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Alshehi MMH, Ilesanmi RE, Dabou EAR. Physical Burden and Perceived Stress of Personal Protective Equipment During COVID-19 Pandemic: A Retrospective Study in the United Arab Emirates. SAGE Open Nurs 2023; 9:23779608231186754. [PMID: 37457618 PMCID: PMC10345910 DOI: 10.1177/23779608231186754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Revised: 06/18/2023] [Accepted: 06/20/2023] [Indexed: 07/18/2023] Open
Abstract
Introduction Over the course of the COVID-19 pandemic, personal protective equipment (PPE) has become necessary. According to published research, PPE-related physical impacts were probably underreported during the pandemic. Objective To examine the physical burden and perceived stress associated with prolonged PPE wearing among nurses during the COVID-19 pandemic in the United Arab Emirates (UAE). Methods This was a cross-sectional retrospective study of 209 nurses working in two hospitals in the UAE. A convenience sampling technique was applied, and the data were collected using an online questionnaire. Data collection was completed within three months (April 2022 to June 2022). The completed questionnaires were analyzed using SPSS version 21. Chi-square statistics was used to test the association of categorical variables at a 5% level of significance. Results A total of 209 nurses had a mean age of 38.4 ± 8.7 years. More than 65.1% wore PPE continuously for 4 hrs per day. The most common physical burdens reported were difficulty in breathing (62.2%), excessive thirst (41.6%), and facial itchiness (39.2%). Most participants (95.2%) reported high-stress levels. There was no significant association between the level of stress and the duration of wearing PPE (p = .43 > .05). However, the authors found a statistically significant association between breathing difficulty with face masks and the duration of wearing them (p < .05). In addition, itchiness/rash related to gloves was significantly associated with wearing duration (p < .05). Conclusion Findings show that nurses experienced adverse effects from PPE use, which increased with the number of hours of wearing. Further studies with a larger sample size will allow for generalization of the study results.
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Affiliation(s)
| | - Rose Ekama Ilesanmi
- RAK College of Nursing, RAK Medical and Health Sciences University, Ras Al-Khaimah, United Arab Emirates
| | - Eman Abdelaziz Rashad Dabou
- RAK College of Nursing, RAK Medical and Health Sciences University, Ras Al-Khaimah, United Arab Emirates
- Medical–Surgical Nursing Department, Faculty of Nursing, Alexandria University, Alexandria, Egypt
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2
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Srinivas CR, Sethy M. Occupational Dermatoses. Indian Dermatol Online J 2022; 14:21-31. [PMID: 36776171 PMCID: PMC9910518 DOI: 10.4103/idoj.idoj_332_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 08/12/2022] [Accepted: 08/14/2022] [Indexed: 12/30/2022] Open
Abstract
Occupational skin diseases (OSDs) are one of the major problems in working life. Among occupational diseases, 30-45% are skin diseases. Contact dermatitis accounts for the greatest part (95%) of OSDs. It adversely affects the quality of life of workers. Classification of OSD is too difficult as there are geographical variations in the occupational groups affected. However, commonly affected occupational groups are agricultural workers, healthcare workers, construction workers, metal workers, cleaners, housekeepers, food handlers, hairdressers, beauticians, and mechanics. Because of the unorganized workplace, lack of a proper notification system for occupational dermatoses, and under-reporting of cases, there is a paucity of information regarding the magnitude of the problem of OSD in India. Although in India many studies have been conducted on individual small occupational groups, data on the complete epidemiology of OSD is limited. In this article, we have tried to compile the common OSDs in various occupations.
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Affiliation(s)
- Chakravarthi R. Srinivas
- Department of Dermatology Venereology and Leprosy, Kalinga Institute of Medical Sciences (KIMS), KIIT Deemed to be University, Bhubaneswar, Odisha, India
| | - Mitanjali Sethy
- Department of Dermatology Venereology and Leprosy, Kalinga Institute of Medical Sciences (KIMS), KIIT Deemed to be University, Bhubaneswar, Odisha, India,Address for correspondence: Dr. Mitanjali Sethy, Assistant Professor, Department of Dermatology Venereology and Leprosy, Kalinga Institute of Medical Sciences (KIMS), KIIT Deemed to be University, Bhubaneswar - 751 024, Odisha, India. E-mail:
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3
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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: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 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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4
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Kathare M, Julander A, Erfani B, Schenk L. OUP accepted manuscript. Ann Work Expo Health 2022; 66:741-753. [PMID: 35217863 PMCID: PMC9250289 DOI: 10.1093/annweh/wxac006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 12/20/2021] [Accepted: 01/25/2022] [Indexed: 11/13/2022] Open
Abstract
Using data from the Swedish Products Register, hosted by the Swedish Chemicals Agency (KemI), national occupational injury and disease statistics, and call records from the Swedish Poisons Information Centre (PIC) we characterize health hazards of marketed cleaning products and recorded injuries, disease, and incidents linked to cleaning or disinfection agents. The results show that cleaning agents pose many kinds of health hazards, although corrosion and irritation hazards dominate, in particular for the eyes (54% of all included products). Few products were recognized as inhalation hazards. The nature of the health hazards is reflected in the occupational disease and injury statistics and PIC records for eyes and skin but not for the respiratory tract. Among occupational disease cases attributed to cleaning or disinfection agents, 61% concern skin and 26% the respiratory tract. Among occupational injury cases 64% concern chemical burns. However, only a small part (<0.5%) of all reported diseases and injuries were explicitly attributed to cleaning or disinfection agents. On average, there were 11 cases of disease attributed to cleaning or disinfection agents per million workers and year. For occupational injuries the corresponding number was 8. The data concern a broad range of sectors and occupations, but notable sectors were healthcare, accommodation and food service, and manufacturing. Women were more likely to suffer from disease, men and women equally likely to suffer from injury. PIC cases were evenly distributed between men and women, but the clear risk cases more frequently involved men. Occupational diseases increased many-fold in 2020 while injuries decreased, which could be due to COVID-19 changing use patterns of cleaning and disinfection agents at work. We conclude that cleaning agents pose a variety of risks to a large part of the workforce, although particular attention for preventive efforts may need to be directed to the healthcare, accommodation and food service, and manufacturing sectors.
