto
- MAP Centre for Urban Health Solutions, St Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
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McKenna K, Bouchoucha S, Redley B, Hutchinson A. Australian health care workers experience of PPE related side-effects. A cross-sectional survey. Front Public Health 2024; 12:1325376. [PMID: 38384885 PMCID: PMC10880185 DOI: 10.3389/fpubh.2024.1325376] [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: 10/21/2023] [Accepted: 01/15/2024] [Indexed: 02/23/2024] Open
Abstract
Introduction Protection of health care workers (HCWs) is a fundamental aspect of an effective pandemic response. During the COVID-19 pandemic, frequency, and duration of Personal Protective Equipment (PPE) use increased. The experience of PPE-related side-effects has potential to contribute to decreased compliance resulting in breaches in infection prevention and increasing risk of HCW exposure. This study aims were to measure the frequency of PPE-related side-effects amongst HCW in Australia, and to establish if an increased frequency of adverse reactions was related to the significant increase in use and extended duration of time spent in PPE. Methods A descriptive cross-sectional survey was used. Results Of the 559 respondents the majority were female (83.7%), aged 31-45 years old (33.6%). A pre-existing skin condition was reported by 266 (47.6%). Frequency of PPE related side-effects were: pressure-related 401 (71.7%), skin 321 (57.4%) and respiratory 20 (3.6%). Surgical mask use was significantly associated with pre-exiting skin conditions (β = 1.494 (SE 0.186), df (1), p < 0.001). Side effects to N95 respirator use was more commonly reported by staff working in COVID-19 high-risk areas (β = 0.572 (SE 0.211), df (1), p = 0.007) independent of work duration (β = -0.056 (SE 0.075), df (1), p = 0.456), and pre-existing skin conditions (β = 1.272, (SE.198), df (1), p < 0.001). Conclusion The COVID-19 pandemic has seen a significant increase in the use of PPE. While the preventative benefits of PPE are significant, adverse events related to PPE use are frequently reported by HCW. Findings in this study highlight the need for innovation in PPE design to maximize protection while decreasing adverse effects and maintaining adhere to use.
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Affiliation(s)
- Karen McKenna
- Deakin University Geelong, Faculty of Health, School of Nursing & Midwifery, Geelong, VIC, Australia
- Deakin University Geelong, Institute of Health Transformation, Centre for Quality & Patient Safety Research, Geelong, VIC, Australia
| | - Stephane Bouchoucha
- Deakin University Geelong, Faculty of Health, School of Nursing & Midwifery, Geelong, VIC, Australia
- Deakin University Geelong, Institute of Health Transformation, Centre for Quality & Patient Safety Research, Geelong, VIC, Australia
- Deakin University Geelong, Centre for Innovation in Infectious Diseases and Immunology Research, Geelong, VIC, Australia
- Adjunct Faculty, Manipal College of Nursing (MCON), Manipal Academy of Higher Education (MAHE), Manipal, India
| | - Bernice Redley
- Deakin University Geelong, Faculty of Health, School of Nursing & Midwifery, Geelong, VIC, Australia
| | - Anastasia Hutchinson
- Deakin University Geelong, Faculty of Health, School of Nursing & Midwifery, Geelong, VIC, Australia
- Deakin University Geelong, Institute of Health Transformation, Centre for Quality & Patient Safety Research, Geelong, VIC, Australia
- Deakin University Geelong, Centre for Innovation in Infectious Diseases and Immunology Research, Geelong, VIC, Australia
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Jia L, Ye M, Wang H, Wang H. Physical discomforts, feeling of the high work intensity and the related risk factors of the frontline medical staff during COVID-19 epidemic: an early-outbreak, national survey in China. Front Public Health 2023; 11:1270366. [PMID: 37900046 PMCID: PMC10602654 DOI: 10.3389/fpubh.2023.1270366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 09/21/2023] [Indexed: 10/31/2023] Open
Abstract
Background Facing the unknown virus, COVID-19 medical staff kept wearing thick personal protective equipment during their work in the early stage of the outbreak. The survey was designed to investigate the physical discomforts, the feeling of the work intensity and the related risk factors of the frontline medical staff during COVID-19 epidemic in the early outbreak. Methods An national survey was carried out in China from March 17th 2020 to March 20th 2020 by applying a standardized WeChat questionnaire survey. The doctors or nurses working in the wards for the confirmed COVID-19 patients on front-line were eligible to participate in the survey. Descriptive analysis and multivariate logistic regression analysis were used. Results A total number of 515 COVID-19 medical staff, including 190 physicians and 325 nurses participated in this survey. 375 medical staff (72.8%) experienced physical discomforts at work, mostly consist of dyspnea (45.8%), pain (41.0%), chest distress (24.1%), dizziness (18.8%), and weakness (17.5%), while wearing thick isolation clothes at work. The mean onset time and peak time of these symptoms were 2.4 h and 3.5 h after working, respectively. 337 medical staff (65.4%) suffered from sleep disorders. 51 medical staff (10%) were highly worried about being infected by COVID-19 even during their work breaks. 246 medical staffs (47.8%) felt high work intensity and the independent influential factors were the effective daily sleep time and anxiety levels at break time (p = 0.04). Conclusion The frontline medical staff during COVID-19 epidemic felt different physical discomforts when they wear thick isolation clothes at work in the early outbreak and they felt high work intensity. These precious data will help optimize the work management strategy to ensure the physical and mental health of medical staff in the face of similar outbreaks in future.
