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Hanse B, Alam SM, Krishnan S, Bhattacharjee M, Sinha A, Sundareswaran L, Kalita J. Occupational heat stress and its health impacts- an overview of research status and need for further research in Southeast Asia with special emphasis on mitigation strategies in North East India. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2024:10.1007/s00484-024-02765-8. [PMID: 39249523 DOI: 10.1007/s00484-024-02765-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Revised: 07/03/2024] [Accepted: 08/19/2024] [Indexed: 09/10/2024]
Abstract
The Intergovernmental Panel on Climate Change, IPCC predicts that hot seasons will get even hotter due to global climate change. There exists a critical dependence of human metabolic processes on temperature. Changes in thermal balance therefore, have an adverse effect on health because they raise body temperature, cause excessive sweating, and accelerate the rate of dehydration. Different nations and professional groups use different techniques to measure heat strain. This paper aims to review previous research conducted in the area of heat strain due to heat exposure among workers in Southeast Asia and also to profile mitigation strategies in North East India. Studies conducted between the years 2011 to 2023 in the evaluation of the health impacts of occupational heat stress were searched systematically using several sources of databases like PubMed, Google Scholar, Science Direct, Web of Science, Scopus, etc. It was noted that a greater proportion of previous research on evaluating physiological effects was carried out in controlled environments as opposed to real-world field settings. While such studies give us valuable insights into the relationship, applying the same methodology in the workplace may not be feasible. In India, very few research has been carried out on workplace heat stress, and even fewer have been done in North East India using physiological indicators. North East India is also affected by global climate change leading top more hotter days than before. The region of Northeast India, particularly Guwahati (Assam), has recently seen extreme heat waves during the sweltering summer months. With less literature available in this geographical location, studies with actual field-based settings are much needed to understand the occupational health impacts in this region. This review can formulate a suitable methodology for assessing the health impacts in working environment. This can also help the local health professionals to recognize the heat strain parameters that are acceptable worldwide, and use as pertinent indicators to scrutinize worker's health and develop preventive agendas as climate change advances.
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Affiliation(s)
- Benzamin Hanse
- Department of Physiology, AIIMS, Guwahati, 781101, India
| | - S M Alam
- Department of Physiology, AIIMS, Guwahati, 781101, India
| | - S Krishnan
- Department of Physiology, AIIMS, Guwahati, 781101, India.
| | | | - A Sinha
- Department of Physiology, AIIMS, Guwahati, 781101, India
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Quartucci C, Wibowo R, Do V, Bose-O Reilly S, Nowak D, Weilnhammer V, Weinmann T, Rakete S. Assessment of subjective well-being of healthcare workers in response to heat and personal protective equipment under controlled conditions using a standardized protocol. J Occup Med Toxicol 2024; 19:16. [PMID: 38750499 PMCID: PMC11095016 DOI: 10.1186/s12995-024-00418-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 05/08/2024] [Indexed: 05/19/2024] Open
Abstract
BACKGROUND Due to climate change, the increasing frequency of hot summer days and heat waves can result in occupational heat strain, especially in non-air-conditioned workplaces. Healthcare workers (HCW) engaged in patient care are particularly affected, as they are additionally exposed to physical stress. The use of personal protective equipment (PPE) can aggravate heat strain in HCW. This study aimed to examine the subjective well-being of HCW when exposed to heat and PPE under controlled conditions. METHODS This study was designed as a randomized crossover trial. Participants performed standardized healthcare tasks in a climatic chamber for approximately 3.5 h at different indoor temperatures (22 °C and 27 °C) and varied working conditions (with or without PPE). The effects on participants' subjective well-being, encompassing thermal, physiological and psychological stress were assessed using a customized questionnaire. RESULTS Heat had a greater effect than PPE on thermal, physical and psychological stress. Conversely, PPE had a greater effect on physical demand and effort. For the majority of outcomes, combined exposure to heat and PPE resulted in the highest perceived discomfort. Furthermore, the participants reported increased sweating and other discomforts when working at elevated temperatures or with PPE. CONCLUSIONS In this study, heat and PPE, but particularly the combination of both factors, were identified as unfavorable working environments. Although the trials were conducted in a controlled environment, the outcomes provide valuable information about the effect of heat and PPE on HCW in a real-life setting. Furthermore, the design used in this study can be beneficial in evaluating the effect of mitigation strategies.
