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Wang S, Hao J, Ruan Q, Hong X, Yu Z, Huang J, Li J, Gao D, Liu S. The mask paradox between perception of discomfort and reality of physiological effects in healthy college students in China: a panel study. BMC Public Health 2024; 24:2845. [PMID: 39415138 PMCID: PMC11481434 DOI: 10.1186/s12889-024-20127-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Accepted: 09/18/2024] [Indexed: 10/18/2024] Open
Abstract
BACKGROUND During the COVID-19 pandemic, masks proved to be an effective measure in preventing virus transmission. However, many people have reported discomfort and negative perceptions toward wearing masks, especially during physical activity. This study aims to evaluate the discomfort and adverse perceptions related to various mask types among young, healthy adults during light exercise, including sitting, stationary stepping, and stair climbing. The study also examines the extent to which masks influence physiological indicators of physical well-being. METHODS The study was conducted in two stages at the campus hospital of Shantou University. In Stage 1, 20 healthy college students (10 males, 10 females) were recruited to identify the mask with the most substantial physiological and psychological impact among four types: KN95 respirators, surgical masks, cloth masks, and 3D medical masks. These specific types were chosen due to their widespread use and varying levels of filtration and breathability. In Stage 2, 14 healthy college students (7 males, 7 females) were included to examine the effects of the identified mask across various levels of physical exertion. Subjective perceptions were measured using the Mask-Related Discomfort and Perception Score (MRDPS), and physiological parameters such as body temperature, blood pressure, pulse rate, and vital capacity were recorded. RESULTS The KN95 respirator and cloth mask were associated with the highest MRDPS, indicating significant discomfort among wearers (p < 0.05). The use of KN95 respirators had the largest impact on MRDPS during stair stepping (β = 10.357, 95% CI [5.755, 14.959]). Physiological parameters showed minor variations across different masks, with KN95 respirators significantly associated with reduced diastolic blood pressure (β=-7.806, 95% CI [-12.294, -3.318]) and pulse rate (β=-10.661, 95% CI [-18.896, -2.425]) in Stage 1. However, after controlling for exercise pace in Stage 2, wearing a KN95 respirator did not significantly affect these parameters. CONCLUSIONS KN95 respirators and cloth masks were found to cause the most discomfort during light physical activity, with males reporting higher discomfort levels than females. While these masks are associated with varying levels of perceived discomfort, their impact on physiological indicators is relatively modest. Future research should include larger and more diverse samples , continuous monitoring of physiological parameters during exercise, and exploration of the underlying mechanisms of gender differences in mask discomfort.
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Affiliation(s)
- Songtao Wang
- Rural Revitalization Research Center, Business School, Shantou University, Shantou, Guangdong Province, China
| | - Jiayuan Hao
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Qianyi Ruan
- School of Public Health, Shantou University, Shantou, Guangdong Province, China
| | - Xuanxuan Hong
- School of Public Health, Shantou University, Shantou, Guangdong Province, China
| | - Zicheng Yu
- School of Public Health, Shantou University, Shantou, Guangdong Province, China
| | - Jiawen Huang
- School of Public Health, Shantou University, Shantou, Guangdong Province, China
| | - Jiayi Li
- School of Public Health, Shantou University, Shantou, Guangdong Province, China
| | - Dongna Gao
- School of Public Health, Shantou University, Shantou, Guangdong Province, China
| | - Suyang Liu
- School of Public Health, Shantou University, Shantou, Guangdong Province, China.
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Lu J, Jiang G. Guarding skin under PPE: Mechanistic insights and technological innovations. Skin Res Technol 2023; 29:e13520. [PMID: 38009022 PMCID: PMC10626285 DOI: 10.1111/srt.13520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 10/24/2023] [Indexed: 11/28/2023]
Abstract
In the presence of diseases transmitted through respiratory droplets and direct contact, healthcare workers (HCWs) necessitate the use of personal protective equipment (PPE). For optimal safety, PPE should securely conform to the skin during extended wear. However, conventional PPE often lacks adequate air permeability and hygroscopicity, trapping heat and moisture emitted by the body within the enclosure. Such a hot and humid internal environment can induce skin damage, such as erythema, rash, pruritus, and itching among others, leading to microbial growth on the skin surface, the production of inflammatory mediators at the wound site and an increased risk of infection. This review strives to comprehensively elucidate the fundamental mechanisms triggering adverse skin reactions and their resultant manifestations. Furthermore, we explore recent advancements aimed at inhibiting these mechanisms to effectively mitigate the occurrence of skin lesions.