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Affiliation(s)
| | | | | | - Huaiquan Wang
- Department of Intensive Care Medicine, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
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Prakoeswa CRS, Damayanti, Anggraeni S, Umborowati MA, Waskito F, Indrastuti N, Febriana SA, Sari ARP, Nababan KA, Hazlianda CP, Nopriyati, Budianti WK, Pangastuti M, Ilyas F, Kartini A, Rusetiyanti N, Anggraini I, Idrus I, Brahmanti H, Akhyar G. Glove-Induced Hand Dermatitis: A Study in Healthcare Workers during COVID-19 Pandemic in Indonesia. Dermatol Res Pract 2023; 2023:6600382. [PMID: 37564133 PMCID: PMC10412120 DOI: 10.1155/2023/6600382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 05/19/2023] [Accepted: 06/28/2023] [Indexed: 08/12/2023] Open
Abstract
Skin damage among healthcare workers has been reported by many centers around the world. Occupational hand dermatitis is one of the most commonly known occupational skin diseases and a socially significant health issue. The use of gloves is one of the risk factors for the occurrence and/or aggravation of hand dermatitis. This cross-sectional study involved healthcare workers in 14 referral hospitals for COVID-19 throughout Indonesia. Questionnaires were distributed to the participants, which consisted of the subject's characteristics, glove-related skin problems, history of glove use, and clinical history. This study involved a total of 845 healthcare workers. Approximately 156 healthcare workers (18.46%) had glove-induced hand dermatitis during the pandemic. Itchy skin was the most common symptom (44.23%), and the palm was the most frequently complained area (48.72%). There was a significant association between glove use and glove-induced hand dermatitis among healthcare workers. In particular, equal to or more than 2 hours per day of glove use was significantly associated with hand dermatitis. Glove-induced hand dermatitis also had a significant association with the subject's history of atopic dermatitis and previous history of hand dermatitis. The use of gloves by healthcare workers should be considered carefully, especially in individuals at increased risk, including those who use gloves for 2 hours or more per day and those who have a history of atopic or hand dermatitis, in order to prevent the incidence of glove-induced hand dermatitis among healthcare workers, as well as to provide a safe working environment.
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Affiliation(s)
- Cita Rosita Sigit Prakoeswa
- Department of Dermatology and Venereology, Faculty of Medicine Universitas Airlangga/Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Damayanti
- Department of Dermatology and Venereology, Faculty of Medicine Universitas Airlangga/Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Sylvia Anggraeni
- Department of Dermatology and Venereology, Faculty of Medicine Universitas Airlangga/Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Menul Ayu Umborowati
- Department of Dermatology and Venereology, Faculty of Medicine Universitas Airlangga/Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Fajar Waskito
- Department of Dermatology and Venereology, Dr. Sardjito General Hospital, Yogyakarta, Indonesia
| | - Niken Indrastuti
- Department of Dermatology and Venereology, Dr. Sardjito General Hospital, Yogyakarta, Indonesia
| | - Sri Awalia Febriana
- Department of Dermatology and Venereology, Dr. Sardjito General Hospital, Yogyakarta, Indonesia
| | | | - Kristo Alberto Nababan
- Department of Dermatology and Venereology, H. Adam Malik General Hospital, Medan, Indonesia
| | - Cut Putri Hazlianda
- Department of Dermatology and Venereology, Sumatera Utara University Hospital, Medan, Indonesia
| | - Nopriyati
- Department of Dermatology and Venereology, Dr. M. Hoesin General Hospital, Palembang, Indonesia
| | - Windy Keumala Budianti
- Department of Dermatology and Venereology, Dr. Cipto Mangunkusumo National Central Public Hospital, Jakarta, Indonesia
| | - Miranti Pangastuti
- Department of Dermatology and Venereology, Dr. Hasan Sadikin General Hospital, Bandung, Indonesia
| | - Faridha Ilyas
- Department of Dermatology and Venereology, Dr. Wahidin Sudirohusodo General Hospital, Makassar, Indonesia
| | - Agnes Kartini
- Department of Dermatology and Venereology, Abdoel Wahab Sjahranie Regional General Hospital, Samarinda, Indonesia
| | - Nurwestu Rusetiyanti
- Department of Dermatology and Venereology, Gadjah Mada University Academic Hospital, Yogyakarta, Indonesia
| | - Ika Anggraini
- Department of Dermatology and Venereology, Indonesia University Hospital, Depok, Indonesia
| | - Idrianti Idrus
- Department of Dermatology and Venereology, Hasanuddin University Hospital, Makassar, Indonesia
| | - Herwinda Brahmanti
- Department of Dermatology and Venereology, Dr. Syaiful Anwar Regional Hospital, Malang, Indonesia
