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Deng K, Tong X, Chen S, Wu G, Shi K, Chen H, Tan Y, Liao J, Zhou J, Zhao J. Exploration of the Changes in Facial Microbiota of Maskne Patients and Healthy Controls Before and After Wearing Masks Using 16 S rRNA Analysis. J Epidemiol Glob Health 2024:10.1007/s44197-024-00240-6. [PMID: 38771488 DOI: 10.1007/s44197-024-00240-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 04/30/2024] [Indexed: 05/22/2024] Open
Abstract
Whether in the field of medical care, or in people's daily life and health protection, the importance of masks has been paid more and more attention. Acne, the most common complication after wearing masks, which is also called maskne, has been successfully introduced into the common language as a common topic of dermatologist consultations. This study aims to study the changes of microflora in maskne patients and healthy controls before and after wearing masks. In the summer of 2023, we collected a total of 50 samples from 15 maskne patients and 10 healthy controls before and after wearing surgical masks for a long time. 16 S ribosomal DNA sequencing and identification technology with V3-V4 variable region were adopted to explore the microbiome changes caused by mask wearing, analyze the changes in microbial diversity, and make interaction network. LDA effect size analysis was used to identify which bacteria showed significant changes in their relative abundance from phylum to genus. After wearing a mask, the microbiome of the maskne patients changed significantly more than that of the healthy controls, with both α diversity and β diversity lower than those of maskne patients before wearing masks and those of healthy controls after wearing masks. Co-occurrence network analysis showed that compared with other groups, the network of maskne patients after wearing masks for a long time had the lowest connectivity and complexity, but the highest clustering property, while the opposite was true for healthy controls. Many microbes that are potentially beneficial to the skin decreased significantly after wearing a mask. There was almost no difference in healthy controls before and after wearing a mask.
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Affiliation(s)
- Kexin Deng
- Department of Burn and Plastic Surgery, The Third Xiangya Hospital, Central South University, No. 138, Tongzipo Road, Yuelu District, Changsha City, Hunan Province, China
| | - Xiaofei Tong
- Department of Burn and Plastic Surgery, The Third Xiangya Hospital, Central South University, No. 138, Tongzipo Road, Yuelu District, Changsha City, Hunan Province, China
| | - Shuyue Chen
- Department of Burn and Plastic Surgery, The Third Xiangya Hospital, Central South University, No. 138, Tongzipo Road, Yuelu District, Changsha City, Hunan Province, China
| | - Guojun Wu
- School of Basic Medical Science, Central South University, No. 172, Tongzipo Road, Changsha City, Hunan Province, China
| | - Ke Shi
- Department of Burn and Plastic Surgery, The Third Xiangya Hospital, Central South University, No. 138, Tongzipo Road, Yuelu District, Changsha City, Hunan Province, China
| | - Hao Chen
- School of Basic Medical Science, Central South University, No. 172, Tongzipo Road, Changsha City, Hunan Province, China
| | - Yurong Tan
- School of Basic Medical Science, Central South University, No. 172, Tongzipo Road, Changsha City, Hunan Province, China
| | - Junlin Liao
- Center of Burn & Plastic and Wound Healing Surgery, The First Affiliated Hospital, Hengyang Medical School Hengyang, NO.69, Chuanshan Road, Hengyang, Hunan, China
| | - Jianda Zhou
- Department of Burn and Plastic Surgery, The Third Xiangya Hospital, Central South University, No. 138, Tongzipo Road, Yuelu District, Changsha City, Hunan Province, China.
| | - Junxiang Zhao
- Department of Burn and Plastic Surgery, Nanshi Hospital Affiliated to Henan University, No. 1081, Zhongzhou West Road, Nanyang City, Henan Province, China.
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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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ALPARSLAN AL, YÜKSEL K, SUTTHANUT K. Analysis of Surgical Masks Adverse Effects on Facial Skin in Long Term Usage During COVID-19 Pandemic. Turk J Pharm Sci 2024; 21:1-6. [PMID: 38528785 PMCID: PMC10982884 DOI: 10.4274/tjps.galenos.2023.82353] [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: 11/22/2022] [Accepted: 02/12/2023] [Indexed: 02/25/2023]
Abstract
Objectives During the coronavirus disease-2019 pandemic, masks have become mandatory for protection against the virus transmitted by breathing. This study examined the impact of surgical masks used daily on civilian facial skin. Materials and Methods Moisture, elasticity, pore, melanin, acne, wrinkle, and sensitivity parameters of 83 volunteers were measured numerically using an API-100 skin analyzer and camera recordings. Numerical values were compared following the device's algorithm calibrated according to age, gender, and race. Finally, the obtained data were statistically evaluated and compared with the averages. Results Pore, melanin, acne, and wrinkle parameters were higher without gender discrimination, whereas moisture and elasticity parameters were low. While a significant increase was observed in women for sensitivity, the increase was not statistically significant in men. Conclusion The negative effects of long-term daily wearing of surgical masks on facial skin were statistically significant. Therefore, taking outdoor breaks during mask use, washing the face intermittently, using moisturizing and purifying cosmetic products, and anti-wrinkle effects have been proposed to reduce the possible defects.
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Affiliation(s)
| | - Kıvanç YÜKSEL
- Ege University Center for Drug Research and Development and Pharmacokinetic Applications (ARGEFAR), İzmir, Türkiye
| | - Khaetthareeya SUTTHANUT
- Khon Kaen University Faculty of Pharmaceutical Sciences, Department of Pharmaceutical Chemistry, Khon Kaen, Thailand
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Yin W, Lee YC. How different face mask types affect interpersonal distance perception and threat feeling in social interaction. Cogn Process 2024:10.1007/s10339-024-01179-z. [PMID: 38492094 DOI: 10.1007/s10339-024-01179-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 02/05/2024] [Indexed: 03/18/2024]
Abstract
Due to the easing of the pandemic, public policies no longer mandated people to wear masks. People can choose to no wear or wear different types of masks based on personal preferences and safety perceptions during daily interaction. Available information about the influence of face mask type on interpersonal distance (IPD) by different aging populations is still lacking. Thus, this study aimed to investigate the face mask type (no wear, cloth, medical and N95 mask) and age group effect of avatars (children, adults and older adults) on IPD perception, threat feeling and physiological skin conductance response under active and passive approaching. One hundred participants with a range from 20 to 35 years old were recruited for this study. Twelve avatars (three age groups*four face mask conditions) were created and applied in a virtual reality environment. The results showed that age group, mask type and approach mode had significant effects on IPD and subjective threat feeling. A non-significant effect was found on skin conductance responses. Participants maintained a significantly longer IPD when facing the older adults, followed by adults and then children. In the passive approach condition, people tended to maintain a significantly greater comfort distance than during the active approach. For the mask type effect, people kept a significantly largest and shortest IPD when facing an avatar with no mask or the N95 mask, respectively. A non-significant IPD difference was found between the N95 and medical mask. Additionally, based on the subjective threat feeling, facing an avatar wearing a medical mask generated the lowest threat feeling compared to the others. The findings of this study indicated that wearing medical masks provided a benefit in bringing people closer for interaction during specific situations. Understanding that mask-wearing, especially medical one, brought to shortest IPD when compared to the unmasked condition can be utilized to enhance safety measures in crowded public spaces and health-care settings. This information could guide the development of physical distancing recommendations, taking into account both the type of mask and the age groups involved, to ensure the maintenance of appropriate distances.
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Affiliation(s)
- Wenjing Yin
- School of Design, South China University of Technology, Guangzhou, China
| | - Yu-Chi Lee
- Department of Industrial Engineering and Management, National Taipei University of Technology, 1, Sec. 3, Zhongxiao E. Rd., Taipei, 10608, Taiwan.
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Fronteira I, Mathews V, Dos Santos RLB, Matsumoto K, Amde W, Pereira A, de Oliveira APC, Craveiro I, Chança R, Boniol M, Ferrinho P, Poz MRD. Impacts for health and care workers of Covid-19 and other public health emergencies of international concern: living systematic review, meta-analysis and policy recommendations. HUMAN RESOURCES FOR HEALTH 2024; 22:10. [PMID: 38273317 PMCID: PMC10809470 DOI: 10.1186/s12960-024-00892-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 01/11/2024] [Indexed: 01/27/2024]
Abstract
BACKGROUND Health and care workers (HCW) faced the double burden of the SARS-CoV-2 pandemic: as members of a society affected by a public health emergency and as HWC who experienced fear of becoming infected and of infecting others, stigma, violence, increased workloads, changes in scope of practice, among others. To understand the short and long-term impacts in terms of the COVID-19 pandemic and other public health emergencies of international concern (PHEICs) on HCW and relevant interventions to address them, we designed and conducted a living systematic review (LSR). METHODS We reviewed literature retrieved from MEDLINE-PubMed, Embase, SCOPUS, LILACS, the World Health Organization COVID-19 database, the ClinicalTrials.org and the ILO database, published from January 2000 until December 2021. We included quantitative observational studies, experimental studies, quasi-experimental, mixed methods or qualitative studies; addressing mental, physical health and well-being and quality of life. The review targeted HCW; and interventions and exposures, implemented during the COVID-19 pandemic or other PHEICs. To assess the risk of bias of included studies, we used the Johanna Briggs Institute (JBI) Critical Appraisal Tools. Data were qualitatively synthetized using meta-aggregation and meta-analysis was performed to estimate pooled prevalence of some of the outcomes. RESULTS The 1013 studies included in the review were mainly quantitative research, cross-sectional, with medium risk of bias/quality, addressing at least one of the following: mental health issue, violence, physical health and well-being, and quality of life. Additionally, interventions to address short- and long-term impact of PHEICs on HCW included in the review, although scarce, were mainly behavioral and individual oriented, aimed at improving mental health through the development of individual interventions. A lack of interventions addressing organizational or systemic bottlenecks was noted. DISCUSSION PHEICs impacted the mental and physical health of HCW with the greatest toll on mental health. The impact PHEICs are intricate and complex. The review revealed the consequences for health and care service delivery, with increased unplanned absenteeism, service disruption and occupation turnover that subvert the capacity to answer to the PHEICs, specifically challenging the resilience of health systems.
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Affiliation(s)
- Inês Fronteira
- Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Rua da Junqueira, 100, 1349-008, Lisbon, Portugal.
- National School of Public Health, Public Health Research Centre, Comprehensive Health Research Center, NOVA University of Lisbon, Avenida Padre Cruz, 1600-560, Lisbon, Portugal.
| | - Verona Mathews
- School of Public, Health University of the Western Cape, South Africa, Private Bag X17, Bellville, 7535, Republic of South Africa
| | - Ranailla Lima Bandeira Dos Santos
- Escola Nacional de Saúde Pública Sérgio Arouca, Fundação Osvaldo Cruz, Rua Leopoldo Bulhões, 1480 - Manguinhos, Rio de Janeiro, Brazil
| | - Karen Matsumoto
- Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rua São Francisco Xavier 524 - 7º andar, Blocos D e E - Maracanã, Rio de Janeiro, RJ, 20550-013, Brazil
| | - Woldekidan Amde
- School of Public, Health University of the Western Cape, South Africa, Private Bag X17, Bellville, 7535, Republic of South Africa
| | - Alessandra Pereira
- Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rua São Francisco Xavier 524 - 7º andar, Blocos D e E - Maracanã, Rio de Janeiro, RJ, 20550-013, Brazil
| | - Ana Paula Cavalcante de Oliveira
- Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rua São Francisco Xavier 524 - 7º andar, Blocos D e E - Maracanã, Rio de Janeiro, RJ, 20550-013, Brazil
| | - Isabel Craveiro
- Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Rua da Junqueira, 100, 1349-008, Lisbon, Portugal
| | - Raphael Chança
- Instituto Nacional de Cancer, Ministério da Saúde, Rua Marquês de Pombal, 125, Centro, Rio de Janeiro, RJ, 20230240, Brazil
| | - Mathieu Boniol
- Health Workforce Department, World Health Organization, Av. Appia 20, 1202, Geneva, Switzerland
| | - Paulo Ferrinho
- Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Rua da Junqueira, 100, 1349-008, Lisbon, Portugal
| | - Mario Roberto Dal Poz
- Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rua São Francisco Xavier 524 - 7º andar, Blocos D e E - Maracanã, Rio de Janeiro, RJ, 20550-013, Brazil
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Jain S, Dempsey K, Clezy K, Bradd P. Evaluation of health worker acceptance and tolerance of respirators in clinical practice-An Australian perspective. Am J Infect Control 2024; 52:46-53. [PMID: 37454930 DOI: 10.1016/j.ajic.2023.07.003] [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: 04/20/2023] [Revised: 07/05/2023] [Accepted: 07/06/2023] [Indexed: 07/18/2023]
Abstract
BACKGROUND One of the main infection prevention and control measures introduced during the COVID-19 pandemic was the focused application of respiratory protection to ensure health worker safety and the effective use of personal protective equipment. However, user acceptance of these strategies is paramount in sustainable compliance. This study explores various aspects of respirator use and provides recommendations to improve and maximize health worker safety. The aim of this study was to understand the relationship between respirator (P2/N95) comfort and user experience toward respiratory protection. The aim of this study was to understand the relationship between respirator (P2/N95) comfort and user experience toward respiratory protection. METHODS The nonexperimental cross-sectional design study was conducted in New South Wales, Australia between November and December 2022 using an anonymous self-administered online questionnaire in Microsoft Forms. RESULTS Of 2,514 respondents, 65% reported to have used a respirator every working day with only a few using a respirator once weekly or less (9%). Almost all respondents had completed at least one quantitative fit test (96%) prior to the survey. Fifty-nine percent reported to have experienced discomfort from wearing a respirator and the most reported adverse effect was difficulty communicating (64%), followed by skin irritation or acne (62%) and headache (56%). CONCLUSIONS Despite somewhat less favorable ratings on comfort and communication, health workers are in favor of respiratory protection. However, a focus on tolerance of respirators and strategies to address adverse effects from prolonged respirator use must be considered when implementing policies and procedures. Moreover, resources must be allocated to improve the design, breathability, and sustainability of a respirator along with education and training on how to use respiratory protection safely and effectively.