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Affiliation(s)
- Junru Lu
- Department of DermatologyAffiliated Hospital of Xuzhou Medical UniversityXuzhouJiangsuChina
- Xuzhou Medical UniversityXuzhouJiangsuChina
| | - Guan Jiang
- Department of DermatologyAffiliated Hospital of Xuzhou Medical UniversityXuzhouJiangsuChina
- Xuzhou Medical UniversityXuzhouJiangsuChina
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3
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Lobato-Berezo A, Fernández Figueras MT, Pujol RM. Auricular Pseudocysts After Prolonged Protective Mask Wearing for SARS-CoV-2. ACTAS DERMO-SIFILIOGRAFICAS 2023; 114:T738-T739. [PMID: 37348832 PMCID: PMC10281039 DOI: 10.1016/j.ad.2022.01.060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 01/30/2022] [Indexed: 06/24/2023] Open
Affiliation(s)
- A Lobato-Berezo
- Departamento de Dermatología, Hospital del Mar-Parc de Salut Mar, Barcelona, España.
| | - M T Fernández Figueras
- Departamento de Patología, Hospital Universitari General de Catalunya, Sant Cugat del Vallès, Barcelona, España
| | - R M Pujol
- Departamento de Dermatología, Hospital del Mar-Parc de Salut Mar, Barcelona, España
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Tang H, Wang H, Hamblin MR, Jiang L, Zhou Y, Xu Y, Wen X. Contact dermatitis caused by prevention measures during the COVID-19 pandemic: a narrative review. Front Public Health 2023; 11:1189190. [PMID: 37546301 PMCID: PMC10400336 DOI: 10.3389/fpubh.2023.1189190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Accepted: 07/04/2023] [Indexed: 08/08/2023] Open
Abstract
Introduction During the outbreak of Coronavirus disease 2019 (COVID-19), health care workers wore personal protective equipment including masks, gloves and goggles for a long time. In order to reduce the transmission routes of the virus, public places were sprayed with disinfectant. Moreover, the body, hands and clothing were frequently disinfected and washed for hygiene purposes. Studies have shown that these practices could easily irritate the skin and damage the skin barrier. Long-term irritation or exposure to allergens may lead to the occurrence of contact dermatitis (CD). Methods Subject headings were searched via the National Library of Medicine (PubMed) and web of science databases: COVID-19; contact dermatitis; adverse skin reaction; PPE; dermatitis; mask; glory; hand hygiene, disinfection; face shield; goggle; protect cloth. A total of 246 and 646 articles were retrieved from the two databases, respectively. 402 articles remained after removing duplicates. Reviews, non-English articles, articles that could not be accessed to read or did not conform to our topic were excluded. Finally, a total of 32 cross-sectional studies, 9 case reports and 2 randomized controlled trials were included. Discussion This article reviews reports of CD caused by various prevention and hygiene measures during the COVID-19 pandemic. The amount of skin damage caused by COVID-19 prevention measures could be decreased by improved education about skin management.
