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Erjavec A, Volmajer Valh J, Hribernik S, Kraševac Glaser T, Fras Zemljič L, Vuherer T, Neral B, Brunčko M. Advance Analysis of the Obtained Recycled Materials from Used Disposable Surgical Masks. Polymers (Basel) 2024; 16:935. [PMID: 38611193 PMCID: PMC11013069 DOI: 10.3390/polym16070935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 03/21/2024] [Accepted: 03/26/2024] [Indexed: 04/14/2024] Open
Abstract
The production of personal protective equipment (PPE) has increased dramatically in recent years, not only because of the pandemic, but also because of stricter legislation in the field of Employee Protection. The increasing use of PPE, including disposable surgical masks (DSMs), is putting additional pressure on waste collectors. For this reason, it is necessary to find high-quality solutions for this type of waste. Mechanical recycling is still the most common type of recycling, but the recyclates are often classified as low-grade materials. For this reason, a detailed analysis of the recyclates is necessary. These data will help us to improve the properties and find the right end application that will increase the value of the materials. This work represents an extended analysis of the recyclates obtained from DSMs, manufactured from different polymers. Using surface and morphology tests, we have gained insights into the distribution of different polymers in polymer blends and their effects on mechanical and surface properties. It was found that the addition of ear loop material to the PP melt makes the material tougher. In the polymer blends obtained, PP and PA 6 form the surface (affects surface properties), while PU and PET are distributed mainly inside the injection-molded samples.
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Affiliation(s)
- Alen Erjavec
- Faculty of Mechanical Engineering, University of Maribor, Smetanova cesta 17, 2000 Maribor, Slovenia; (J.V.V.); (T.K.G.); (L.F.Z.); (T.V.); (B.N.); (M.B.)
| | - Julija Volmajer Valh
- Faculty of Mechanical Engineering, University of Maribor, Smetanova cesta 17, 2000 Maribor, Slovenia; (J.V.V.); (T.K.G.); (L.F.Z.); (T.V.); (B.N.); (M.B.)
| | - Silvo Hribernik
- Faculty of Electrical Engineering and Computer Science, University of Maribor, Koroška cesta 46, 2000 Maribor, Slovenia;
| | - Tjaša Kraševac Glaser
- Faculty of Mechanical Engineering, University of Maribor, Smetanova cesta 17, 2000 Maribor, Slovenia; (J.V.V.); (T.K.G.); (L.F.Z.); (T.V.); (B.N.); (M.B.)
| | - Lidija Fras Zemljič
- Faculty of Mechanical Engineering, University of Maribor, Smetanova cesta 17, 2000 Maribor, Slovenia; (J.V.V.); (T.K.G.); (L.F.Z.); (T.V.); (B.N.); (M.B.)
| | - Tomaž Vuherer
- Faculty of Mechanical Engineering, University of Maribor, Smetanova cesta 17, 2000 Maribor, Slovenia; (J.V.V.); (T.K.G.); (L.F.Z.); (T.V.); (B.N.); (M.B.)
| | - Branko Neral
- Faculty of Mechanical Engineering, University of Maribor, Smetanova cesta 17, 2000 Maribor, Slovenia; (J.V.V.); (T.K.G.); (L.F.Z.); (T.V.); (B.N.); (M.B.)
| | - Mihael Brunčko
- Faculty of Mechanical Engineering, University of Maribor, Smetanova cesta 17, 2000 Maribor, Slovenia; (J.V.V.); (T.K.G.); (L.F.Z.); (T.V.); (B.N.); (M.B.)
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Lazar MS, Ganesh V, Naik B N, Singh A, Puri GD, Kaur S. Efficacy of remote audio-visual system versus standard onsite buddy system to monitor the doffing of personal protective equipment during COVID-19 pandemic: An observational study. Int J Health Plann Manage 2024; 39:530-540. [PMID: 38163283 DOI: 10.1002/hpm.3754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Revised: 09/17/2023] [Accepted: 12/21/2023] [Indexed: 01/03/2024] Open
Abstract
OBJECTIVES Literature states a higher self-contamination rate among healthcare workers (HCWs) while doffing personal protective equipment (PPE). During the Covid-19 pandemic, onsite trained observers were not always available to monitor PPE compliance. The remote audio-visual doffing surveillance (RADS) system has the potential to overcome this limitation. We aimed to compare the efficacy of this real-time RADS system against the onsite buddy system for monitoring the doffing of PPE. METHODS This prospective, observational study was carried out at our tertiary care centre in northern India. 200 HCWs who cared for Covid-19 patients in the intensive care units/operation theatres were included. Group A included HCWs who performed doffing with the help of an onsite trained observer and group B included HCWs who performed doffing with the RADS system. An independent observer noted the error at any step using the CDC doffing checklist, in both groups. An online questionnaire to analyse the level of satisfaction post-doffing was also surveyed. RESULTS The proportion of errors committed during doffing was significantly lower in group B compared to group A with a low relative risk of 0.34 (95% CI 0.22-0.51) (p < 0.001) (Figure 1A,B). In both groups, there was no difference in HCWs feedback regarding the ease of the system and fear of committing an error. Though the perceived quality of monitoring was felt better with onsite buddy, the overall confidence rating of being safe after doffing was better with the RADS system. CONCLUSION Real-time RADS system may be more effective than the onsite buddy system for ensuring the safety of HCWs during doffing PPE. HCWs level of satisfaction related to the ease and anxiety with the monitoring systems were comparable. RADS system can reduce reliance on HCW resources and can integrate well into existing healthcare systems.
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Affiliation(s)
- Michelle Shirin Lazar
- Department of Anaesthesia & Intensive Care, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Venkata Ganesh
- Department of Anaesthesia & Intensive Care, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Naveen Naik B
- Department of Anaesthesia & Intensive Care, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Ajay Singh
- Department of Anaesthesia & Intensive Care, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - G D Puri
- Department of Anaesthesia & Intensive Care, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Sukhpal Kaur
- National Institute of Nursing Education, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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Zoran DL, Bassinger SC, Budke CM, Fridley JL. Mass Decontamination of Companion Dogs in Disaster: Planning for Personnel, Water, and Time Requirements. Disaster Med Public Health Prep 2024; 18:e40. [PMID: 38415396 DOI: 10.1017/dmp.2023.229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Abstract
OBJECTIVE The importance of companion animals in the daily lives of people, and the increasing incidence and severity of natural disasters impacting people and their animals, is very well documented. However, despite the advancement of companion animal response capabilities, decontamination remains an inconsistently implemented component of disaster response. The challenge for local authorities is their need for planning factors and protocols specific to companion animal decontamination which are generally lacking. Data is provided on the average time requirements, water use and containment resources necessary, and the personnel required to decontaminate (decon) a large number of companion dogs. METHODS Sixty-three lightly contaminated, medium weight, short to medium coat, highly tractable dogs (Labradors and Hounds) from a State facility colony were used to determine the water requirements, soap effectiveness, and time required to complete decon (washing/bathing). Data were collected over a 6-mo period using 2 personnel that were randomly assigned to wash the dogs. Difference in weight, bathing time, and water use between groups was evaluated using a 2-tailed 2-sample t-test for independent data. RESULTS The time and water requirements were significantly different between medium coated dogs and short coated dogs. On average, for a short coated dog, the amount of time to complete decon was 7 min, and the amount of water was 8-10 gal. For medium coated dogs, the time increased to 10-12 min to complete the process and 12-15 gal water. DISCUSSION The results of this study provide important insights emergency management planners, animal response team members, and community personnel tasked with implementation of mass decontamination of companion dogs following a natural or man-made disaster.
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Affiliation(s)
- Debra L Zoran
- Department of Small Animal Clinical Sciences, School of Veterinary Medicine and Biomedical Sciences (VMBS) Texas A&M University, College Station, TX, USA
| | - Shawn C Bassinger
- Department of Small Animal Clinical Sciences, School of Veterinary Medicine and Biomedical Sciences (VMBS) Texas A&M University, College Station, TX, USA
| | - Christine M Budke
- Department of Integrative Biosciences, School of Veterinary Medicine and Biomedical Sciences (VMBS) Texas A&M University, College Station, TX, USA
| | - Jennifer L Fridley
- Department of Large Animal Clinical Sciences, School of Veterinary Medicine and Biomedical Sciences (VMBS) Texas A&M University, College Station, TX, USA
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Sowole L, Kainth R, Tuudah C, Delmonte Sen A, Price N, O'Hara G. High-consequence infectious diseases: the conception and development of a multi-disciplinary, interprofessional simulation training programme. J Hosp Infect 2024; 147:87-97. [PMID: 38403083 DOI: 10.1016/j.jhin.2024.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 02/08/2024] [Accepted: 02/09/2024] [Indexed: 02/27/2024]
Abstract
BACKGROUND High-consequence infectious diseases (HCIDs) represent a group of acute infectious diseases with the potential to impact healthcare systems and public health profoundly. Effective management requires a system-based strategy focused on early detection, initiation of infection prevention and control measures, and appropriate use of personal protective equipment (PPE). Inadequate training in the safe use of HCID PPE, and lack of familiarity with key processes such as HCID waste and spills management, exacerbates the risk posed to healthcare workers (HCWs). Enhanced training opportunities are required to ensure that staff are equipped with the necessary knowledge and capabilities to protect themselves from pathogen exposure and infection. AIM To create a bespoke interprofessional HCID simulation training programme. METHODS A detailed learning needs analysis was undertaken, which identified multiple areas amenable to educational intervention. A full-day HCID simulation programme was developed, providing HCWs the opportunity to practice and gain proficiency in various domains. FINDINGS Six interprofessional participants took part in the HCID simulation programme pilot. All six (100%) participants felt that the stated learning objectives had been achieved, and five and one participants found the programme to be extremely useful (83%) or very useful (17%), respectively. Following refinement based on pilot feedback, a further six courses have been run for 38 participants, of whom 97% found the programme to be extremely useful or very useful. CONCLUSION The development of a training intervention in the low-frequency, high-risk field of HCIDs had a positive impact. Given the disproportionate impact on HCWs at times of HCID outbreaks, more investment is needed to keep the workforce upskilled.