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Affiliation(s)
- Susan Jain
- Healthcare Associated Infection Program, Clinical Excellence Commission, Sydney, New South Wales, Australia.
| | - Kathy Dempsey
- Healthcare Associated Infection Program, Clinical Excellence Commission, Sydney, New South Wales, Australia
| | - Kate Clezy
- Healthcare Associated Infection Program, Clinical Excellence Commission, Sydney, New South Wales, Australia
| | - Patricia Bradd
- Healthcare Associated Infection Program, Clinical Excellence Commission, Sydney, New South Wales, Australia
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Altin L, Akbiyik A. Skin problems associated with using of personal protective equipment in COVID-19 intensive care units. Nurs Crit Care 2023; 28:985-995. [PMID: 37495564 DOI: 10.1111/nicc.12956] [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: 09/29/2022] [Revised: 06/21/2023] [Accepted: 07/05/2023] [Indexed: 07/28/2023]
Abstract
BACKGROUND Health care workers, who worked intensively during the COVID-19 pandemic, faced some problems, including skin problems, due to the personal protective equipment (PPE) they used to control the spread of infection. AIMS This study aimed to identify the skin problems because of using PPE by nurses during the delivery of health care in three COVID-19 intensive care units (ICUs) within one hospital service. STUDY DESIGN The study was designed as a cross-sectional survey. The study was conducted with nurses working in three intensive care units in the metropolitan districts of Ankara, Turkey. The data were collected online with a questionnaire developed by the researchers between December 2021 and June 2022. RESULTS In this study, 82/120 (68.33%) nurses responded to the questionnaire at least once during the distribution period. The mean of the duration of PPE utilization per each time including goggles, N95 mask, bonnet, face-shield, gloves, boots/shoe covers and coverall was 3.76 ± 1.36 h. The proportion of nurses who experienced any skin problem related to any PPE at least two or more was 74/82 (90.24%). The proportion of pressure sores, acne, skin reaction including allergic dermatitis or contact urticaria, and regional pain varied between 4.9% and 79.3%. The proportion of nurses who applied any protective application to prevent skin problems was 53.66%. Among the protective applications, pressure-reducing surfaces were used the most. The use of protective applications for goggles (p = .010), bonnet (p = .000) and face shield (p = .000) effectively reduced PPE-related skin problems. CONCLUSION During the pandemic, nurses faced a wide variety of skin problems because of PPEs. It may be beneficial to design a study programme that reduces the duration of PPEs use in clinics. In addition, there is a need for effective protective applications to prevent skin problems and new development of PPE that do not cause skin problems. RELEVANCE TO CLINICAL PRACTICE In the pandemic, skin problems have developed because of the use of PPE in nurses who provide health care, intensively. These problems, which were not seen as a priority in the pandemic, may adversely affect the health of nurses, their performance in the treatment and care process and their work quality.
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Affiliation(s)
- Leyla Altin
- Internal Diseases Intensive Care Unit, Ankara University Faculty of Medicine İbni Sina Hospital, Ankara, Turkey
| | - Ayşe Akbiyik
- Faculty of Health Sciences, Department of Nursing, Fundamental of Nursing, Izmir Katip Çelebi University, İzmir, Turkey
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Zhang J, Jiang P, Zhang Y, Liu W, Kong S, Hou X, Qi Z, Sun Y, Jiang G. Effects of wearing masks during COVID-19 pandemic on the composition and diversity of skin bacteria and fungi in medical workers. Front Microbiol 2023; 14:1274050. [PMID: 37965552 PMCID: PMC10640980 DOI: 10.3389/fmicb.2023.1274050] [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: 08/08/2023] [Accepted: 10/10/2023] [Indexed: 11/16/2023] Open
Abstract
Background Although studies have shown that wearing masks can affect the skin microbiome, more detailed and comprehensive research on wearing masks needs to be further explored. Objective This study aimed to characterize the influence of mask wearing on the diversity and structural characteristics of the facial skin microbial community of medical staff during the COVID-19 pandemic by means of metagenomic sequencing (mNGS). Methods A total of 40 samples were taken by swabbing the cheek in the 2 × 2 cm2 area before and after wearing the masks. DNA was extracted for metagenomic sequencing. Results A statistically significant decrease was found in the α diversity between BN and AN groups and between B2 h and A2 h groups. BN and AN mean groups before and after 8 h of wearing the medical protective mask (N95), including 10 volunteers, respectively. B2 h and A2 h mean groups before and after 8 h of wearing masks, including 10 volunteers changing mask every 2 h, respectively. The β diversity was found to be statistically reduced between BS and AS groups (p = 0.025), BN and AN groups (p = 0.009), and B2 h and A2 h group (p = 0.042). The fungal beta diversity was significantly decreased in every group before and after wearing masks. The main bacteria on the face before and after wearing masks were Cutibacterium (68.02 and 71.73%). Among the fungi, Malassezia predominated the facial skin surface before and after wearing masks (35.81 and 39.63%, respectively). Conclusion Wearing different types of masks and changing masks according to different frequency will have different effects on the facial skin's microbiota.
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Affiliation(s)
- Jingxi Zhang
- Department of Dermatology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Peiyun Jiang
- Department of Dermatology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
- Xuzhou Medical University, Xuzhou, China
| | | | - Wenlou Liu
- Department of Oncology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Shujing Kong
- Department of Dermatology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Xiaoyang Hou
- Department of Dermatology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Zuoyao Qi
- Department of Dermatology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
- Xuzhou Medical University, Xuzhou, China
| | - Yujin Sun
- Department of Dermatology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
- Xuzhou Medical University, Xuzhou, China
| | - Guan Jiang
- Department of Dermatology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
- Xuzhou Medical University, Xuzhou, China
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Megha KB, Reshma S, Amir S, Krishnan MJA, Shimona A, Alka R, Mohanan PV. Comprehensive Risk Assessment of Infection Induced by SARS-CoV-2. Mol Neurobiol 2023:10.1007/s12035-023-03682-4. [PMID: 37817031 DOI: 10.1007/s12035-023-03682-4] [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: 06/19/2023] [Accepted: 09/28/2023] [Indexed: 10/12/2023]
Abstract
The pandemic COVID-19 (coronavirus disease 2019) is caused by the severe acute respiratory syndrome corona virus 2 (SARS-CoV-2), which devastated the global economy and healthcare system. The infection caused an unforeseen rise in COVID-19 patients and increased the mortality rate globally. This study gives an overall idea about host-pathogen interaction, immune responses to COVID-19, recovery status of infection, targeted organs and complications associated, and comparison of post-infection immunity in convalescent subjects and non-infected individuals. The emergence of the variants and episodes of COVID-19 infections made the situation worsen. The timely introduction of vaccines and precautionary measures helped control the infection's severity. Later, the population that recovered from COVID-19 grew significantly. However, understanding the impact of healthcare issues resulting after infection is paramount for improving an individual's health status. It is now recognised that COVID-19 infection affects multiple organs and exhibits a broad range of clinical manifestations. So, post COVID-19 infection creates a high risk in individuals with already prevailing health complications. The identification of post-COVID-19-related health issues and their appropriate management is of greater importance to improving patient's quality of life. The persistence, sequelae and other medical complications that normally last from weeks to months after the recovery of the initial infection are involved with COVID-19. A multi-disciplinary approach is necessary for the development of preventive measures, techniques for rehabilitation and strategies for clinical management when it comes to long-term care.
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Affiliation(s)
- K B Megha
- Toxicology Division, Biomedical Technology Wing, Sree Chitra Tirunal Institute for Medical Sciences and Technology (Govt. of India), Poojapura, Trivandrum, Kerala, 695 012, India
| | - S Reshma
- Toxicology Division, Biomedical Technology Wing, Sree Chitra Tirunal Institute for Medical Sciences and Technology (Govt. of India), Poojapura, Trivandrum, Kerala, 695 012, India
| | - S Amir
- Toxicology Division, Biomedical Technology Wing, Sree Chitra Tirunal Institute for Medical Sciences and Technology (Govt. of India), Poojapura, Trivandrum, Kerala, 695 012, India
| | - M J Ajai Krishnan
- Toxicology Division, Biomedical Technology Wing, Sree Chitra Tirunal Institute for Medical Sciences and Technology (Govt. of India), Poojapura, Trivandrum, Kerala, 695 012, India
| | - A Shimona
- CSIR-Institute of Microbial Technology, Sector 39-A, Chandigarh, 160036, India
- Academy of Scientific and Innovation Research (AcSIR), Ghaziabad, 201002, India
| | - Rao Alka
- CSIR-Institute of Microbial Technology, Sector 39-A, Chandigarh, 160036, India
- Academy of Scientific and Innovation Research (AcSIR), Ghaziabad, 201002, India
| | - P V Mohanan
- Toxicology Division, Biomedical Technology Wing, Sree Chitra Tirunal Institute for Medical Sciences and Technology (Govt. of India), Poojapura, Trivandrum, Kerala, 695 012, India.
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Choi H, Ha JH, Kang HC, Seo WS, Bin BH. The Protective Effects of Moisturizer Containing Potentilla anserina Extract in the Topical Treatment of Skin Damage Caused by Masks. Int J Mol Sci 2023; 24:14294. [PMID: 37762597 PMCID: PMC10531951 DOI: 10.3390/ijms241814294] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 09/13/2023] [Accepted: 09/18/2023] [Indexed: 09/29/2023] Open
Abstract
The use of face masks during the COVID-19 pandemic resulted in significant societal changes, particularly for individuals with sensitive skin. To address this issue, the researchers explored traditional medicine and identified Potentilla anserina extract as a potential solution due to its anti-inflammatory and moisturizing effects. This research investigated how this extract influences skin hydration, barrier function, and itching. The findings revealed that the extract had a hydrating effect by elevating Aquaporin-3 (AQP3) expression. Additionally, the study demonstrated that the extract improved skin barrier function, with Filaggrin (FLG) expression being approximately three times higher (p < 0.001) in the Potentilla-anserina-extract-treated group compared to the control group and the genes associated with itching being reduced. In this process, we researched and developed HPβCD (hydroxypropyl-β-cyclodextrin)-Liposome containing Potentilla anserina extract, gradually and sustainably releasing the active components of the Potentilla anserina extract. During four weeks of clinical trials involving individuals wearing masks for over 6 h a day, a moisturizer containing Potentilla anserina extract demonstrated a notable reduction in skin redness. Hemoglobin values (A.U.), which serve as indicators of skin redness, showed decreases of 5.06% and 6.74% in the test area inside the mask after 2 and 4 weeks, respectively, compared to the baseline measurements. Additionally, the moisturizer containing Potentilla anserina extract notably decreased Trans Epidermal Water Loss (TEWL), with reductions of 5.23% and 9.13% observed in the test area inside the mask after 2 and 4 weeks, respectively. The moisturizer, especially in the test area treated with the extract-containing moisturizer, significantly enhanced skin hydration compared to the control group. The Corneometer values (A.U) exhibited notable increases of 11.51% and 15.14% in the test area inside the mask after 2 and 4 weeks, respectively. These discoveries emphasize the potential of Potentilla anserina extract and its utility in tackling skin issues caused by mask wearing, including enhancing moisture, fortifying the skin's barrier, and alleviating itching. These results indicate that moisturizers incorporating specific ingredients provide greater benefits compared to conventional moisturizers.