| | - Gardenia Akhyar
- Department of Dermatology and Venereology, Dr. M. Djamil General Hospital, Padang, Indonesia
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Tang H, Wang H, Hamblin MR, Jiang L, Zhou Y, Xu Y, Wen X. Contact dermatitis caused by prevention measures during the COVID-19 pandemic: a narrative review. Front Public Health 2023; 11:1189190. [PMID: 37546301 PMCID: PMC10400336 DOI: 10.3389/fpubh.2023.1189190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Accepted: 07/04/2023] [Indexed: 08/08/2023] Open
Abstract
Introduction During the outbreak of Coronavirus disease 2019 (COVID-19), health care workers wore personal protective equipment including masks, gloves and goggles for a long time. In order to reduce the transmission routes of the virus, public places were sprayed with disinfectant. Moreover, the body, hands and clothing were frequently disinfected and washed for hygiene purposes. Studies have shown that these practices could easily irritate the skin and damage the skin barrier. Long-term irritation or exposure to allergens may lead to the occurrence of contact dermatitis (CD). Methods Subject headings were searched via the National Library of Medicine (PubMed) and web of science databases: COVID-19; contact dermatitis; adverse skin reaction; PPE; dermatitis; mask; glory; hand hygiene, disinfection; face shield; goggle; protect cloth. A total of 246 and 646 articles were retrieved from the two databases, respectively. 402 articles remained after removing duplicates. Reviews, non-English articles, articles that could not be accessed to read or did not conform to our topic were excluded. Finally, a total of 32 cross-sectional studies, 9 case reports and 2 randomized controlled trials were included. Discussion This article reviews reports of CD caused by various prevention and hygiene measures during the COVID-19 pandemic. The amount of skin damage caused by COVID-19 prevention measures could be decreased by improved education about skin management.
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Affiliation(s)
- Huimiao Tang
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, China
- Laboratory of Dermatology, Clinical Institute of Inflammation and Immunology, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
| | - Hao Wang
- Laboratory of Dermatology, Clinical Institute of Inflammation and Immunology, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
| | - Michael R. Hamblin
- Laser Research Centre, Faculty of Health Science, University of Johannesburg, Doornfontein, South Africa
| | - Lu Jiang
- Outpatient Department of West China Hospital, Sichuan University, Chengdu, China
| | - Yanjun Zhou
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, China
- Laboratory of Dermatology, Clinical Institute of Inflammation and Immunology, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
| | - Yidan Xu
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, China
- Laboratory of Dermatology, Clinical Institute of Inflammation and Immunology, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
| | - Xiang Wen
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, China
- Laboratory of Dermatology, Clinical Institute of Inflammation and Immunology, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
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Kisielinski K, Hirsch O, Wagner S, Wojtasik B, Funken S, Klosterhalfen B, Kanti Manna S, Prescher A, Sukul P, Sönnichsen A. Physio-metabolic and clinical consequences of wearing face masks-Systematic review with meta-analysis and comprehensive evaluation. Front Public Health 2023; 11:1125150. [PMID: 37089476 PMCID: PMC10116418 DOI: 10.3389/fpubh.2023.1125150] [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: 12/15/2022] [Accepted: 02/17/2023] [Indexed: 04/08/2023] Open
Abstract
Background As face masks became mandatory in most countries during the COVID-19 pandemic, adverse effects require substantiated investigation. Methods A systematic review of 2,168 studies on adverse medical mask effects yielded 54 publications for synthesis and 37 studies for meta-analysis (on n = 8,641, m = 2,482, f = 6,159, age = 34.8 ± 12.5). The median trial duration was only 18 min (IQR = 50) for our comprehensive evaluation of mask induced physio-metabolic and clinical outcomes. Results We found significant effects in both medical surgical and N95 masks, with a greater impact of the second. These effects included decreased SpO2 (overall Standard Mean Difference, SMD = -0.24, 95% CI = -0.38 to -0.11, p < 0.001) and minute ventilation (SMD = -0.72, 95% CI = -0.99 to -0.46, p < 0.001), simultaneous increased in blood-CO2 (SMD = +0.64, 95% CI = 0.31-0.96, p < 0.001), heart rate (N95: SMD = +0.22, 95% CI = 0.03-0.41, p = 0.02), systolic blood pressure (surgical: SMD = +0.21, 95% CI = 0.03-0.39, p = 0.02), skin temperature (overall SMD = +0.80 95% CI = 