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Affiliation(s)
- Huimiao Tang
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, China
- Laboratory of Dermatology, Clinical Institute of Inflammation and Immunology, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
| | - Hao Wang
- Laboratory of Dermatology, Clinical Institute of Inflammation and Immunology, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
| | - Michael R. Hamblin
- Laser Research Centre, Faculty of Health Science, University of Johannesburg, Doornfontein, South Africa
| | - Lu Jiang
- Outpatient Department of West China Hospital, Sichuan University, Chengdu, China
| | - Yanjun Zhou
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, China
- Laboratory of Dermatology, Clinical Institute of Inflammation and Immunology, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
| | - Yidan Xu
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, China
- Laboratory of Dermatology, Clinical Institute of Inflammation and Immunology, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
| | - Xiang Wen
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu, China
- Laboratory of Dermatology, Clinical Institute of Inflammation and Immunology, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
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Ostrowski P, Masiuk H, Kulig P, Skoryk A, Wcisłek A, Jursa-Kulesza J, Sarna A, Sławiński M, Kotowski M, Tejchman K, Kotfis K, Sieńko J. Medical Face Masks Do Not Affect Acid-Base Balance Yet Might Facilitate the Transmission of Staphylococcus aureus in Hospital Settings during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2474. [PMID: 36767840 PMCID: PMC9915457 DOI: 10.3390/ijerph20032474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 01/17/2023] [Accepted: 01/24/2023] [Indexed: 06/18/2023]
Abstract
INTRODUCTION Due to the SARS-CoV-2 coronavirus pandemic, the wearing of masks has become a common phenomenon. Most of the undesirable effects of using a protective face covering are usually related to the prolonged time of its wearing, and the adverse consequences of face coverings should be considered two-fold. The aim of the study was to evaluate the rate of contamination of the three types of face coverings (surgical, N95, and FFP2 masks) with the microorganism-aerobic bacteria, yeasts, and molds-after the 3 h exposure time. The study aimed to investigate the effects of wearing FFP2 masks (KN95) on respiratory function and the acid-base balance of the human body. RESULTS The presence of S. aureus was confirmed in both nasal carriers and non-carriers which may demonstrate the cross-contamination and spread of this bacterium via hands. S. aureus was found on external and internal surfaces of face masks of each type, and therefore could also be transmitted via hands from external sources. The 3 h exposure time is not sufficient for Gram-negative rods and mold contamination. Moreover, there were no significant differences in most of the parameters studied between the first and second examinations, both in spirometry and capillary blood gas analysis (p > 0.05).
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Affiliation(s)
- Piotr Ostrowski
- Department of General Surgery and Transplantation, Pomeranian Medical University, 70-111 Szczecin, Poland
| | - Helena Masiuk
- Independent Laboratory of Medical Microbiology, Pomeranian Medical University, 70-111 Szczecin, Poland
| | - Piotr Kulig
- Department of General Pathology, Pomeranian Medical University, 70-111 Szczecin, Poland
| | - Anastasiia Skoryk
- Department of General Surgery and Transplantation, Pomeranian Medical University, 70-111 Szczecin, Poland
| | - Aleksandra Wcisłek
- Independent Laboratory of Medical Microbiology, Pomeranian Medical University, 70-111 Szczecin, Poland
| | - Joanna Jursa-Kulesza
- Independent Laboratory of Medical Microbiology, Pomeranian Medical University, 70-111 Szczecin, Poland
| | - Angela Sarna
- Department of Laboratory Diagnostics, Public Clinical Hospital No. 2, 70-111 Szczecin, Poland
| | - Michał Sławiński
- Department of Laboratory Diagnostics, Public Clinical Hospital No. 2, 70-111 Szczecin, Poland
| | - Maciej Kotowski
- Department of General Surgery and Transplantation, Pomeranian Medical University, 70-111 Szczecin, Poland
| | - Karol Tejchman
- Department of General Surgery and Transplantation, Pomeranian Medical University, 70-111 Szczecin, Poland
| | - Katarzyna Kotfis
- Department of Anesthesiology, Intensive Therapy and Acute Intoxications, Pomeranian Medical University, 70-111 Szczecin, Poland
| | - Jerzy Sieńko
- Department of General Surgery and Transplantation, Pomeranian Medical University, 70-111 Szczecin, Poland
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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] [MESH Headings] [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 MedicineNanyang Technological UniversitySingapore
- Tan Tock Seng HospitalSingapore
| | - Yik Weng Yew
- Lee Kong Chian School of MedicineNanyang Technological UniversitySingapore
- National Skin CentreSingapore
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7
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Nakamura T, Yoshida H, Haneoka M, Nakamura S, Takahashi Y. Season- and facial site-specific skin changes due to long-term mask wearing during the COVID-19 pandemic. Skin Res Technol 2022; 28:749-758. [PMID: 35789503 PMCID: PMC9349579 DOI: 10.1111/srt.13196] [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: 01/26/2022] [Accepted: 06/19/2022] [Indexed: 11/30/2022]
Abstract
Background As people have regularly worn facial masks due to the coronavirus disease 2019 (COVID‐19) pandemic, mask‐wear‐related adverse effects on the skin have been recognized. The aim of this study was to explore skin changes, their seasonal variations in the general population caused by commonly used masks and a possible mechanism underlying negative effects of mask‐wearing. Materials and methods Eighteen Japanese females participated in the study during summer and winter in Japan. Skin characteristics were measured in the non‐mask‐wearing preauricular area and the mask‐wearing cheek and perioral areas. Results Trans‐epidermal water loss (TEWL) on the cheek area tended to be increased in winter, which was positively correlated with skin scaliness on the same area. Ceramide (CER) content and composition in the mask‐covered stratum corneum (SC) were slightly changed between summer and winter, and CER [NP]/[NS] ratio was negatively correlated with the TEWL on the perioral skin in winter. Skin hydration and sebum secretion were higher on the cheek compared to the perioral area in summer. Skin redness was particularly high on the cheek in winter. Conclusion Mask‐wear‐related skin changes were season‐ and facial site‐specific, and alterations in SC CER may play a role in barrier‐related skin problems caused by mask use.