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Affiliation(s)
- Hyeong Choi
- Department of Applied Biotechnology, Ajou University, Suwon 16499, Republic of Korea;
- R&D Complex, Kolmar Korea, Seocho 06800, Republic of Korea;
| | - Ji Hoon Ha
- R&D Complex, Kolmar Korea, Seocho 06800, Republic of Korea;
| | - Hee Cheol Kang
- Green & Biome Customizing Laboratory, GFC Co., Ltd., Hwaseong 18471, Republic of Korea;
| | - Won Sang Seo
- Green & Biome Customizing Laboratory, GFC Co., Ltd., Hwaseong 18471, Republic of Korea;
| | - Bum-Ho Bin
- Department of Applied Biotechnology, Ajou University, Suwon 16499, Republic of Korea;
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Luong Nguyen Dac T, Vu Thi Thuy T, Le Dang Mai A, Nguyen Thi Bich L, Huynh Thi Xuan T. Factors associated with mask-induced dermatosis and its impact on patients' quality of life. Dermatol Reports 2023; 15:9694. [PMID: 37822983 PMCID: PMC10563030 DOI: 10.4081/dr.2023.9694] [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: 02/21/2023] [Accepted: 02/24/2023] [Indexed: 10/13/2023] Open
Abstract
The COVID-19 pandemic continues to have a significant impact on society, both physically and mentally. Mask use in public places has been made mandatory in many countries, as it is one of the most effective methods to prevent transmission of the virus. However, continuous mask usage has been associated with the emergence of various cutaneous diseases in the areas of contact with the mask. This study aimed to evaluate the effect of various cutaneous manifestations resulting from mask use on patients' quality of life through a questionnaire survey. This was a cross-sectional study conducted at a hospital from May to July 2022. Patients who had experienced skin symptoms related to mask use in the past or present were included in the study. Participants completed the questionnaire with informed consent. A total of 165 participants participated in the survey, with the most common complaint being itching (58.18%), followed by acne (52.73%). Itching was found to have the highest dermatology life quality index score. Patients with skin redness had a lower quality of life compared to those without it. Prolonged mask-wearing can result in skin diseases that can seriously impair patients' quality of life.
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12
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Santosa A, Choi E, Chandran NS. Impact of Hand Hygiene and Mask-Wearing Practices on Hand Eczema and Facial Acne Incidence in Healthcare Workers during COVID-19 Outbreak. Ann Dermatol 2023; 35:313-317. [PMID: 37550232 PMCID: PMC10407335 DOI: 10.5021/ad.20.189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 02/19/2021] [Accepted: 04/13/2021] [Indexed: 08/09/2023] Open
Affiliation(s)
- Adinia Santosa
- Division of Dermatology, National University Hospital, Singapore
| | - Ellie Choi
- Division of Dermatology, National University Hospital, Singapore
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Lee YH, Kim H, Heo DW, Ahn IS, Park HK. Oral microbiome of the inner surface of face masks and whole saliva during the COVID-19 pandemic. FRONTIERS IN ORAL HEALTH 2023; 4:1178020. [PMID: 37521176 PMCID: PMC10379621 DOI: 10.3389/froh.2023.1178020] [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: 03/02/2023] [Accepted: 07/03/2023] [Indexed: 08/01/2023] Open
Abstract
Wearing a face mask was strongly recommended during the COVID-19 pandemic. The purpose of this study was to investigate the diversity of the oral microbiome, the abundance of each bacterium on the inner surface of the mask, and the effects of xerostomia on the microbiota. The study was conducted on 55 generally healthy adults (45 women and 10 men, mean age 38.18 ± 12.49 years). Unstimulated flow rate (UFR) and stimulated flow rate (SFR) were measured in whole saliva samples collected for each condition. The 14 major oral bacterial species, including Porphyromonas gingivalis (P. gingivalis), Lactobacillus casei (L. casei), Tannerella forsythia (T. forsythia), and Treponema denticola (T. denticola) on the inner surface of the mask and in the UFR and SFR samples, were analyzed by real-time PCR. We found that the total DNA copy number of oral bacteria was significantly higher in UFR and SFR than in the mask (p < 0.001). On the inner surface of the mask, P. gingivalis and L. casei were the most abundant Gram-negative and Gram-positive species, respectively. The oral microbiome profile of the mask differed from that of the UFR and SFR samples. Shannon's diversity index was also significantly higher in the UFR and SFR than in the mask (2.64 ± 0.78, 2.66 ± 0.76, and 1.26 ± 1.51, respectively, p < 0.001). Shannon's diversity index of UFR and SFR had a significant positive correlation with each other (r = 0.828, p < 0.001), but there was no significant relationship with Shannon's diversity index of mask. Red complex abundance, including P. gingivalis, T. forsythia, and T. denticola, was significantly higher in UFR than in the mask. Interestingly, the DNA copy number of each of the 14 bacteria, the total bacterial amount, and Shannon's diversity index did not differ in the absence or presence of xerostomia (p > 0.05). In summary, oral bacteria migrated to and existed on the inside of the mask, and the presence of xerostomia did not affect the bacterial profiles. The inner surface of the mask had an independent oral microbiome profile, although this showed lower quantity and diversity than the UFR and SFR samples.
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Affiliation(s)
- Yeon-Hee Lee
- Department of Orofacial Pain and Oral Medicine, Kyung Hee University Dental Hospital, Kyung Hee University School of Dentistry, Seoul, Republic of Korea
| | - Hyeongrok Kim
- Life Sciences Lab, Denomics, Seoul, Republic of Korea
| | - Dae Wook Heo
- Life Sciences Lab, Denomics, Seoul, Republic of Korea
| | - In-Suk Ahn
- Life Sciences Lab, Denomics, Seoul, Republic of Korea
| | - Hee-Kyung Park
- Department of Oral Medicine and Oral Diagnosis, Dental Research Institute, Seoul National University School of Dentistry, Seoul, Republic of Korea
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Bhatia R, Aggarwal R, Ravichandrane B, Rajendrakumar K, Ahmed A, Sahoo D, Soni KD, Khanna P, Trikha A. Early Doffing among Frontline Healthcare Workers Working in the COVID Areas in Resource-Limited Settings: Lessons Learned and Interventions Taken. Indian J Occup Environ Med 2023; 27:209-213. [PMID: 38047167 PMCID: PMC10691514 DOI: 10.4103/ijoem.ijoem_46_22] [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: 02/08/2022] [Revised: 08/22/2022] [Accepted: 09/02/2022] [Indexed: 12/05/2023] Open
Abstract
Background In the fight against the pandemic, personal protective equipment (PPE) has played a vital role. However, working with PPE has its own difficulties and problems. The aim of this study was to find out the reasons of early doffing, that is, in doffing in emergency situations before the shift among healthcare workers (HCWs) working in PPE in the COVID areas in resource-limited settings. Methods This cross-sectional, survey-based study was carried out on healthcare workers involved in direct care of patients with COVID-19 in tertiary care COVID center, India. The questionnaire was sent as a Google form through email and social media platforms like WhatsApp and Facebook. The data was reported as the mean ± SD for continuous variables and as the percentage for categorical variables. Findings Among 252 healthcare workers who participated in the survey, 145 (57.5%) participants doffed early on 300 occasions. Out of these 145, 50% doffed early only once and rest doffed early multiple times. The most common reason of early doffing was found to be breach in PPE (15.33%) followed by fogging (14%) and headache (12%), and most commonly, breach was in mask or coverall/gown (32.6% each). Conclusion Although PPE decreases the risk of infection, it is challenging for HCWs to work in PPE leading to instances of early doffing. The most common reason for early doffing in our study was the breach in PPE and the most common component of breach was found to be mask and coverall/gown. Therefore, we suggest that the proper sizes of the PPE should be made available and proper training in donning should be imparted to HCWs working in PPE.
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Affiliation(s)
- Ridhima Bhatia
- Department of Anaesthesiology, Critical Care and Pain Medicine, JPN Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India
| | - Richa Aggarwal
- Critical and Intensive Care, JPN Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India
| | - Banupriya Ravichandrane
- Department of Anaesthesiology, Critical Care and Pain Medicine, JPN Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India
| | - Karthiga Rajendrakumar
- Department of Anaesthesiology, Critical Care and Pain Medicine, JPN Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India
| | - Aasim Ahmed
- Department of Anaesthesiology, Critical Care and Pain Medicine, JPN Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India
| | - Debasis Sahoo
- Department of Anaesthesiology, Critical Care and Pain Medicine, JPN Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India
| | - Kapil Dev Soni
- Critical and Intensive Care, JPN Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India
| | - Puneet Khanna
- Department of Anaesthesiology, Critical Care and Pain Medicine, JPN Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India
| | - Anjan Trikha
- Department of Anaesthesiology, Critical Care and Pain Medicine, JPN Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India
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15
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Alghader MRM, Valvi D, de la Hoz RE. Transmission and Risk Factors of COVID-19 among Health Care Workers. Semin Respir Crit Care Med 2023; 44:340-348. [PMID: 37015285 DOI: 10.1055/s-0043-1766118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/06/2023]
Abstract
Coronavirus disease 2019 (COVID-19) poses a significant occupational risk factor to health care workers (HCWs). As in previous events, this occupational risk amplifies and compounds the adverse impact of the pandemic. We conducted a narrative review summarizing risk factors associated with severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) transmission in HCWs. We searched for original observational studies (including case-control, cross-sectional, prospective and retrospective cohorts) using PubMed, Scopus, and Google Scholar. A total of 22 articles were reviewed, including eligible English articles published between April 2020 and May 2022. Job category, work environment, personal protective equipment (PPE) noncompliance, lack of PPE awareness and training, unvaccinated status, and competing community and household exposures were identified as risk factors for SARS-CoV-2 transmission among HCWs. Effective measures to protect HCWs from SARS-CoV-2 need to account for the identified occupational risk factors. Identifying and understanding COVID-19 risk factors among HCWs must be considered a public health priority for policy makers to mitigate occupational and community transmission in current and future epidemics.
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Affiliation(s)
- Majdi R M Alghader
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Damaskini Valvi
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Rafael E de la Hoz
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York
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16
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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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17
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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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18
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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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 02/17/2023] [Indexed: 04/08/2023] Open
Abstract
BackgroundAs face masks became mandatory in most countries during the COVID-19 pandemic, adverse effects require substantiated investigation.MethodsA 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.ResultsWe 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).DiscussionMasks 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.ConclusionFace 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 registrationhttps://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
- *Correspondence: Kai Kisielinski
| | - 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
- Pritam Sukul
| | - Andreas Sönnichsen
- Internal Medicine, Clinical Medicine, Private Practice, Gesundheit für Österreich e.V. (Health for Austria), Vienna, Austria
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19
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Lujia C, Hanlong Z, Hui S, Jieying T, Jianmin Y, Weiwei L. Mask-related adverse skin reactions in orientals during COVID-19: Prevalence, social-psychological impacts and risk factors for acne exacerbation. J Cosmet Dermatol 2023; 22:370-377. [PMID: 36606398 DOI: 10.1111/jocd.15593] [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: 09/20/2022] [Revised: 11/26/2022] [Accepted: 12/13/2022] [Indexed: 01/07/2023]
Abstract
BACKGROUND COVID-19 pandemic has caused mask-related skin problems on health-care professions, yet very few studies have investigated the prevalence in oriental general population. OBJECTIVE To investigate the prevalence of mask-related adverse skin reactions in Orientals, to explore psychological influence, to identify risk factors for mask-related acne exacerbation. METHODS We performed a survey through social media. Participant demographics, skin condition before and after COVID-19, and the influence of adverse skin on social-psychological conditions were collected. We compared characteristics between individuals with or without acne exacerbation, and we performed a logistic regression to identify risk factors. RESULTS Six hundred and six participants (62.3%) responded the survey and 23.3% complained their facial acnes become exacerbated since COVID-19. The social-psychological impact of acnes is more prevalent in women. Risk factors for mask-related acne exacerbation were occupation as health-care workers (OR = 1.861, p = 0.027), prolonged wearing of N95 masks (OR = 3.167, p = 0.001), and touching of acnes (OR = 2.65, p = 0.002). Sex, pre-existed acnes, and prolonged wearing time per day are also associated with acne exacerbation. CONCLUSIONS Mask-related adverse skin reactions are common in Orientals, and could lead to negative social-psychological effects.
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Affiliation(s)
- Chen Lujia
- Department of Plastic Surgery, Beijing Tsinghua Changgung Hospital Medical Center, Tsinghua University, Beijing, China
| | - Zheng Hanlong
- Department of Orthopedics, Beijing Jishuitan Hospital, Fourth Clinical College of Peking University, Beijing, China
| | - Shao Hui
- Department of Plastic Surgery, Beijing Tsinghua Changgung Hospital Medical Center, Tsinghua University, Beijing, China
| | - Tang Jieying
- Department of Plastic Surgery, Beijing Tsinghua Changgung Hospital Medical Center, Tsinghua University, Beijing, China
| | - Yang Jianmin
- Department of Plastic Surgery, Beijing Tsinghua Changgung Hospital Medical Center, Tsinghua University, Beijing, China
| | - Li Weiwei
- Department of Plastic Surgery, Beijing Tsinghua Changgung Hospital Medical Center, Tsinghua University, Beijing, China
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Chen JQ, Zhang XQ, Shen JH, Guo YF, Lei GF, Tong L, Wang H, Li DH. The Relationship Between Mindfulness, Fatigue, and Perceived Symptoms Among Frontline Nurses Who Performed Nucleic Acid Sample Collection During the COVID-19 in China: A Cross-Sectional Study. Psychol Res Behav Manag 2023; 16:1165-1180. [PMID: 37077763 PMCID: PMC10108863 DOI: 10.2147/prbm.s401764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 04/05/2023] [Indexed: 04/21/2023] Open
Abstract
Objective Given the immense stress faced by medical staff during the COVID-19 pandemic, this study aimed to evaluate the relationship between mindful attention awareness, fatigue, and perceived symptoms among frontline nurses who performed nucleic acid sample collection during the COVID-19 pandemic, to reduce their fatigue and help them cope with perceived uncomfortable symptoms. Methods A convenience sampling method was used to survey nurses who travelled to Hainan for nucleic acid sampling in August 2022 using an online (WeChat) questionnaire. A total of 514 frontline nurses who performed nucleic acid tests completed the questionnaire. The questionnaire covered basic demographic information, Mindful Attention Awareness Scale (MAAS) ratings, and Fatigue Severity Scale (FSS) ratings. Spearman correlation analysis was used to separate the relationship between MASS and FSS, and univariate and multivariate factor analyses were used to explore the relevant influences contributing to the occurrence of fatigue. Results A total of 514 individuals completed the survey,93.97% (n=483) were female, mean age was 31.15 ± 5.7, MASS score was 69.01 ± 13.53, and 296 (57.59%) nurses experienced symptoms of fatigue during the auxiliary period. Spearman correlation analysis showed that FSS was associated with MASS. Multifactorial analysis showed that sex, age, marital status, fertility status, years of work, adaptation to dietary habits, hidrorrhea, and MAAS scores affected the presence of fatigue symptoms among the medical staff in Hainan (P<0.05). Conclusion The psychological status of frontline nurses undergoing nucleic acid testing during the pandemic was poor, and the appearance of fatigue symptoms could be effectively reduced by increasing levels of positive thinking among medical staff to help them cope with public health emergencies.