0.23-1.38, p = 0.006) and humidity (SMD +2.24, 95% CI = 1.32-3.17, p < 0.001). Effects on exertion (overall SMD = +0.9, surgical = +0.63, N95 = +1.19), discomfort (SMD = +1.16), dyspnoea (SMD = +1.46), heat (SMD = +0.70), and humidity (SMD = +0.9) were significant in n = 373 with a robust relationship to mask wearing (p < 0.006 to p < 0.001). Pooled symptom prevalence (n = 8,128) was significant for: headache (62%, p < 0.001), acne (38%, p < 0.001), skin irritation (36%, p < 0.001), dyspnoea (33%, p < 0.001), heat (26%, p < 0.001), itching (26%, p < 0.001), voice disorder (23%, p < 0.03), and dizziness (5%, p = 0.01). Discussion Masks interfered with O2-uptake and CO2-release and compromised respiratory compensation. Though evaluated wearing durations are shorter than daily/prolonged use, outcomes independently validate mask-induced exhaustion-syndrome (MIES) and down-stream physio-metabolic disfunctions. MIES can have long-term clinical consequences, especially for vulnerable groups. So far, several mask related symptoms may have been misinterpreted as long COVID-19 symptoms. In any case, the possible MIES contrasts with the WHO definition of health. Conclusion Face mask side-effects must be assessed (risk-benefit) against the available evidence of their effectiveness against viral transmissions. In the absence of strong empirical evidence of effectiveness, mask wearing should not be mandated let alone enforced by law. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021256694, identifier: PROSPERO 2021 CRD42021256694.
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Affiliation(s)
- Kai Kisielinski
- Orthopaedic and Trauma Surgery, Clinical Medicine, Private Practice, Düsseldorf, Germany
| | - Oliver Hirsch
- Department of Psychology, Fachhochschule für Oekonomie und Management (FOM) University of Applied Sciences, Siegen, Germany
| | - Susanne Wagner
- Veterinary Medicine, Wagner Medical Science Liason (MSL) Management, Blankenfelde-Mahlow, Germany
| | - Barbara Wojtasik
- Department of Genetics and Biosystematics, Faculty of Biology, University of Gdańsk, Gdansk, Poland
| | - Stefan Funken
- Internal Medicine, Clinical Medicine, Private Practice, Moers, Germany
| | | | - Soumen Kanti Manna
- Biophysics and Structural Genomics Division, Saha Institute of Nuclear Physics, Kolkata, India
| | - Andreas Prescher
- Institute of Molecular and Cellular Anatomy (MOCA), Rhine-Westphalia Technical University of Aachen, Aachen, Germany
| | - Pritam Sukul
- Rostock Medical Breath Research Analytics and Technologies (ROMBAT), Department of Anesthesiology and Intensive Care, University Medicine Rostock, Rostock, Germany
| | - Andreas Sönnichsen
- Internal Medicine, Clinical Medicine, Private Practice, Gesundheit für Österreich e.V. (Health for Austria), Vienna, Austria
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10
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Pawankar R, Thong BY, Recto MT, Wang JY, Abdul Latiff AH, Leung TF, Li PH, Lobo RCM, Lucas M, Oh JW, Kamchaisatian W, Nagao M, Rengganis I, Udwadia ZF, Dhar R, Munkhbayarlakh S, Narantsetseg L, Pham DL, Zhang Y, Zhang L. COVID-19 in the Asia Pacific: Impact on climate change, allergic diseases and One Health. Asia Pac Allergy 2023; 13:44-49. [PMID: 37389098 PMCID: PMC10166246 DOI: 10.5415/apallergy.0000000000000021] [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: 02/23/2023] [Accepted: 02/24/2023] [Indexed: 07/01/2023] Open
Abstract
Climate change and environmental factors such as air pollution and loss of biodiversity are known to have a major impact not only on allergic diseases but also on many noncommunicable diseases. Coronavirus disease 2019 (COVID-19) resulted in many environmental changes during the different phases of the pandemic. The use of face masks, enhanced hand hygiene with hand rubs and sanitizers, use of personal protective equipment (gowns and gloves), and safe-distancing measures, reduced the overall incidence of respiratory infections and other communicable diseases. Lockdowns and border closures resulted in a significant reduction in vehicular traffic and hence environmental air pollution. Paradoxically, the use of personal protective equipment and disposables contributed to an increase in environmental waste disposal and new problems such as occupational dermatoses, especially among healthcare workers. Environmental changes and climate change over time may impact the exposome, genome, and microbiome, with the potential for short- and long-term effects on the incidence and prevalence of the allergic disease. The constant use and access to mobile digital devices and technology disrupt work-life harmony and mental well-being. The complex interactions between the environment, genetics, immune, and neuroendocrine systems may have short- and long-term impact on the risk and development of allergic and immunologic diseases in the future.