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Affiliation(s)
- Caroline Quartucci
- Institute and Clinic for Occupational, Social and Environmental Medicine, LMU University Hospital, LMU Munich, Munich, Germany
- Institute for Occupational Health and Product Safety, Bavarian Health and Food Safety Authority, Environmental Health, Munich, Germany
| | - Razan Wibowo
- Institute and Clinic for Occupational, Social and Environmental Medicine, LMU University Hospital, LMU Munich, Munich, Germany
- Institute for Occupational Health and Product Safety, Bavarian Health and Food Safety Authority, Environmental Health, Munich, Germany
| | - Viet Do
- Institute and Clinic for Occupational, Social and Environmental Medicine, LMU University Hospital, LMU Munich, Munich, Germany
| | - Stephan Bose-O Reilly
- Institute and Clinic for Occupational, Social and Environmental Medicine, LMU University Hospital, LMU Munich, Munich, Germany
- Department of Public Health, Medical Informatics and Technology, Health Services Research and Health Technology Assessment, UMIT - University for Health Sciences, Hall in Tirol, Austria
| | - Dennis Nowak
- Institute and Clinic for Occupational, Social and Environmental Medicine, LMU University Hospital, LMU Munich, Munich, Germany
| | - Veronika Weilnhammer
- Institute for Occupational Health and Product Safety, Bavarian Health and Food Safety Authority, Environmental Health, Munich, Germany
| | - Tobias Weinmann
- Institute and Clinic for Occupational, Social and Environmental Medicine, LMU University Hospital, LMU Munich, Munich, Germany
| | - Stefan Rakete
- Institute and Clinic for Occupational, Social and Environmental Medicine, LMU University Hospital, LMU Munich, Munich, Germany.
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Yang HY, Chou HL, Leow CHW, Kao CC, Daniel D, Jaladara V, Khoe LC, Latha PK, Mahendradhata Y, Nguyen PM, Sirijatuphat R, Soemarko DS, Venugopal V, Zhang K, Lee JKW. Poor personal protective equipment practices were associated with heat-related symptoms among Asian healthcare workers: a large-scale multi-national questionnaire survey. BMC Nurs 2024; 23:145. [PMID: 38429747 PMCID: PMC10905833 DOI: 10.1186/s12912-024-01770-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 01/28/2024] [Indexed: 03/03/2024] Open
Abstract
BACKGROUND It is pertinent to understand the perceptions of healthcare workers (HCWs) with their associated personal protective equipment (PPE) usage and heat strain symptoms experienced to effectively combat the negative effects of heat stress during treatment and care activities. METHODS We evaluated the associated heat stress perceived by HCWs across Asia and validated a questionnaire on perceptions of heat stress, associated PPE usage, and heat strain symptoms experienced. The questionnaire was administered to 3,082 HCWs in six Asian regions. Factor analyses, including Cronbach's alpha, assessed the questionnaire's validity and reliability. Structural equation modelling analysed the effects of knowledge, attitudes and practices, and heat strain symptoms. RESULTS The questionnaire was found to be reliable in assessing HCWs' knowledge, and attitudes and practices towards heat stress and PPE usage (both Cronbach's alpha = 0.9), but not heat strain symptoms (Cronbach's alpha = 0.6). Despite knowledge of heat stress, HCWs had negative attitudes and practices regarding PPE usage (β1 = 0.6, p < 0.001). Knowledge (path coefficient = 0.2, p < 0.001), and negative attitudes and practices (path coefficient = 0.2, p < 0.001) of HCWs towards heat stress and PPE usage adversely affected symptoms experienced. CONCLUSIONS The questionnaire was not reliable in assessing symptoms. HCWs should, nevertheless, still self-assess their symptoms for early detection of heat strain. To effectively attenuate heat strain, understanding HCWs' attitudes and practices towards PPE usage should guide policymakers in implementing targeted heat management strategies.