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Affiliation(s)
- Jian-qin Chen
- Department of Nursing, The First People’s Hospital of Changde City, Changde, Hunan Province, People’s Republic of China
| | - Xue-qing Zhang
- Department of Nursing, The First People’s Hospital of Changde City, Changde, Hunan Province, People’s Republic of China
| | - Jin-hua Shen
- Department of Nursing, The First People’s Hospital of Changde City, Changde, Hunan Province, People’s Republic of China
| | - Ya-fen Guo
- Department of Nursing, The First People’s Hospital of Changde City, Changde, Hunan Province, People’s Republic of China
| | - Guang-feng Lei
- Department of Nursing, The First People’s Hospital of Changde City, Changde, Hunan Province, People’s Republic of China
| | - Li Tong
- Department of Nursing, The First People’s Hospital of Changde City, Changde, Hunan Province, People’s Republic of China
| | - Hui Wang
- Department of Nursing, The First People’s Hospital of Changde City, Changde, Hunan Province, People’s Republic of China
| | - De-hui Li
- Department of Infectious Diseases, The First People’s Hospital of Changde City, Changde, Hunan Province, People’s Republic of China
- Correspondence: De-hui Li, Department of Infectious Diseases, The First People’s Hospital of Changde City, 818 Ren min Road, Changde, Hunan Province, People’s Republic of China, Email
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Ghozali DRA, Indrastiti R, Ratnaningrum K. Type and Duration of Mask Use Related To Acne Vulgaris During The Pandemic Period. JOURNAL OF HEALTH SCIENCES 2022. [DOI: 10.33086/jhs.v15i03.2875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023] Open
Abstract
The masks' use has been a suggested strategy to counter COVID-19 transmission throughout this disease outbreak; however, wearing masks tightly closed for an extended period can cause acne vulgaris. The mask's form and duration of use are two factors that may affect the occurrence of acne vulgaris. Therefore, more research is needed to determine the impact of using masks on the prevalence of acne vulgaris. This study aimed to analyze the relationship between the type and duration of mask use and the prevalence of acne vulgaris in the citizens of Kawistowindu Village during the pandemic. This study used an analytical-observational study with a cross-sectional approach, with a sample of 63 people who met the inclusion and exclusion criteria throughout the neighborhood of RT.02 RW.01 Kawistowindu Village. The sample was chosen using a simple random sampling technique. Questionnaire forms, history-taking instruments, and physical examination techniques were used to collect data—the analysis used the Chi-Square test. The results showed that during the pandemic era, there was a significant correlation between the type of mask and the duration of mask use with the occurrence of acne vulgaris (p=0.000; p=0.004). In conclusion, in the pandemic era, the mask form and duration of mask use could be linked to acne vulgaris
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22
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Kumar P, Radha G, Muthukrishnan M, Chandrasekaran B, Subbiah P, Raman J. Cutaneous Manifestations Associated with COVID-19 Infection in a COVID-Designated Hospital in North Chennai - A Descriptive Cross-Sectional Study. Indian Dermatol Online J 2022; 14:67-71. [PMID: 36776182 PMCID: PMC9910528 DOI: 10.4103/idoj.idoj_279_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: 05/14/2022] [Revised: 09/07/2022] [Accepted: 09/12/2022] [Indexed: 12/30/2022] Open
Abstract
Background Coronavirus disease 2019 (COVID-19) affects different organ systems, including the skin. There are reports on cutaneous manifestations of COVID-19 available in the literature. In this study, we have tried to describe the dermatological signs of COVID-19 in different categories of patients. Materials and Methods A descriptive cross sectional study was conducted to describe various cutaneous manifestations of COVID-19 in different categories of reverse transcriptase polymerase chain reaction (RT-PCR)-positive COVID-19 patients in a COVID-designated tertiary care hospital. Approval was obtained from the Institutional Ethical Committee, and 5460 RT-PCR-confirmed COVID-19-positive patients were included under five categories. Investigators following a strict COVID protocol examined and documented the findings. Investigations and treatment were carried out as per the protocol, and the study was conducted for a period of 6 months. Results Out of the 5460 patients studied, 1.9% patients had cutaneous manifestations. Vasculitis (24%) and maculo papular rash (19%) were the common findings. The incidence of vasculitis was 44.4%, 61%, and 6.6% in categories A, B, and C, respectively. Maculopapular rash and urticaria were the common findings in categories D and E, respectively. COVID digit was seen in only one case. Other manifestations such as acne, adverse drug reaction, erythroderma, and bullous disorders were also noted. Conclusion Cutaneous manifestations because of vascular pathology were the most common association in severe COVID-19, which indicates that the presence of vasculitic skin signs correlated with disease severity and elevated d-dimer values. Urticaria and maculo-papular rash were transient and did not give any clue to the diagnosis or severity of the disease.
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Affiliation(s)
- Parimalam Kumar
- Prof & Head Department of Dermatology, Madras Medical College, Chennai, Tamil Nadu, India,Address for correspondence: Dr. Parimalam Kumar, No 4, East Ellaiamman Koil Street, Dr. Radhakrishnan Nagar, Thiruottiyur, Chennai - 600 019, Tamil Nadu, India. E-mail:
| | - Guru Radha
- Assistant Surgeon, Govt Leprosy Training Centre, Arangandanallur, Thirukkoilur, Tamil Nadu, India
| | | | | | - Pravinkumar Subbiah
- Assistant Surgeon, Govt Headquarters Hospital, Manaparai, Trichy, Tamil Nadu, India
| | - Jagan Raman
- Assistant Prof, Department of Dermatology Indira Medical College, Thiruvallur, Tamil Nadu, India
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23
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Anczyk S, Stępień M, Raczyński M, Anczyk A, Woźniakowska M, Miziołek B, Polak K, Bergler‐Czop B. The impact of face masks on acne-prone skin in Polish young adults during COVID-19 pandemic. Dermatol Ther 2022; 35:e15922. [PMID: 36218217 PMCID: PMC9874778 DOI: 10.1111/dth.15922] [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: 05/15/2022] [Revised: 09/10/2022] [Accepted: 10/08/2022] [Indexed: 01/27/2023]
Abstract
COVID-19 pandemic raised many problems for patients with acne-prone skin: a limited access to health care services, the necessity of developing telemedical consultations also in dermatology, and the usage of face masks. The aim of the study was to investigate the influence of respiratory protective measures (type of masks, wearing time during the day) on declared skin condition in patients already diagnosed with acne or reporting acne for the first time. The study was conducted in Poland among 1420 responders using the original authors' questionnaire, of which 1274 responders were included in the final sample. Acne exacerbations were reported as being more frequent and more severe in women than in men. Changing cosmetic products, facial skin decontamination before or after applying masks, the number of days per week that a mask was worn were related to acne exacerbation. The type of mask had no significant impact on the occurrence of acne lesions. Respondents noted that masks contribute significantly to skin condition worsening by exacerbating existing and causing new acne lesions. This phenomenon was particularly observable in women, in whom, according to the research results, new lesions appeared much more frequently. Therefore, there is a need to develop new ways of limiting acne exacerbation during COVID-19 pandemic.
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Affiliation(s)
- Stanisław Anczyk
- Student Scientific Club of the Department of DermatologyMedical University of SilesiaKatowicePoland
| | - Maciej Stępień
- Student Scientific Club of the Department of DermatologyMedical University of WarsawWarsawPoland
| | - Michał Raczyński
- Student Scientific Club of the Department of DermatologyMedical University of SilesiaKatowicePoland
| | - Adam Anczyk
- Institute of PsychologyJesuit University Ignatianum in KrakówKrakówPoland
| | - Maja Woźniakowska
- Ludwik Rydygier Collegium Medicum in BydgoszczNicolaus Copernicus University in ToruńToruńPoland
| | - Bartosz Miziołek
- Chair and Department of DermatologyMedical University of SilesiaKatowicePoland
| | - Karina Polak
- Doctoral SchoolMedical University of SilesiaKatowicePoland
| | - Beata Bergler‐Czop
- Chair and Department of DermatologyMedical University of SilesiaKatowicePoland
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Guan X, Lin J, Han J, Gao X, Zhang Y, Hu B, Guidoin R, Wang L. Prolonged Use of Surgical Masks and Respirators Affects the Protection and Comfort for Healthcare Workers. MATERIALS (BASEL, SWITZERLAND) 2022; 15:ma15227918. [PMID: 36431403 PMCID: PMC9696921 DOI: 10.3390/ma15227918] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Revised: 11/01/2022] [Accepted: 11/07/2022] [Indexed: 05/24/2023]
Abstract
This study explored the ideal period for wearing masks to prevent the physiological and psychological problems associated with long-term face mask use during respiratory infections by healthcare workers. Breathing simulators, surgical masks (SM) and medical respirators (PM) were prepared for two to eight hours. Changes in the comfort of masks (facial skin temperature, breathing resistance, and moisture permeability) and protection (filtration efficiency, resistance to blood penetration, and colony count) were assessed. The results demonstrated that the masks offered efficient liquid-particle filtering even after eight hours of use. However, the number of bacterial colonies using PM and SM grew significantly after two and four hours, respectively. Concerning comfort, the inspiratory resistance of masks rose dramatically after two hours, whereas the moisture permeability declined considerably after four hours. In addition, skin temperature had a significant increase within two hours, which may result in facial discomfort. When conditions permitted, the hospital staff was instructed to replace their masks every two hours.
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Affiliation(s)
- Xiaoning Guan
- Key Laboratory of Textile Science and Technology, Ministry of Education, College of Textiles, Donghua University, Shanghai 201620, China
- Key Laboratory of Textile Industry for Biomedical Textile Materials and Technology, Donghua University, Shanghai 201620, China
| | - Jing Lin
- Key Laboratory of Textile Science and Technology, Ministry of Education, College of Textiles, Donghua University, Shanghai 201620, China
- Key Laboratory of Textile Industry for Biomedical Textile Materials and Technology, Donghua University, Shanghai 201620, China
| | - Jiaxiang Han
- Key Laboratory of Textile Science and Technology, Ministry of Education, College of Textiles, Donghua University, Shanghai 201620, China
- Key Laboratory of Textile Industry for Biomedical Textile Materials and Technology, Donghua University, Shanghai 201620, China
| | - Xiaodong Gao
- Department of Hospital Infection Management, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Ying Zhang
- Key Laboratory of Textile Science and Technology, Ministry of Education, College of Textiles, Donghua University, Shanghai 201620, China
- Key Laboratory of Textile Industry for Biomedical Textile Materials and Technology, Donghua University, Shanghai 201620, China
| | - Bijie Hu
- Department of Hospital Infection Management, Zhongshan Hospital, Fudan University, Shanghai 200032, China
- Department of Infectious Diseases, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Robert Guidoin
- LOEX, Division of Regenerative Medicine, Centre de Recherche du CHU, Université Laval, Quebec City, QU G1V 0A6, Canada
- Department of Surgery, Faculty of Medicine, Université Laval, Quebec City, QU G1V 0A6, Canada
| | - Lu Wang
- Key Laboratory of Textile Science and Technology, Ministry of Education, College of Textiles, Donghua University, Shanghai 201620, China
- Key Laboratory of Textile Industry for Biomedical Textile Materials and Technology, Donghua University, Shanghai 201620, China
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25
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Alamawi HO, Alruwaili MS, Alswayed SK, Alhumaidi WA, Aldabali SO, Alfalah HA. Mask-Induced Facial Dermatoses in the Saudi Arabian Population During the COVID-19 Pandemic: A Cross-Sectional Study. Cureus 2022; 14:e31151. [DOI: 10.7759/cureus.31151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/05/2022] [Indexed: 11/08/2022] Open
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26
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Alizadeh N, Darjani A, Rafiei R, Gharaeinejad K, Eftekhari H, Bahrami E, Rafiei E. Dermatologic problems associated with personal protective equipment in health-care workers managing COVID-19 patients. JOURNAL OF RESEARCH IN MEDICAL SCIENCES : THE OFFICIAL JOURNAL OF ISFAHAN UNIVERSITY OF MEDICAL SCIENCES 2022; 27:80. [PMID: 36438073 PMCID: PMC9693753 DOI: 10.4103/jrms.jrms_921_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Revised: 04/23/2022] [Accepted: 07/11/2022] [Indexed: 12/01/2022]
Abstract
BACKGROUND The safety of health-care workers (HCWs) during the COVID-19 pandemic is a major concern worldwide. Dermatological problems due to personal protective equipment are annoying issues. We aimed to evaluate dermatological adverse events following the use of these protections in HCWs managing COVID-19 patients. MATERIALS AND METHODS One hundred and fifty-six workers managing COVID-19 patients were enrolled in this cross-sectional study. We conducted face-to-face interviews to collect the data and focused mainly on protection type and mucocutaneous symptoms with new onset or exaggeration after this equipment. RESULTS Dermatological problems following protective equipment usage occurred mainly during the 1st week (65.4%). The most common site of skin involvement was the nose (82.7%) and the most frequent visible complaints were the pressure effect and erythema on the nose in 80.8% and 57.7% of cases, respectively. There was a significant association between mask type and facial skin problems (P < 0.001). The main symptoms were itching (21.8% scalp, 39.1% face and body) and burning sensation (14.1% scalp, 23.7% face and body). Skin desquamation (37.2%) and dorsal hand dermatitis (41.66%) were significantly more frequent in atopic participants (P = 0.02 and P = 0.01, respectively). Hand involvement was significantly associated with frequency of hand washing (odds ratio = 1.97, 95% confidence interval = 1.04-3.74, P = 0.03). CONCLUSION We found that skin problems related to protective equipment were common and frequently located on the face mainly due to facial masks. These complications should be prevented by proper use of this equipment.