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Affiliation(s)
- Ruby Pawankar
- Department of Pediatrics, Nippon Medical School, Tokyo, Japan
| | - Bernard Y Thong
- Department of Rheumatology, Allergy and Immunology, Tan Tock Seng Hospital, Singapore
| | - Marysia T Recto
- Division of Allergy and Immunology, Department of Pediatrics, University of the Philippines-Philippine General Hospital, Manila, Philippines
| | - Jiu-Yao Wang
- Allergy, Immunology, and Microbiome (A.I.M.) Research Centre, China Medical University Children’s Hospital, Taichung, Taiwan
| | | | - Ting-Fan Leung
- Department of Paediatrics, The Chinese University of Hong Kong, Hong Kong
| | - Philip H Li
- Division of Rheumatology and Clinical Immunology, Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong
| | - Rommel Crisenio M Lobo
- Philippine Children’s Medical Center Hospital of Infant Jesus Medical Center, Fe Del Mundo Medical Center, Manila, Philippines
| | - Michela Lucas
- Department of Clinical Immunology, Sir Charles Gairdner Hospital, Perth Children’s Hospital, Pathwest; Medical School, University of Western Australia, Perth, WA, Australia
| | - Jae-Won Oh
- Department of Pediatrics, Hanyang University Guri Hospital, Guri, Korea
| | - Wasu Kamchaisatian
- Pediatric Allergy and Immunology, Samitivej Children’s Hospital, Bangkok, Thailand
| | - Mizuho Nagao
- Institute for Clinical Research, National Hospital Organization Mie National Hospital, Tsu, Japan
| | - Iris Rengganis
- Division of Allergy and Clinical Immunology, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia, Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | - Zarir F Udwadia
- P.D. Hinduja National Hospital and Medical Research Centre and the Breach Candy Hospital, Mumbai, India
| | - Raja Dhar
- CMRI Hospital, Kolkata, West Bengal, India
| | - Sonomjamts Munkhbayarlakh
- Department of Pulmonology and Allergology, School of Medicine, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
| | - Logii Narantsetseg
- Department of Biochemistry, School of Biomedicine, National University of Medical Sciences, Ulaanbaatar, Mongolia
| | - Duy L Pham
- Faculty of Medicine, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam
| | - Yuan Zhang
- Department of Allergy, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Luo Zhang
- Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
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11
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Sawada Y. Occupational Skin Dermatitis among Healthcare Workers Associated with the COVID-19 Pandemic: A Review of the Literature. Int J Mol Sci 2023; 24:ijms24032989. [PMID: 36769309 PMCID: PMC9918113 DOI: 10.3390/ijms24032989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 01/31/2023] [Accepted: 02/01/2023] [Indexed: 02/05/2023] Open
Abstract
The skin is the outermost layer of the human body and is continually exposed to numerous external stimuli, which can cause unwanted skin irritation. Occupational skin diseases are the most prevalent form of work-related illness and are found in a variety of sectors, particularly healthcare. During the recent COVID-19 pandemic, healthcare professionals experienced a variety of unexpected, unusual occupational skin diseases associated with COVID-19-engaged employment. Because the clinical characteristics of these types of skin inflammation are unique, this review focuses on the characteristics of a large category of occupational workers, namely COVID-19-engaged healthcare professionals. Furthermore, we examined the potential pathogeneses of occupational skin disorders associated with COVID-19-engaged labor, as well as different preventative methods.
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Affiliation(s)
- Yu Sawada
- Department of Dermatology, University of Occupational and Environmental Health, 1-1, Iseigoaka, Yahatanishi-Ku, Kitakyushu 807-8555, Fukuoka, Japan
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12
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Srinivas CR, Sethy M. Occupational Dermatoses. Indian Dermatol Online J 2022; 14:21-31. [PMID: 36776171 PMCID: PMC9910518 DOI: 10.4103/idoj.idoj_332_22] [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: 06/06/2022] [Revised: 08/12/2022] [Accepted: 08/14/2022] [Indexed: 12/30/2022] Open
Abstract
Occupational skin diseases (OSDs) are one of the major problems in working life. Among occupational diseases, 30-45% are skin diseases. Contact dermatitis accounts for the greatest part (95%) of OSDs. It adversely affects the quality of life of workers. Classification of OSD is too difficult as there are geographical variations in the occupational groups affected. However, commonly affected occupational groups are agricultural workers, healthcare workers, construction workers, metal workers, cleaners, housekeepers, food handlers, hairdressers, beauticians, and mechanics. Because of the unorganized workplace, lack of a proper notification system for occupational dermatoses, and under-reporting of cases, there is a paucity of information regarding the magnitude of the problem of OSD in India. Although in India many studies have been conducted on individual small occupational groups, data on the complete epidemiology of OSD is limited. In this article, we have tried to compile the common OSDs in various occupations.