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Affiliation(s)
- Hsiao-Yu Yang
- Institute of Environmental and Occupational Health Sciences, National Taiwan University College of Public Health, 10055, Taipei, Taiwan
- Department of Public Health, National Taiwan University College of Public Health, 10055, Taipei, Taiwan
- Department of Environmental and Occupational Medicine, National Taiwan University Hospital, 100225, Taipei, Taiwan
- Population Health Research Center, National Taiwan University, 10617, Taipei City, Taiwan
| | - Hsiu-Ling Chou
- Department of Nursing, Asia Eastern University of Science and Technology, 220303, New Taipei City, Taiwan
- Department of Nursing, Far Eastern Memorial Hospital, 220216, New Taipei City, Taiwan
| | - Clarence Hong Wei Leow
- Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, 117593, Singapore, Singapore
- Campus for Research Excellence and Technological Enterprise (CREATE), National University of Singapore, 138602, Singapore, Singapore
| | - Ching-Chiu Kao
- Department of Nursing, Wan Fang Hospital, Taipei Medical University, 116079, Taipei, Taiwan
- School of Nursing, College of Nursing, Taipei Medical University, 110301, Taipei, Taiwan
| | - D Daniel
- Department of Health Behaviour, Environment and Social Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, 55281, Yogyakarta, Indonesia
| | - Vena Jaladara
- Department of Health Behaviour, Environment and Social Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, 55281, Yogyakarta, Indonesia
| | - Levina Chandra Khoe
- Department of Community Medicine, Faculty of Medicine, Universitas Indonesia, 10430, Jakarta, Indonesia
| | - P K Latha
- Sri Ramachandra Institute of Higher Education & Research, 600116, Chennai, Tamil Nadu, India
| | - Yodi Mahendradhata
- Center for Tropical Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, 55281, Yogyakarta, Indonesia
- Department of Health Policy and Management, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, 55281, Yogyakarta, Indonesia
| | - Phuong Minh Nguyen
- Department of Military Occupational Medicine, Vietnam Military Medical University, Hanoi, Vietnam
| | - Rujipas Sirijatuphat
- Division of Infectious Diseases and Tropical Medicine, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, 10700, Bangkok, Thailand
| | - Dewi Sumaryani Soemarko
- Department of Community Medicine, Faculty of Medicine, Universitas Indonesia, 10430, Jakarta, Indonesia
| | - Vidhya Venugopal
- Sri Ramachandra Institute of Higher Education & Research, 600116, Chennai, Tamil Nadu, India
| | - Kai Zhang
- Department of Environmental Health Sciences, School of Public Health, University at Albany, State University of New York, 12144, Rensselaer, NY, USA
| | - Jason Kai Wei Lee
- Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, 117593, Singapore, Singapore.
- Campus for Research Excellence and Technological Enterprise (CREATE), National University of Singapore, 138602, Singapore, Singapore.
- Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, 117593, Singapore, Singapore.
- Heat Resilience and Performance Centre, Yong Loo Lin School of Medicine, National University of Singapore, Block MD9, 2 Medical Drive Level 4, 117593, Singapore, Singapore.
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Wibowo R, Do V, Quartucci C, Koller D, Daanen HAM, Nowak D, Bose-O'Reilly S, Rakete S. Effects of heat and personal protective equipment on thermal strain in healthcare workers: part B-application of wearable sensors to observe heat strain among healthcare workers under controlled conditions. Int Arch Occup Environ Health 2024; 97:35-43. [PMID: 37947815 DOI: 10.1007/s00420-023-02022-2] [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: 06/07/2023] [Accepted: 10/23/2023] [Indexed: 11/12/2023]
Abstract
PURPOSE As climate change accelerates, healthcare workers (HCW) are expected to be more frequently exposed to heat at work. Heat stress can be exacerbated by physical activity and unfavorable working requirements, such as wearing personal protective equipment (PPE). Thus, understanding its potential negative effects on HCW´s health and working performance is becoming crucial. Using wearable sensors, this study investigated the physiological effects of heat stress due to HCW-related activities. METHODS Eighteen participants performed four experimental sessions in a controlled climatic environment following a standardized protocol. The conditions were (a) 22 °C, (b) 22 °C and PPE, (c) 27 °C and (d) 27 °C and PPE. An ear sensor (body temperature, heart rate) and a skin sensor (skin temperature) were used to record the participants´ physiological parameters. RESULTS Heat and PPE had a significant effect on the measured physiological parameters. When wearing PPE, the median participants' body temperature was 0.1 °C higher compared to not wearing PPE. At 27 °C, the median body temperature was 0.5 °C higher than at 22 °C. For median skin temperature, wearing PPE resulted in a 0.4 °C increase and higher temperatures in a 1.0 °C increase. An increase in median heart rate was also observed for PPE (+ 2/min) and heat (+ 3/min). CONCLUSION Long-term health and productivity risks can be further aggravated by the predicted temperature rise due to climate change. Further physiological studies with a well-designed intervention are needed to strengthen the evidence for developing comprehensive policies to protect workers in the healthcare sector.