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Affiliation(s)
- Maitreyi Kathare
- Integrative Toxicology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Anneli Julander
- Integrative Toxicology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Sustainable work and management, IVL Swedish Environmental Research Institute, Stockholm, Sweden
| | - Behnaz Erfani
- Integrative Toxicology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Linda Schenk
- Author to whom correspondence should be addressed. Tel: +46-8-5248-7968; fax: +46-8-33-69-81; e-mail:
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5
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Skiveren JG, Ryborg MF, Nilausen B, Bermark S, Philipsen PA. Adverse skin reactions among health care workers using face personal protective equipment during the coronavirus disease 2019 pandemic: A cross-sectional survey of six hospitals in Denmark. Contact Dermatitis 2021; 86:266-275. [PMID: 34865243 PMCID: PMC9302995 DOI: 10.1111/cod.14022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 11/26/2021] [Accepted: 11/27/2021] [Indexed: 10/25/2022]
Abstract
BACKGROUND Health care workers (HCWs) report frequent adverse skin reactions (ASRs) due to face personal protective equipment (F-PPE) use during the coronavirus disease 2019 (COVID-19) pandemic. OBJECTIVES To describe self-reported ASRs among HCWs using F-PPE; investigate background factors, such as chronic skin diseases and skin types (dry, oily, combination, sensitive), and determine whether HCWs took preventive methods against ASRs. METHODS An online questionnaire was distributed to 22 993 HCWs at hospitals. RESULTS The prevalence of ASRs was 61.9% based on 10 287 responders. Different types of F-PPE caused different reactions. The most common ASRs from surgical masks were spots and pimples (37.2%) and from FFP3 masks was red and irritated skin (27.3%). A significantly higher proportion of HCWs with chronic skin diseases had ASRs (71.6%) than those without chronic skin diseases (59.7%) (P < .001). Some skin types were more prone to ASRs (sensitive skin [78.8%] vs dry skin [54.3%]; P = .001). HCWs using F-PPE for >6 hours versus <3 hours per day had a four times higher ASR risk (P = <.001). Nearly all HCWs used preventive and/or counteractive methods (94.2%). CONCLUSIONS It is important to consider background factors, such as chronic skin diseases and skin types, to prevent and counteract ASRs due to F-PPE use. HIGHLIGHTS Daily long-term use of face protective equipment increased the risk of adverse skin reaction by four times. Health care workers (HCWs) with chronic skin diseases had significantly more skin reactions than those without. Sensitive skin types were more prone to skin reactions. The skin reactions were higher in HCWs in intensive care units than HCWs in in-patient clinics.
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Affiliation(s)
- Jette G Skiveren
- Department of Dermatology and Copenhagen Wound Healing Centre, Bispebjerg University Hospital, Copenhagen, Denmark
| | - Malene F Ryborg
- Department of Dermatology and Copenhagen Wound Healing Centre, Bispebjerg University Hospital, Copenhagen, Denmark
| | - Britt Nilausen
- Department of Dermatology and Copenhagen Wound Healing Centre, Bispebjerg University Hospital, Copenhagen, Denmark
| | - Susan Bermark
- Department of Dermatology and Copenhagen Wound Healing Centre, Bispebjerg University Hospital, Copenhagen, Denmark
| | - Peter A Philipsen
- Department of Dermatology and Copenhagen Wound Healing Centre, Bispebjerg University Hospital, Copenhagen, Denmark
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6
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Keng BMH, Gan WH, Tam YC, Oh CC. Personal protective equipment-related occupational dermatoses during COVID-19 among health care workers: A worldwide systematic review. JAAD Int 2021; 5:85-95. [PMID: 34485949 PMCID: PMC8407949 DOI: 10.1016/j.jdin.2021.08.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/18/2021] [Indexed: 12/22/2022] Open
Abstract
Background Occupational dermatoses caused by personal protective equipment (PPE) in the ongoing COVID-19 pandemic are emerging occupational health challenges that must be promptly and effectively addressed to ease burden on our health care workers. Objective A systematic review was conducted to determine common PPE-related dermatoses, affected body sites, and implicated occupational contactants. We further proposed solutions to mitigate this problem. Methods Online databases were searched for articles on PPE-related dermatoses in health care workers during the COVID-19 pandemic written in English and published from January 1, 2020, to January 30, 2021. Results Sixteen studies, including a total of 3958 participants, were included. The most common dermatoses were xerosis, pressure-related erythema, and contact dermatitis, mainly affecting the face and hands. The most widely implicated contactants were increased frequency of hand hygiene, gloves, N95 masks, and goggles. Proposed solutions were categorized as individual self-care, protection of the workforce, and long-term preventive measures. Conclusion Through measures such as regular basic skin care education, early access to specialty clinics via telemedicine, and designing of better-fit PPE, the challenges posed by PPE-related occupational dermatoses can be significantly reduced.
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Affiliation(s)
| | - Wee Hoe Gan
- Department of Occupational and Environmental Medicine, Singapore General Hospital, Singapore, Singapore.,Duke-NUS Medical School, Singapore, Singapore.,Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Yew Chong Tam
- Education Resource Centre, Singapore General Hospital, Singapore, Singapore
| | - Choon Chiat Oh
- Duke-NUS Medical School, Singapore, Singapore.,Department of Dermatology, Singapore General Hospital, Singapore, Singapore
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7
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Rizzi A, Inchingolo R, Viola M, Boldrini L, Lenkowicz J, Lohmeyer FM, De Simone FM, Staiti D, Sarnari C, Gasbarrini A, Nucera E. Occupational hand dermatitis web survey in a university hospital during COVID-19 pandemic: the SHIELD study. LA MEDICINA DEL LAVORO 2021; 112:320-326. [PMID: 34446683 PMCID: PMC8436823 DOI: 10.23749/mdl.v112i4.11670] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Accepted: 06/18/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND Occupational hand dermatitis (OHD) is a skin disease occurring on employees' hands in certain jobs. Little is known about prevalence, incidence and characteristics of this adverse skin reaction and its associated risk factors during COVID-19 pandemic. To evaluate both prevalence and incidence of OHD and associated risk factors in Italian clinicians. METHODS A cross-sectional study was performed using a self-report questionnaire. RESULTS Two hundred and thirty clinicians responded to the survey and 82% of responders did not report previous OHD history before the COVID-19 pandemic. Daily use of gloves was reported by 80% of responders. OHD prevalence was 18%, while incidence was 80%. We found a protective effect on symptom occurrence for vinyl/nitrile gloves if the time with gloves was ≥ 6 hours per day. CONCLUSIONS This survey reveals a high OHD incidence in an Italian population of clinicians. Furthermore, wearing vinyl/nitrile gloves for at least 6 hours a day had a protective effect on symptom onset.
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Affiliation(s)
- Angela Rizzi
- UOSD Allergologia e Immunologia Clinica, Dip. Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy.
| | | | - Marinella Viola
- UOSD Allergologia e Immunologia Clinica, Dip. Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy.
| | - Luca Boldrini
- UOC Radioterapia Oncologica, Dip. Diagnostica per immagini, radioterapia oncologica ed ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS Roma, Italy.
| | - Jacopo Lenkowicz
- UOC Radioterapia Oncologica, Dip. Diagnostica per immagini, radioterapia oncologica ed ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS Roma, Italy.
| | | | | | - Domenico Staiti
- Servizio di Sorveglianza Sanitaria, Fondazione Policlinico Universitario A. Gemelli IRCCS. Università Cattolica del Sacro Cuore. Roma, Italy.
| | - Caterina Sarnari
- UOSD Allergologia e Immunologia Clinica, Dip. Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy.
| | - Antonio Gasbarrini
- UOC Gastroenterologia, Dip. Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS. Medicina e chirurgia traslazionale, Università Cattolica del Sacro Cuore. Roma, Italy.
| | - Eleonora Nucera
- UOSD Allergologia e Immunologia Clinica, Dip. Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS. Medicina e chirurgia traslazionale, Università Cattolica del Sacro Cuore. Roma, Italy.