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Affiliation(s)
- L Sowole
- Directorate of Infection, Guy's and St Thomas' NHS Foundation Trust, London, UK; Simulation and Interactive Learning Centre, Guy's and St Thomas' NHS Foundation Trust, London, UK.
| | - R Kainth
- Simulation and Interactive Learning Centre, Guy's and St Thomas' NHS Foundation Trust, London, UK; Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - C Tuudah
- Directorate of Infection, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - A Delmonte Sen
- Directorate of Infection, Guy's and St Thomas' NHS Foundation Trust, London, UK; Simulation and Interactive Learning Centre, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - N Price
- Directorate of Infection, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - G O'Hara
- Directorate of Infection, Guy's and St Thomas' NHS Foundation Trust, London, UK
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Larsson MEV, Jonasson PI, Apell PS, Kearney PP, Lundh CJ. Evaluation of novel radiation protection devices during radiologically guided interventions. CVIR Endovasc 2024; 7:18. [PMID: 38353904 PMCID: PMC10866844 DOI: 10.1186/s42155-024-00430-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 01/24/2024] [Indexed: 02/17/2024] Open
Abstract
BACKGROUND In radiologically guided interventions, medical practitioners are subjected to radiation exposure, which may lead to radiation-induced diseases. In this study, novel radiation shields for the head and neck were evaluated for their potential to reduce radiation exposure. METHOD An anthropomorphic phantom was exposed on its left side to scattered radiation from beneath to simulate the exposure of an operator in a x-ray operating room. Thermoluminescent dosimeters (TLDs) were positioned at different depths in five slices in the phantom, measuring personal dose equivalent. Two different set up situations were evaluated: a head protector designed to reduce radiation in the upper section of the head; and a novel thyroid protector prototype extended in the front and on both sides, designed to reduce radiation in the lower and middle sections of the head. A standard thyroid collar prototype and a ceiling mounted lead glass shield were used as comparisons. Furthermore, the head protector was evaluated in a clinical study in which TLDs were positioned to measure scattered radiation exposure to the heads of operators during endovascular interventions. RESULTS The extended thyroid protector reduced the scattered radiation in the throat, chin, and ear slices. Some shielding effect was seen in the brain and skull slices. The head protector showed a shielding effect in the skull slice up to two cm depth where it covered the phantom head. As expected, the ceiling mounted lead glass shield reduced the scattered radiation in all measuring points. CONCLUSIONS A ceiling mounted lead glass shield is an effective radiation protection for the head, but in clinical practice, optimal positioning of a ceiling mounted lead shield may not always be possible, particularly during complex cases when radiation protection may be most relevant. Added protection using these novel guards may compliment the shielding effect of the ceiling mounted lead shield. The head protector stand-alone did not provide sufficient protection of the head. The extended thyroid protector stand-alone provided sufficient protection in the lower and middle sections of the head and neck.
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Affiliation(s)
- Maria E V Larsson
- Department of Medical Radiation Sciences, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
- Department of Medical Physics and Biomedical Engineering, Sahlgrenska University Hospital, Gothenburg, Sweden.
| | - Pernilla I Jonasson
- Department of Medical Radiation Sciences, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Petra S Apell
- Texray AB, Gothenburg, Sweden
- Department of Technology Management and Economics, Chalmers University of Technology, Gothenburg, Sweden
| | - Peter P Kearney
- Department of Cardiology, Cork University Hospital, Cork, Ireland
| | - Charlotta J Lundh
- Department of Medical Radiation Sciences, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
- Department of Medical Physics and Biomedical Engineering, Sahlgrenska University Hospital, Gothenburg, Sweden
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Rogula-Kozłowska W, Piątek P, Kozielska B, Walczak A. Off-gassing from firefighter suits (nomex) as an indoor source of BTEXS. Chemosphere 2024; 350:140996. [PMID: 38141684 DOI: 10.1016/j.chemosphere.2023.140996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 11/05/2023] [Accepted: 12/18/2023] [Indexed: 12/25/2023]
Abstract
The clothes and special equipment of firefighters can be a source of indoor air pollution. Nevertheless, it has not been investigated so far what the scale of the release of various compounds from such materials into the indoor air can be. The following study analysed the results of an experiment involving the passive measurement of concentrations of selected compounds, i.a. benzene, toluene, ethylbenzene, m,p-xylene, o-xylene, styrene, isopropylbenzene and n-propylbenzene (BTEXS) in the air of a room where firefighters' special clothing, which had been previously exposed to emissions from simulated fires, was stored. The study included simulations of fires involving three materials: wood, processed wood (OSB/fibreboard) and a mixture of plastics. After being exposed to the simulated fire environment, special clothing (so-called nomex) was placed in a sealed chamber, where passive collection of BTEXS was carried out using tube-type axial passive samplers and a gas chromatograph. Irrespective of which burned material special clothing was exposed to, the compound emitted into the air most intensively was toluene. Its rate of release from a single nomex ranges from 4.4 to 28.6 μg h-1, while the corresponding rates for the sum of BTEXS are between 9.97 and 44.29 μg h-1.
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Affiliation(s)
| | - Piotr Piątek
- Fire University, 52/54 Słowackiego St., 01-629, Warsaw, Poland.
| | - Barbara Kozielska
- Silesian University of Technology, 22B Konarskiego St., 44-100, Gliwice, Poland.
| | - Agata Walczak
- Fire University, 52/54 Słowackiego St., 01-629, Warsaw, Poland.
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King WB, Goulart MA, Luciani DL, Brown DS, El Itani R, Hays AK, Buchanan SR, Neilsen CD. Revisiting Ebola Virus Disease infection control protocols at an academic level I trauma center: Successes, challenges, and ways ahead. Am J Infect Control 2024; 52:243-245. [PMID: 37640159 DOI: 10.1016/j.ajic.2023.08.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 08/16/2023] [Accepted: 08/17/2023] [Indexed: 08/31/2023]
Abstract
In the decade since the largest Ebola Virus Disease (EVD) outbreak in history, hospitals within the United States have discovered deficiencies in EVD infection control protocols. A large academic level I trauma medical center and frontline EVD receiving hospital in northeast Florida conducted a large-scale review and revision of the facility's EVD infection control protocols to increase preparedness. The revision process revealed opportunities for improvement and highlighted the need for excellent resource management and interdepartmental communication.
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Affiliation(s)
- Walker B King
- Department of Infection Prevention and Control, University of Florida Health Jacksonville, Jacksonville, FL.
| | - Michael A Goulart
- Department of Infection Prevention and Control, University of Florida Health Jacksonville, Jacksonville, FL
| | - Dana L Luciani
- Department of Infection Prevention and Control, University of Florida Health Jacksonville, Jacksonville, FL
| | - David S Brown
- Department of Infection Prevention and Control, University of Florida Health Jacksonville, Jacksonville, FL
| | - Rayan El Itani
- Department of Infection Prevention and Control, University of Florida Health Jacksonville, Jacksonville, FL
| | - Amanda K Hays
- Department of Infection Prevention and Control, University of Florida Health Jacksonville, Jacksonville, FL
| | - Stefanie R Buchanan
- Department of Infection Prevention and Control, University of Florida Health Jacksonville, Jacksonville, FL
| | - Chad D Neilsen
- Department of Infection Prevention and Control, University of Florida Health Jacksonville, Jacksonville, FL
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Tu J, Liu F, Wang K, Mao Y, Qi Q, Zhang J. Donning and doffing of personal protective equipment for health care workers in a tertiary hospital in China: A simulation study. J Occup Environ Hyg 2024; 21:108-118. [PMID: 37812187 DOI: 10.1080/15459624.2023.2268727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/10/2023]
Abstract
The application and removal of personal protective equipment (PPE) by health care workers (HCWs) is pivotal to their health and safety and the comprehensive efficacy of hospital infection control measures. This investigation was orchestrated to elucidate the challenges that HCWs may encounter during the donning and doffing of PPE. A total of 110 participants from a tertiary hospital in China were engaged. The study employed fluorescent markers to mimic the exposure of HCWs to tainted body fluids, quantified the contamination outcomes, and evaluated adherence to procedures for donning and doffing. Factors including gender, educational background, and the timing of the most recent instruction on PPE donning and doffing were found to influence the occurrence of contamination points (p < 0.05). No significant differences were identified in contamination frequency when assessing age, body mass index (BMI), occupation, educational background, positional title, working tenure, and experience in managing respiratory infectious diseases (p > 0.05). Predominant contamination sites for fluorescent marker residue included the shoulder (32.73%), neck (21.82%), forearm (16.36%), chest (12.73%), and abdomen (11.82%), with the shoulder being the most contaminated body part. A majority of HCWs exhibited susceptibility to errors during the removal of protective clothing, boot covers, and gloves. The contamination frequency was observed to be correlated with the timing of the last PPE training, educational background, and gender. In acknowledging the intricacy of PPE removal and the deficiencies in HCWs' removal techniques, there emerges a perpetual necessity to refine training methodologies and perpetuate regular PPE instruction.
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Affiliation(s)
- Jiajia Tu
- School of Nursing, Xuzhou Medical University, Xuzhou, China
| | - Fang Liu
- School of Nursing, Xuzhou Medical University, Xuzhou, China
| | - Kexuan Wang
- School of Nursing, Xuzhou Medical University, Xuzhou, China
| | - Yiping Mao
- School of Nursing, Xuzhou Medical University, Xuzhou, China
- The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Qi Qi
- The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Jie Zhang
- The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
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Aljaffary A, Al Elaiwi T, AlOtaibi N, AlAnsari F, Alumran A, Salama KF. Determining the nurses' perception regarding the effectiveness of COVID-19 protocols implemented in Eastern Province: Saudi Arabia. Front Public Health 2024; 11:1291261. [PMID: 38249370 PMCID: PMC10796469 DOI: 10.3389/fpubh.2023.1291261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 12/14/2023] [Indexed: 01/23/2024] Open
Abstract
Background The global impact of Coronavirus Disease 2019 (COVID-19) has been profound, affecting public health, the global economy, and overall human life. Past experiences with global pandemics underscored the significance of understanding the perception of HCWs and hospital staff in developing and implementing preventive measures. The World Health Organization (WHO) provided protocols to manage the spread of COVID-19 and assist healthcare workers and health systems globally in maintaining high-quality health services. Objective This study aims to assess nurses' perception, awareness, and compliance regarding the implementation of COVID-19 protocols and explore factors influencing their perception. Methodology A quantitative cross-sectional survey-based study was conducted, distributing a constructed survey among nurses in the Eastern Province of Saudi Arabia. Results Out of 141 participants, most adhered to protocols such as hand sanitization, social distancing, and proper personal protective equipment (PPE) usage. The predominant age group among respondents was 31 to 40 years (n = 71, 50%). A significant portion of participants reported holding a bachelor's degree (n = 86, 61%), with only 14% possessing advanced degrees (n = 19). Nearly a third of the nurses in the study had accumulated 6 to 10 years of professional experience (n = 49, 34.8%). A noteworthy percentage of nurses were engaged in daily shifts exceeding 8 h (n = 98, 70%). Gender differences were observed, with females exhibiting a higher tendency to avoid shaking hands and social gatherings. Saudi nationals were more inclined to shake hands and engage in gatherings. Non-Saudi nurses and those aged between <25 to 40 years demonstrated proper donning/doffing practices. Nurses with over 6 years of experience avoided social gatherings, while those working >8 h adhered better to PPE usage, proper donning/doffing, and disposal of PPE in designated bins. Conclusion Understanding COVID-19 protocols is crucial for tailoring interventions and ensuring effective compliance with COVID-19 preventive measures among nurses. More efforts should be made toward preparing the healthcare nursing to deal with the outbreak. Preparing healthcare nursing with the right knowledge, attitude, and precautionary practices during the COVID-19 outbreak is very essential to patient and public safety.