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Affiliation(s)
- Tomomi Nakamura
- Biological Science Research, Kao Corporation, Odawara-shi, Kanagawa, Japan
| | - Hiroyuki Yoshida
- Biological Science Research, Kao Corporation, Odawara-shi, Kanagawa, Japan
| | - Mai Haneoka
- Analytical Science Research, Kao Corporation, Ichikai-machi, Tochigi, Japan
| | - Shun Nakamura
- Analytical Science Research, Kao Corporation, Ichikai-machi, Tochigi, Japan
| | - Yoshito Takahashi
- Biological Science Research, Kao Corporation, Odawara-shi, Kanagawa, Japan
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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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9
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Lobato-Berezo A, Fernández Figueras MT, Pujol M. Auricular Pseudocysts After Prolonged Protective Mask Wearing for SARS-CoV2. ACTAS DERMO-SIFILIOGRAFICAS 2022; 114:S0001-7310(22)00154-5. [PMID: 35221341 PMCID: PMC8857761 DOI: 10.1016/j.ad.2022.01.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 01/30/2022] [Indexed: 10/29/2022] Open
Affiliation(s)
- A Lobato-Berezo
- Department of Dermatology, Hospital del Mar-Parc de Salut Mar (Barcelona), Spain
| | - M T Fernández Figueras
- Department of Pathology, Hospital Universitari General de Catalunya (Sant Cugat del Vallès, Barcelona), Spain
| | - M Pujol
- Department of Dermatology, Hospital del Mar-Parc de Salut Mar (Barcelona), Spain
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Babino G, Argenziano G, Balato A. Impact in Contact Dermatitis during and after SARS-CoV2 Pandemic. CURRENT TREATMENT OPTIONS IN ALLERGY 2022; 9:19-26. [PMID: 35194543 PMCID: PMC8830973 DOI: 10.1007/s40521-022-00298-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/10/2022] [Indexed: 12/28/2022]
Abstract
Purpose of the review Due to the recent COVID-19 pandemic, several skin conditions have emerged due to the preventive measures adopted by both health care workers and the general population against SARS-CoV-2. Above all, wearing of personal protective equipment, frequent hand-washing and disinfecting of surfaces have resulted in an increased risk of irritant or allergic contact dermatitis. The aim of this review is to investigate contact dermatitis associated with COVID-19 pandemic period. Recent findings There is a real evidence of the rising prevalence of irritant and allergic contact dermatitis in response to the COVID-19 pandemic. The most commonly recorded symptoms are dryness, itch and redness of the skin. Nasal bridge, cheeks, forehead and hands represent the mainly affected skin sites. Summary Contact dermatitis lesions may appear as a result of various recommendations to prevent transmission of COVID-19. Procedures to alleviate pressure and friction, gentle skin care and adequate moisturizing, have been identified as important preventive strategies for contact dermatitis related to personal protective equipment and personal hygiene measures.