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8
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Etgu F, Onder S. Skin problems related to personal protective equipment among healthcare workers during the COVID-19 pandemic (online research). Cutan Ocul Toxicol 2021; 40:207-213. [PMID: 34047217 DOI: 10.1080/15569527.2021.1902340] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Coronavirus disease-2019 (COVID-19) is a highly contagious infectious disease that first appeared in Wuhan, China, in December 2019. Health care workers (HCWs) are at increased risk of infection because the virus is highly contagious and can be transmitted by a variety of routes. Health care workers are required to use a variety of personal protective equipment (PPE) for prolonged hours and, as a result, they face varying degrees of cutaneous complications. METHODS We conducted a cross-sectional online questionnaire survey to investigate skin problems caused by the use of PPE and personal hygiene measures. We developed a survey with 32 questions using Google forms and distributed it via WhatsApp and Facebook groups. RESULTS A total of 1142 responses were obtained. Among the respondents, 88.1% reported adverse skin reactions due to PPE and personal hygiene measures. Female sex, working as a nurse, wearing PPE more than 6 h/day, and working more than 3 days/week increase the risk of PPE-related skin problems. CONCLUSION In this study, we highlighted skin problems related to PPE and found out risk factors for PPE-related skin problems.
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Affiliation(s)
- Fatma Etgu
- Department of Dermatology, Ordu University Educational and Research Hospital, Ordu, Turkey
| | - Sevda Onder
- Department of Dermatology, Ordu University, Ordu, Turkey
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9
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Montero-Vilchez T, Cuenca-Barrales C, Martinez-Lopez A, Molina-Leyva A, Arias-Santiago S. Skin adverse events related to personal protective equipment: a systematic review and meta-analysis. J Eur Acad Dermatol Venereol 2021; 35:1994-2006. [PMID: 34077565 DOI: 10.1111/jdv.17436] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 05/21/2021] [Indexed: 01/03/2023]
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a global pandemic that has spread all over the word. To avoid the virus transmission, healthcare workers must wear adequate personal protective equipment (PPE). PPE is associated with several side events, including skin reactions. The objective of this study was to summarize the prevalence, type and risk factors for cutaneous adverse events related to PPE and prevention measures to avoid them. A systematic review and meta-analysis was conducted using MEDLINE, Scopus and EMBASE databases from conception to 21 January 2021. All types of epidemiological studies regarding skin adverse events related to PPE were included. The literature search identified 1007 references, 35 of them met the eligible criteria and were included for analysis, representing 31 453 participants. The media of skin side events related to PPE was 75.13%. The rate of cutaneous adverse events related to mask was 57.71%, and those associated with gloves and hand hygiene products was 49.16%. Most common skin adverse events were contact dermatitis, acne and itching. The most damaged anatomical regions were the nasal bridge, the cheeks and the hands. The duration of PPE wearing was the most common risk factor. Frequent handwashing, gloves and masks were the agents most frequently related to skin reactions. N95 respirators were the most harmful mask type for the skin. Hydrocolloid use prevented from developing skin adverse events related to masks. In conclusion, the rate of cutaneous adverse events related to PPE use is high. A longer duration of PPE wearing was the most common risk factor. Using hydrocolloid could prevent from skin injuries related to mask use.
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Affiliation(s)
- T Montero-Vilchez
- Department of Dermatology, Virgen de las Nieves University Hospital, Granada, Spain.,Biosanitary Institute of Granada (ibs.GRANADA), Granada, Spain
| | - C Cuenca-Barrales
- Department of Dermatology, Virgen de las Nieves University Hospital, Granada, Spain.,Biosanitary Institute of Granada (ibs.GRANADA), Granada, Spain
| | - A Martinez-Lopez
- Department of Dermatology, Virgen de las Nieves University Hospital, Granada, Spain.,Biosanitary Institute of Granada (ibs.GRANADA), Granada, Spain
| | - A Molina-Leyva
- Department of Dermatology, Virgen de las Nieves University Hospital, Granada, Spain.,Biosanitary Institute of Granada (ibs.GRANADA), Granada, Spain
| | - S Arias-Santiago
- Department of Dermatology, Virgen de las Nieves University Hospital, Granada, Spain.,Biosanitary Institute of Granada (ibs.GRANADA), Granada, Spain.,Cell Production and Tissue Engineering Unit, Virgen de las Nieves University Hospital, Andalusian Network of Design and Translation of Advanced Therapies, Granada, Spain.,Department of Dermatology, Faculty of Medicine, University of Granada, Granada, Spain
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10
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Yuan X, Xi H, Le Y, Xu H, Wang J, Meng X, Yang Y. Online survey on healthcare skin reactions for wearing medical-grade protective equipment against COVID-19 in Hubei Province, China. PLoS One 2021; 16:e0250869. [PMID: 33914813 PMCID: PMC8084174 DOI: 10.1371/journal.pone.0250869] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 04/15/2021] [Indexed: 11/19/2022] Open
Abstract
With the spread of Coronavirus Disease 2019 globally, more than 40,000 healthcare staff rushed to Wuhan, Hubei Province to fight against this threatening disease. All staff had to wear personal protective equipment (PPE) for several hours when caring for patients, which resulted in adverse skin reactions and injuries. In this study, we used an online questionnaire to collect the self-reported skin damages among the first-line medical staff in the epidemic. The questionnaire was designed by four front-line wound care nurses and then revised through Delphi consultants. Items mainly focused on the adverse skin reactions and preventive strategies. The survey was distributed through phone application from March 15th to March 20th and received 275 responses in total. The prevalence of skin reactions (212, 77.09%) was high in both head and hands. The common clinical symptoms of skin reactions were redness, device-like mark, and burning pain in face; and dryness, dermatitis, and itch/irritation in hands. Three risk factors included gender, level of protection, and daily wearing time of PPE were identified that caused skin reactions among medical staff. 150 of 275 (54.55%) participants took preventive strategies like prophylactic dressings, however, more than 75% users had little knowledge about dressings. We suggest the frontline staff strengthened the protection of skin integrity and reduced the prevalence of adverse skin reactions after professional education.