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Affiliation(s)
- Afnan Aljaffary
- Health Information Management and Technology Department, College of Public Health, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Tahani Al Elaiwi
- Health Information Management and Technology Department, College of Public Health, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Noot AlOtaibi
- Health Information Management and Technology Department, College of Public Health, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Fatimah AlAnsari
- Health Information Management and Technology Department, College of Public Health, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Arwa Alumran
- Health Information Management and Technology Department, College of Public Health, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Khaled F. Salama
- Environmental Health Department, College of Public Health, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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11
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Nakata JA, Arif A, Chai LF, Su S. First report of a post-pneumonectomy nocardia empyema. J Surg Case Rep 2024; 2024:rjae002. [PMID: 38304314 PMCID: PMC10832585 DOI: 10.1093/jscr/rjae002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 01/05/2024] [Indexed: 02/03/2024] Open
Abstract
Post-pneumonectomy empyema (PPE) is an uncommon but serious complication that carries significant therapeutic challenges. We present a late-onset PPE due to Nocardia nova in an immunocompetent individual. Nine years after a right pneumonectomy for non-small cell lung cancer, surveillance scans revealed new right pleural thickening and FDG avidity concerning for recurrence. Thoracoscopic pleural biopsies were negative for malignancy, but tissue cultures grew N. nova. Nocardia empyema is rare with few reported cases. Most occur in immunocompromised hosts, and all were associated with pulmonary or disseminated nocardiosis. Our case describes the first report of a PPE secondary to Nocardia.
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Affiliation(s)
- Jonathan A Nakata
- Division of Thoracic Surgery, Department of Surgical Oncology, Fox Chase Cancer Center, Philadelphia, PA 19111, United States
| | - Azzan Arif
- Division of Thoracic Surgery, Department of Surgical Oncology, Fox Chase Cancer Center, Philadelphia, PA 19111, United States
| | - Louis F Chai
- Department of Thoracic Medicine and Surgery, Temple University Health Systems, Philadelphia, PA 19140, United States
| | - Stacey Su
- Division of Thoracic Surgery, Department of Surgical Oncology, Fox Chase Cancer Center, Philadelphia, PA 19111, United States
- Department of Thoracic Medicine and Surgery, Temple University Health Systems, Philadelphia, PA 19140, United States
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12
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Yarroo MYK, Rathebe PC. Assessment of the effects of solvents on lung function among paint industry workers in Mauritius. Int J Environ Health Res 2024; 34:138-149. [PMID: 36223593 DOI: 10.1080/09603123.2022.2134558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 10/03/2022] [Indexed: 06/16/2023]
Abstract
The study aimed to determine the respiratory effects of solvents among workers in the Mauritius paint industry. A total of 388 participants were selected using simple random sampling, and were subjected to a questionnaire for data collection. Lung function test was performed using a spirometer. Multiple regression was used to analyze the relationship between hours of exposure to solvents, while adjusting for socio-demographic factors. Independent t-test was also used to identify any difference between the means of lung function tests and the two exposed groups. Male participants were found less likely exposed to solvents compared to females (AOR, 3.39, CI 1.97-5.81). Those with secondary and lower secondary education, and worked for ≤12 hours per week, had an increased likelihood of being exposed to solvents (AOR 2.95, CI 1.20-7.28) (AOR 2.48, CI 1.19-5.16). Participants who were aware of occupational hazards (AOR 0.15, CI (0.05-0.46), and have used PPE (AOR 0.14, CI 0.08-0.25) were less likely to be less exposed to solvents. This study highlights the adverse effects of workplace exposures on respiratory health among paint factory workers. .
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Affiliation(s)
- Mohammad Yusuf Khan Yarroo
- Department of Environmental Health, Faculty of Health Sciences, University of Johannesburg, Johannesburg, South Africa
| | - Phoka C Rathebe
- Department of Environmental Health, Faculty of Health Sciences, University of Johannesburg, Johannesburg, South Africa
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13
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Tattari N, Forss M, Laukkanen AM, Rantala L. The Efficacy of the NHS Waterpipe in Superficial Hydration for People With Healthy Voices: Effects on Acoustic Voice Quality, Phonation Threshold Pressure and Subjective Sensations. J Voice 2024; 38:244.e29-244.e42. [PMID: 34702612 DOI: 10.1016/j.jvoice.2021.08.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 08/18/2021] [Accepted: 08/18/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES This study examined the efficacy of the NHS waterpipe as a superficial hydration treatment in voice production in healthy young women. STUDY DESIGN This is a prospective, single-blind, within- and between-subject experimental design. METHODS Thirty six female university students (mean age 24.6 years, range 19-45 years) were recruited to the study. Participants were randomized to two experimental groups (E1 and E2) and a control group. E1 underwent hydration treatment with the NHS waterpipe filled with 0.9% saline that was immersed in a cup of heated water. E2 underwent a similar treatment but without heated immersion. The control group received no treatment. Acoustic Voice Quality Index (AVQI v03.01) and its subparameters, phonation threshold pressure, self-perceived phonatory effort and sensation of throat dryness was measured at three time points (before the intervention and immediately and 15 minutes after it). RESULTS The Tilt of the AVQI's subparameters increased significantly in the E1 (P = 0.027) and E2 groups (P = 0.027) after the intervention. Furthermore, the E1 group had significantly lower harmonics-to-noise-ratio values at the third measurement point compared to the E2 group (P = 0.023). These findings may result from fluid transported to the vocal fold level. The sensations of throat dryness decreased in the E1 (P = 0.001) and E2 groups (P < 0.0005) after the intervention. Perceived phonatory effort decreased statistically significantly at the final measurement point in the E1 (P = 0.002) and E2 (P = 0.031) groups. No variables changed in the control group. CONCLUSIONS The waterpipe seems to be efficient in hydrating vocal folds on single use. It seems to be more efficient when employed with a hot water bath, albeit slightly impairing some acoustic values in the short term. Without the heated fluid, it still seems to decrease sensations of throat dryness and affect acoustic voice quality. The waterpipe does not seem to have an effect on phonation threshold pressure, and it seems to lower self-perceived effort just as efficiently whether the waterpipe is employed using a hot water bath or not. Further research is needed to prove the efficacy of long-term usage and usage with voice patients.
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Affiliation(s)
- Niko Tattari
- Master Program of Logopedics, Faculty of Social Sciences, Tampere University, Tampere, Finland.
| | - Milja Forss
- Master Program of Logopedics, Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Anne-Maria Laukkanen
- Speech and Voice Research Laboratory, Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Leena Rantala
- Degree Programme in Logopedics, Tampere University, Tampere, Finland
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14
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Plitman E, Kim E, Patel R, Kohout S, Jin R, Chan V, Dinsmore M. Development of an Automated and Scalable Virtual Assistant to Aid in PPE Adherence: A Study with Implications for Applications within Anesthesiology. J Med Syst 2023; 48:7. [PMID: 38157145 DOI: 10.1007/s10916-023-02028-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 12/14/2023] [Indexed: 01/03/2024]
Abstract
Virtual assistants (VAs) are conversational agents that are able to provide cognitive aid. We developed a VA device for donning and doffing personal protective equipment (PPE) procedures and compared it to live human coaching to explore the feasibility of using VAs in the anesthesiology setting. An automated, scalable, voice-enabled VA was built using the Amazon Alexa device and Alexa Skills application. The device utilized voice-recognition technology to allow a touch-free interactive user experience. Audio and video step-by-step instructions for proper donning and doffing of PPE were programmed and displayed on an Echo Show device. The effectiveness of VA in aiding adherence to PPE protocols was compared to traditional human coaching in a randomized, controlled, single-blinded crossover design. 70 anesthesiologists, anesthesia assistants, respiratory therapists, and operating room nurses performed both donning and doffing procedures, once under step-by-step VA instructional guidance and once with human coaching. Performance was assessed using objective performance evaluation donning and doffing checklists. More participants in the VA group correctly performed the step of "Wash hands for 20 seconds" during both donning and doffing tests. Fewer participants in the VA group correctly performed the steps of "Put cap on and ensure covers hair and ears" and "Tie gown on back and around neck". The mean doffing total score was higher in the VA group; however, the donning score was similar in both groups. Our study demonstrates that it is feasible to use commercially available technology to create a voice-enabled VA that provides effective step-by-step instructions to healthcare professionals.
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Affiliation(s)
- Eric Plitman
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Department of Anesthesia and Pain Medicine, Toronto Western Hospital, University of Toronto, Toronto, ON, Canada
| | - Edward Kim
- Department of Computer Sciences, Drexel University, Philadelphia, USA
| | - Rajesh Patel
- Department of Anesthesia and Pain Medicine, Toronto Western Hospital, University of Toronto, Toronto, ON, Canada
| | - Seema Kohout
- Department of Anesthesia and Pain Medicine, Toronto Western Hospital, University of Toronto, Toronto, ON, Canada
| | - Rongyu Jin
- Department of Anesthesia and Pain Medicine, Toronto Western Hospital, University of Toronto, Toronto, ON, Canada
| | - Vincent Chan
- Department of Anesthesia and Pain Medicine, Toronto Western Hospital, University of Toronto, Toronto, ON, Canada
| | - Michael Dinsmore
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
- Department of Anesthesia and Pain Medicine, Toronto Western Hospital, University of Toronto, Toronto, ON, Canada.
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15
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Mutch CP, Tiernan J, Koch O, Poller B. The PATH to PPE Mastery - Programme for Assessment and Training in HCID (High Consequence Infectious Diseases) PPE (Personal Protective Equipment), Mastery. Infect Prev Pract 2023; 5:100308. [PMID: 38107242 PMCID: PMC10724480 DOI: 10.1016/j.infpip.2023.100308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 07/10/2023] [Indexed: 12/19/2023] Open
Abstract
Background High Consequence Infectious Diseases (HCIDs), have the potential to cause pandemics and require particular focus for preparedness due to their high mortality rates. The application of Personal Protective Equipment (PPE) for HCIDs is complex and carries significant risk of Health Care Worker (HCW) contamination if done incorrectly. Previous reviews have reported a lack of information on the nature of training provided and the ideal timing of repeat training to best retain skills. Simulation Based Mastery Learning (SBML) is a methodology for skill acquisition which encompasses deliberate practice and repeated assessment until the learner achieves a pre-set Mastery standard. SBML has been demonstrated to improve competence, skill retention and patient outcomes in other clinical procedures. SBML has not been previously studied or utilised in HCID PPE training. Aim We aimed to increase the likelihood of safe clinical practice by evidencing that Lothian modified SBML for PPE effectively prepares our priority learners. Methods A quasi-experimental within group post-test design was used. Learners undertook a modified SBML programme which included two-hour asynchronous and two-hour synchronous components. Findings 11 learners (10 infectious diseases registrars and 1 infectious diseases consultant) were enrolled in the programme with 8 completing all stages, all of whom achieved the Mastery passing standard. The resources were highly rated by learners with the exemplar videos of skills highlighted as particularly useful. Self-assessed preparedness for each skill increased following pre-learning and synchronous sessions. Conclusion Modified SBML can be used as an effective methodology for the training and assessment of HCWs in the donning and doffing of HCID PPE.