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Affiliation(s)
- Chakravarthi R. Srinivas
- Department of Dermatology Venereology and Leprosy, Kalinga Institute of Medical Sciences (KIMS), KIIT Deemed to be University, Bhubaneswar, Odisha, India
| | - Mitanjali Sethy
- Department of Dermatology Venereology and Leprosy, Kalinga Institute of Medical Sciences (KIMS), KIIT Deemed to be University, Bhubaneswar, Odisha, India,Address for correspondence: Dr. Mitanjali Sethy, Assistant Professor, Department of Dermatology Venereology and Leprosy, Kalinga Institute of Medical Sciences (KIMS), KIIT Deemed to be University, Bhubaneswar - 751 024, Odisha, India. E-mail:
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13
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The prevalence of facial pressure injuries among nurses during COVID-19 pandemic and its relationship to COVID-19 infection. J Tissue Viability 2022; 31:699-706. [PMID: 36195528 PMCID: PMC9526514 DOI: 10.1016/j.jtv.2022.09.008] [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: 04/14/2022] [Revised: 08/12/2022] [Accepted: 09/25/2022] [Indexed: 02/04/2023]
Abstract
AIM The aim of this study was to investigate the prevalence of facial pressure injuries related to personal protective equipment use in nurses and the relationship with getting COVID-19 infection. DESIGN The study used descriptive and correlational online survey design. METHODS Nurses in Turkey were recruited via an electronic link sent to their social media platforms (e.g., Facebook, Instagram, Twitter), WhatsApp, and e-mail during the study: March-April 2021. Of them, 603 participants completed the survey form from all over Turkey. RESULTS/FINDINGS Facial pressure injuries develop in nurses due to use of personal protective equipment. The rates of facial pressure injuries were higher in the nurses who were younger (p=0.002) and those who had less experience years (p=0.005) than the other nurses. The statistically significant variables were determined as age, status of using face shield, status of wearing overalls and status of wearing shoe covers (p<0.05). We determined that facial pressure injuries were not significantly associated with getting COVID-19 infection (p>0,05). CONCLUSIONS This study showed that facial pressure injuries associated with personal protective equipment use among nurses, who work on the frontlines in the COVID-19 pandemic period, is highly prevalent. Experiencing facial pressure injuries did not have a significant effect on the participants' statuses of getting infected with COVID-19. Providing training in health institutions may present an effective strategy in lowering problems.
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14
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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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15
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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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16
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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: 3] [Impact Index Per Article: 1.5] [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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17
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Patel K, Nixon RL. Mask exemptions for facial skin diseases: are they warranted? Med J Aust 2022; 216:490. [PMID: 35445410 PMCID: PMC9115046 DOI: 10.5694/mja2.51513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 01/11/2022] [Accepted: 03/23/2022] [Indexed: 12/03/2022]
Affiliation(s)
- Kajal Patel
- Occupational Dermatology Research and Education Centre Skin Health Institute Melbourne VIC
| | - Rosemary L Nixon
- Occupational Dermatology Research and Education Centre Skin Health Institute Melbourne VIC
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18
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Cosansu NC, Yuksekal G, Kutlu O, Umaroglu M, Yaldız M, Dikicier BS. The Change in The Frequency and Severity of Facial Dermatoses and Complaints in Healthcare Workers During the COVID-19. J Cosmet Dermatol 2022; 21:3200-3205. [PMID: 35509253 PMCID: PMC9347995 DOI: 10.1111/jocd.15044] [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: 01/18/2022] [Revised: 04/19/2022] [Accepted: 05/02/2022] [Indexed: 11/27/2022]
Abstract
Background The coronavirus disease 2019 (COVID‐19) pandemic has led to a dramatic increase in the use of personal protective equipment (PPE). However, the increased use of PPEs may lead to facial skin complaints. Aims This survey study aims to evaluate the effect of the COVID‐19 pandemic on facial dermatoses and complaints. Methods A total of 1017 volunteers (age 18–60 years), consisting of healthcare workers, participated in the study. In the present study, healthcare professionals were screened for facial dermatoses and complaints between 1 and 15 April 2021 with an online survey. Results The vast majority of the survey were women (82.4%) and between 26 and 35 years old (49.2%). The most new‐onset facial complaints were acne (25.3%) and lip dryness (29.2%). Along with the pandemic, 50.9% of patients with seborrheic dermatitis had an increase in lesions. Another remarkable result was a 60.5% increase in acne complaints. Moreover, the rate of exacerbations of rosacea, melasma, and lip dryness was increased after the COVID‐19 pandemic (39.1%, 22.0%, and 42.7%, respectively). Exacerbations of seborrheic dermatitis, acne, and lip dryness have occurred more frequently in females when compared to males (p < 0.001). Conclusions The current pandemic has had serious impacts on facial dermatoses which had to be managed carefully. Compared to the pre‐pandemic period, there was a significant increase in the frequency and severity of complaints in facial dermatoses related to PPE. If the complaints that may develop due to PPE are known in advance, their development can be prevented by taking precautions against them.