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Affiliation(s)
- Xiuqun Yuan
- Department of Urology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Huiqin Xi
- Department of Nursing, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Ye Le
- Department of Geriatrics, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Honglian Xu
- Department of Colorectal Surgery, Changhai Hospital, Naval Medical University, Shanghai, China
| | - Jing Wang
- Department of Nursing, Shanghai Yangpu District Central Hospital (Yangpu Hospital, Tongji University), Shanghai, China
| | - Xiaohong Meng
- Department of Urology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
- * E-mail: (XM); (YY)
| | - Yan Yang
- Department of Nursing, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
- * E-mail: (XM); (YY)
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11
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Erdem Y, Inal S, Sivaz O, Copur S, Boluk KN, Ugurer E, Kaya HE, Gulsunay IE, Sekerlisoy G, Vural O, Altunay IK, Aksu Çerman A, Özkaya E. How does working in pandemic units affect the risk of occupational hand eczema in healthcare workers during the coronavirus disease-2019 (COVID-19) pandemic: A comparative analysis with nonpandemic units. Contact Dermatitis 2021; 85:215-224. [PMID: 33797109 PMCID: PMC8251387 DOI: 10.1111/cod.13853] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 03/24/2021] [Accepted: 03/29/2021] [Indexed: 01/22/2023]
Abstract
BACKGROUND Hand eczema (HE) has increased among healthcare workers (HCWs) working in coronavirus disease-2019 (COVID-19) units, and was associated with increased hand hygiene practices. OBJECTIVES To compare the prevalence and clinical characteristics of HE, and hand hygiene practices in HCWs working in COVID-19 and non-COVID-19 units. METHODS A total of 244 HCWs working in COVID-19 (n = 118) and non-COVID-19 patient care units (n = 126) were examined by dermatologists with regard to demographic parameters and hand hygiene practices. The COVID-19 and non-COVID-19 groups were matched at a 1:1 ratio according to age, atopy, and generalized dry skin. RESULTS HE was more frequent in the COVID-19 group (48.3% vs 12.7%, P < .001), whereas working years (P < .05) and additional housework at home (P < .001) were longer in the non-COVID-19 group. After the development of HE, moisturizing creams were reported to be more frequently used in the COVID group (P < .001). Topical corticosteroids were used in a minority (40% in the COVID group and 26.7% in the non-COVID group). CONCLUSIONS HCWs in COVID-19 units developed HE more frequently. A majority increased the frequency of moisturizer use, instead of using topical corticosteroids, after the development of HE for the purpose of treating eczema. New approaches are needed for the prevention and management of HE in HCWs, especially by facilitating access to dermatologists.
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Affiliation(s)
- Yasemin Erdem
- Department of DermatologyHealth Science University, Şişli Hamidiye Etfal Training and Research HospitalIstanbulTurkey
| | - Sena Inal
- Department of DermatologyHealth Science University, Şişli Hamidiye Etfal Training and Research HospitalIstanbulTurkey
| | - Onur Sivaz
- Department of DermatologyHealth Science University, Şişli Hamidiye Etfal Training and Research HospitalIstanbulTurkey
| | - Sevkiye Copur
- Istanbul Faculty of Medicine, Department of Dermatology and VenereologyIstanbul UniversityIstanbulTurkey
| | - Kubra N. Boluk
- Istanbul Faculty of Medicine, Department of Dermatology and VenereologyIstanbul UniversityIstanbulTurkey
| | - Ece Ugurer
- Department of DermatologyHealth Science University, Şişli Hamidiye Etfal Training and Research HospitalIstanbulTurkey
| | - Hazel E. Kaya
- Department of DermatologyHealth Science University, Şişli Hamidiye Etfal Training and Research HospitalIstanbulTurkey
| | - Ilayda E. Gulsunay
- Department of DermatologyHealth Science University, Şişli Hamidiye Etfal Training and Research HospitalIstanbulTurkey
| | - Gul Sekerlisoy
- Department of DermatologyHealth Science University, Şişli Hamidiye Etfal Training and Research HospitalIstanbulTurkey
| | - Osman Vural
- Department of DermatologyHealth Science University, Şişli Hamidiye Etfal Training and Research HospitalIstanbulTurkey
| | - Ilknur K. Altunay
- Department of DermatologyHealth Science University, Şişli Hamidiye Etfal Training and Research HospitalIstanbulTurkey
| | - Aslı Aksu Çerman
- Department of DermatologyHealth Science University, Şişli Hamidiye Etfal Training and Research HospitalIstanbulTurkey
| | - Esen Özkaya
- Istanbul Faculty of Medicine, Department of Dermatology and VenereologyIstanbul UniversityIstanbulTurkey
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12
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Uthayakumar AK, Panagou E, Manam S, Schauer A, Veraitch O, Walker S, Edmonds E, Crawley J, Martyn-Simmons C. PPE-associated dermatoses: effect on work and wellbeing. Future Healthc J 2021; 8:e67-e69. [PMID: 33791479 DOI: 10.7861/fhj.2020-0210] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The COVID-19 pandemic has led to more stringent infection control practice within hospitals, with the added requirement of personal protective equipment (PPE). Consequentially, the incidence of PPE-related dermatoses in healthcare workers is increasing. Analysis of staff members seen in a dermatology self-referral service during the first COVID-19 peak revealed a wide range of healthcare professionals being affected, with irritant hand dermatitis and acneiform eruptions being the commonest diagnoses. These PPE-related dermatoses had significant effects on staff members' work and wellbeing, which improved following assessment and treatment by dermatology. Given the change to our behaviour wearing PPE daily, which is likely to continue for the foreseeable future, the consequences will inevitably affect both healthcare workers and the general public, with these common dermatoses presenting in both primary and secondary care. It is therefore imperative to recognise both the physical and emotional impact that COVID-19 PPE has, and initiate prompt treatment to improve wellbeing.
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Affiliation(s)
| | - Evangelia Panagou
- University College London Hospitals NHS Foundation Trust, London, UK
| | - Seshi Manam
- University College London Hospitals NHS Foundation Trust, London, UK
| | - Anna Schauer
- University College London Hospitals NHS Foundation Trust, London, UK
| | - Ophelia Veraitch
- University College London Hospitals NHS Foundation Trust, London, UK
| | - Steve Walker
- University College London Hospitals NHS Foundation Trust, London, UK
| | - Emma Edmonds
- University College London Hospitals NHS Foundation Trust, London, UK
| | - Jennifer Crawley
- University College London Hospitals NHS Foundation Trust, London, UK
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13
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Abstract
The first cases of coronavirus disease 2019 (COVID-19) in Iran were detected on February 19, 2020. Soon the entire country was hit with the virus. Although dermatologists were not immediately the frontline health care workers, all aspects of their practice were drastically affected. Adapting to this unprecedented crisis required urgent appropriate responses. With preventive measures and conserving health care resources being the most essential priorities, dermatologists, as an integral part of the health system, needed to adapt their practices according to the latest guidelines. The spectrum of the challenges encompassed education, teledermatology, lasers, and other dermatologic procedures, as well as management of patients who were immunosuppressed or developed drug reactions and, most importantly, the newly revealed cutaneous signs of COVID-19. These challenges have paved the way for new horizons in dermatology.