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Affiliation(s)
- Razan Wibowo
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, 80336, Munich, Germany
| | - Viet Do
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, 80336, Munich, Germany
| | - Caroline Quartucci
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, 80336, Munich, Germany
- Institute for Occupational Safety and Environmental Health Protection, Bavarian Health and Food Safety Authority, 80538, Munich, Germany
| | - Daniela Koller
- Institute for Medical Information Processing, Biometry and Epidemiology, LMU Munich, 81377, Munich, Germany
| | - Hein A M Daanen
- Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Dennis Nowak
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, 80336, Munich, Germany
| | - Stephan Bose-O'Reilly
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, 80336, Munich, Germany
- Institute of Public Health, Medical Decision Making and Health Technology Assessment, Department of Public Health, Health Services Research and Health Technology Assessment, UMIT-University for Health Sciences, Medical Informatics and Technology, Hall in Tirol, Austria
| | - Stefan Rakete
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, 80336, Munich, Germany.
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Tetzlaff EJ, Goulet N, Gorman M, Richardson GRA, Kenny GP. The Intersection of the COVID-19 Pandemic and the 2021 Heat Dome in Canadian Digital News Media: A Content Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6674. [PMID: 37681814 PMCID: PMC10488163 DOI: 10.3390/ijerph20176674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 08/18/2023] [Accepted: 08/25/2023] [Indexed: 09/09/2023]
Abstract
During the 2021 Heat Dome, 619 people in British Columbia died due to the heat. This public health disaster was made worse by the ongoing COVID-19 pandemic. Few studies have explored the intersection of heat with COVID-19, and none in Canada. Considering that climate change is expected to increase the frequency of extreme heat events, it is important to improve our understanding of intersecting public health crises. Thus, this study aimed to explore media-based public health communication in Canada during the COVID-19 pandemic and the 2021 Heat Dome. A qualitative content analysis was conducted on a subset of media articles (n = 520) related to the COVID-19 pandemic which were identified through a previous media analysis on the 2021 Heat Dome (n = 2909). Many of the articles provided conflicting health messages that may have confused the public about which health protective actions to take. The articles also showed how the COVID-19 pandemic may have exacerbated the health impacts of the 2021 Heat Dome, as pandemic-related public health measures may have deterred people away from protecting themselves from heat. This study, which provides novel insight into the prioritization of public health messaging when an extreme heat event occurs concurrently with a pandemic, supports the need for consistent heat health guidance.
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Affiliation(s)
- Emily J. Tetzlaff
- Human and Environmental Physiology Research Unit, School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, ON K1N 6N5, Canada; (E.J.T.); (G.P.K.)
- Heat Division, Climate Change and Innovation Bureau, Healthy Environment and Consumer Safety Branch, Safe Environments Directorate, Health Canada, Ottawa, ON K1A 0K9, Canada;
| | - Nicholas Goulet
- Human and Environmental Physiology Research Unit, School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, ON K1N 6N5, Canada; (E.J.T.); (G.P.K.)