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Affiliation(s)
- Graziella Babino
- Dermatology Unit, Department of Mental and Physical Health and Preventive Medicine, University of Campania “Luigi Vanvitelli”, Via Pansini 5, 80131 Naples, Italy
| | - Giuseppe Argenziano
- Dermatology Unit, Department of Mental and Physical Health and Preventive Medicine, University of Campania “Luigi Vanvitelli”, Via Pansini 5, 80131 Naples, Italy
| | - Anna Balato
- Dermatology Unit, Department of Mental and Physical Health and Preventive Medicine, University of Campania “Luigi Vanvitelli”, Via Pansini 5, 80131 Naples, Italy
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11
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Skin-related problems associated with the use of personal protective equipment among health care workers during the COVID-19 pandemic: A online survey study. J Tissue Viability 2022; 31:112-118. [PMID: 35027251 PMCID: PMC8741328 DOI: 10.1016/j.jtv.2022.01.003] [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: 09/02/2021] [Revised: 12/27/2021] [Accepted: 01/06/2022] [Indexed: 12/02/2022]
Abstract
Aim The aim of this study was to determine the skin-related problems caused by personal protective equipment (PPE) use in health care workers (HCWs) and to identify the factors contributing to their occurrence. Materials and Methods This descriptive and cross-sectional online survey study was carried out with 297 HCWs working in a university hospital in Turkey between March 20, 2021, and May 20, 2021. The study data was collected using an online questionnaire consisting of 3 parts. Descriptive statistics, Pearson's Chi-square, and Fisher's Exact Chi-square tests were used to analyze the data. Results Among the HCWs, 95.6% reported that skin-related problems associated with at least one PPE use. Skin-related problems that develop due to PPE use were mostly associated with the use of Surgical/N95 masks (97.1%) and gloves (96.8%). The most commonly reported problems were ''dryness'' (%74.0) and ''itching'' (%72.1) when wearing gloves, ''perspiration and moisture'' (73.6%), ''formation of equipment traces'' (53.9%), and ''skin lesions'' (52.8%) when wearing a surgical/N95 mask, ''perspiration and moisture'' (89.7%) when wearing protective overalls/gowns. Wearing PPE for more than 4h (p=0.001), taking additional precautions to increase the sense of protection (p=0.026), and not applying preventive measures while using PPE (p=0.003) significantly increase the risk of skin-related problems. Conclusion The results suggest that skin-related problems due to the use of PPE are common among HCWs.
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12
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Pedersen ESL, Collaud ENR, Mozun R, Dexter K, Kruljac C, Silberschmidt H, Lucas JS, Goutaki M, Kuehni CE. Facemask Usage Among People With Primary Ciliary Dyskinesia During the COVID-19 Pandemic: A Participatory Project. Int J Public Health 2022; 66:1604277. [PMID: 34975364 PMCID: PMC8715719 DOI: 10.3389/ijph.2021.1604277] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Accepted: 10/04/2021] [Indexed: 12/21/2022] Open
Abstract
Objectives: Primary ciliary dyskinesia (PCD) is a rare genetic disease that causes recurrent respiratory infections. People with PCD may be at high risk of severe COVID-19 and protection against SARS-CoV-2 is therefore important. We studied facemask usage and problems reported in relation with their use among people with PCD. Methods: We used data from COVID-PCD, an international observational cohort study. A questionnaire was e-mailed to participants in October 2020 that asked about facemask usage. Results: In total, 282 participants from 27 countries were included (Median age 32 years; 63% female). In total, 252 (89%) wore facemasks everywhere in public, 13 (5%) wore facemasks in most places, and 17 (6%) did not wear facemasks in public. Half of the participants reported that it was uncomfortable to wear facemasks because of runny nose, cough, or difficulty breathing. Participants less often wore facemasks when there was no national requirement. Conclusion: Most people with PCD wore facemasks despite frequent respiratory problems related to their use. Facemask usage was most frequent in countries with a national requirement emphasizing the importance of nationwide policies mandating facemasks.