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Affiliation(s)
- Callum P. Mutch
- Medical Education Department, NHS Lothian, Edinburgh, United Kingdom
- Regional Infectious Diseases Unit, NHS Lothian, Edinburgh, United Kingdom
| | - James Tiernan
- Medical Education Department, NHS Lothian, Edinburgh, United Kingdom
| | - Oliver Koch
- Regional Infectious Diseases Unit, NHS Lothian, Edinburgh, United Kingdom
| | - Bozena Poller
- Department of Medical Virology, NHS Lothian, Edinburgh, United Kingdom
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16
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Kilinc-Balci FS. Investigation of the barrier performance of disposable isolation gowns. Am J Infect Control 2023; 51:1401-1405. [PMID: 37690482 DOI: 10.1016/j.ajic.2023.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 08/31/2023] [Accepted: 09/01/2023] [Indexed: 09/12/2023]
Abstract
BACKGROUND Recent epidemics and pandemics highlighted the need for effective personal protective equipment, including isolation gowns. The most critical property of an isolation gown is its ability to keep liquids and viruses from passing through the gown. Liquid and viral barrier penetration can be measured using laboratory test methods. Association for the Advancement of Medical Instrumentation (AAMI) PB70 standard defines isolation gown barrier performance levels and requirements. In this study, 22 disposable isolation gown models from 6 manufacturers were tested for liquid and viral penetration resistance. METHODS Standard test methods were used to evaluate water and viral penetration. Test results were evaluated using AAMI PB70 barrier performance criteria for 4 protection levels. RESULTS Seven of the 22 tested gown models did not pass liquid and viral penetration testing based on AAMI PB70 at the level claimed by the manufacturer. The majority of these failures occurred at the seam and/or tie attachment areas. CONCLUSIONS The study findings underscore the need for improved processes surrounding activities such as premarket testing and postmarket evaluation of gowns according to standardized test methods by third-party laboratories. This study also supports the recent Food and Drug Administration guidance document that clarified the characteristics of isolation gowns considered to be class II and subject to Food and Drug Administration premarket review. Infection preventionists, hospital purchasers, and safety professionals should seek isolation gowns demonstrating conformance to industry standards from manufacturers.
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Affiliation(s)
- F Selcen Kilinc-Balci
- US Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, National Personal Protective Technology Laboratory, Pittsburgh, PA.
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17
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Van Singer M, Senn L, Blanc DS, Koenig I, Simon C, Grandbastien B. COVID-19 isolation measures did not prevent vancomycin-resistant enterococci transmissions. J Hosp Infect 2023; 141:129-131. [PMID: 37774928 DOI: 10.1016/j.jhin.2023.09.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 09/22/2023] [Accepted: 09/24/2023] [Indexed: 10/01/2023]
Affiliation(s)
- M Van Singer
- Infection Prevention and Control Unit, Infectious Diseases Service, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
| | - L Senn
- Infection Prevention and Control Unit, Infectious Diseases Service, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - D S Blanc
- Infection Prevention and Control Unit, Infectious Diseases Service, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland; Swiss National Reference Center for Emerging Antibiotic Resistance, (NARA), University of Fribourg, Fribourg, Switzerland
| | - I Koenig
- Infection Prevention and Control Unit, Infectious Diseases Service, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - C Simon
- Department of Otolaryngology, Head and Neck Surgery, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - B Grandbastien
- Infection Prevention and Control Unit, Infectious Diseases Service, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
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Papachristidou S, Lapea V, Charisi M, Kourkouni E, Kousi D, Xirogianni A, Dedousi O, Papaconstadopoulos I, Eleftheriou E, Krepis P, Pasparaki S, Pantalos G, Doudoulakakis A, Bozavoutoglou E, Daskalaki M, Kostaridou-Nikolopoulou S, Tzanakaki G, Spoulou V, Tsolia M. A multicenter study on the epidemiology of complicated parapneumonic effusion in the era of currently available pneumococcal conjugate vaccines. Vaccine 2023; 41:6727-6733. [PMID: 37805358 DOI: 10.1016/j.vaccine.2023.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 09/27/2023] [Accepted: 10/02/2023] [Indexed: 10/09/2023]
Abstract
BACKGROUND Parapneumonic effusion (PPE) is a common complication of pneumonia. Streptococcus pneumoniae is the most common cause of bacterial pneumonia. A reduction in pneumonia hospitalizations has been observed since the introduction of the 7-valent pneumococcal conjugate vaccine (PCV7). Despite this apparent benefit, an increase in the incidence of PPE was recorded in some countries following PCV7 implementation. As the 13-valent pneumococcal conjugate vaccine (PCV13) was expected to provide a wider protection against PPE, the aim of the present study was to evaluate the impact of PCV13 introduction on the epidemiology of complicated parapneumonic effusion (c-PPE) among children in the Athens greater area. METHODS All cases of community-acquired pneumonia (CAP) with PPE requiring chest tube insertion (complicated PPE, c-PPE) hospitalized in the 3 public Children's hospitals in Athens between 01/01/2004 and 31/12/2019 were included in the study. RESULTS A total of 426 cases of c-PPE associated with pneumonia were recorded of which 198 were admitted during 2004-2010 (period A, prePCV13/PCV -7 introduction period) and 228 during 2011-2018 (period B, post - PCV13 period). A definite bacterial etiology was established in 44.4 % of all cases and of those 25.4 % were caused by S. pneumoniae. An increasing trend in c-PPE incidence was observed during period A; although, a significant decrease on c-PPE annual rates was observed during the period B (p = 0.011), a remarkable increase in serotype 3 cases was recorded. CONCLUSION A decreasing time trend in c-PPE cases among children was shown after the introduction of PCV13 in our area. However, serotype 3 is nowadays a common cause of PPE. Hence, continuous surveillance is imperative in order to follow c-PPE epidemiology over time.
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Affiliation(s)
- Smaragda Papachristidou
- Second Department of Paediatrics, School of Medicine, National and Kapodistrian University of Athens (NKUA), P.& A. Kyriakou Children's Hospital, Athens, Greece.
| | - Vasiliki Lapea
- First Department of Paediatrics, School of Medicine, National and Kapodistrian University of Athens (NKUA), Aghia Sophia Children's Hospital, Athens, Greece
| | - Martha Charisi
- Department of Paediatrics, Penteli Children's Hospital, Athens, Greece
| | - Eleni Kourkouni
- Collaborative Center for Clinical Epidemiology and Outcomes Research (CLEO), Athens, Greece
| | - Dimitra Kousi
- Collaborative Center for Clinical Epidemiology and Outcomes Research (CLEO), Athens, Greece
| | - Athanasia Xirogianni
- National Meningitis Reference Laboratory, Dept of Public Health Policy, School of Public Health, University of West Attica, Athens, Greece
| | - Olga Dedousi
- Second Department of Paediatrics, School of Medicine, National and Kapodistrian University of Athens (NKUA), P.& A. Kyriakou Children's Hospital, Athens, Greece
| | - Irene Papaconstadopoulos
- First Department of Paediatrics, School of Medicine, National and Kapodistrian University of Athens (NKUA), Aghia Sophia Children's Hospital, Athens, Greece
| | - Eirini Eleftheriou
- Second Department of Paediatrics, School of Medicine, National and Kapodistrian University of Athens (NKUA), P.& A. Kyriakou Children's Hospital, Athens, Greece
| | - Panagiotis Krepis
- Second Department of Paediatrics, School of Medicine, National and Kapodistrian University of Athens (NKUA), P.& A. Kyriakou Children's Hospital, Athens, Greece
| | - Sophia Pasparaki
- Second Department of Paediatrics, School of Medicine, National and Kapodistrian University of Athens (NKUA), P.& A. Kyriakou Children's Hospital, Athens, Greece
| | - Georgios Pantalos
- Pediatric Intensive Care Unit, Penteli's Children Hospital, Penteli, Greece
| | | | | | - Maria Daskalaki
- Microbiology Laboratory, Penteli Children's Hospital, Athens, Greece
| | | | - Georgina Tzanakaki
- National Meningitis Reference Laboratory, Dept of Public Health Policy, School of Public Health, University of West Attica, Athens, Greece
| | - Vana Spoulou
- First Department of Paediatrics, School of Medicine, National and Kapodistrian University of Athens (NKUA), Aghia Sophia Children's Hospital, Athens, Greece
| | - Maria Tsolia
- Second Department of Paediatrics, School of Medicine, National and Kapodistrian University of Athens (NKUA), P.& A. Kyriakou Children's Hospital, Athens, Greece
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D'Ercole S, Parisi P, D'Arcangelo S, Lorusso F, Cellini L, Dotta TC, Di Carmine M, Petrini M, Scarano A, Tripodi D. Correlation between use of different type protective facemasks and the oral ecosystem. BMC Public Health 2023; 23:1992. [PMID: 37828542 PMCID: PMC10571399 DOI: 10.1186/s12889-023-16936-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 10/09/2023] [Indexed: 10/14/2023] Open
Abstract
BACKGROUND Spread worldwide through droplets, the Virus Sars-Cov-19 has caused a global health emergency alarm. In order to limit its spread, the use of masks has become part of the daily life of the entire population, however, little is known about its constant use and the changes generated in the oral cavity. This work aims to investigate correlations between the continuous use of masks covering the nose and mouth for 3 h and changes in the ecological factors of the oral cavity. METHODS 34 volunteers were divided into 2 groups: wear only the filtering facepiece code 2 (FFP2) mask (Group A) and wear the FFP2 mask covered by a surgical mask (Group B). Measurement of Volatile Organic Compounds (VOCs), saliva rehydration and consistency test, collection of basal saliva and saliva stimulated with paraffin gum and mucosal swab were collected and analyzed at two times: before using the mask(s) (T0) and 3 h after continuous use of the mask(s) (T1). RESULTS The results indicated a significant difference between the groups, in which the basal saliva volume and pH and the peaks of VOCs increased for group B between T0 and T1. The rehydration time decreased and the volume and pH of the stimulated saliva increased, but with no significant difference between the groups. Furthermore, group B showed a significant decrease in Candida albicans Colony Forming Units (CFUs) and Total Bacterial Count (TBC) between T0 and T1. CONCLUSION It is concluded that the prolonged use of the FFP2 mask covered by a surgical mask can generate oral alterations in the user.