- Heat Division, Climate Change and Innovation Bureau, Healthy Environment and Consumer Safety Branch, Safe Environments Directorate, Health Canada, Ottawa, ON K1A 0K9, Canada;
- Behavioural and Metabolic Research Unit, School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, ON K1N 6N5, Canada
| | - Melissa Gorman
- Heat Division, Climate Change and Innovation Bureau, Healthy Environment and Consumer Safety Branch, Safe Environments Directorate, Health Canada, Ottawa, ON K1A 0K9, Canada;
| | - Gregory R. A. Richardson
- Heat Division, Climate Change and Innovation Bureau, Healthy Environment and Consumer Safety Branch, Safe Environments Directorate, Health Canada, Ottawa, ON K1A 0K9, Canada;
| | - Glen P. Kenny
- Human and Environmental Physiology Research Unit, School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, ON K1N 6N5, Canada; (E.J.T.); (G.P.K.)
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON K1H 8L6, Canada
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Zhao Y, Su M, Meng X, Liu J, Wang F. Thermophysiological and Perceptual Responses of Amateur Healthcare Workers: Impacts of Ambient Condition, Inner-Garment Insulation and Personal Cooling Strategy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:612. [PMID: 36612933 PMCID: PMC9819836 DOI: 10.3390/ijerph20010612] [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: 11/07/2022] [Revised: 12/16/2022] [Accepted: 12/27/2022] [Indexed: 06/17/2023]
Abstract
While personal protective equipment (PPE) protects healthcare workers from viruses, it also increases the risk of heat stress. In this study, the effects of environmental heat stress, the insulation of the PPE inner-garment layer, and the personal cooling strategy on the physiological and perceptual responses of PPE-clad young college students were evaluated. Three levels of wet bulb globe temperatures (WBGT = 15 °C, 28 °C, and 32 °C) and two types of inner garments (0.37 clo and 0.75 clo) were chosen for this study. In an uncompensable heat stress environment (WBGT = 32 °C), the effects of two commercially available personal cooling systems, including a ventilation cooling system (VCS) and an ice pack cooling system (ICS) on the heat strain mitigation of PPE-clad participants were also assessed. At WBGT = 15 °C with 0.75 clo inner garments, mean skin temperatures were stabilized at 31.2 °C, Hskin was 60-65%, and HR was about 75.5 bpm, indicating that the working scenario was on the cooler side. At WBGT = 28 °C, Tskin plateaued at approximately 34.7 °C, and the participants reported "hot" thermal sensations. The insulation reduction in inner garments from 0.75 clo to 0.37 clo did not significantly improve the physiological thermal comfort of the participants. At WBGT = 32 °C, Tskin was maintained at 35.2-35.7 °C, Hskin was nearly 90% RH, Tcore exceeded 37.1 °C, and the mean HR was 91.9 bpm. These conditions indicated that such a working scenario was uncompensable, and personal cooling to mitigate heat stress was required. Relative to that in NCS (no cooling), the mean skin temperatures in ICS and VCS were reduced by 0.61 °C and 0.22 °C, respectively, and the heart rates were decreased by 10.7 and 8.5 bpm, respectively. Perceptual responses in ICS and VCS improved significantly throughout the entire field trials, with VCS outperforming ICS in the individual cooling effect.
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Affiliation(s)
- Yingying Zhao
- School of Thermal Engineering, Shandong Jianzhu University, Jinan 250101, China
| | - Meng Su
- School of Thermal Engineering, Shandong Jianzhu University, Jinan 250101, China
| | - Xin Meng
- School of Thermal Engineering, Shandong Jianzhu University, Jinan 250101, China
| | - Jiying Liu
- School of Thermal Engineering, Shandong Jianzhu University, Jinan 250101, China
| | - Faming Wang
- Department of Biosystems, Katholieke Universiteit Leuven, 3001 Leuven, Belgium
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Hunt A, Ting J, Schweitzer D, Laakso E, Stewart I. Personal protective equipment for COVID-19 among healthcare workers in an emergency department: An exploratory survey of workload, thermal discomfort and symptoms of heat strain. Emerg Med Australas 2022; 35:483-488. [PMID: 36478390 PMCID: PMC9877975 DOI: 10.1111/1742-6723.14152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 09/30/2022] [Accepted: 11/28/2022] [Indexed: 12/12/2022]
Abstract