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Affiliation(s)
- Narges Alizadeh
- Skin Research Center, Department of Dermatology, Razi Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Abbas Darjani
- Skin Research Center, Department of Dermatology, Razi Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Rana Rafiei
- Skin Research Center, Department of Dermatology, Razi Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran,Address for correspondence: Dr. Rana Rafiei, Department of Dermatology, Skin Research Center, School of Medicine, Razi Hospital, Guilan University of Medical Sciences, Rana Rafiei, Rasht, Iran. E-mail:
| | - Kaveh Gharaeinejad
- Skin Research Center, Department of Dermatology, Razi Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Hojat Eftekhari
- Skin Research Center, Department of Dermatology, Razi Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Elahe Bahrami
- Skin Research Center, Department of Dermatology, Razi Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Elahe Rafiei
- Razi Clinical Research Development Unit, Guilan University of Medical Sciences, Rasht, Iran
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27
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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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28
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Novák M, Gloor C, Wicki E, Herb D, Schibli A, Richner G. Assessment of a novel, easy-to-implement, aerosolized H 2O 2 decontamination method for single-use filtering facepiece respirators in case of shortage. JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL HYGIENE 2022; 19:663-675. [PMID: 36107018 DOI: 10.1080/15459624.2022.2125519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The COVID-19 pandemic has affected the world and caused a supply shortage of personal protection equipment, especially filtering facepiece respirators (FFP). This has increased the risk of many healthcare workers contracting SARS-CoV-2. Various strategies have been assessed to tackle these supply issues. In critical shortage scenarios, reusing single-use-designed respirators may be required. Thus, an easily applicable and reliable FFP2 (or alike) respirator decontamination method, allowing safe re-use of FFP2 respirators by healthcare personnel, has been developed and is presented in this study. A potent and gentle aerosolized hydrogen peroxide (12% wt) method was applied over 4 hr to decontaminate various brands of FFP2 respirators within a small common room, followed by adequate aeration and storage overnight. The microbial efficacy was tested on unused respirator pieces using spores of Geobacillus stearothermophilus. Further, decontamination effectiveness was tested on used respirators after one 12-hr shift by swabbing before and after the decontamination. The effects of up to ten decontamination cycles on the respirators' functionality were evaluated using material properties, the structural integrity of the respirators, and fit tests with subjects. The suggested H2O2 decontamination procedure was proven to be (a) sufficiently potent (no microbial recovery, total inactivation of biological indicators as well as spore inoculum on critical respirator surfaces), (b) gentle as no significant damage to the respirator structural integrity and acceptable fit factors were observed, and (c) safe as no H2O2 residue were detected after the defined aeration and storage. Thus, this easy-to-implement and scalable method could overcome another severe respirator shortage, providing enough flexibility to draft safe, effective, and logistically simple crisis plans. However, as highlighted in this study, due to the wealth of design and material used in different models and brands of respirators, the decontamination process should be validated for each FFP respirator model before its field implementation.
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Affiliation(s)
- Martin Novák
- Research and Strategic Business Development, SKAN AG, Allschwil, Switzerland
| | - Christian Gloor
- Federal Office for Civil Protection, Spiez Laboratory, Spiez, Switzerland
| | - Esther Wicki
- Division of Infectious Diseases and Hospital Epidemiology, Zurich City Hospital, Zurich, Switzerland
| | - Dorothea Herb
- Division of Infectious Diseases and Hospital Epidemiology, Zurich City Hospital, Zurich, Switzerland
| | - Adrian Schibli
- Division of Infectious Diseases and Hospital Epidemiology, Zurich City Hospital, Zurich, Switzerland
| | - Gilles Richner
- Federal Office for Civil Protection, Spiez Laboratory, Spiez, Switzerland
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29
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Wolszczak-Biedrzycka B, Bieńkowska A, Maksymowicz S. Adaptation of medical laboratory scientists to workplace hazards - experiences from the COVID-19 pandemic. Front Public Health 2022; 10:997049. [PMID: 36249256 PMCID: PMC9554429 DOI: 10.3389/fpubh.2022.997049] [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: 07/18/2022] [Accepted: 09/08/2022] [Indexed: 01/26/2023] Open
Abstract
The COVID-19 pandemic has dramatically changed healthcare personnel's working environment and sense of security. Medical laboratory scientists were also faced with new occupational challenges. They were tasked with performing novel tests for SARS-CoV-2 without being aware of the associated risks. At the beginning of the pandemic, strict sanitary requirements and the fear of becoming infected with the "new virus" were considerable sources of stress. However, these stress responses abated over time. The aim of this two-stage study was to explore the extent to which this group of medical professionals adapted to new working conditions 1 year after the outbreak of the pandemic. The study was conducted at the beginning of the fourth pandemic wave in Poland, i.e., between 10 September and 31 October 2021. The first stage was a pilot study that involved interviews with 14 medical laboratory scientists. The results were used to perform a survey of 294 laboratory scientists in the second stage. The study investigated the problems and fears faced by this professional group at the beginning of the pandemic, as well as changes in their attitudes during successive waves of COVID-19. The analyzed data demonstrated that most medical laboratory scientists had grown accustomed to the pandemic and workplace changes by the beginning of the fourth wave. The study also indicates that in addition to adequate means of personal protection, health professionals should also be provided with emotional support in times of pandemic.
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30
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Wyer M, Barratt R, Hor SY, Ferguson PE, Gilbert GL. Exploring healthcare workers' perspectives of video feedback for training in the use of powered air purifying respirators (PAPR) at the onset of the COVID-19 pandemic. BMC MEDICAL EDUCATION 2022; 22:688. [PMID: 36151565 PMCID: PMC9502944 DOI: 10.1186/s12909-022-03742-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 09/07/2022] [Indexed: 05/10/2023]
Abstract
BACKGROUND With the advent of COVID-19, many healthcare workers (HWs) in Australia requested access to powered air purifying respirators (PAPR) for improved respiratory protection, comfort and visibility. The urgency of the response at our hospital required rapid deployment of innovative training to ensure the safe use of PAPRs, in particular, a video-feedback training option to prepare HWs for PAPR competency. AIM To explore the feasibility, acceptability, and utility of video-feedback in PAPR training and competency assessment. METHODS Semi-structured interviews were conducted with 12 HWs, including clinicians from Intensive Care, Anaesthetics and Respiratory Medicine, at a large teaching hospital in Australia. FINDINGS Participants believed that the use of video-feedback in PAPR training was feasible, acceptable and useful. They described a variety of benefits to learning and retention, from a variety of ways in which they engaged with the personal video-feedback. Participants also described the impact of reviewing personalised practice footage, compared to generic footage of an ideal performance. CONCLUSION By conceptualising video-feedback using a pedagogical approach, this study contributes to knowledge around optimising methods for training HWs in PPE use, particularly when introducing a new and complex PPE device during an infectious disease outbreak.
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Affiliation(s)
- Mary Wyer
- Sydney Institute for Infectious Diseases, The University of Sydney, Level 6 Block K Westmead Hospital, Westmead, NSW 2145 Australia
- New South Wales Biocontainment Centre, Westmead Hospital, Cnr Darcy and Hawkesbury Rds, Westmead, Australia
| | - Ruth Barratt
- Sydney Institute for Infectious Diseases, The University of Sydney, Level 6 Block K Westmead Hospital, Westmead, NSW 2145 Australia
- New South Wales Biocontainment Centre, Westmead Hospital, Cnr Darcy and Hawkesbury Rds, Westmead, Australia
- Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW Australia
| | - Su-yin Hor
- Centre for Health Services Management, Faculty of Health, University of Technology Sydney, Sydney, NSW Australia
| | - Patricia E. Ferguson
- Sydney Institute for Infectious Diseases, The University of Sydney, Level 6 Block K Westmead Hospital, Westmead, NSW 2145 Australia
- New South Wales Biocontainment Centre, Westmead Hospital, Cnr Darcy and Hawkesbury Rds, Westmead, Australia
- Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW Australia
- Department of Infectious Diseases, Westmead hospital, Cnr Darcy and Hawkesbury Rds, Westmead, Australia
| | - Gwendolyn L. Gilbert
- Sydney Institute for Infectious Diseases, The University of Sydney, Level 6 Block K Westmead Hospital, Westmead, NSW 2145 Australia
- Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW Australia
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Rathi SK, Dsouza JM. Maskne: A New Acne Variant in Covid-19 Era. Indian J Dermatol 2022; 67:552-555. [PMID: 36865865 PMCID: PMC9971751 DOI: 10.4103/ijd.ijd_1054_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/04/2023] Open
Abstract
"Maskne" has been one of the negative spinoffs of the universally acceptable and effective role of face mask in containing the ongoing pandemic of SARS-CoV-2 virus or COVID 19. Several factors contribute to its aetiopathogenesis including heat, humidity, mechanical friction and microbiome dysbiosis in a complex interplay under the occlusive area of the mask. Clinically, the morphology is not very different from acne vulgaris with comedones and inflammatory acne, but in a characteristic distribution over a roughly circular area of face covered by mask. Since the use of face masks is likely to continue in the near future, measures like wearing a comfortably fitting mask of appropriate fabric, using disposable masks, increasing mask-free period when at safer places, avoiding unnecessary use of personal care products over the occluded skin, proper and gentle cleaning of the affected areas, intermittent mopping off of the excessive sebum and sweat and use of specific, topical and systemic therapy could help in its resolution.
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Affiliation(s)
- Sanjay K. Rathi
- From the Dr. Rathi's Skin Clinic, Siliguri, West Bengal, India
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Maskne-Dermatosis of a Pandemic. A Survey on the Impact of PPE on Facial Skin Among HCW and N-HCW in Poland. Dermatol Ther (Heidelb) 2022; 12:2297-2308. [PMID: 36048330 PMCID: PMC9434523 DOI: 10.1007/s13555-022-00796-w] [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: 06/14/2022] [Accepted: 08/12/2022] [Indexed: 12/03/2022] Open
Abstract
Introduction During the SARS-CoV-2 pandemic, personal protective equipment (PPE) became the new social norm for preventing COVID-19, but with an impact on the skin barrier. This study aimed to analyze the factors influencing PPE wearing, following hygiene rules, and effect on facial skin, including onset or exacerbation of dermatoses among healthcare workers (HCW) and non-healthcare workers (N-HCW). Methods In 2020, an original survey was carried out among 300 N-HCW and 60 HCW with 60 questions about using PPE and skin lesions experienced before and during the pandemic. Cross-sectional statistical analysis was completed to assess the interplay between environmental factors and maskne occurrence. Results The N-HCW group included 74% females and 26% males with an average age 24.67 ± 0.74. Among HCW respondents 91.7% were women and 8.3% were men, with an average age of 30.07 ± 0.36. All participants used PPE. Volunteers for N-HCW mainly chose a disposable (53.3%) and reusable masks (37.3%), while HCW preferred surgical (66.7%) and FFP2/FFP3/N95 masks (30%) and almost never used reusable masks (3.3%). HCW mainly spent 5–8 h with PPE, and N-HCW spent 1–4 h with PPE/day. Respondents with dermatological problems before the pandemic were more aware of the maskne and paid more attention to hygiene with PPE. Significantly, HCW experienced more severe facial skin lesions than N-HCW (p < 0.0001). There was statistical significance in following the basic hygienic rules of wearing PPE between both groups, where HCW practiced them more. Conclusions Maskne is a current and urgent problem to be cured. HCW should receive help if they develop maskne, such as limited time spent in PPE and treatment of the results of wearing it, as it is the main trigger of developing maskne. In addition, education about the correct use and choice of PPE should be improved. Supplementary Information The online version contains supplementary material available at 10.1007/s13555-022-00796-w.