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Affiliation(s)
- Nur Cihan Cosansu
- Sakarya University, Education and Research Hospital, Department of Dermatology, Sakarya, Turkey
| | - Gulcan Yuksekal
- Yenikent State Hospital, Department of Dermatology, Sakarya, Turkey
| | - Omer Kutlu
- Tokat Gaziosmanpaşa University, School of Medicine, Department of Dermatology and Venereology
| | - Mutlu Umaroglu
- Sakarya University, Sakarya Medical Faculty, Department of Biostatistics, Sakarya, Turkey
| | - Mahizer Yaldız
- Sakarya University, Education and Research Hospital, Department of Dermatology, Sakarya, Turkey
| | - Bahar Sevimli Dikicier
- Sakarya University, Education and Research Hospital, Department of Dermatology, Sakarya, Turkey
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19
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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: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [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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Tezcan B, Eraydin C, Karabacak BG. Protective equipment-related pressure ulcers in healthcare workers during COVID-19 pandemic: A systematic review. J Tissue Viability 2022; 31:213-220. [PMID: 35210162 PMCID: PMC8856964 DOI: 10.1016/j.jtv.2022.02.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 01/29/2022] [Accepted: 02/14/2022] [Indexed: 01/17/2023]
Abstract
AIM This systematic review was carried out to examine pressure ulcers in healthcare staff due to the use of protective equipment during COVID-19 pandemic and the precautions taken to prevent these injuries. METHOD Relevant studies were retrospectively searched. Seven English keywords identified from MESH were used while searching. The search was carried out in five international databases by trying various combinations of these words during February 15-25, 2021. This systematic review was updated by rescanning databases on December 20, 2021 and a total of 611 studies were attained. RESULTS 17 studies which met the study inclusion criteria, which were conducted mostly through online survey method in different study designs and which included a total of 24,889 healthcare professionals were examined. The incidence of PPE-related pressure ulcers was found to be between 30% and 92.8%. Grade I pressure ulcers were the most common (44.1%-82%). The incidence of skin problems except PPE-related pressure ulcers such as itching, redness and dry skin was found to be between 42.8-88.1%. Risk factors that frequently played a role in the development of PPE-related pressure ulcers and other skin problems were longer use of PPE and sweating. PPE-related pressure ulcers and other skin problems were more frequent over the nose (nasal bone/nasal bridge), ears, forehead and cheeks. PPE-related itching, redness and dry skin mostly occurred. Several dressing applications were found to be effective in the prevention of PPE-related pressure ulcers and other skin problems that might develop especially on the facial region. CONCLUSION PPE-related pressure ulcers and other skin problems were found to be higher among healthcare professionals. Data regarding the sealing of dressing applications against viral transmission in the prevention of PPE-related pressure ulcers and other skin problems are limited. It is estimated that future studies will be performed to prevent device-related pressure ulcers in healthcare workers. It is suggested that there is a need to conduct studies with larger samples where expert researchers make observations for pressure ulcers in order to determine the prevalence and incidence of PPE-related pressure ulcers.
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Affiliation(s)
- Bilge Tezcan
- Marmara University, Institute of Health Science, Nursing Department, İstanbul, Turkey.
| | - Canan Eraydin
- Marmara University, Institute of Health Science, Nursing Department, İstanbul, Turkey.
| | - Bilgi Gülseven Karabacak
- Marmara University Faculty of Health Sciences, Department of Nursing Fundamentals, Istanbul, Turkey.