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Affiliation(s)
- Simonetta D'Ercole
- Department of Medical, Oral and Biotechnological Sciences, University "G. D'Annunzio" of Chieti- Pescara, Via dei Vestini, 31, Chieti, 66100, Italy.
| | - Paolo Parisi
- Department of Medical, Oral and Biotechnological Sciences, University "G. D'Annunzio" of Chieti- Pescara, Via dei Vestini, 31, Chieti, 66100, Italy
| | - Sara D'Arcangelo
- Department of Pharmacy, University "G. D'Annunzio" of Chieti-Pescara, Via dei Vestini, 31, Chieti, 66100, Italy
| | - Felice Lorusso
- Department of Innovative Technologies in Medicine and Dentistry, University "Gd'Annunzio" of Chieti-Pescara, Via dei Vestini, 31, Chieti, 66100, Italy
| | - Luigina Cellini
- Department of Pharmacy, University "G. D'Annunzio" of Chieti-Pescara, Via dei Vestini, 31, Chieti, 66100, Italy
| | - Tatiane Cristina Dotta
- Department of Medical, Oral and Biotechnological Sciences, University "G. D'Annunzio" of Chieti- Pescara, Via dei Vestini, 31, Chieti, 66100, Italy
- Department of Dental Materials and Prosthodontics, School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, 14040-904, Brazil
| | - Maristella Di Carmine
- Department of Innovative Technologies in Medicine and Dentistry, University "Gd'Annunzio" of Chieti-Pescara, Via dei Vestini, 31, Chieti, 66100, Italy
| | - Morena Petrini
- Department of Medical, Oral and Biotechnological Sciences, University "G. D'Annunzio" of Chieti- Pescara, Via dei Vestini, 31, Chieti, 66100, Italy
| | - Antonio Scarano
- Department of Innovative Technologies in Medicine and Dentistry, University "Gd'Annunzio" of Chieti-Pescara, Via dei Vestini, 31, Chieti, 66100, Italy
| | - Domenico Tripodi
- Department of Medical, Oral and Biotechnological Sciences, University "G. D'Annunzio" of Chieti- Pescara, Via dei Vestini, 31, Chieti, 66100, Italy
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Singh R, Singh R, Suri A. Personalized 3D Printed Eye Gear for Microscopic Surgeons Amidst and beyond COVID-19. Bioengineering (Basel) 2023; 10:1129. [PMID: 37892859 PMCID: PMC10604268 DOI: 10.3390/bioengineering10101129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 07/03/2023] [Accepted: 07/04/2023] [Indexed: 10/29/2023] Open
Abstract
The COVID-19 pandemic underscored the need for enhanced protective measures for healthcare workers, particularly surgeons, who face a heightened risk of exposure to infectious aerosols. However, conventional eye protection equipment such as face shields, goggles, or glasses often leads to ergonomic discomfort and a reduced field of view (FOV), impeding surgeons' ability to perform microsurgical procedures with precision and ease. To address these limitations, this study aimed to develop personalized 3D-printed eye gear for microscopic surgeons based on facial anthropometry data. 3D scanning was employed to obtain facial data from ten neurosurgery residents. Utilizing computer-aided designing, eye gears tailored to the unique facial features of each participant were developed. Finite element analysis-based contact simulation was used to assess the pressure exerted by the eye gear. Multi-material 3D printing was employed to fabricate the personalized eye gear. Participants, while donning the eye gear, engaged in simulation-based micro suturing tasks at various magnifications of the operating microscope, and marked the FOV range. They provided feedback scores (1-10) on the effectiveness of the eye gear through a Likert scale questionnaire (Q1-Q8). Finite element analysis demonstrated uniform strain distribution on the face, indicating that the edges of the customized eye gear fit exactly to the user's face. The average scores for the questionnaire Q1 to Q8 ranged from 6.8 to 8.5, with an overall mean score of 7.6. This indicates that the developed eye gear was simple to use and did not cause any discomfort. Additionally, the average reduction in the FOV was only 10.93% across the different operating microscope magnifications. These findings highlight eye gear's potential to alleviate discomfort and enhance precision in microscopic surgeries. Consequently, personalized 3D-printed eye gear offers a promising solution for providing surgeons with a safe environment while preserving the benefits of the operating microscope.
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Affiliation(s)
| | | | - Ashish Suri
- Neuro-Engineering Laboratory, Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi 110029, India; (R.S.); (R.S.)
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Polyong CP, Thetkathuek A. Comparison of acetylcholinesterase among employees based on job positions and personal protective equipment in fuel station. Environ Anal Health Toxicol 2023; 38:e2023018-0. [PMID: 37853699 PMCID: PMC10613560 DOI: 10.5620/eaht.2023018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 09/14/2023] [Indexed: 10/20/2023] Open
Abstract
The purpose of this study was to compare the levels of acetylcholinesterase (AChE) among employees based on job positions and the wearing of personal protective equipment (PPE) in fuel station areas. The sample group consisted of 200 people sorted into various groups, including (i) Inside fuel dispenser area (I-FDA) group consisting of 100 employees for refueling, cashier, and loading fuel into storage tanks, and (ii) Outside fuel dispenser area (O-FDA) group, consisting of 100 employees working in convenience stores, food stores, coffee shops, and offices, as well as general staff and car washers. Data were collected using interview questionnaires and blood samples were analyzed for AChE activity. The results showed that the I-FDA group had a significantly lower mean of serum AChE (7.38±1.73 U/ml) than the O-FDA group (7.85±1.49 U/ml) (p<0.05). The I-FDA group had a 2.43 times higher risk of abnormal serum AChE than the O-FDA group (OR=2.43, 95%CI=1.05-5.60). When considering the risk factors for job positions, it was found that refueling and cashier positions had lower AChE activity levels than those who did not (p<0.05). In the part, employees for food sales in a closed building and those wearing PPE masks had significantly higher AChE activity levels than those who did not or who wore them (p<0.05). Based on the aforementioned, employers at fuel stations should strictly determine the appropriate measures for wearing a PPE mask. Further, employees should be provided accommodation away from oil supply or enclosed buildings during breaks to reduce the effects on the neurotransmitter.
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Affiliation(s)
- Chan Pattama Polyong
- Occupational Health and Safety Program, Faculty of Science and Technology, Bansomdejchaopraya Rajabhat University, Bangkok 10600, Thailand
| | - Anamai Thetkathuek
- Department of Industrial Hygiene and Safety, Faculty of Public Health, Burapha University, Chonburi Province 20131, Thailand
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Golechha S, Juneja S, Raipurkar AR, Kale RV. Personal Protection Equipment Kit Tracker. Indian J Otolaryngol Head Neck Surg 2023; 75:1429-1434. [PMID: 37636728 PMCID: PMC10447329 DOI: 10.1007/s12070-023-03595-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 02/16/2023] [Indexed: 02/27/2023] Open
Abstract
The primary efficient review on the status of individual defensive gear for medical services workers in India has uncovered that practically all parts of PPE were discovered to be either deficiently accessible or inaccessible in many clinics. PPEs are a significant clinical asset for cutting edge laborers during the pandemic that incorporate body coveralls, N-95 covers, goggles, face shields among others. The public authority has been guaranteeing that after the underlying long stretches of the pandemic, PPE were just imported and there is no deficiency since the most recent couple of months as several homegrown makers are delivering almost 4.5 lakh PPE units every day now. Nonetheless, the most recent review by a gathering of free wellbeing analysts has affirmed that cutting edge workers are as yet not getting these units. The study depended on reactions from specialists, inhabitants and understudies, attendants and network wellbeing workers. Almost 33% of respondents revealed that covers were not accessible at all. (According to an article by The New Indian Express). There are claims that demonstrate no deficiencies of PPE units the nation over, yet as per ongoing overviews, the undeniable realities are not replicated. These realities get significantly more heart-breaking when we move from green zones (one out of five) to red zones (one out of three). At present, India does not have an appropriate framework for the board of the PPE packs, guaranteeing legitimate unit purchasing and selling or permitting taking an interest element to chip away at the regular stage to fix bargains with respect to PPE parts, as indicated by their prerequisites.
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Affiliation(s)
- Siddharth Golechha
- Research Scholar, Computer Science and Engineering, Shri. Ramdeobaba College of Engineering & Management, Nagpur, India
| | - Sudha Juneja
- Research Scholar, Computer Science and Engineering, Shri. Ramdeobaba College of Engineering & Management, Nagpur, India
| | - Abhijeet R. Raipurkar
- Computer Science and Engineering, Shri. Ramdeobaba College of Engineering & Management, Nagpur, India
| | - Rishikesh Vinod Kale
- Computer Science and Engineering, Shri. Ramdeobaba College of Engineering & Management, Nagpur, India
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23
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Chen XE, Zhao C, Luo Y, Tang T, Chen W. Contamination of SARS-CoV-2 RNA on personal protective equipment and environmental surfaces in nonpatient entry area of a Fangcang shelter hospital. Am J Ind Med 2023; 66:805-812. [PMID: 37394558 DOI: 10.1002/ajim.23513] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 06/19/2023] [Accepted: 06/21/2023] [Indexed: 07/04/2023]
Abstract
OBJECTIVES To determine the extent of contamination of personal protective equipment (PPE) and surfaces by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the nonpatient entry area of a Fangcang shelter hospital, the medical staff accommodation area, and the staff transport bus. METHODS We collected 816 samples from the nonpatient entry area and floors in a Fangcang shelter hospital, medical staff accommodation area, and scheduled bus, and the five major types of PPE used from April 13 to May 18, 2022. SARS-CoV-2 ribonucleic acid (RNA) was detected by reverse transcription-polymerase chain reaction. RESULTS Overall, 22.2% of PPE samples were positive for SARS-CoV-2 RNA. Boot covers and gowns were the most contaminated types of PPE. The positive PPE contamination rate of staff collecting respiratory specimens was significantly higher than that of the general-treatment staff group (35.8% vs. 12.2%) and cleaner group (35.8% vs. 26.4%), p < 0.01. In total, 27 of 265 (10.2%) environmental surface samples were positive for SARS-CoV-2 RNA. The contamination-positive rates were 26.8% (22/82), 5.4% (4/74), and 0.9% (1/109) for contaminated, potentially contaminated, and clean zones, respectively. SARS-CoV-2 RNA was frequently detected on objects such as mobile phones, tables, computer keyboards and mice, and door handles. CONCLUSIONS SARS-CoV-2 RNA was widely distributed on high-touch surfaces and on PPE in the contaminated zone of the Fangcang shelter hospital, implying a potentially high infection risk for healthcare workers. Our findings emphasize the need to ensure adequate environmental cleaning, improve hand hygiene, and reduce the risk of infection. Additionally, prevention of self-contamination during PPE donning and doffing is complex and needs more research.
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Affiliation(s)
- Xue-E Chen
- Department of Nosocomial Infection Control, The Second Affiliated Hospital, Army Medical University, Chongqing, China
| | - ChenHao Zhao
- Department of Neurology, The Second Affiliated Hospital, Army Medical University, Chongqing, China
| | - YeTao Luo
- Department of Nosocomial Infection Control, The Second Affiliated Hospital, Army Medical University, Chongqing, China
| | - Tang Tang
- Department of Obstetrics and Gynecology, The Second Affiliated Hospital, Army Medical University, Chongqing, China
| | - Wei Chen
- Department of Nosocomial Infection Control, The Second Affiliated Hospital, Army Medical University, Chongqing, China
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Figueroa M, McMullen KM, Kruger E, Peterson AV, Johnson C, Line W. Respiratory Protection: Lessons Learned from a Global Pandemic. Risk Manag Healthc Policy 2023; 16:1693-1702. [PMID: 37670731 PMCID: PMC10476861 DOI: 10.2147/rmhp.s417979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 08/11/2023] [Indexed: 09/07/2023] Open
Abstract
The COVID-19 pandemic exposed the limitations of global health systems' abilities to manage the rapid spread of a novel infectious disease, which was exacerbated by shortages of respiratory protective devices and other critical personal protective equipment (PPE). An advisory panel of experienced health-care professionals with backgrounds in Occupational and Environmental Health and Safety (OEHS), Infection Prevention, Nursing, and Clinical Application Specialists convened to discuss challenges and strategies associated with the selection and use of respiratory protective devices as experienced during the first year of the COVID-19 pandemic. This discussion led to the following recommendations: 1) the need for clear communication of alternative respiratory protection selection and use recommendations in accordance with US regulatory and agency guidance; 2) the need for collaboration between Infection Prevention, OEHS, clinical staff, supply chain/materials management, emergency preparedness, executive leadership, and finance; 3) the need for adequate stockpiling, inventory rotation, and diverse respiratory protection options to accommodate the majority of health-care workers; 4) the need for efficient and innovative strategies to communicate evolving regulatory, agency, and facility recommendations and to deliver appropriate training on respiratory protection; and 5) the need for additional research on respiratory protection use - involving filtering facepiece respirators (FFRs) as well as other respirator types designed to be reused - to balance infection prevention best practices with a sustainable process. In conclusion, these considerations may offer guidance and identify areas for research on preparedness, communication, education, and training to enhance the preparation of health-care facilities including community-based health-care organizations for unexpected public health events.