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Affiliation(s)
- Maryam Daneshpazhooh
- Department of Dermatology, Tehran University of Medical Sciences, Tehran, Iran; Autoimmune Bullous Diseases Research Center, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran.
| | - HamidReza Mahmoudi
- Department of Dermatology, Tehran University of Medical Sciences, Tehran, Iran; Autoimmune Bullous Diseases Research Center, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
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14
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Wilcha RJ. Does Wearing a Face Mask During the COVID-19 Pandemic Increase the Incidence of Dermatological Conditions in Health Care Workers? Narrative Literature Review. JMIR DERMATOLOGY 2021; 4:e22789. [PMID: 34028470 PMCID: PMC8104277 DOI: 10.2196/22789] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 08/21/2020] [Accepted: 04/17/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND COVID-19 is a health emergency. SARS-CoV-2 was discovered in Wuhan (Hubei Province, China) and has rapidly spread worldwide, leaving no country untouched. COVID-19 is a respiratory infection characterized by a pneumonia of unknown etiology. It is transmitted through respiratory droplets; for example: through breathing, talking, and coughing. Transmission of the virus is high. Health care workers play important roles in helping those affected by COVID-19; this could not be done without the use of personal protective equipment (PPE). PPE involves the use of goggles, masks, gloves, and gowns and is known to reduce COVID-19 transmission; however, multiple reports of skin disease and damage associated with occupational mask-wearing have emerged. OBJECTIVE The objective of this study is to review the literature for newly emerging dermatological conditions as a result of occupational mask-wearing during the COVID-19 pandemic. METHODS A narrative review of new reports of dermatological conditions associated with occupational mask-wearing was carried out in May 2020 by referencing keywords including: "covid mask dermatology," "covid dermatological damage," "covid mask skin," "covid N95 mask damage," and "covid mask skin damage" from PubMed, supplemented by searches on both Google Scholar and ResearchGate. A total of 287 articles were found, of which 40 were successfully included in this study, and an additional 7 were selected from the reference lists of these 40 articles. The findings were tabulated and analyzed under the following headings: dermatological diagnosis, causes, and management. RESULTS Qualitative analysis of the reviewed data was carried out. A number of dermatological conditions were found to increasingly occur owing to prolonged and frequent use of face masks. Pressure-related injuries were often the most serious complaint; recommendations to reduce this type of injury include the use of hydrocolloid dressings, plastic handles, education, and regular moisturization. Innovation in PPE as well as services, such as virtual clinics, need to be advanced to protect the welfare of health care staff. CONCLUSIONS In these unprecedented times, PPE has been an effective barrier to the transmission of COVID-19 among health care workers. This has allowed health care workers to provide care to patients, with minimal risk. However, our findings suggest that despite the obvious benefits of using face masks to protect the respiratory system, there are also considerable health consequences to the skin. Future research studies are required to focus on improving face masks to ensure both the protection of the respiratory system as well as skin care, which, according to our study, has been overlooked.
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Affiliation(s)
- Robyn-Jenia Wilcha
- Faculty of Biology, Medicine and Health University of Manchester Manchester United Kingdom
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15
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Darlenski R, Kazandjieva J, Tsankov N. Prevention and occupational hazards for the skin during COVID-19 pandemic. Clin Dermatol 2020; 39:92-97. [PMID: 33972059 PMCID: PMC7833884 DOI: 10.1016/j.clindermatol.2020.12.017] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The life of medical specialists worldwide has dramatically changed due to the spread of the coronavirus disease 2019 (COVID-19) pandemic. Health care professionals (HCPs) have personally faced the outbreak by being on the first line of the battlefield with the disease and, as such, compose a significant number of people who have contracted COVID-19. We propose a classification and discuss the pathophysiology, clinical findings, and treatments and prevention of the occupational skin hazards COVID-19 poses to HCPs. The multivariate pattern of occupational skin diseases during the COVID-19 pandemic can be classified into four subgroups: mechanical skin injury, moisture-associated skin damage, contact reactions, and exacerbation of preexisting dermatoses. The clinical pattern is versatile, and the most affected skin sites were the ones in contact with the protective equipment. Dermatologists should recognize the plethora of HCPs’ occupational skin reactions that are occurring during the COVID-19 pandemic and implement treatment and preventive strategies.
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Affiliation(s)
- Razvigor Darlenski
- Department of Dermatology and Venereology, Acibadem City Clinic, Tokuda Hospital, Sofia, Bulgaria; Department of Dermatology and Venereology, Medical Faculty, Trakia University, Stara Zagora, Bulgaria.
| | - Jana Kazandjieva
- Department of Dermatology and Venereology, Medical University Sofia, Sofia, Bulgaria
| | - Nikolai Tsankov
- Department of Dermatology and Venereology, Acibadem City Clinic, Tokuda Hospital, Sofia, Bulgaria
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16
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Abstract
Background/aim Sars-CoV-2 virus infection (COVID-19) was observed in China in the last months of 2019. In the period following, this infection spread all over the world. In March 2020 the World Health Organization announced the existence of a pandemic. The aim of this manuscript is to investigate skin diseases associated with COVID-19 under three main headings: skin problems related to personal protective equipment and personal hygiene measures, skin findings observed in SARS-CoV-2 virus infections, and skin findings due to COVID-19 treatment agents. Materials and methods In PubMed, Google Scholar databases, skin lesions related to personal protective equipment and personal hygiene measures, skin findings observed in SARS-CoV-2 virus infections and skin findings due to COVID-19 treatment agents subjects are searched in detail. Results Pressure injury, contact dermatitis, itching, pressure urticaria, exacerbation of preexisting skin diseases, and new skin lesion occurrence/new skin disease occurrence may be due to personal protective equipment. Skin problems related to personal hygiene measures could include itching, dryness, and contact dermatitis. Skin findings may also be observed in SARS-CoV-2 virus infections. The incidence of skin lesions due to COVID-19 was reported to be between 0.2% and 29%. Many skin lesions including maculopapular, urticarial, vesicular, chilblain-like, thrombotic/ischemic, etc. are observed in COVID-19 patients. Some authors have stated that there is an absence of SARS-CoV-2 virus infection-specific skin findings. However, in asymptomatic or presymptomatic COVID-19 patients in particular, skin lesions can lead to the diagnosis of COVID-19. In addition, skin lesions may occur due to COVID-19 treatment agents. Conclusion Many skin lesions may appear as a result of COVID-19. Even in the absence of a COVID-19 diagnosis, skin findings should be evaluated carefully in this pandemic period.