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Yang R, Ke Q, Chan SW, Liu Y, Lin H, Li W, Zhu J. The relationship between frontline nurses’ skin lesions and their anxiety and depression during the COVID‐19 pandemic: exploring the mediating role of fear and resilience. J Nurs Manag 2022; 30:1903-1912. [PMID: 35434883 PMCID: PMC9115287 DOI: 10.1111/jonm.13638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 03/25/2022] [Accepted: 04/12/2022] [Indexed: 11/28/2022]
Abstract
Aim Background Methods Results Conclusion Implications for nursing management
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Affiliation(s)
- Rumei Yang
- School of Nursing, Nanjing Medical University Nanjing city Jiangsu Province P. R. China
| | - Qiaohong Ke
- Department of Gynaecology, Women and Children's Hospital, School of Medicine Xiamen University Xiamen Fujian Province P. R. China
| | | | - Yang Liu
- School of Medicine Xiamen University Xiamen Fujian Province P.R. China
| | - Huicong Lin
- School of Medicine Xiamen University Xiamen Fujian Province P.R. China
| | - Wengang Li
- School of Medicine Xiamen University Xiamen Fujian Province P.R. China
| | - Jiemin Zhu
- School of Medicine Xiamen University Xiamen Fujian Province P.R. China
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22
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Assessment of Hygiene Indicators When Using Gloves by Transport Workers in Russia during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031198. [PMID: 35162223 PMCID: PMC8834553 DOI: 10.3390/ijerph19031198] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 01/13/2022] [Accepted: 01/19/2022] [Indexed: 12/18/2022]
Abstract
The COVID-19 outbreak represents a global public health emergency. National governments have gradually introduced restrictive measures. Using respiratory protective equipment (face masks) and gloves was essential practice without specific infection control measures or guidelines. This study aimed to assess hygiene indicators when using gloves by transport workers in Russia during the COVID-19 pandemic and to develop integral indicators and recommendations for wearing gloves for workers for whom this is a mandatory requirement. For this purpose, 1103 transport workers were surveyed using a questionnaire. We investigated the hygiene aspects of gloves and evaluated the bacterial contamination of the contact side of the gloves based on the wash results. We assessed the socio-demographic characteristics of the respondents, the duration of the work shift, the frequency of use of types of gloves, skin manifestations, the degree of comfort, and bacterial growth. We carried out the ranking according to comfort, the absence of adverse dermatological reactions when wearing gloves, and bacterial contamination of the inner surface of the gloves. It has been identified that it is necessary to use a comprehensive assessment of gloves to create a register of protective equipment, taking into account the frequency with which it was worn, the severity of the skin condition, comfort, and bacterial contamination.
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Malathy PA, Daniel SJ, Venkatesan S, Priya BY. A Clinico Epidemiological Study of Adverse Cutaneous Manifestations on Using Personal Protective Equipment Among Health Care Workers During Covid Pandemic in a Tertiary Care Centre. Indian J Dermatol 2022; 67:478. [PMID: 36578707 PMCID: PMC9792000 DOI: 10.4103/ijd.ijd_1157_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Background COVID-19 (Coronavirus Disease 2019) pandemic was caused by a novel coronavirus. The frontline health care workers (HCW), wearing personal protective equipment (PPE) for a longer duration can result in a spectrum of adverse skin reactions. Recognizing occupationally induced adverse skin manifestations from PPE is necessary to avoid skin damage and risk of infections and to maintain compliance. Aim This study aimed to determine the prevalence, clinical characteristics of adverse cutaneous manifestations due to PPE, and also the contributing epidemiological factors among HCW in a tertiary care institute. Materials and Methods This cross-sectional study was conducted for a period of one month. Four hundred fifteen health care workers who used PPE continuously for >4 hours voluntarily participated in this study. By using a self-administered online questionnaire, the information and clinical photographs were collected. Results The prevalence of adverse skin manifestations was 62.1% (258). The prevalence was more common in females. Mask-related facial skin problems were most commonly reported. Of 74 participants with pre-existing acne lesions, 35 (8.4%) reported acne flare-ups after using PPE. Increased sweating (22.6%) and itching (11%) were the most commonly noted symptoms. Conclusion This study provides an insight into the prevalence of adverse skin reactions due to prolonged PPE usages, such as N95 masks and latex gloves in particular. Hence dermatological screening of HCW at regular intervals is inevitable to facilitate early management and prevent inadvertent protocol breaches. Further, it proposes the importance of raising proper safety measures to effectively reduce the COVID positivity rate among HCW by minimizing and preventing occupationally induced dermatosis.
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Affiliation(s)
- Priyavathani A. Malathy
- From the Department of Dermatology, Madras Medical College and RGGGH, Chennai, Tamil Nadu, India
| | - Samuel J. Daniel
- From the Department of Dermatology, Madras Medical College and RGGGH, Chennai, Tamil Nadu, India
| | - S Venkatesan
- From the Department of Dermatology, Madras Medical College and RGGGH, Chennai, Tamil Nadu, India
| | - B Yuva Priya
- From the Department of Dermatology, Madras Medical College and RGGGH, Chennai, Tamil Nadu, India,Address for correspondence: Dr. Yuva Priya B, Department of Dermatology, Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu - 600 003, India. E-mail:
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