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Affiliation(s)
- Marta Figueroa
- Environmental Health and Safety, NYU Langone Health, New York, NY, USA
| | - Kathleen M McMullen
- Infection Prevention, Christian Hospital and Northwest Healthcare, St. Louis, MO, USA
| | - Elizabeth Kruger
- Home Infusion and Infection Prevention, Park Nicollet Health Services, St. Louis Park, MN, USA
| | | | | | - Whitney Line
- Medical Solutions Division, 3M Company, St. Paul, MN, USA
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25
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Fortin G, Saucier A, Munoz-Bertrand M, Yuan M, Ante Z, Narasiah L, Zinszer K. Portrait of Montréal healthcare workers infected with SARS-CoV-2 during the first wave of the pandemic: a cross-sectional study. Can J Public Health 2023; 114:534-546. [PMID: 37410364 PMCID: PMC10351277 DOI: 10.17269/s41997-023-00789-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 05/23/2023] [Indexed: 07/07/2023]
Abstract
OBJECTIVES During the first wave of COVID-19 in Québec, healthcare workers (HCWs) represented 25% of the cases in Montréal. A study was conducted to describe SARS-CoV-2-infected HCWs in Montréal, and certain workplace and household characteristics. Secondary objectives included estimating the associations between having had access to personal protective equipment (PPE) and training, and following self-isolation recommendations, and certain sociodemographic and workplace characteristics. METHODS A cross-sectional study was conducted, based on a stratified random sample, among Montréal HCWs who tested positive for SARS-CoV-2 between March and July 2020. A total of 370 participants answered a telephone-administered questionnaire. Descriptive statistics were conducted, followed by log binomial regressions to estimate the associations. RESULTS Study participants were mostly female (74%), born outside of Canada (65%), and identified as Black, Indigenous, and People of Colour (BIPOC; 63%). In terms of healthcare positions, most were orderlies (40%) or registered nurses (20%). Half (52%) of the participants reported having had insufficient access to PPE and 30% reported having received no training related to SARS-CoV-2 infection prevention, with large proportions being BIPOC women. Working evening or night shifts decreased chances of having had sufficient access to PPE (OR 0.50; 0.30-0.83). CONCLUSION This study describes the profile of the HCWs who were infected during the first wave of the pandemic in Montréal. Recommendations include collecting comprehensive sociodemographic data on SARS-CoV-2 infections and ensuring equitable access to infection prevention and control training and PPE during health crises, particularly those at highest risk of exposure.
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Affiliation(s)
- Geneviève Fortin
- École de Santé Publique, Université de Montréal, Montréal, QC, Canada.
- Centre de Recherche en Santé Publique (CReSP), Montréal, QC, Canada.
| | - Adrien Saucier
- École de Santé Publique, Université de Montréal, Montréal, QC, Canada
- Centre de Recherche en Santé Publique (CReSP), Montréal, QC, Canada
| | - Marie Munoz-Bertrand
- Direction Régionale de Santé Publique de Montréal, Centre Intégré Universitaire de Santé et de Services Sociaux du Centre-Sud-de-l'Île-de-Montréal, Montréal, QC, Canada
| | - Mengru Yuan
- École de Santé Publique, Université de Montréal, Montréal, QC, Canada
| | | | - Lavanya Narasiah
- Direction Régionale de Santé Publique de Montréal, Centre Intégré Universitaire de Santé et de Services Sociaux du Centre-Sud-de-l'Île-de-Montréal, Montréal, QC, Canada
| | - Kate Zinszer
- École de Santé Publique, Université de Montréal, Montréal, QC, Canada
- Centre de Recherche en Santé Publique (CReSP), Montréal, QC, Canada
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Alqahtani S, Alqahtani S, Saquib Q, Mohiddin F. Toxicological impact of microplastics and nanoplastics on humans: understanding the mechanistic aspect of the interaction. Front Toxicol 2023; 5:1193386. [PMID: 37521752 PMCID: PMC10375051 DOI: 10.3389/ftox.2023.1193386] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 06/29/2023] [Indexed: 08/01/2023] Open
Abstract
Plastic is a pervasive material that has become an indispensable part of our daily lives and is used in various commercial products. However, plastic waste has significantly impacted the environment, accumulating in water and land ecosystems and harming all forms of life. When plastic degrades, it breaks down into smaller particles called microplastics (MPs), which can further breakdown into nanoplastics (NPs). Due to their small size and potential toxicity to humans, NPs are of particular concern. During the COVID-19 pandemic, the production of plastic had reached unprecedented levels, including essential medical kits, food bags, and personal protective equipment (PPE), which generate MPs and NPs when burned. MPs and NPs have been detected in various locations, such as air, food, and soil, but our understanding of their potential adverse health effects is limited. This review aims to provide a comprehensive overview of the sources, interactions, ecotoxicity, routes of exposure, toxicity mechanisms, detection methods, and future directions for the safety evaluation of MPs and NPs. This would improve our understanding of the impact of MPs and NPs on our health and environment and identify ways to address this global crisis.
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Affiliation(s)
- Saeed Alqahtani
- Advanced Diagnostics and Therapeutics Institute, Health Sector, King Abdulaziz City for Science and Technology (KACST), Riyadh, Saudi Arabia
- Comparative Pathobiology Department, Purdue University Center for Cancer Research, Purdue University, West Lafayette, IN, United States
| | - Shaherah Alqahtani
- School of Health Sciences, College of Health and Human Sciences, Purdue University, West Lafayette, IN, United States
| | - Quaiser Saquib
- Chair for DNA Research, Zoology Department, College of Science, King Saud University, Riyadh, Saudi Arabia
| | - Fayaz Mohiddin
- Mountain Research Center for Field Crops, Khudwani, Sher-e-Kashmir University of Agricultural Sciences and Technology, Srinagar, India
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Yosef T, Shifera N. Personal Protective Equipment Utilization and Associated Factors among Industry Park Construction Workers in Northwest Ethiopia. Environ Health Insights 2023; 17:11786302231185683. [PMID: 37434665 PMCID: PMC10331180 DOI: 10.1177/11786302231185683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Accepted: 06/15/2023] [Indexed: 07/13/2023]
Abstract
Introduction Equipment that safeguards the user from the risk of accidents or harmful health effects is known as personal protective equipment. Reports show personal protective equipment utilization is low in Africa. Workers are exposed to a wide range of physical, chemical, and incidental hazards because of low utilization of personal protective equipment. Therefore, this study aimed to assess the magnitude and factors associated with personal protective equipment utilization among Bure Industrial Park construction workers, Northwest Ethiopia. Methods A cross-sectional study involving 368 construction workers was carried out. The questionnaire was prepared to collect data on sociodemographic, work-related, and behavioral characteristics. Personal protective equipment usage was assessed by observation. Descriptive statistics' frequencies, proportions, and means were computed, and the analysis results were presented in text and tables. To find independent variables associated with personal protective equipment utilization, bi-variable and multivariable logistic regression analyses were performed. Results The proportion of workers at the Bure Industrial Park who utilized personal protective equipment was 47.8%, 95% CI (47.7-47.9). After adjusting employment type as a confounding factor; not being a substance user [AOR = 9.52, 95% CI (5.07-17.8)], regular workplace supervision [AOR = 4.09, 95% CI (1.26-5.48)], having occupational safety training [AOR = 6.01, 95% CI (2.05-17.6)], and provision of personal protective equipment at workplace [AOR = 7.36, 95% CI (3.97-13.6)] were the factors associated with personal protective equipment utilization. Conclusion and recommendation Nearly 1 in 2 workers wear PPE at work. Lack of PPE utilization is a public health problem in the study area. According to the study, personal protective equipment utilization was influenced by behavioral and occupational factors. To increase the utilization of personal protective equipment, training in safety procedures and regular workplace supervision must be considered.
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Affiliation(s)
- Tewodros Yosef
- School of Public Health, College of Medicine and Health Sciences, Mizan-Tepi University, Mizan Teferi, Ethiopia
- School of Medicine, Faculty of Health, Deakin University, Waurn Ponds, Australia
| | - Nigusie Shifera
- School of Public Health, College of Medicine and Health Sciences, Mizan-Tepi University, Mizan Teferi, Ethiopia
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28
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Zhao Z, Tang L, Wu Y. Fatigue during the COVID-19 pandemic: The experiences of Chinese seafarers. Mar Policy 2023; 153:105643. [PMID: 37152074 PMCID: PMC10150193 DOI: 10.1016/j.marpol.2023.105643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 04/10/2023] [Accepted: 04/28/2023] [Indexed: 05/09/2023]
Abstract
Though the COVID-19 pandemic is drawing to a close, very little is known about the impact of China's zero-COVID policy on Chinese seafarers. This paper examines Chinese seafarers' experiences of fatigue during the pandemic. It adopted a mix-method research design involving two quantitative surveys conducted with seafarers before and during the pandemic and 35 in-depth interviews with both seafarers and managers. All the participants were from two Chinese shipping companies. The comparisons between the two surveys show that Chinese seafarers experienced significantly higher levels of fatigue during the pandemic. The interview data suggest a range of factors underpinning the higher levels of fatigue including fear of being infected, increased workload, wearing of four-piece personal protection equipment (PPE), the deprivation of shore leaves, and the prolonged service time. More importantly, the data indicate that the draconian zero-COVID policy in China and the related policy guidelines for Chinese shipping companies and seafarers reinforce these factors. This research extends previous research by providing an exclusive and comprehensive examination of seafarer fatigue during the pandemic and revealing that the policies adopted by seafarers' home countries can have profound implications for seafarers' experiences of fatigue. Suggestions are provided at the end of the paper.