OBJECTIVES To examine workload, thermal discomfort and heat-related symptoms among healthcare workers (HCWs) in an Australian ED during the COVID-19 pandemic. METHODS A cross-sectional study design was employed among HCWs in an ED at a metropolitan hospital in Brisbane, Australia. Respondents provided demographic information including their self-reported age, sex, height, weight, role (e.g. doctor, nurse), and whether they wore personal protective equipment (PPE) during their shift, rated as either Full PPE, Partial PPE, or usual uniform or scrubs. The workload of HCWs was assessed with the National Aeronautics and Space Administration's task load index (NASA-TLX). Thermal discomfort was evaluated using scales from the International Organisation for Standardisation. Responders rated their subjective heat illness using the Environmental Symptoms Questionnaire. RESULTS Fifty-nine HCWs completed the survey (27 male, 31 female, one prefer not to answer). Overall workload from the NASA-TLX was 64.6 (interquartile range [IQR] 56.5-73.3) for doctors, 72.5 (IQR 63.3-83.3) for nurses and 66.7 (IQR 58.3-74.17) for other staff, representing moderate to high ratings. Eighty-one percent reported thermal sensation to be slightly warm, warm, or hot, and 88% reported being uncomfortable, ranging from slightly to extremely. Ninety-seven percent reported at least one heat-strain symptom. More than 50% reported light-headedness or headache and approximately 30% reported feeling dizzy, faint, or weak. CONCLUSIONS ED HCWs experience thermal discomfort when wearing PPE. Combined with their workloads, HCWs experienced symptoms related to heat strain. Therefore, careful consideration should be given to managing heat strain among HCWs when wearing PPE in an ED.
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Affiliation(s)
- Andrew Hunt
- School of Biomedical Sciences, Faculty of HealthQueensland University of TechnologyBrisbaneQueenslandAustralia
| | - Joseph Ting
- School of Public Health and Social Work, Faculty of HealthQueensland University of TechnologyBrisbaneQueenslandAustralia,Department of Emergency MedicineMater HospitalBrisbaneQueenslandAustralia
| | - Daniel Schweitzer
- Centre for NeurosciencesMater HospitalBrisbaneQueenslandAustralia,Wesley HospitalBrisbaneQueenslandAustralia,School of MedicineThe University of QueenslandBrisbaneQueenslandAustralia
| | - E‐Liisa Laakso
- Mater Research InstituteThe University of QueenslandBrisbaneQueenslandAustralia,Menzies Health Institute QueenslandGriffith UniversityGold CoastQueenslandAustralia
| | - Ian Stewart
- School of Exercise and Nutrition Sciences, Faculty of HealthQueensland University of TechnologyBrisbaneQueenslandAustralia
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Shao Y, Wu J, Wu P, Liu X, Shen J, Zhang L, Bi Y. Emphasis on heat strain to the ocular surface: A functional and clinical study of a modified goggle. Front Public Health 2022; 10:955443. [PMID: 35983364 PMCID: PMC9379306 DOI: 10.3389/fpubh.2022.955443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Accepted: 07/07/2022] [Indexed: 11/13/2022] Open
Abstract
Purpose The limitations of conventional goggles have caused immense inconvenience, and even damage, to the physical and mental health of healthcare workers. Hence, this study aimed to build a modified goggle (MG) with better physical performance. The temperature-humidity index (THI) was used as an indicator to investigate the impact of goggle-related heat strain on the ocular surface. Methods The basic functions of antifog, anti-ultraviolet (UV), and anti-blue-light radiation capabilities were evaluated. Furthermore, the clinical impact on noninvasive keratography tear film break-up time (NIKBUT), intraocular pressure, central corneal thickness, Schirmer test I, and the Dry Eye-related Quality of life Score (DEQS) were assessed in 40 healthcare workers by comparing MG with standard goggles (SG). The relationships between THI and the above parameters were explored. Results MG had a significantly longer antifog time than SG (212.75 ± 23.95 vs. 138.35 ± 5.54 min, p < 0.05), stronger antiultraviolet ability at 400 nm (99.99 vs. 45.55%), and optimal anti-blue-light performance at 440 nm (33.32 vs. 13.31%). Tear film stability after wearing the goggle was significantly worse than that before wearing them (p < 0.05). Both goggles achieved moderate to strong heat strain, with a THI of >80 at all timepoints. The MG group showed lower THI and DEQS and higher NIKBUT than the SG group (p < 0.05). THI was significantly correlated with DEQS, NIKBUT, and real fogging time (r = 0.876, −0.532, −0.406; all p < 0.05). Conclusion Wearing goggles for a long time may cause heat strain to the eyes, thereby leading to eye discomfort and changes in the microenvironment of the ocular surface. Our MG exhibited better antifog, antiultraviolet, and optimal anti-blue-light performance and lower heat strain than SG, thus making it ideally suited for healthcare workers.