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Bansal H, Mittal R, Kumar V. Maskne: A side effect of wearing face mask and face mask-wearing attitudes and behavior during 1 st, 2 nd and 3 rd waves of COVID-19 in rural population of Haryana. J Family Med Prim Care 2022; 11:5588-5592. [PMID: 36505531 PMCID: PMC9730977 DOI: 10.4103/jfmpc.jfmpc_378_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: 02/14/2022] [Revised: 05/11/2022] [Accepted: 05/20/2022] [Indexed: 11/07/2022] Open
Abstract
Introduction The term "maskne" originated during the SARS CoV-2 (COVID-19) pandemic; it is a variant of acne associated with continuous wearing of face mask. Maskne is mainly observational, and the most common cause of maskne is contact irritant dermatitis. Materials and methods The average mask use percentage by OPD cases visiting the hospital for a month in each wave of the COVID -19, that is, in the month of June 2020 during the first wave, in the month of April 2021 during the second wave and in the month of December 2021 during the third wave was calculated. We also included 30 patients with a diagnosis of irritant contact dermatitis aka maskne and 30 patients with diagnosis of acne vulgaris, all >18 years of age from April 2020 to December 2021. Results 66% of people wore masks coming to hospital in the month of June 2020 (first wave) which increased to 74% during the second wave in the month of April 2021 and during the third wave only 23% of people wore masks in the month of December 2021. Conclusion Maskne and worsening of acne vulgaris can be due to wearing of dirty face masks for longer duration. Use of moisturizers and regular "mask breaks" are important aspects in management of maskne.
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Affiliation(s)
- Himanshu Bansal
- Amity Institute of Neuropsychology & Neurosciences, Amity University, Noida, Uttar Pradesh, India,Address for correspondence: Himanshu Bansal, Civil Hospital Narwana, Narwana, Haryana, India. E-mail:
| | - Riya Mittal
- Department of Health and Family Welfare, Civil Hospital Narwana, Narwana, Haryana, India
| | - Vijay Kumar
- Department of Audiology & Speech-Language Pathology, Amity University, Gurgaon, Haryana, India
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Valk B, Ivanov NN, Nahhas A, Corwin K, Hansen K, Globerson J, LaCasse A, Corser W, Sikorski L. Mask-related skin changes among healthcare workers in a community-based hospital. J Osteopath Med 2022; 122:609-615. [PMID: 36028224 DOI: 10.1515/jom-2022-0097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 08/04/2022] [Indexed: 11/15/2022]
Abstract
CONTEXT During the COVID-19 pandemic, dermatologists within the Beaumont Farmington Hills' Dermatology program noticed an increase in conditions associated with mask wearing, such as "maskne" (acne in a mask distribution, thought to be caused by mask wearing), as well as worsening of previously diagnosed dermatologic conditions. OBJECTIVES The goal of our study was to explore various factors that impacted mask-related skin changes and how these skin changes affected quality of life. METHODS A cross-sectional study was performed. The primary 10-item survey instrument administered was the Dermatology Life Quality Index (DLQI). Respondents were asked a series of 10 additional questions concerning the degree to which abnormal mask-related skin conditions affect their skin symptoms, possible embarrassment/self-consciousness, and perceived impact of mask-related skin changes. A series of descriptive statistics, cross-tabulation charts, and graphical examinations of data was utilized to evaluate sample subgroup and outcome distributional patterns. Pearson r bivariate correlation coefficients between possible collinear predictive measures on the primary study outcome were calculated. A series of simple inferential chi-squared (Χ2) tests of independence were also conducted. RESULTS A total of 370 out of 430 (86.0%) Beaumont Health employees noticed some degree of skin changes since the work-hours face mask requirement was instituted, while 378 out of 430 (87.9%) felt that their skin was better when not wearing a mask. The majority of respondents, 283 (65.8%), reported having at least a little symptomatic skin (i.e., itchy, painful, sore, stinging) during the prior week. Furthermore, 72.3% reported that they were at least a little embarrassed or self-conscious of their skin. Chi-squared analysis of composite DLQI score categories by the number of types of masks utilized (Pearson X2=19.0, df=8, p=0.015), and some degree of symptomatic skin (Pearson X2=156.4, df=4, p<0.001) were found to be statistically significant. CONCLUSIONS A large number of healthcare workers are affected by mask-related skin changes. Further research should be directed at better understanding how skin changes associated with mask wearing impact one's quality of life and mental health.
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Affiliation(s)
- Brittany Valk
- Beaumont Health Systems - Department of Dermatology, Farmington Hills Campus, Farmington Hills, MI, USA
| | - Nedyalko N Ivanov
- Beaumont Health Systems - Department of Dermatology, Farmington Hills Campus, Farmington Hills, MI, USA
| | - Amanda Nahhas
- Beaumont Health Systems - Department of Dermatology, Farmington Hills Campus, Farmington Hills, MI, USA
| | - Katie Corwin
- Beaumont Health Systems - Department of Dermatology, Farmington Hills Campus, Farmington Hills, MI, USA
| | - Katrina Hansen
- Beaumont Health Systems - Department of Dermatology, Farmington Hills Campus, Farmington Hills, MI, USA
| | - Jeff Globerson
- Beaumont Health Systems - Department of Dermatology, Farmington Hills Campus, Farmington Hills, MI, USA
| | - Annette LaCasse
- Beaumont Health Systems - Department of Dermatology, Farmington Hills Campus, Farmington Hills, MI, USA
| | - William Corser
- Michigan State University Statewide Campus System, East Lansing, MI, USA
| | - Lynn Sikorski
- Beaumont Health Systems - Department of Dermatology, Farmington Hills Campus, Farmington Hills, MI, USA
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Kaur M, Kumar A, Kaur S, Nagar PK, Nagi M, Thakur V, Khan R. Adverse Effects of Personal Protective Equipment and Their Self-Practiced Preventive Strategies among the Covid-19 Frontline Health Care Workers. Hosp Top 2022:1-12. [PMID: 35983853 DOI: 10.1080/00185868.2022.2112523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
BACKGROUND Owing to the highly contagious nature of SARS-CoV-2, the use of personal protective equipment (PPE) among the healthcare workers (HCWs) is mandatory. However, PPE associated adverse effects are also there. OBJECTIVE To study the adverse effects associated with PPE and their preventive measures amongst the HCWs. MATERIAL AND METHODS A descriptive study was conducted among 200 HCWs working in a Covid center of a tertiary care center. The participants were sent the questionnaires online. Some of them not having smart phones were interviewed telephonically. Their information profile, the various adverse effects associated with PPE, and the preventive measures being practiced by them were noted. Data was analyzed using descriptive and inferential statistics. RESULTS Total 97% HCWs reported adverse effects with hazmat suit; 96% with N 95 mask; 92% with goggle and 78% with gloves. The adverse effects associated with the prolonged use of the mask were erythema; erosions and scar at the nasal bridge; ear pain; difficulty in breathing; and headache. Sixty-seven percent of the participants had sweating with the use of gloves, which led to cutaneous exfoliation such as dry hands (55%) and skin itching (43%). Moisturizers and natural oils were used to prevent the dryness of hands. For the pressure related injury over the nasal bridge due to N95 mask, participants used to apply Band-Aid (adhesive bandage) and cotton dressing. CONCLUSION Adverse skin reactions related to PPE are common among HCWs. Comprehensive assessment of the skin condition and awareness on adverse skin reactions should be advocated.
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Affiliation(s)
| | - Ashok Kumar
- National Institute of Nursing Education, PGIMER, Chandigarh, India
| | - Sukhpal Kaur
- National Institute of Nursing Education, PGIMER, Chandigarh, India
| | | | - Manisha Nagi
- National Institute of Nursing Education, PGIMER, Chandigarh, India
| | - Vishal Thakur
- Department of Dermatology, Venereology & Leprology, Himalayan Institute of Medical Sciences, Uttarakhand, India
| | - Reshma Khan
- Nursing Department, PGIMER, Chandigarh, India
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Justin LYS, Yew YW. Facial Dermatoses Induced by Face Masks: A Systematic Review and Meta-Analysis of Observational Studies. Contact Dermatitis 2022; 87:473-484. [PMID: 35980367 PMCID: PMC9539048 DOI: 10.1111/cod.14203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 08/08/2022] [Accepted: 08/14/2022] [Indexed: 12/04/2022]
Abstract
The use of masks for infection control was common in the COVID‐19 pandemic. As numerous cross‐sectional studies have suggested a link between the use of such masks and various facial dermatoses, a systematic review and meta‐analysis of published studies was conducted to evaluate this association, as well as potential risk factors for the development of such facial dermatoses. Observational studies were searched for in MEDLINE, EMBASE and the Cochrane Central Register. Thirty‐seven observational studies with a total of 29 557 study participants were identified. This study was performed according to the Preferred Reporting Items for Systematic reviews and Meta‐Analyses (PRISMA) 2020 checklist and quality was assessed via the Newcastle‐Ottawa Quality Assessment Scale., Overall prevalence of facial dermatoses was 55%. Individually, acne, facial dermatitis, itch and pressure injuries were consistently reported as facial dermatoses, with a pooled prevalence of 31%, 24%, 30% and 31%, respectively. Duration of mask‐wear was the most significant risk factor for the development of facial dermatoses (95% CI: 1.31–1.54, p < 0.001). Overall, facial dermatoses associated with mask wear are common, and consist of distinct entities. They are related to duration of use. Appropriate and tailored treatment is important to improve the outcomes for these affected patients.
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Affiliation(s)
- Lim Yi Shen Justin
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore.,Tan Tock Seng Hospital, Singapore
| | - Yik Weng Yew
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore.,National Skin Centre, Singapore
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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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Cretu S, Dascalu M, Salavastru CM. Acne care in health care providers during the
COVID
‐19 pandemic: A national survey. Dermatol Ther 2022; 35:e15753. [PMID: 36190007 PMCID: PMC9538804 DOI: 10.1111/dth.15753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Revised: 07/26/2022] [Accepted: 08/01/2022] [Indexed: 11/30/2022]
Abstract
The medical face mask, widely used by health care providers (HCPs) during the COVID‐19 pandemic, is reported to be associated with adverse reactions, among which acne is one of the most common. This study aims to evaluate treatment strategies employed by HCPs affected by acne in association with prolonged medical face mask use, their openness towards accessing telemedicine as a patient, and other lifestyle factors with potential influence on the evolution of their acne. Our online‐based cross‐sectional survey was distributed between December 17, 2020, and February 17, 2021, and targeted HCPs from different medical centers in Romania. From the n = 134 respondents, 50% reported current acne lesions and 56.7% required treatment. Of the latter, 65.8% self‐medicated and 34.2% sought medical advice. The most common treatment associations between anti‐acne topical products were: retinoids and salicylic acid (18.18%; n = 8), retinoids and benzoyl peroxide (13.64%; n = 6), salicylic acid and benzoyl peroxide (13.64%; n = 6), and azelaic acid together with salicylic acid (9.09%; n = 4). The health care provider responders were reluctant to use telemedicine, as only 14.2% participants were open to telemedicine. Our results suggest inadequate management of acne in HCPs using medical face masks. As with other occupational hazards and proper usage of personal protective equipment, HCPs should receive adequate screening, training, and treatment for this condition.
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Affiliation(s)
- Stefana Cretu
- “Carol Davila” University of Medicine and Pharmacy Bucharest Romania
- Dermatology Research Unit Colentina Clinical Hospital Bucharest Romania
| | - Mihai Dascalu
- Department of Computer Science Polytechnic University of Bucharest Romania
| | - Carmen Maria Salavastru
- “Carol Davila” University of Medicine and Pharmacy Bucharest Romania
- Pediatric Dermatology Department Colentina Clinical Hospital Bucharest Romania
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Hussain SA, Mahmood NMA, Mahmood TMA, Salih NAM, Abdulrahman ZS. Adverse effects associated with the use of N95 mask among health-care workers at the COVID-19 care units: A cross-sectional study in Sulaimani city, Iraq. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2022; 11:198. [PMID: 36003243 PMCID: PMC9393953 DOI: 10.4103/jehp.jehp_1001_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 11/09/2021] [Indexed: 06/15/2023]
Abstract
BACKGROUND Health-care workers have to use the N95 mask as a part of the protection kit during the COVID-19 pandemic. The adverse effects of such practice are not fully elucidated. The study aims to evaluate negative impacts of N95 face masks on health-care personnel at COVID-19 care units. MATERIALS AND METHODS One hundred and twenty-two health-care workers (aged 20-58 years) from various health-care settings in Sulaimani, Iraq, from January to August 2020, were enrolled in this prospective, cross-sectional study. The physiological variables (blood pressure, heart rate, and oxygen saturation) were recorded before putting on the N95 mask and postremoval of the mask. The incidence of adverse effects such as headache, difficulty breathing, redness, irritation, and dizziness were also reported as a number and percent at the end of the work shift. RESULTS There was a statistically significant difference in the physiological parameters after removal of the mask compared with baseline. Only diastolic pressure was significantly lower in those working >6 h when compared to those working 1-6 h. The changes in physiological markers were poorly and nonsignificantly associated with the duration of wearing the mask. Moreover, 67.2%-70.5% of the participants complain of headaches and breathing difficulties, while 45.9%-51.6% reported signs of itching, redness, and irritation. However, health-care workers who put on the face mask >6 h showed signs of headache, breathing difficulties, and itching at the exposed areas higher than those working for 1-6 h. CONCLUSION N95 mask negatively impacts the physiological variables of health-care providers. The adverse effects may lead to excessive exhaustion after long shifts in the intensive care unit during treatment of COVID-19 patients.