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Affiliation(s)
- Eva S L Pedersen
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Eugenie N R Collaud
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Rebeca Mozun
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | | | | | - Hansruedi Silberschmidt
- Verein Kartagener Syndrom und Primaere Ciliaere Dyskinesie Deutschland, Wetzikon, Switzerland
| | - Jane S Lucas
- Primary Ciliary Dyskinesia Centre, NIHR Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom.,Faculty of Medicine, School of Clinical and Experimental Medicine, University of Southampton, Southampton, United Kingdom
| | | | - Myrofora Goutaki
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.,Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Claudia E Kuehni
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.,Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
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Gueniche A, Valois A, Salomao Calixto L, Sanchez Hevia O, Labatut F, Kerob D, Nielsen M. A dermocosmetic formulation containing Vichy volcanic mineralizing water, Vitreoscilla filiformis extract, niacinamide, hyaluronic acid, and vitamin E regenerates and repairs acutely stressed skin. J Eur Acad Dermatol Venereol 2022; 36 Suppl 2:26-34. [PMID: 34979590 DOI: 10.1111/jdv.17785] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 10/11/2021] [Indexed: 11/28/2022]
Abstract
The exposome has an impact on skin from life-long exposure. Acute short-term exposure to exposome stressors can also alter skin functions such as skin physical barrier and immune defenses, leading to skin dryness, sensitivity, flares of inflammatory skin conditions, or viral reactivations. Probiotics are defined as live microorganisms, which, when administered in adequate amounts, confer a health benefit on the host. An extract produced by lysing Vitreoscilla filiformis (VfeV) cultured in Vichy volcanic mineralizing water (VVMW) has properties of probiotic fractions. In this review, we present in vivo and ex vivo studies with a dermocosmetic formulation containing 80% VVMW, 5% VfeV, 4% niacinamide (vitamin B3), 0.4% hyaluronic acid, and 0.2% vitamin E (M89PF) to evaluate the clinical efficacy in preventing and repairing stressed skin. Skin barrier benefits of M89PF were shown in studies after the skin was exposed to sudden thermal changes, after skin irritation by tape stripping, and in sleep-deprived women. M89PF significantly accelerated skin renewal compared to untreated skin. Skin antioxidant defense activity of M89PF was shown after exposure to stress from UVA plus cigarette smoke aggression. Skin microbiome recovery after acute stress from a harsh cleanser was significantly better in M89PF-treated skin compared to bare skin. Clinical benefits of M89PF on correcting clinical signs of stressed skin were shown in both Caucasian and Asian women exposed to a stressful lifestyle and various external (pollution, tobacco smoking, solar radiation) and internal (poor sleep, stressful work, unbalanced diet, and alcohol consumption) exposome factors. M89PF also showed depigmenting properties on dark spots in Asian women. Further clinical studies are now warranted to evaluate the efficacy of M89PF as adjuvant care to prevent and repair skin barrier disruption and reinforce skin defenses in skin exposed to acute stresses.
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Affiliation(s)
- A Gueniche
- L'Oréal Research & Innovation, Chevilly Larue, France
| | - A Valois
- L'Oréal Research & Innovation, Chevilly Larue, France
| | | | | | - F Labatut
- L'Oréal Research & Innovation, Chevilly Larue, France
| | - D Kerob
- Laboratoires Vichy, Levallois Perret, France
| | - M Nielsen
- Laboratoires Vichy, Levallois Perret, France
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14
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Abstract
Unhealthy levels of air pollution are breathed by billions of people worldwide, and air pollution is the leading environmental cause of death and disability globally. Efforts to reduce air pollution at its many sources have had limited success, and in many areas of the world, poor air quality continues to worsen. Personal interventions to reduce exposure to air pollution include avoiding sources, staying indoors, filtering indoor air, using face masks, and limiting physical activity when and where air pollution levels are elevated. The effectiveness of these interventions varies widely with circumstances and conditions of use. Compared with upstream reduction or control of emissions, personal interventions place burdens and risk of adverse unintended consequences on individuals. We review evidence regarding the balance of benefits and potential harms of personal interventions for reducing exposure to outdoor air pollution, which merit careful consideration before making public health recommendations with regard to who should use personal interventions and where, when, and how they should be used. Expected final online publication date for the Annual Review of Public Health, Volume 43 is April 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.