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Affiliation(s)
- Ülker GÜL
- Department of Dermatology, Gülhane Faculty of Medicine, Health Sciences University, İstanbulTurkey
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17
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Mushtaq S, Terzi E, Recalcati S, Salas-Alanis JC, Amin S, Faizi N. Cutaneous adverse effects due to personal protective measures during COVID-19 pandemic: a study of 101 patients. Int J Dermatol 2020; 60:327-331. [PMID: 33320331 DOI: 10.1111/ijd.15354] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 10/03/2020] [Accepted: 11/18/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Coronavirus Disease 2019 (COVID-19) is a viral illness caused by the novel coronavirus SARS-CoV-2 which spreads via droplets from an infected person. There has been an unprecedented rise in the use of personal protective equipment and practice of personal hygiene measures against COVID-19. The extended use of protective measures (PM) can lead to ill effects on the skin. Our aim was to investigate PM-induced dermatoses amongst healthcare workers and the general population during the COVID-19 pandemic. METHODS A cross-sectional study was conducted over a period of 2 months. The study subjects were patients who presented to dermatology outpatient clinics or sought teleconsultation for skin problems related to the use of PMs against COVID-19. A detailed history was obtained and cutaneous examination was documented for all the patients in a pre-set proforma. Diagnoses of the adverse skin effects were formulated based upon history and clinical examination. RESULTS A total of 101 cases with cutaneous adverse effects due to the use of PMs against COVID-19 were included in the study. The general population and healthcare workers were affected similarly, comprising of 54.5% and 45.5%, respectively. The mean age of the study participants was 36.71 ± 15.72 years. The most common culprit material was soap and water (56.4%). Contact dermatitis was found to be the most common adverse effect in the majority of our patients (72.3%). The most common symptom reported was pruritus (45.5%). The wearing of personal protective equipment for a longer duration was significantly associated with multiple symptoms (P = 0.026). CONCLUSION The enhanced use of different PMs against COVID-19 can result in a variety of adverse skin effects. In our study, the use of soap and water was the most common culprit PM, and contact dermatitis was the most common adverse effect noted.
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Affiliation(s)
- Sabha Mushtaq
- Department of Dermatology, Venereology & Leprology, Government Medical College & associated hospitals, University of Jammu, Jammu, J&K, India
| | - Erdinc Terzi
- Department of Dermatology, School of Health Sciences, Istanbul Gelisim University Istanbul, Istanbul, Turkey
| | - Sebastiano Recalcati
- Department of Dermatology, ASST Lecco, Alessandro Manzoni Hospital, Lecco, Italy
| | | | | | - Nafis Faizi
- Department of Community Medicine, Jawahar Lal Nehru Medical College, AMU, Aligarh, UP, India
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18
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Daye M, Cihan FG, Durduran Y. Evaluation of skin problems and dermatology life quality index in health care workers who use personal protection measures during COVID-19 pandemic. Dermatol Ther 2020; 33:e14346. [PMID: 32985745 PMCID: PMC7536955 DOI: 10.1111/dth.14346] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 09/03/2020] [Accepted: 09/23/2020] [Indexed: 12/15/2022]
Abstract
The aim of this study was to evaluate the skin problems and dermatological life quality of the health care workers (HCWs) due to personal protection equipment (PPE) use, who are at high risk for COVID-19 infection. A questionnaire about HCWs' PPE use, their skin symptoms, and prevention, management methods and Dermatology Life Quality Index (DLQI) was fulfilled. The median age of 440 participants was 33.5 (21.0-65.0) years old. Skin problems were found to be 90.2%, the most common were dryness, itching, cracking, burning, flaking, peeling and lichenification. The presence of skin problems (P < .001) was higher in those who did not use moisturizers. Of all, 22.3% (n = 98) stated that the use of PPE increased the severity of their previously diagnosed skin diseases and allergies (P < .01). Only 28.0% (n = 123) stated that they know the skin symptoms that may develop by using PPE. The proper hand washing rate was higher as education level increased (P < .001). Skin problems were higher in those using mask with metal nose bridge (P: .02 and P: .003, respectively). As the mask using period prolonged, acne was more common (P: .02). DLQI was significantly affected in women (P = .003), and with increased skin problems related to PPE (P < .001). It is important to organize trainings on prevention and management of possible skin symptoms due to PPE use according to guidelines.
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Affiliation(s)
- Munise Daye
- Department of Dermatology, Necmettin Erbakan University, Meram Medical Faculty, Konya, Turkey
| | - Fatma Gökşin Cihan
- Department of Family Medicine, Necmettin Erbakan University, Meram Medical Faculty, Konya, Turkey
| | - Yasemin Durduran
- Department of Public Health, Necmettin Erbakan University, Meram Medical Faculty, Konya, Turkey
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19
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Harmooshi NN, Shirbandi K, Rahim F. Environmental concern regarding the effect of humidity and temperature on 2019-nCoV survival: fact or fiction. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2020; 27:36027-36036. [PMID: 32592048 PMCID: PMC7316637 DOI: 10.1007/s11356-020-09733-w] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 06/15/2020] [Indexed: 04/16/2023]
Abstract
The new coronavirus, called 2019-nCoV, is a new type of virus that was first identified in Wuhan, China, in December 2019. Environmental conditions necessary for survival and spread of 2019-nCoV are somewhat transparent but unlike animal coronaviruses. We are poorly aware of their survival in environment and precise factors of their transmission. Countries located in east and west of globe did not have a significant impact on prevalence of disease among communities, and on the other hand, north and south have provided a model for relative prediction of disease outbreaks. The 2019-nCoV can survive for up to 9 days at 25 °C, and if this temperature rises to 30 °C, its lifespan will be shorter. The 2019-nCoV is sensitive to humidity, and lifespan of viruses in 50% humidity is longer than that of 30%. Also, temperature and humidity are important factors influencing the COVID-19 mortality rate and may facilitate 2019-nCoV transmission. Thus, considering the available and recent evidence, it seems that low temperatures, as well as dry and unventilated air, may affect stability and transmissibility of 2019-nCoV.
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Affiliation(s)
- Narges Nazari Harmooshi
- Epidemiology, Deputy of Health, Health Centre, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Kiarash Shirbandi
- Universal Scientific Education and Research Network (USERN), Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Fakher Rahim
- School of Health, Research Center of Thalassemia & Hemoglobinopathy, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
- Clinical Research Development Unit, Golestan Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
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20
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Trepanowski N, Larson AR, Evers-Meltzer R. Occupational dermatoses among front-line health care workers during the COVID-19 pandemic: A cross-sectional survey. J Am Acad Dermatol 2020; 84:223-225. [PMID: 32950541 PMCID: PMC7497545 DOI: 10.1016/j.jaad.2020.08.126] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 08/12/2020] [Accepted: 08/30/2020] [Indexed: 12/30/2022]
Affiliation(s)
| | - Allison R Larson
- Department of Dermatology, Boston University School of Medicine, Boston, Massachusetts
| | - Rachel Evers-Meltzer
- Department of Dermatology, Boston University School of Medicine, Boston, Massachusetts.