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Affiliation(s)
- Saad Abdulrahman Hussain
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Al-Rafidain University College, Baghdad, Iraq
| | - Naza Mohammed Ali Mahmood
- Department of Pharmacology and Toxicology, College of Pharmacy, University of Sulaimani, Kurdistan Region, Iraq
| | - Trefa Mohammed Ali Mahmood
- Department of Periodontics, Orthodontics and Prevention Dentistry, College of Dentistry, University of Sulaimani, Kurdistan Region, Iraq
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Puaratanaarunkon T, Washrawirul C, Chuenboonngarm N, Noppakun N, Asawanonda P, Kumtonrnrut C. The efficacy and safety of a facial serum containing snail secretion filtrate, Calendula officinalis, and Glycyrrhiza glaba root extract in the treatment of maskne: A randomized placebo-controlled Study. J Cosmet Dermatol 2022; 21:4470-4478. [PMID: 35763437 DOI: 10.1111/jocd.15190] [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: 05/05/2022] [Revised: 06/22/2022] [Accepted: 06/26/2022] [Indexed: 11/28/2022]
Abstract
INTRODUCTION During the ongoing COVID-19 outbreak, face mask use has increased and became a part of our daily lives. While wearing, prolonged contact time and microenvironmental change profoundly lead to an acne flare-up, defined as "maskne". AIMS We aimed to assess the efficacy and safety of snail secretion filtrate, Calendula officinalis, and Glycyrrhiza glaba root extract combination serum (SCGS) in treating the maskne. METHODS This was a randomized, double-blind, placebo-controlled trial study. This study enrolled 66 participants with mild to moderate maskne. The SCGS and placebo were randomly assigned for participants to use twice daily for 12 weeks. Percentage change of acne lesion count, acne severity by Investigator Global Evaluation Acne (IGEA), sebum levels, corneometry levels, transepidermal water loss (TEWL), erythema score by Visia®, and adverse events were evaluated 4-weekly at baseline to week 12. At week 12, all participants evaluated their satisfaction scores using a 10-point visual analog scale (VAS). RESULTS In the mask-covered area, the percent reduction in inflammatory acne lesions from the treatment group was significantly greater than the placebo group at all time points (coefficient of percentage change of inflammatory lesions = -33.89 [95% CI -65.24, -2.53]; p = 0.03). Also, a subgroup analysis with participants using concurrent acne treatments revealed similar results (12 participants, coefficient = -50.30 [95% -88.65, -11.95]; p = 0.01). However, there were no significant differences in non-inflammatory lesions, all skin biophysics, and VAS between groups. Adverse events were mild and occurred in a few cases in both groups. CONCLUSIONS The SCGS could significantly improved inflammatory acne lesions and had a favorable tolerability profile, suggesting its role as an adjunctive treatment in maskne.
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Affiliation(s)
- Thanaporn Puaratanaarunkon
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Chanudda Washrawirul
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Nunthanach Chuenboonngarm
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Nopadon Noppakun
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Pravit Asawanonda
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Chanat Kumtonrnrut
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.,Division of Dermatology, Department of Medicine, King Chulalongkorn Memorial Hospital, The Thai Red Cross Society, Bangkok, Thailand
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Darnall AR, Sall D, Bay C. Types and Prevalence of Adverse Skin Reactions Associated With Prolonged N95 and Simple Mask Usage during the COVID-19 Pandemic. J Eur Acad Dermatol Venereol 2022; 36:1805-1810. [PMID: 35748134 PMCID: PMC9349824 DOI: 10.1111/jdv.18365] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 06/02/2022] [Indexed: 12/01/2022]
Abstract
Background As the coronavirus 2019 (COVID‐19) pandemic persists on a global level, the chronic daily use of face masks within the healthcare system remains an important component of disease prevention and transmission. Increased use of personal protective equipment (PPE) may result in increased rates of occupational dermatoses and adverse skin reactions. Objectives The purpose of this study is to explore how chronic, prolonged use of N95 masks or simple surgical masks affects the prevalence of adverse skin reactions in Healthcare Workers (HCWs). Methods An optional, quantitative, web‐based survey was administered to patient‐facing HCWs across six network hospitals in a large metropolitan city. Data were analysed to assess the types and sites of adverse skin reactions, and to evaluate correlations between single mask use duration and adverse skin reactions. Results A total of 230 HCWs responded with 192 endorsing occupational dermatoses. Among the healthcare responders, (n = 192, 83.5%) experienced at least one adverse skin reaction. The most common occupational adverse skin reactions were acne (n = 133, 57.8%), dryness (n = 108, 47.0%) and redness (n = 105, 45.7%). Anatomical areas most commonly affected included the nasal bridge (n = 92, 40.0%), cheeks (n = 92, 40.0%) and chin (n = 91, 39.6%). Acne (P = 0.002), dryness/scaling (P = 0.002), increased pore size (0.003), itch (P = 0.003), nasal bridge scarring (P < 0.001), redness (P < 0.001), frictional erosions (P = 0.001) and ulcerations (P = 0.002) showed a positive correlation to duration of mask use. Conclusions Prolonged, daily usage of PPE is associated with numerous adverse skin reactions among HCWs with acne being the most commonly seen adverse reaction. Many adverse reactions are associated with prolonged use of single mask.
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Affiliation(s)
- Ariel R Darnall
- Department of Dermatology, Honorhealth, Scottsdale, Arizona, USA.,HonorHealth Internal Medicine Residency, Honorhealth, Scottsdale, Arizona, USA
| | - Dana Sall
- HonorHealth Internal Medicine Residency, Honorhealth, Scottsdale, Arizona, USA.,Department of Internal Medicine, University of Arizona College of Medicine - Phoenix, Phoenix, Arizona, USA
| | - Curt Bay
- Biostatistics, A.T. Still University, Mesa, Arizona, USA
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Tunçer Vural A. The development of acne vulgaris due to face masks during the pandemic, risk awareness and attitudes of a group of university students. J Cosmet Dermatol 2022; 21:5306-5313. [PMID: 35621247 PMCID: PMC9348015 DOI: 10.1111/jocd.15120] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 05/06/2022] [Accepted: 05/23/2022] [Indexed: 12/27/2022]
Abstract
BACKGROUND Recent work conducted with healthcare workers and middle-aged populations has recognized the association between acne vulgaris (AV) and mask-wearing. OBJECTIVE This study aimed to evaluate the correlation between the face mask and AV in a group of university students, triggering factors, the awareness, and attitudes of the students. METHODS A face-to-face survey was conducted to 200 participants (84 males, 116 females) who composed of third- and fifth-grade medical faculty students. The questionnaire compiled the demographic data, skin care habits, mask-wearing habits, skin lesions developed on their faces with the use of face masks, awareness, and attitudes of the students. RESULTS The mean age of the participants was 21.39 ± 1.34 (range, 19-26 years). While 40.5% of the students developed new AV, 20.5% had exacerbation of their old AV. Lesions developed most frequently in the cheek (51%) and chin (45.5%) regions. During the COVID-19 pandemic, being female (p = 0.04), prolonged masks use (p = 0.001), and fewer mask changes throughout the day (p = 0.01) were found to be associated with the development of AV. Moreover, 90.5% of students stated that the face mask could cause the development of AV. The most frequent protective precautions of the students were the intermittent removal of face masks and regular handwashing. CONCLUSION The use of face masks triggers the development of AV in young people. Wearing masks over long periods of time without breaks and infrequently changing one's mask throughout the day may lead to the development of new or worsening of AV in young populations.
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Affiliation(s)
- Ayşe Tunçer Vural
- Department of DermatologyBaşkent University Faculty of MedicineAnkaraTurkey
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Prevalence of dermatological manifestations due to face mask use and its associated factors during COVID-19 among the general population of Bangladesh: A nationwide cross-sectional survey. PLoS One 2022; 17:e0269922. [PMID: 35696406 PMCID: PMC9191724 DOI: 10.1371/journal.pone.0269922] [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: 12/21/2021] [Accepted: 05/31/2022] [Indexed: 11/19/2022] Open
Abstract
Following the worldwide COVID-19 pandemic, individuals have begun to take preventive measures to avoid exposure. Among the precautionary measures, facemask was mostly emphasized. This study aimed to determine the prevalence of dermatological symptoms linked with face mask usage and explore other associated factors. This cross-sectional survey was conducted throughout all eight divisions of Bangladesh. 1297 people were approached using a fixed-step procedure on a random route sample where 803 fulfilled the inclusion criteria. The overall prevalence of dermatological manifestation in this study was 40.85%. The common dermatological manifestations due to facemasks use were acne (26%), allergy symptoms (24%), traumatic symptoms (24%), and other symptoms (26%). Two important frequently reported risk factors were previous history of skin diseases and obesity. Females were more likely to have acne (CI: 1.199, 3.098; p = .007) and allergy issues (CI: 1.042, 2.359; p = .031). N95 and KN95 masks were more likely to produce allergic symptoms, while surgical mask users were more likely to develop acne. Acne was prevalent more than twice (CI: 1.42, 4.26; p = 0.001) in persons with a COVID-19 infection history. Further exploration is required to find out the reason. Surgical mask users reported more complaints than other types of masks, and prolonged use caused more skin symptoms. Modifications in the pattern of facemask usage and planning for work recesses might also be advised to provide for a pause from uninterrupted facemask use.
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Liu N, Ye M, Zhu Q, Chen D, Xu M, He J, Li Q, Li J. Adverse Reactions to Facemasks in Health-Care Workers: A Cross-Sectional Survey. Clin Cosmet Investig Dermatol 2022; 15:947-954. [PMID: 35642175 PMCID: PMC9148581 DOI: 10.2147/ccid.s365390] [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: 03/16/2022] [Accepted: 05/17/2022] [Indexed: 11/23/2022]
Abstract
Background Coronavirus disease 2019 (COVID-19) has developed into a worldwide pandemic, which presents several challenges for frontline health-care workers (HCWs). HCWs are highly prone to various skin diseases due to prolonged use of personal protective equipment (PPE). The most frequently used type of PPE is facemasks. To effectively control adverse skin reactions, there is an urgent need for a range of preventive practices. Methods This cross-sectional study was conducted at 12 hospitals in Zhejiang province, China. HCWs were invited to participate in the web survey. Data were extracted by two independent reviewers using a predesigned data collection form and analyzed with SPSS 20.0. Results A total of 1147 questionnaires were collected, and of these, 1090 (95.03%) were valid and returned. The incidence of chest tightness and shortness of breath and face eczema was significantly higher in HCWs wearing N95 facemasks (41.91%; 31.62%) than in the HCWs wearing medical facemasks (38.05%, P = 0.010; 21.91%, P = 0.012). The incidence of ear pain and indentation was significantly higher in HCWs wearing hang-facemasks (83.81%) than in HCWs wearing strains-facemasks (61.19%, P < 0.001). The incidence of ear pain and indentation was significantly higher in HCWs wearing undiscriminating size code facemasks (79.88%) than in the HCWs wearing discriminating size code facemasks (67.86%, P = 0.031). There was a significant reduction (P < 0.001) in the incidence of HCWs without adverse reactions (ADRs) with increasing time wearing facemasks. Conclusion Incidence of ADRs does not significantly increase with the durations of mask wear where wearing mask time exceeded 4 hours per day. The medical staff generally wore masks for more than 4 hours per day; therefore, we recommend taking 15 min of rest after 2 hours of mask-wearing. Results in this study support the conclusion that the type of strain-facemasks and discriminating size code facemasks has a lower incidence of ADRs than other type of medical facemasks.