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Affiliation(s)
- Robert J Laumbach
- Rutgers School of Public Health, and Environmental and Occupational Health Sciences Institute, Piscataway, New Jersey, USA;
| | - Kevin R Cromar
- Marron Institute of Urban Management, New York University, New York, NY, USA.,Departments of Environmental Medicine and Population Health, Grossman School of Medicine, New York University, New York, NY, USA;
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15
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Yaqoob S, Saleem A, Jarullah FA, Asif A, Essar MY, Emad S. Association of Acne with Face Mask in Healthcare Workers Amidst the COVID-19 Outbreak in Karachi, Pakistan. Clin Cosmet Investig Dermatol 2021; 14:1427-1433. [PMID: 34675578 PMCID: PMC8504703 DOI: 10.2147/ccid.s333221] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 09/28/2021] [Indexed: 12/11/2022]
Abstract
Background In the wake of coronavirus (COVID-19) global alert, people have begun to practice safety measures in order to reduce the exposure to life-threatening disease. The largest at risk population is undoubtedly the frontline healthcare workers (HCWs) who are using personal protective equipment (PPE), essentially face masks, to battle against this deadly virus. This study was conducted with the prime intention to reveal an association between face mask and acne and measure the prevalence of acne amongst HCWs amidst COVID-19 outbreak in Karachi. Furthermore, this study aimed to identify the type of mask generating acne, locate the common sites, assess the severity and establish an association of mask use with the skin type. Methods This cross-sectional study was carried out at Medicare Cardiac and General Hospital, Jinnah Medical College Hospital, Jinnah Postgraduate Medical Centre and Jamal Noor Hospital located in Karachi, Pakistan. A total of 348 HCWs were interviewed, of which only 193 met the inclusion criteria. All information was recorded on a predesigned proforma and analyzed using SPSS 25.0. Results Among 193 participants, acne was prevalent in 103 (53.4%) participants with maximum cases reported in female HCWs, and in doctors (p<0.05). Out of 73 HCWs using N-95 masks, 46 (44.7%) developed acne, with a p-value of 0.036. Skin type and past history of acne also yielded statistically significant results. Among all the skin types, HCWs with oily skin (64, 62.1%) were prone to face resurgence of acne or new-onset acne. The most common sites of eruption of acne were along the cheeks (45.1%) followed by the nose (40.9%). Majority of the population suffered from mild acne. Moderate and severe acne eruption was particularly observed in those wearing N-95 and surgical masks. Conclusion The use of face masks is associated with high rates of acne eruption. Disseminating the guidelines and indications of World Health Organization (WHO) regarding proper use of mask, encouraging awareness among HCWs and following proper doffing and donning protocol as endorsed by Centers for Disease Control and Prevention (CDC) will possibly minimize the adverse reactions.
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Affiliation(s)
- Sadia Yaqoob
- Department of Medicine, Jinnah Medical and Dental College, Karachi, Pakistan
| | - Amna Saleem
- Department of Medicine, Jinnah Medical and Dental College, Karachi, Pakistan
| | | | - Areeba Asif
- Department of Medicine, Jinnah Medical and Dental College, Karachi, Pakistan
| | - Mohammad Yasir Essar
- Department of Dentistry, Kabul University of Medical Sciences, Kabul, Afghanistan
| | - Shaista Emad
- Department of Biochemistry, Sohail University, Karachi, Pakistan
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16
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Abdali S, Yu J. Occupational Dermatoses Related to Personal Protective Equipment Used During the COVID-19 Pandemic. Dermatol Clin 2021; 39:555-568. [PMID: 34556245 PMCID: PMC8165076 DOI: 10.1016/j.det.2021.05.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The recent coronavirus disease 2019 (COVID-19) pandemic has led to the dramatic increase in use of personal protective equipment (PPE) among health care providers and the general public. Herein the authors discuss the various occupational dermatoses including allergic and irritant contact dermatitis, acne, seborrheic dermatitis, and rosacea related to frequent handwashing, disinfecting of surfaces, and prolonged wear of various PPE including face masks, gloves, and gowns. The authors provide an overview of published PPE-associated occupational dermatoses during the COVID-19 pandemic and also discuss prevention strategies and treatment options to help patients with these complaints.
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Affiliation(s)
- Selli Abdali
- Philadelphia College of Osteopathic Medicine, Philadelphia, PA 19131, USA
| | - JiaDe Yu
- Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, 50 Staniford St, Boston, MA 02114, USA.