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21
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Daanen H, Bose-O'Reilly S, Brearley M, Flouris DA, Gerrett NM, Huynen M, Jones HM, Lee JKW, Morris N, Norton I, Nybo L, Oppermann E, Shumake-Guillemot J, Van den Hazel P. COVID-19 and thermoregulation-related problems: Practical recommendations. Temperature (Austin) 2020; 8:1-11. [PMID: 33553500 PMCID: PMC7849778 DOI: 10.1080/23328940.2020.1790971] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
The COVID-19 pandemic started in the cold months of the year 2020 in the Northern hemisphere. Concerns were raised that the hot season may lead to additional problems as some typical interventions to prevent heat-related illness could potentially conflict with precautions to reduce coronavirus transmission. Therefore, an international research team organized by the Global Health Heat Information Network generated an inventory of the specific concerns about this nexus and began to address the issues. Three key thermal and covid-19 related topics were highlighted: 1) For the general public, going to public cool areas in the hot season interferes with the recommendation to stay at home to reduce the spread of the virus. Conflicting advice makes it necessary to revise national heat plans and alert policymakers of this forecasted issue. 2) For medical personnel working in hot conditions, heat strain is exacerbated due to a reduction in heat loss from wearing personal protective equipment to prevent contamination. To avoid heat-related injuries, medical personnel are recommended to precool and to minimize the increase in body core temperature using adopted work/rest schedules, specific clothing systems, and by drinking cold fluids. 3) Fever, one of the main symptoms of COVID-19, may be difficult to distinguish from heat-induced hyperthermia and a resting period may be necessary prior to measurement to avoid misinterpretation. In summary, heat in combination with the COVID-19 pandemic leads to additional problems; the impact of which can be reduced by revising heat plans and implementing special measures attentive to these compound risks.
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Affiliation(s)
- Hein Daanen
- Department of Human Movement Sciences. Faculty of Behavioral and Movement Sciences. Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Stephan Bose-O'Reilly
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Germany.,Institute for Public Health, Medical Decision Making and HTA, UMIT - Private University for Health Sciences, Medical Informatics and Technology, Hall i.T., Austria.,Hospital St. Hedwig of the Order of St. John, Institute and Clinic for Occupational, Social and Environmental Medicine, University Children's Hospital Regensburg (KUNO), University of Regensburg, Regensburg, Munich, Germany
| | - Matt Brearley
- National Critical Care and Trauma Response Centre, Australia
| | - D Andreas Flouris
- FAME Laboratory, Department of Exercise Science, University of Thessaly, Greece
| | - Nicola M Gerrett
- Department of Human Movement Sciences. Faculty of Behavioral and Movement Sciences. Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Maud Huynen
- Maastricht University Institute (MSI), Maastricht University, Maastricht, The Netherlands
| | - Hunter M Jones
- University Corporation for Atmospheric Research in Service to the U.S. National Oceanic & Atmospheric Administration, Silver Spring, MD, USA
| | - Jason Kai Wei Lee
- Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Global Asia Institute, National University of Singapore, Singapore.,N.1 Institute for Health, National University of Singapore, Singapore
| | | | - Ian Norton
- Respond Global, Australia.,Previously World Health Organization, Switzerland
| | - Lars Nybo
- University of Copenhagen, Copenhagen, Denmark
| | - Elspeth Oppermann
- Department Für Geographie, Ludwig-Maximilians-Universität München, Germany
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22
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Yu X, Zhao Y, Li Y, Hu C, Xu H, Zhao X, Huang J. Factors Associated With Job Satisfaction of Frontline Medical Staff Fighting Against COVID-19: A Cross-Sectional Study in China. Front Public Health 2020; 8:426. [PMID: 32850610 PMCID: PMC7417651 DOI: 10.3389/fpubh.2020.00426] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 07/14/2020] [Indexed: 12/14/2022] Open
Abstract
Purpose: The current research on frontline medical staff in China fighting against COVID-19 has not yet addressed job satisfaction. The purpose of this study is to investigate the job satisfaction of those who were sent to support Hubei province, China, or worked in local designated hospitals, and then analyze the associated influencing factors. Materials and Methods: A total of 455 medical staff who worked at the frontline of the prevention and control of COVID-19 in Hubei province was selected using simple random sampling. They were asked to fill out a self-developed general information questionnaire as well as the Minnesota Satisfaction Questionnaire (MSQ), from 10 January to 10 March 2020. Results: The average job satisfaction score of the participants was 82.58 ± 11.11. The influencing factors include education (P = 0.002), years of work experience (P = 0.006), anti-epidemic work duration (P = 0.048), daily sleep duration (P < 0.001), and the form of participation (P < 0.001). Conclusions: This study, for the first time, measures the job satisfaction of frontline medical staff in fighting against COVID-19 in China. The job satisfaction of frontline medical staff was at a “relatively decent” level, higher than the previous similar measures among medical staff. Related management departments should further improve the job satisfaction of frontline medical staff by meeting their reasonable demands, strengthening the emergency response and practical operation training of junior staff, and ensuring their ample time for sleep and rest. This study is of great reference value for improving the job satisfaction level of frontline medical staff during public health emergencies, developing medical staff security policies, and promoting the establishment of emergency response teams.
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Affiliation(s)
- Xiaoyan Yu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China.,Department of Clinical Nursing, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Yuxin Zhao
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
| | - Yuxi Li
- Department of Health Toxicology, Xiangya School of Public Health, Central South University, Changsha, China
| | - Chao Hu
- High School of National University of Defense Technology, Changsha, China
| | - Huilan Xu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
| | - Xianmei Zhao
- Department of Clinical Nursing, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Jin Huang
- Department of Clinical Nursing, The Second Xiangya Hospital of Central South University, Changsha, China
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23
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Chernyshov PV, Tomas-Aragones L, Augustin M, Svensson A, Bewley A, Poot F, Szepietowski JC, Marron SE, Manolache L, Pustisek N, Suru A, Salavastru CM, Blome C, Salek MS, Abeni D, Sampogna F, Dalgard F, Linder D, Evers AWM, Finlay AY. Position statement of the European Academy of Dermatology and Venereology Task Force on Quality of Life and Patient Oriented Outcomes on quality of life issues in dermatologic patients during the COVID-19 pandemic. J Eur Acad Dermatol Venereol 2020; 34:1666-1671. [PMID: 32498128 PMCID: PMC7301033 DOI: 10.1111/jdv.16720] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 05/27/2020] [Indexed: 12/11/2022]
Abstract
The pandemic of COVID‐19 is a global challenge for health care, and dermatologists are not standing apart from trying to meet this challenge. The European Academy of Dermatology and Venereology (EADV) has collected recommendations from its Task Forces (TFs) related to COVID‐19. The Journal of the EADV has established a COVID‐19 Special Forum giving free access to related articles. The psychosocial effects of the pandemic, an increase in contact dermatitis and several other skin diseases because of stress, disinfectants and protective equipment use, especially in healthcare workers, the temporary limited access to dermatologic care, the dilemma whether or not to pause immunosuppressive therapy, and, finally, the occurrence of skin lesions in patients infected by COVID‐19 all contribute to significant quality of life (QoL) impairment. Here, we present detailed recommendations of the EADV TF on QoL and patient‐oriented outcomes on how to improve QoL in dermatologic patients during the COVID‐19 pandemic for several different groups of patients and for the general population.