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Affiliation(s)
- Yuting Shao
- Department of Ophthalmology, School of Medicine, Tongji Hospital, Tongji University, Shanghai, China
| | - Jingzhong Wu
- Actif Polarizers Technology R&D Center, Xiamen, China
| | - Peichen Wu
- Actif Polarizers Technology R&D Center, Xiamen, China
| | - Xin Liu
- Department of Ophthalmology, School of Medicine, Tongji Hospital, Tongji University, Shanghai, China
- Department of Ophthalmology, Guizhou Provincial People's Hospital, Guiyang, China
| | - Jiaqi Shen
- Department of Ophthalmology, School of Medicine, Tongji Hospital, Tongji University, Shanghai, China
| | - Li Zhang
- Department of Ophthalmology, School of Medicine, Tongji Hospital, Tongji University, Shanghai, China
- Li Zhang
| | - Yanlong Bi
- Department of Ophthalmology, School of Medicine, Tongji Hospital, Tongji University, Shanghai, China
- Tongji Eye Institute, Tongji University, Shanghai, China
- *Correspondence: Yanlong Bi
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Zhao M, Zhao J, Yan J, Gao X. The Evaluation of Physiological Index Changes and Safety Work of Female Medical Staff With Different Medical Protection Standards in the Ward of COVID-19. Front Med (Lausanne) 2022; 9:906140. [PMID: 35814785 PMCID: PMC9256920 DOI: 10.3389/fmed.2022.906140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 05/25/2022] [Indexed: 11/13/2022] Open
Abstract
Background Effective personal protective equipment (PPE) contribute to the prevention of COVID-19 infection. However, it is necessary to evaluate the potential risk of different medical protections in the isolation ward of COVID-19. Objectives We aimed to explore the dynamics in physiological indexes of medical staff under primary and secondary PPE in the isolation ward of COVID-19 and provide the scientific basis for determining the safe work strategy. Materials and Methods In this study, 30 female nurses were selected to simulate medical work under the primary or secondary PPE, respectively. The oral temperature, axillary temperature, heart rate, respiratory rate, blood oxygen saturation, and blood pressure were measured and recorded every 20 min. The subjective adverse symptoms were recorded every 30 min. The blood glucose and weight of the individuals were measured and recorded before and after the trial. Results The results indicated that the median trial persistence time in the participants with moderate-intensity work wearing the secondary PPE (70.0 min) was much lower than that with moderate-intensity work wearing the primary PPE (180 min) and with light-intensity work wearing the primary PPE (110 min; p < 0.05). Importantly, the heart rate, oral/axillary temperature, and respiratory rate of physiological indexes of the participants under moderate-intensity work wearing the secondary PPE increased significantly faster than the primary PPE (p < 0.001), while blood oxygen saturation decreased significantly faster than the primary PPE (p < 0.001). In addition, the proportions of subjective adverse symptoms (such as dry mouth, dizziness, palpitations, and anhelation) were much higher than primary PPE (p < 0.001). The average sweat volume and blood glucose consumption of participants under moderate-intensity work wearing primary PPE were higher than secondary PPE (p < 0.001). Conclusion The combination of an exacerbated workload and secondary PPE worn by COVID-19 healthcare workers increases the change in physiological indicators, and in some cases the adverse symptoms, which can affect and even suspend their medical work. For any medical institution, there is room for improvement in terms of bioethics of a "Job Well Done" to reduce the risks of medical activities under secondary PPE.