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Affiliation(s)
- Zhiwei Zhao
- Seafarers Research Institute, Dalian Maritime University, China
- Transportation Engineering College, Dalian Maritime University, No. 1 Linghai Road, Dalian 116026, China
| | - Lijun Tang
- Plymouth Business School, University of Plymouth, Cookworthy Building, Drake Circus, Plymouth PL4 8AA, UK
| | - Yueyan Wu
- College Of Sciences, Dalian Maritime University, No. 1 Linghai Road, Dalian 116026 China
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29
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Srinidhi S, Stephen S, Mohankumar K, D’Cruz TM, Subbiah K, Subbiah GK, Nagappan N, Mani B. Assessment of Role of PPE in Preventing the Spread of Infection among the Dental Surgeons: A Prospective Study. J Pharm Bioallied Sci 2023; 15:S362-S366. [PMID: 37654383 PMCID: PMC10466661 DOI: 10.4103/jpbs.jpbs_546_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 12/04/2022] [Accepted: 12/22/2022] [Indexed: 09/02/2023] Open
Abstract
Although there is easy accessibility of infection control measures and recommendation regarding the PPE, most of the dentists failed to practice appropriate infection control measures. The aim of the current survey was conducted to assess the knowledge, perception, and attitude regarding the role of PPE among the dental care professionals in COVID-19. This is cross-sectional web-based questionnaire survey conducted among dental care professionals in Tamil Nadu. The self-administered questions related to the PPE infection control measures were collected from 500 subjects. The statistical analysis was done using Statistical Package for Social Sciences SPSS (V 22.0). The frequency distribution was computed. This survey revealed that all the 500 (100%) respondents had awareness about the role of PPE in COVID-19 pandemic. Among the 500 study subjects, 93.2% had well-known knowledge about PPE, 60.4% of dentist strictly adheres to the use of PPE in routine dental practice, 80.2% of dentist mentioned PPE is safe and effective against spread of infection, and 93.4% of dentist had awareness about donning and doffing. Conclusion From the beginning of this COVID-19, information provided by the health organization like CDC and WHO regarding the role of PPE had positive impact among the dental care professionals.
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Affiliation(s)
- S. Srinidhi
- Department of Public Health Dentistry, Karpaga Vinayaga Institute of Dental Sciences, Chengalpet District, Tamil Nadu, India
| | - Sujithraj Stephen
- Department of Dentistry, Panimalar Medical College Hospital and Research Institute, Varadharajapuram, Chennai, Tamil Nadu, India
| | | | - Thomson M. D’Cruz
- Department of Oral and Maxillofacial Surgery, Dr. G. D. Pol Foundation’s Y. M. T. Dental College and Hospital, Navi Mumbai, Maharashtra, India
| | - Krithika Subbiah
- Department of Public Health, University of Waterloo, Ontario, Canada
| | | | - Nagappan Nagappan
- Department of Public Health Dentistry, Chettinad Dental College and Research Institute, Kelambakkam, Tamil Nadu, India
| | - Bhuvaneswari Mani
- Department of Orthodontics and Dentofacial Orthopedics, KarpagaVinayaga Institute of Dental Sciences, Chengalpet District, Tamil Nadu, India
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30
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Bhatia R, Aggarwal R, Ravichandrane B, Rajendrakumar K, Ahmed A, Sahoo D, Soni KD, Khanna P, Trikha A. Early Doffing among Frontline Healthcare Workers Working in the COVID Areas in Resource-Limited Settings: Lessons Learned and Interventions Taken. Indian J Occup Environ Med 2023; 27:209-213. [PMID: 38047167 PMCID: PMC10691514 DOI: 10.4103/ijoem.ijoem_46_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 08/22/2022] [Accepted: 09/02/2022] [Indexed: 12/05/2023] Open
Abstract
Background In the fight against the pandemic, personal protective equipment (PPE) has played a vital role. However, working with PPE has its own difficulties and problems. The aim of this study was to find out the reasons of early doffing, that is, in doffing in emergency situations before the shift among healthcare workers (HCWs) working in PPE in the COVID areas in resource-limited settings. Methods This cross-sectional, survey-based study was carried out on healthcare workers involved in direct care of patients with COVID-19 in tertiary care COVID center, India. The questionnaire was sent as a Google form through email and social media platforms like WhatsApp and Facebook. The data was reported as the mean ± SD for continuous variables and as the percentage for categorical variables. Findings Among 252 healthcare workers who participated in the survey, 145 (57.5%) participants doffed early on 300 occasions. Out of these 145, 50% doffed early only once and rest doffed early multiple times. The most common reason of early doffing was found to be breach in PPE (15.33%) followed by fogging (14%) and headache (12%), and most commonly, breach was in mask or coverall/gown (32.6% each). Conclusion Although PPE decreases the risk of infection, it is challenging for HCWs to work in PPE leading to instances of early doffing. The most common reason for early doffing in our study was the breach in PPE and the most common component of breach was found to be mask and coverall/gown. Therefore, we suggest that the proper sizes of the PPE should be made available and proper training in donning should be imparted to HCWs working in PPE.
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Affiliation(s)
- Ridhima Bhatia
- Department of Anaesthesiology, Critical Care and Pain Medicine, JPN Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India
| | - Richa Aggarwal
- Critical and Intensive Care, JPN Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India
| | - Banupriya Ravichandrane
- Department of Anaesthesiology, Critical Care and Pain Medicine, JPN Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India
| | - Karthiga Rajendrakumar
- Department of Anaesthesiology, Critical Care and Pain Medicine, JPN Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India
| | - Aasim Ahmed
- Department of Anaesthesiology, Critical Care and Pain Medicine, JPN Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India
| | - Debasis Sahoo
- Department of Anaesthesiology, Critical Care and Pain Medicine, JPN Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India
| | - Kapil Dev Soni
- Critical and Intensive Care, JPN Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India
| | - Puneet Khanna
- Department of Anaesthesiology, Critical Care and Pain Medicine, JPN Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India
| | - Anjan Trikha
- Department of Anaesthesiology, Critical Care and Pain Medicine, JPN Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India
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Ahmed G, Rasheed A, Munawar KS, Bandaru S, Khan J, Liu Z, Ahmad MS. Visible light-driven photocatalytic bacterial inactivation on PPE, supported by the DFT and bactericidal study. Environ Sci Pollut Res Int 2023:10.1007/s11356-023-27867-5. [PMID: 37273042 DOI: 10.1007/s11356-023-27867-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 05/18/2023] [Indexed: 06/06/2023]
Abstract
A novel ZnO-MoO3-ZnMoO3@graphene GZM composite catalyst prepared by microwave hydrothermal process for personal protective equipment textiles (PPE) is presented in this study. The results indicated that the GZM with defect vacancy sites of two types as observed by EPR showed significantly superior inactivation of the E. coli bacteria compared to GZM without the lower defect vacancy sites and concomitant lower electron densities. Photocatalytic activated oxidation by the GZM composites coatings was observed to proceed in acceptable times as well as the bacterial inactivation (log bact. C/Co > 107 within 3 h). Defect sites in the GZM seem to be important leading to the bacterial inactivation process. DFT calculations on the GZM with and without catalyst defect sites were carried out. The electron densities were estimated by the Fourier mapping. The results found in this study showed the potential of GZM-PPE for practical applications.
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Affiliation(s)
- Gulzar Ahmed
- School of Materials Science and Engineering, South China University of Technology, Guangzhou, 510640, China.
| | - Adeel Rasheed
- Department of Physics, University of Mianwali, Mianwali, 42200, Pakistan
| | | | - Satesh Bandaru
- College of Material Science and Environmental Engineering, Hangzhou Dianzi University, Hangzhou, 310018, China
| | - Javid Khan
- College of Material Science and Engineering, Hunan University, Changsha, 410082, China
| | - Zhongwu Liu
- School of Materials Science and Engineering, South China University of Technology, Guangzhou, 510640, China
| | - Muhammad Sheraz Ahmad
- Center for Environmental Sustainability and Human Health, Ming Chi University of Technology, New Taipei City, 24301, Taiwan
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Girase A, Thompson D, Ormond RB. Bench-Scale and Full-Scale Level Evaluation of the Effect of Parameters on Cleaning Efficacy of the Firefighters' PPE. Textiles (Basel) 2023; 3:201-218. [PMID: 37786877 PMCID: PMC10543714 DOI: 10.3390/textiles3020014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
The National Fire Protection Association (NFPA) 1851 document provides guidelines for firefighters on the care and maintenance of their PPE, including decontamination practices. Firefighters are exposed to various toxic chemicals during fire suppression activities, making effective decontamination crucial for their safety. This study evaluated the efficacy of different washing parameters, including temperature, time, and surfactants, on cleaning outer-shell material contaminated with nine targeted compounds from three different functional groups: phenols, polycyclic aromatic hydrocarbons (PAHs), and phthalates. The study was conducted on both bench-scale and full-scale levels, with contaminated swatches washed in a water shaker bath in the bench-scale evaluation and full-sized washer extractors used in the full-scale evaluation. The results showed that bench-scale washing demonstrated similar trends in contaminant removal to full-scale washing. Importantly, the study highlighted the complexity of removing fireground contaminants from the personal protective ensemble (PPE). The findings of this study have practical implications for the firefighting industry as they provide insight into the effectiveness of different washing parameters for PPE decontamination. Future studies could explore the impact of repeated washing on PPE and investigate the potential for developing more efficient decontamination strategies. Ultimately, the study underscores the importance of ongoing efforts to ensure the safety of firefighters, who face significant occupational hazards.
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Affiliation(s)
- Arjunsing Girase
- Textile Protection and Comfort Center, Wilson College of Textiles, North Carolina State University, Raleigh, NC 27695, USA
| | - Donald Thompson
- Textile Protection and Comfort Center, Wilson College of Textiles, North Carolina State University, Raleigh, NC 27695, USA
| | - Robert Bryan Ormond
- Textile Protection and Comfort Center, Wilson College of Textiles, North Carolina State University, Raleigh, NC 27695, USA
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Clemente I, Santini SJ, Vittorini P, Pallotta E, Sinatti G, Fontana A, Mammarella L, Rancitelli E, Balsano C. Fall of viral and bacterial pneumonia hospitalizations following COVID-19 pandemic mitigation strategies: a central Italian Region retrospective study. Intern Emerg Med 2023; 18:1181-1189. [PMID: 36750536 PMCID: PMC9904871 DOI: 10.1007/s11739-023-03213-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 01/30/2023] [Indexed: 02/09/2023]
Abstract
Community-Acquired Pneumonia (CAP) represents one of the first causes of hospitalization and death in the elderly all over the world and weighs heavily on public health system. Since the beginning of the COVID-19 (CoronaVirus Disease-19) pandemic, everybody's behavior was forced to change, as the result of a global lockdown strategy and the obligation of using personal protection equipment (PPE). We aimed to evaluate how the mitigation strategies adopted to fight SARS-CoV-2 (Severe Acute Respiratory Coronavirus Syndrome 2) infection have influenced hospitalizations due to CAP in two different Local Health Boards (LHBs) of central Italy. We considered two main periods of observation: before and after the national start of lockdown, in two Abruzzo's LHBs. We analyzed 19,558 hospital discharge records of bacterial and viral CAP. Excluding SARS-CoV2 infection, a significant decrease in CAP hospitalizations was observed. Through the analysis of Diagnosis Related Group (DRG) values, we highlighted a significant saving of founds for the Regional Health Service. The enactment of social distancing measures to contain COVID-19 spread, brought down admissions for bacterial and viral pneumonia. Our study emphasizes that costs for hospitalizations due to CAP could be drastically reduced by mask wearing and social distancing.