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Affiliation(s)
- P V Chernyshov
- Department of Dermatology and Venereology, National Medical University, Kiev, Ukraine
| | - L Tomas-Aragones
- Department of Psychology, University of Zaragoza, Zaragoza, Spain
| | - M Augustin
- Institute for Health Services Research in Dermatology and Nursing, German Center for Health Services Research in Dermatology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - A Svensson
- Department of Dermatology and Venereology, Skane University Hospital, Malmö, Sweden
| | - A Bewley
- Whipps Cross University Hospital, London, UK.,Queen Mary University Medical School, London, UK
| | - F Poot
- Department of Dermatology, University Hospital Erasme, Brussels, Belgium
| | - J C Szepietowski
- Department of Dermatology, Wroclaw Medical University, Wroclaw, Poland
| | - S E Marron
- Department of Dermatology, University, Hospital Miguel Servet, Aragon Psychodermatology Research Group (GAI+PD), Zaragoza, Spain
| | - L Manolache
- Dermatology, Dali Medical, Bucharest, Romania
| | - N Pustisek
- Children's Hospital Zagreb, Medical School, University of Zagreb, Zagreb, Croatia
| | - A Suru
- Paediatric Dermatology Discipline, Dermatology Research Unit, "Carol Davila" University of Medicine and Pharmacy, Colentina Clinical Hospital, Bucharest, Romania
| | - C M Salavastru
- Department of Paediatric Dermatology, Colentina Clinical Hospital, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - C Blome
- Institute for Health Services Research in Dermatology and Nursing, German Center for Health Services Research in Dermatology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - M S Salek
- School of Life & Medical Sciences, University of Hertfordshire, Hatfield, UK
| | - D Abeni
- Clinical Epidemiology Unit, IDI-IRCCS, Rome, Italy
| | - F Sampogna
- Clinical Epidemiology Unit, IDI-IRCCS, Rome, Italy
| | - F Dalgard
- Department of Dermatology and Venereology, Skane University Hospital, Malmö, Sweden
| | - D Linder
- Department of Dermatology, Ben Gurion University of the Negev, Beer-Sheva, Israel
| | - A W M Evers
- Health, Medical, and Neuropsychology unit, Leiden University, Leiden, The Netherlands
| | - A Y Finlay
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
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Soutou B, Tomb R. The Multifaceted Engagement of the Dermatologist in the Covid-19 Pandemic. SN COMPREHENSIVE CLINICAL MEDICINE 2020; 2:1388-1392. [PMID: 32838174 PMCID: PMC7373845 DOI: 10.1007/s42399-020-00423-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Accepted: 07/17/2020] [Indexed: 01/08/2023]
Abstract
Dermatologists worldwide are engaged in the struggle against Covid-19. They limited their daily activity to priority cases, intending to reduce the exposure of patients in the waiting room. Teledermatology was recommended as an efficient alternative to assure patients' needs and safety. At the same time, dermatologists had to manage the skin injuries of frontline healthcare workers; to characterize the cutaneous manifestations of Covid-19; to assess the optimal treatment of patients with skin diseases, especially those taking immunomodulating and immunosuppressant molecules; and finally to promote balanced precautions in healthy persons.
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Affiliation(s)
- Boutros Soutou
- Dermatology Department, School of Medicine, Université Saint-Joseph, Beirut, Lebanon ,Hôtel-Dieu de France Hospital, Achrafieh, Bvd Alfred Naccache, Beirut, 16-6830 Lebanon
| | - Roland Tomb
- Dermatology Department, School of Medicine, Université Saint-Joseph, Beirut, Lebanon
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Seirafianpour F, Sodagar S, Pour Mohammad A, Panahi P, Mozafarpoor S, Almasi S, Goodarzi A. Cutaneous manifestations and considerations in COVID-19 pandemic: A systematic review. Dermatol Ther 2020; 33:e13986. [PMID: 32639077 PMCID: PMC7362033 DOI: 10.1111/dth.13986] [Citation(s) in RCA: 73] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 07/01/2020] [Accepted: 07/06/2020] [Indexed: 01/07/2023]
Abstract
COVID-19 had a great impact on medical approaches among dermatologist. This systematic review focuses on all skin problems related to COVID-19, including primary and secondary COVID-related cutaneous presentations and the experts recommendations about dermatological managements especially immunomodulators usage issues. Search was performed on PubMed, Scopus, Embase and ScienceDirect. Other additional resources were searched included Cochrane, WHO, Medscape and coronavirus dermatology resource of Nottingham university. The search completed on May 3, 2020. Three hundred seventy-seven articles assigned to the inclusion and exclusion groups. Eighty-nine articles entered the review. Primary mucocutaneous and appendageal presentations could be the initial or evolving signs of COVID-19. It could be manifest most commonly as a maculopapular exanthamatous or morbiliform eruption, generalized urticaria or pseudo chilblains recognized as "COVID toes" (pernio-like acral lesions or vasculopathic rashes). During pandemic, Non-infected non-at risk patients with immune-medicated dermatologic disorders under treatment with immunosuppressive immunomodulators do not need to alter their regimen or discontinue their therapies. At-risk o suspected patients may need dose reduction, interval increase or temporary drug discontinuation (at least 2 weeks). Patients with an active COVID-19 infection should hold the biologic or non-biologic immunosuppressives until the complete recovery occur (at least 4 weeks).
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Affiliation(s)
- Farnoosh Seirafianpour
- Student Research Committee, school of medicineIran University of Medical SciencesTehranIran
| | - Sogand Sodagar
- Student Research Committee, school of medicineIran University of Medical SciencesTehranIran
| | - Arash Pour Mohammad
- Student Research Committee, school of medicineIran University of Medical SciencesTehranIran
| | - Parsa Panahi
- Student Research Committee, school of medicineIran University of Medical SciencesTehranIran
| | - Samaneh Mozafarpoor
- Department of Dermatology, Skin Disease and Leishmaniasis Research CenterIsfahan University of Medical SciencesIsfahanIran
| | - Simin Almasi
- Department of Rheumatology, Rheumatology Research CenterFiroozgar Hospital, Iran University of Medical Sciences (IUMS)TehranIran
| | - Azadeh Goodarzi
- Department of DermatologyRasoul Akram Hospital, Iran University of Medical Sciences (IUMS)TehranIran
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