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Affiliation(s)
- Ning Liu
- Outpatient Department, Zhejiang Rongjun Hospital, Jiaxing, Zhejiang Province, 314000, People's Republic of China
| | - Min Ye
- Nursing Department, Zhejiang Rongjun Hospital, Jiaxing, Zhejiang Province, 314000, People's Republic of China
| | - Qinya Zhu
- Nursing Department, Zhejiang Rongjun Hospital, Jiaxing, Zhejiang Province, 314000, People's Republic of China
| | - Dingchao Chen
- Medical Department, Zhejiang Rongjun Hospital, Jiaxing, Zhejiang Province, 314000, People's Republic of China
| | - Mingmin Xu
- Ultrasonic Department, Zhejiang Rongjun Hospital, Jiaxing, Zhejiang Province, 314000, People's Republic of China
| | - Jia He
- Department of Urology, Zhejiang Rongjun Hospital, Jiaxing, Zhejiang Province, 314000, People's Republic of China
| | - Qian Li
- Ultrasonic Department, Zhejiang Rongjun Hospital, Jiaxing, Zhejiang Province, 314000, People's Republic of China
| | - Jie Li
- The Health Administration Center, Zhejiang Rongjun Hospital, Jiaxing, Zhejiang Province, 314000, People's Republic of China
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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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Yoo MA, Kim SH, Han HS, Byun JW, Park KH. The effects of wearing a face mask and of subsequent moisturizer use on the characteristics of sensitive skin. Skin Res Technol 2022; 28:714-718. [PMID: 35639816 PMCID: PMC9348451 DOI: 10.1111/srt.13173] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Accepted: 05/03/2022] [Indexed: 11/29/2022]
Abstract
Background COVID‐19 is a serious respiratory disease, and wearing masks has become essential in daily life. Nevertheless, the number of people complaining of skin problems caused by wearing masks is increasing. Therefore, we investigated the characteristics of changes in sensitive skin caused by wearing a mask. Materials and methods Twenty healthy Korean women with sensitive skin participated in this study. To determine any skin‐related changes caused by mask‐wearing, we evaluated redness, hydration, transepidermal water loss (TEWL), and moisture at 2.5 mm below the surface before and 4 h after wearing a Korea Filter 94 mask. In addition, we tested whether applying a moisturizer for 30 min after mask removal could reverse any mask‐induced changes. Results Skin redness and TEWL were significantly increased at 4 h after wearing a mask (p < 0.05), otherwise skin hydration and the 2.5 mm moisture were significantly decreased (p < 0.05). After applying the moisturizer, skin redness and TEWL were significantly decreased compared to their values 4 h after wearing masks (p < 0.05), whereas skin hydration and the 2.5 mm moisture were significantly increased (p < 0.05). Moreover, after applying the moisturizer, skin redness and TEWL were significantly reduced compared to the pre‐masking baseline (p < 0.05), whereas skin hydration was significantly increased (p < 0.05); the 2.5 mm moisture showed no significant change. Conclusion We observed that wearing masks causes physiological changes in sensitive skin, whereas applying a moisturizer after removing the mask improved skin conditions.
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Affiliation(s)
- Mi Ae Yoo
- Skin Clinical Trials Center, OATC Inc., Seoul, South Korea
| | - Song Hee Kim
- Skin Clinical Trials Center, OATC Inc., Seoul, South Korea
| | - Hyo Sun Han
- Research and Development, KOREATECH Co., Seoul, South Korea
| | - Ji Won Byun
- Department of Dermatology, Inha University School of Medicine, Incheon, South Korea
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Kim K, Sung HK, Jang J, Suh EE, Lee K, Park SK. Health Status, Health-Related Factors and Work Environment in Korean Semiconductor Workers between 1984–2012: A Qualitative Study and a Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19106286. [PMID: 35627823 PMCID: PMC9140394 DOI: 10.3390/ijerph19106286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Revised: 05/17/2022] [Accepted: 05/18/2022] [Indexed: 12/03/2022]
Abstract
Background: The environment of semiconductor facilities and exposure status has undergone changes. To identify changes in the work environment, health status, and risk factors, a qualitative and cross-sectional study was conducted. Methods: For the qualitative study, 38 current and retired workers who worked for at least 10-years were studied; for the cross-sectional study, 306 current workers who worked for at least 5-years based on JEM strata from Samsung Electronics were selected. Participants were asked about occupational history, cancer-relating risk factors during the working period, medical history, dietary habits for the past year, and hematological cancer-relating infection. Results: In the qualitative study, fabrication workers reported bladder cystitis, dermatitis in hands, gastritis/ulcer, and dry eye as frequent symptoms during work environment changes (manual to automatic process). In the cross-sectional study, there were no abnormal findings for infection biomarkers related to hematological cancer and spontaneous abortion, and their general health status was no different from the general population. Also, questionnaire feasibility was evaluated for the applicability in the prospective cohort. Conclusion: Current semiconductor workers’ health status was good compared to other populations. For lifelong health assessment, a cohort study is needed which considers health worker effects and current environments.
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Affiliation(s)
- Kyungsik Kim
- Department of Preventive Medicine, Seoul National University College of Medicine, Daehak-ro 101, Jongno-gu, Seoul 03080, Korea; (K.K.); (J.J.)
- Department of Biomedical Science, Seoul National University Graduate School, Daehak-ro 101, Jongno-gu, Seoul 03080, Korea
- Cancer Research Institute, Seoul National University College of Medicine, Daehak-ro 101, Jongno-gu, Seoul 03080, Korea
| | - Ho Kyung Sung
- Institute for Public Healthcare, National Medical Center, Eulji-ro 245, Jung-gu, Seoul 04564, Korea;
- National Emergency Medical Center, National Medical Center, Eulji-ro 245, Jung-gu, Seoul 04564, Korea
| | - Jieun Jang
- Department of Preventive Medicine, Seoul National University College of Medicine, Daehak-ro 101, Jongno-gu, Seoul 03080, Korea; (K.K.); (J.J.)
- Gyeongnam Center for Infectious Disease Control and Prevention, Jungang-daero 300, Uichang-gu, Changwon 51154, Korea
| | - Eunyoung E. Suh
- College of Nursing Research Institute of Nursing Science, Seoul National University, Daehak-ro 101, Jongno-gu, Seoul 03080, Korea;
| | - Kwan Lee
- Department of Preventive Medicine, Dongkuk University College of Medicine, Gyeongju 38066, Korea;
| | - Sue K. Park
- Department of Preventive Medicine, Seoul National University College of Medicine, Daehak-ro 101, Jongno-gu, Seoul 03080, Korea; (K.K.); (J.J.)
- Cancer Research Institute, Seoul National University College of Medicine, Daehak-ro 101, Jongno-gu, Seoul 03080, Korea
- Integrated Major in Innovative Medical Science, Seoul National University College of Medicine, Daehak-ro 101, Jongno-gu, Seoul 03080, Korea
- Correspondence: ; Tel.: +82-2-740-8338; Fax: +82-2-747-4830
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Falodun O, Medugu N, Sabir L, Jibril I, Oyakhire N, Adekeye A. An epidemiological study on face masks and acne in a Nigerian population. PLoS One 2022; 17:e0268224. [PMID: 35588427 PMCID: PMC9119463 DOI: 10.1371/journal.pone.0268224] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 04/25/2022] [Indexed: 12/22/2022] Open
Abstract
Background
Acne vulgaris is a skin disorder that affects males and females with significant impact on quality of life. The onset of the COVID-19 pandemic led to a series of non-pharmaceutical interventions globally to reduce the spread of the virus particularly since there have been no known cures or definitive treatment for the disease. One key non-pharmaceutical intervention was recommendation on wearing of face masks. There are reports of discomfort associated with wearing face mask including complaints of various skin rashes, acne and headaches which could hinder appropriate use of face masks. While the dermatological problems associated with face mask use have been comprehensively explored in high income countries, the data is sparse in sub-Saharan Africa. We aimed to determine the association between face mask use and development of acne vulgaris in our developing country setting. We subsequently determined risk factors for development of acne vulgaris such as duration of wearing face masks, type of face mask, and prior dermatological skin condition history. We aimed to also determine the potential of acne development secondary to face mask use to reducing predisposition to wearing face masks.
Methods
This was an observational cross-sectional study conducted in within two local government areas of the Federal Capital Territory, Abuja. Trained interviewers administered pre-tested questionnaires to 1316 consecutive consenting adult participants randomly approached for informed consent at various public locations. Information was inputted into MS Excel and analyzed using Epi-info.
Results
A total number of 1316 persons participated in this study with mean age 34.4 ±12.3 years and median age 35.5years. Male: female ratio was 1:1.41. New onset acne or worsening of acne following consistent wearing of face masks was reported by 323 (24.5%) of the 1316 participants in this study. The surgical face mask was the least likely to predispose to acne p<0.05. Compared with the surgical mask, persons using N95 face mask and cloth mask were 1.89 and 1.41 times more likely to have acne respectively. Persons with prior history of acne were more likely to develop new acne or experience worsening of acne following wearing of face mask OR 3.89, 95% CI 2.85, 5.33; p <0.05). The length of time of daily mask wearing was not significantly associated with occurrence of new onset acne or worsening of acne. Persons reporting prior histories of allergy were more likely to develop acne in this study (OR 2.01, 95% CI 1.50, 2.88; p<0.05). In this study, 192 (59.4%) of those who reported having acne following face masks use responded they have a negative predisposition to wearing masks.
Conclusion
Our finding of greater predisposition to development or worsening of acne following consistent use of face masks could have implications for the control strategy of COVID-19. The finding that the N95 face mask was more significantly associated with acne is of concern as this is the preferred face mask in healthcare settings. It is important for the medical community to investigate feasible and safe recommendations to help alleviate this condition.
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Affiliation(s)
- Olanrewaju Falodun
- Dermatology Unit Department of Internal Medicine, National Hospital Abuja, Abuja, Nigeria
- * E-mail:
| | - Nubwa Medugu
- Department of Medical Microbiology and Parasitology, National Hospital Abuja, Abuja, Nigeria
| | - Laila Sabir
- Dermatology Unit Department of Internal Medicine, National Hospital Abuja, Abuja, Nigeria
| | - Ihsan Jibril
- Dermatology Unit Department of Internal Medicine, National Hospital Abuja, Abuja, Nigeria
| | - Nnebuogo Oyakhire
- Dermatology Unit Department of Internal Medicine, National Hospital Abuja, Abuja, Nigeria
| | - Adeola Adekeye
- Dermatology Unit Department of Internal Medicine, National Hospital Abuja, Abuja, Nigeria
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Manookian A, Dehghan Nayeri N, Shahmari M. Physical problems of prolonged use of personal protective equipment during the COVID-19 pandemic: A scoping review. Nurs Forum 2022; 57:874-884. [PMID: 35575417 PMCID: PMC9347983 DOI: 10.1111/nuf.12735] [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: 06/02/2021] [Revised: 04/23/2022] [Accepted: 04/27/2022] [Indexed: 11/29/2022]
Abstract
Background It is widely believed that using personal protective equipment (PPE) provides high levels of protection for healthcare workers (HCWs) in the fight against coronavirus disease (COVID‐19). However, the long‐term use of PPE is inconvenient for HCWs and may cause physical discomfort. These factors could result in poor compliance and disrupt the health and safety of HCWs, which may negatively affect the patient's safety. Objective This study aimed to investigate the literature for the purpose of collecting convincing evidence of HCWs' physical problems associated with PPE use during the COVID‐19 pandemic. Methods This scoping review was conducted using PubMed, Embase, ProQuest, Science Direct, Springer, Biomed Central, and Google Scholar to identify the related literature. Results HCWs have experienced various physical disorders including skin, respiratory, musculoskeletal, nervous, urinary, and circulatory system problems that are associated with PPE in various body systems. Among these, skin problems were the most frequent physical problems. Conclusions The literature demonstrated the adverse impacts of using PPE on HCWs. Therefore, healthcare policymakers should take the appropriate measures to improve the work environment during the COVID‐19 pandemic, which could consequently prevent and mitigate the adverse effects of using PPE.
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Affiliation(s)
- Arpi Manookian
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.,USERN Care (TUMS) Office, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Nahid Dehghan Nayeri
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehraban Shahmari
- Department of Medical-Surgical, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
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Doğan A, Karasu F, Yilmaz L. The effects of nurses' use of personal protective equipment on their vital signs during the COVID-19 pandemic. Work 2022; 71:843-850. [PMID: 35253717 DOI: 10.3233/wor-211232] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND In order for nurses to provide the desired/expected care during the COVID-19 pandemic, the personal protective equipment (PPE) they use should not cause additional damage. OBJECTIVE The current study examined the effect of nurses' use of PPE on their vital signs during the COVID-19 pandemic. METHODS The present study was executed in a public hospital located in Turkey between October 2020 and December 2020 with a total of 112 nurses, 54 of them were serving in COVID-19 clinics, and 58 of them were working in other clinics. The data of the study was collected by using the introductory information form, the vital signs measurement, and the Visual Analogue Scale. The numbers, percentages, means, standard deviation, Chi-square, ANOVA, Mann-Whitney U and Wilcoxon tests were used to analyze the data. RESULTS The mean scores of SpO2, respiratory rate, body temperature, heart rate and blood pressure measurements of the nurses in the experimental group were compared before and after putting on the PPE. It was found that the difference between the two averages was statistically significant (p < 0.05). CONCLUSION It was found that the use of PPE for a long time causes a decrease in SpO2, increase in respiratory rate, pulse and blood pressure, as well as the aches in face, ear, nose and head.
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Affiliation(s)
- Aysel Doğan
- Department of Nursing, Faculty of Health Sciences, Toros University, Mersin, Turkey
| | - Fatma Karasu
- Department of Nursing, Faculty of Health Sciences, Kilis 7 Aralık University, Kilis, Turkey
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