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Affiliation(s)
- Min Zhao
- Department of Internal Medicine, Fuzhou Pulmonary Hospital of Fujian, Fuzhou, China
| | - Jianhui Zhao
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Junbing Yan
- Department of Internal Medicine, Fuzhou Pulmonary Hospital of Fujian, Fuzhou, China
| | - Xiaoye Gao
- Department of Internal Medicine, Fuzhou Pulmonary Hospital of Fujian, Fuzhou, China
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Moyo N, Bhappu AD, Bhebhe M, Ncube F. Perceived Risk of COVID-19 and Employee Decision-Making: How Psychological Distress during the Pandemic Increases Negative Performance Outcomes among Healthcare Workers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:6762. [PMID: 35682345 PMCID: PMC9180025 DOI: 10.3390/ijerph19116762] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 05/26/2022] [Accepted: 05/29/2022] [Indexed: 02/06/2023]
Abstract
In this research, we examined how COVID-19 impacts employee decision-making and performance, knowing that this virus has negatively affected public health, crippled economies, and transformed social and business environments across the globe. To quantitatively test our specific hypotheses regarding the effects of employees’ perceived risk of COVID-19 and psychological distress on negative performance outcomes, we surveyed 443 healthcare workers who were employed by a group of private hospitals in Zimbabwe. These essential workers were delivering day-to-day frontline services with high exposure to COVID-19 during the pandemic. We find that employees’ perceived risk of COVID-19 increases their disengagement, turnover intention, burnout, and low morale at a p < 0.05 significance level. These latter relationships are mediated by employees’ psychological distress at a p < 0.05 significance level. Our findings shed light on how the COVID-19 pandemic is affecting the cognitions and behaviors of the frontline workers who are vulnerable to this contagious disease. Turnover intentions are amplified among healthcare employees, due to their perceived risk of COVID-19 and the resulting psychological distress. Similarly, burnout becomes predominant as these workers worry about contracting the coronavirus due to the poor working conditions they face. As such, our research confirms that the pandemic has intensified the precariousness of work and challenge of managing employee performance, especially for frontline healthcare workers.
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Affiliation(s)
- Ngqabutho Moyo
- Department of Management of Complex Systems, School of Engineering, University of California, 5200 North Lake Rd., Merced, CA 95343, USA;
| | - Anita D. Bhappu
- Department of Management of Complex Systems, School of Engineering, University of California, 5200 North Lake Rd., Merced, CA 95343, USA;
| | - Moment Bhebhe
- Department of Human Resource Management, Faculty of Social Sciences, Midlands State University, Gweru P. Bag 9055, Zimbabwe; (M.B.); (F.N.)
| | - Farai Ncube
- Department of Human Resource Management, Faculty of Social Sciences, Midlands State University, Gweru P. Bag 9055, Zimbabwe; (M.B.); (F.N.)
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The Study of Alternative Fire Commanders' Training Program during the COVID-19 Pandemic Situation in New Taipei City, Taiwan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116633. [PMID: 35682218 PMCID: PMC9180510 DOI: 10.3390/ijerph19116633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 05/17/2022] [Accepted: 05/27/2022] [Indexed: 02/04/2023]
Abstract
In Taiwan, firefighters are responsible for transporting confirmed coronavirus cases to hospitals or epidemic prevention hotels. During the epidemic, in order to reduce the chance of cross-infection between the general public and the fire brigade, traditional collective mobilization training was limited. As a solution, this study combines a fire command course (C1) and a VR simulation for training fire station captains (VRST) and then applies the pre- and post-test evaluation approaches and the after-class questionnaire to summarize the learning effectiveness. The results show that, from a total of 244 captains that were trained, the after-training scores are significantly better when compared with the scores before training (p < 0.05, Cohen’s d > 0.8). Additionally, the post-test scores collected during the epidemic (n = 158) have no significant difference compared to the ones taken before the outbreak (2019, n = 86) in terms of sizing up, decision making, and safety management. The training results are still improving. The after-class questionnaire showed that most trainees believed that VRST helped to improve their confidence as incident commanders (ICs) (mean = 4.63, top box = 66.98%), with the novice and suburban groups exhibiting more significant improvements in command ability after the training. After the pandemic, VRST can continue as a regular training method for ICs. Because of the intervention of VRST, the differences in the command experience between different IC groups can be compensated for.
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