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17
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Johansson B. Challenges and Controversies in COVID-19: Masking the General Population may Attenuate This Pandemic's Outbreak. Front Public Health 2021; 9:643991. [PMID: 34568248 PMCID: PMC8455895 DOI: 10.3389/fpubh.2021.643991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Accepted: 06/22/2021] [Indexed: 11/13/2022] Open
Abstract
SARS-CoV-2, the virus that causes COVID-19, spreads i. a., by respiratory droplets. The use of masks in preventing spread is controversial; masks are considered useless by many, while being mandated in some locations. Here, the effect of masking the general population on a COVID-19-like epidemic is estimated by computer simulation using three separate types of software. The main questions are whether mask use by the general population can limit the spread of SARS-CoV-2 in a country and how to identify opportunities when mask use is cost-effective and safe. To address these questions, the protective effects of different types of masks, the side-effects of masks, and avenues for improvements of masks and masking are addressed. Main results: (i) Any type of mask, even simple home-made ones, may be of value, even if the protective effect of each mask (here dubbed "one mask-protection") is low. Strict adherence to mask use does not appear to be critical but increasing one mask-protection to >50% was found to be advantageous. (ii) Masks do seem to reduce the number of new cases even if introduced at a late stage in an epidemic, but early implementation helps reduce the cumulative and total number of cases. (iii) The simulations suggest that it might be possible to eliminate a COVID-19 outbreak by widespread mask use during a limited period. There is a brief discussion of why the reported effect size of masking varies widely, and is expected to do so, because of different filtration abilities of different masks, differences in compliance and fitting, other routes of transmission, pre-existing immunity, and because a system of interconnected, disease-prone individuals has non-linear properties. A software solution to visualize infection spread is presented. The results from these simulations are encouraging, but do not necessarily represent the real-life situation, so it is suggested that clinical trials of masks are now carried out while continuously monitoring effects and side-effects. As mask use is not without risks and costs, it is suggested that governments and scientists have an important role in advising the public about the sensible use of masks.
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Affiliation(s)
- Björn Johansson
- Theme Aging, Karolinska University Hospital, Stockholm, Sweden
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
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18
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Tasic-Kostov M, Martinović M, Ilic D, Cvetkovic M. Cotton versus medical face mask influence on skin characteristics during COVID-19 pandemic: A short-term study. Skin Res Technol 2021; 28:66-70. [PMID: 34420235 PMCID: PMC8661639 DOI: 10.1111/srt.13091] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 07/31/2021] [Indexed: 12/27/2022]
Abstract
BACKGROUND In the still ongoing COVID-19 pandemic, one of the main prevention strategy remain to be the use of protective face masks. Changes in skin characteristics and dermatological problems related to wearing different types of masks have been observed. The aim of this study was to compare the short-term effects of cotton versus medical masks on skin biophysical parameters in general population. MATERIALS AND METHODS Twenty-eight human volunteers were enrolled and divided in cotton mask and medical mask wearing groups. We measured four skin biophysical parameters: trans-epidermal water loss (TEWL), stratum corneum hydration (SCH), skin pH, and erythema index (EI) before and 3 h after wearing masks on both uncovered and mask-wearing face area. RESULTS TEWL increased after 3 h on exposed skin in cotton mask group and slightly decreased in medical mask group There was an increase in SCH after 3 h of wearing protective face masks in both groups. pH of the covered skin slightly decreased while EI increased after 3 h in both groups; changes were not statistically significant. Parameters did not change significantly on uncovered skin. CONCLUSION There were no differences between the influence of cotton versus medical protective masks on the skin of healthy volunteers in our study. Both types of masks could be recommended for short-time protection in individuals with healthy skin during COVID-19 pandemic.
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Affiliation(s)
| | - Milica Martinović
- Department of Pharmacy, Faculty of Medicine, University of Niš, Niš, Serbia
| | - Dusan Ilic
- Department of Pharmacy, Faculty of Medicine, University of Niš, Niš, Serbia
| | - Maja Cvetkovic
- Department of Pharmacy, Faculty of Medicine, University of Niš, Niš, Serbia
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19
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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: 28] [Impact Index Per Article: 9.3] [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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