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Affiliation(s)
- Irma Clemente
- Department of Life, Health and Environmental Sciences-MESVA, School of Emergency-Urgency Medicine, University of L'Aquila, 67100, L'Aquila, Italy
| | - Silvano Junior Santini
- Department of Life, Health and Environmental Sciences-MESVA, School of Emergency-Urgency Medicine, University of L'Aquila, 67100, L'Aquila, Italy
- Francesco Balsano Foundation, Via Giovanni Battista Martini 6, 00198, Rome, Italy
| | - Pierpaolo Vittorini
- Department of Life, Health and Environmental Sciences-MESVA, School of Emergency-Urgency Medicine, University of L'Aquila, 67100, L'Aquila, Italy
| | - Enrico Pallotta
- Department of Life, Health and Environmental Sciences-MESVA, School of Emergency-Urgency Medicine, University of L'Aquila, 67100, L'Aquila, Italy
| | - Gaia Sinatti
- Department of Life, Health and Environmental Sciences-MESVA, School of Emergency-Urgency Medicine, University of L'Aquila, 67100, L'Aquila, Italy
| | - Antonella Fontana
- Department of Life, Health and Environmental Sciences-MESVA, School of Emergency-Urgency Medicine, University of L'Aquila, 67100, L'Aquila, Italy
| | - Leondino Mammarella
- U.O.S.D. Servizio Gestione Flussi Informativi e Statistica Sanitaria, L'Aquila, Italy
| | | | - Clara Balsano
- Department of Life, Health and Environmental Sciences-MESVA, School of Emergency-Urgency Medicine, University of L'Aquila, 67100, L'Aquila, Italy.
- Francesco Balsano Foundation, Via Giovanni Battista Martini 6, 00198, Rome, Italy.
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Selcen Kilinc-Balci F. Evaluation of the Physical Performance of Disposable Isolation Gowns. Am J Infect Control 2023:S0196-6553(23)00333-4. [PMID: 37121472 DOI: 10.1016/j.ajic.2023.04.169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 04/15/2023] [Accepted: 04/15/2023] [Indexed: 05/02/2023]
Abstract
BACKGROUND The threat of emerging infectious diseases has highlighted the need for effective gowns to protect healthcare workers and patients. Although studies identified end user issues with the physical performance of gowns, the literature that evaluates the performance is scarce. This paper represents one of the first efforts to investigate the physical performance of a substantial set of isolation gown models in the marketplace. OBJECTIVE Physical performance of 20 commercial and two experimental disposable isolation gowns was evaluated. METHODS Standard test methods were used to investigate a range of properties including; thickness, weight, tensile strength, tearing strength, and seam strength. RESULTS In general, due to the differences in the fibers and methods used for the construction, large variations in the tensile, tear, and seam strength results were found. When the gowns were compared to their respective AAMI PB70 protection levels, no clear trend was found between protection levels and tear strength or between protection levels and seam strength, while there was a linear relationship between gowns' AAMI PB70 levels and their tensile strength. It was found that fabric construction significantly affects the physical performance of gowns. CONCLUSIONS Based on this work, a new standard, ASTM F3352, was published and has been recognized by the FDA. ASTM F3352 is expected to help end users in selecting the appropriate protective clothing.
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Affiliation(s)
- F Selcen Kilinc-Balci
- US Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, National Personal Protective Technology Laboratory, 626 Cochrans Mill Road, Pittsburgh, PA 15236, USA.
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Sankey N, Merrick H, Singh P, Rogers J, Reddi A, Hartson SD, Mitra A. Role of the Mycobacterium tuberculosis ESX-4 Secretion System in Heme Iron Utilization and Pore Formation by PPE Proteins. mSphere 2023; 8:e0057322. [PMID: 36749044 PMCID: PMC10117145 DOI: 10.1128/msphere.00573-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 01/16/2023] [Indexed: 02/08/2023] Open
Abstract
Mycobacterium tuberculosis (Mtb) is transmitted through aerosols and primarily colonizes within the lung. The World Health Organization estimates that Mtb kills ~1.4 million people every year. A key aspect that makes Mtb such a successful pathogen is its ability to overcome iron limitation mounted by the host immune response. In our previous studies, we have shown that Mtb can utilize iron from heme, the largest source of iron in the human host, and that it uses two redundant heme utilization pathways. In this study, we show that the ESX-4 type VII secretion system (T7SS) is necessary for extracellular heme uptake into the Mtb cell through both heme utilization pathways. ESX-4 influences the secretion of the culture filtrate proteins Rv0125 and Rv1085c, which are also necessary for efficient heme utilization. We also discovered that deletion of the alternative sigma factor SigM significantly reduced Mtb heme utilization through both pathways and predict that SigM is a global positive regulator of core heme utilization genes of both pathways. Finally, we present the first direct evidence that some mycobacterial PPE (proline-proline-glutamate motif) proteins of the PPE protein family are pore-forming membrane proteins. Altogether, we identified core components of both Mtb Heme utilization pathways that were previously unknown and identified a novel channel-forming membrane protein of Mtb. IMPORTANCE M. tuberculosis (Mtb) is completely dependent on iron acquisition in the host to cause disease. The largest source of iron for Mtb in the human host is heme. Here, we show that the ancestral ESX-4 type VII secretion system is required for the efficient utilization of heme as a source of iron, which is an essential nutrient. This is another biological function identified for ESX-4 in Mtb, whose contribution to Mtb physiology is poorly understood. A most exciting finding is that some mycobacterial PPE (proline-proline-glutamate motif) proteins that have been implicated in the nutrient acquisition are membrane proteins that can form channels in a lipid bilayer. These observations have far-reaching implications because they support an emerging theme that PPE proteins can function as channel proteins in the outer mycomembrane for nutrient acquisition. Mtb has evolved a heme uptake system that is drastically different from all other known bacterial heme acquisition systems.
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Affiliation(s)
- November Sankey
- Department of Microbiology and Molecular Genetics, Oklahoma State University, Stillwater, Oklahoma, USA
| | - Haley Merrick
- Department of Microbiology and Molecular Genetics, Oklahoma State University, Stillwater, Oklahoma, USA
| | - Padam Singh
- Department of Microbiology and Molecular Genetics, Oklahoma State University, Stillwater, Oklahoma, USA
| | - Janet Rogers
- Department of Biochemistry and Molecular Biology, Oklahoma State University, Stillwater, Oklahoma, USA
| | - Amit Reddi
- School of Chemistry and Biochemistry, Parker Petit Institute for Bioengineering and Biosciences, Georgia Institute of Technology, Atlanta, Georgia, USA
| | - Steven D. Hartson
- Department of Biochemistry and Molecular Biology, Oklahoma State University, Stillwater, Oklahoma, USA
| | - Avishek Mitra
- Department of Microbiology and Molecular Genetics, Oklahoma State University, Stillwater, Oklahoma, USA
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Fogarasi M, Snodderly K, Herman A, Guha S, Porter D. Benchtop assessment of sealing efficacy and breathability of additively manufactured (AM) face masks. Addit Manuf 2023; 67:103468. [PMID: 36925558 PMCID: PMC9974208 DOI: 10.1016/j.addma.2023.103468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 01/20/2023] [Accepted: 02/23/2023] [Indexed: 05/23/2023]
Abstract
The onset of the 2019 novel coronavirus disease (COVID-19) led to a shortage of personal protective equipment (PPE), medical devices, and other medical supplies causing many stakeholders and the general public alike to turn to additive manufacturing (AM) as a stopgap when normally accessible devices were not available. However, without a method to test these AM constructs, there continued to be a disconnect between AM suppliers and the community's needs. The objective of this study was to characterize the pressure drop and leakage of four different publicly available AM face mask models with two filter material combinations, as well as to investigate the impact of frame modification techniques including the use of foam strips and hot-water face forming to improve fit when the masks are donned on manikin head forms. AM face mask frame designs were downloaded from public repositories during the early stages of the COVID-19 pandemic. AM face masks were fabricated and tested on manikin head forms within a custom chamber containing dry aerosolized NaCl. Pressure drops, particle penetration, and leakage were evaluated for various flow rates and NaCl concentrations. Results indicated that filter material combination and frame modification played a major role in the overall performance of the AM face masks studied. Filter material combinations showed improved performance when high filtration fabric was used, and the cross-sectional area of the fabric was increased. AM frame modifications appeared to improve AM face mask leakage performance by as much as 69.6%.
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Affiliation(s)
- Magdalene Fogarasi
- Division of Applied Mechanics, Office of Science and Engineering Laboratories, Center for Devices and Radiological Health, United States Food and Drug Administration, Silver Spring, MD 20993, USA
| | - Kirstie Snodderly
- Division of Applied Mechanics, Office of Science and Engineering Laboratories, Center for Devices and Radiological Health, United States Food and Drug Administration, Silver Spring, MD 20993, USA
| | - Alexander Herman
- Division of Applied Mechanics, Office of Science and Engineering Laboratories, Center for Devices and Radiological Health, United States Food and Drug Administration, Silver Spring, MD 20993, USA
| | - Suvajyoti Guha
- Division of Applied Mechanics, Office of Science and Engineering Laboratories, Center for Devices and Radiological Health, United States Food and Drug Administration, Silver Spring, MD 20993, USA
| | - Daniel Porter
- Division of Applied Mechanics, Office of Science and Engineering Laboratories, Center for Devices and Radiological Health, United States Food and Drug Administration, Silver Spring, MD 20993, USA
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Anlimah F, Gopaldasani V, MacPhail C, Davies B. A systematic review of the effectiveness of dust control measures adopted to reduce workplace exposure. Environ Sci Pollut Res Int 2023; 30:54407-54428. [PMID: 36964805 PMCID: PMC10121514 DOI: 10.1007/s11356-023-26321-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 03/03/2023] [Indexed: 06/18/2023]
Abstract
The recent increase in silicosis cases in several countries casts doubt on dust control practices and their effectiveness in preventing respirable crystalline silica (RCS) exposure. Apart from silicosis, RCS may lead to other illnesses, health-related quality of life losses for workers and their families, and economic losses for companies. Thus, this systematic literature review examined the effectiveness of interventions employed to prevent exposure to RCS and increase the use of dust control measures. The review used keywords related to dust control interventions to search seven databases. Search results were screened and extracted for synthesis. The narrative synthesis showed the extent of research investment in China. In several designs and combinations, the interventions utilized water, surfactant, foam, and air currents to reduce dust exposure. These interventions offer varying degrees of dust control effectiveness against RCS and respirable dust. Although evidence indicates that interventions significantly decrease dust concentration levels, the control measures in place may not effectively prevent workplace overexposure to RCS. The review found that education and training interventions are employed to improve dust controls and respiratory protective equipment (RPE) use. Also, marketing strategies promote the use of RPE. These interventions can increase the frequency of use of RPE and the adoption of best practice dust control measures. Interventions increase knowledge, awareness, and attitudes about RPE usage and generate positive perceptions while reducing misconceptions. However, the benefits obtained from an intervention may diminish after its implementation, indicating that the interventions may not continually motivate workers to adopt control measures or use RPE.
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Affiliation(s)
- Frederick Anlimah
- Faculty of the Arts, Social Sciences and Humanities, School of Health and Society, Centre for Occupational Public and Environmental Research in Safety and Health (COPERSH), University of Wollongong, Building 29, Wollongong, NSW 2522 Australia
| | - Vinod Gopaldasani
- Faculty of the Arts, Social Sciences and Humanities, School of Health and Society, Centre for Occupational Public and Environmental Research in Safety and Health (COPERSH), University of Wollongong, Building 29, Room 124, Wollongong, NSW 2522 Australia
| | - Catherine MacPhail
- Faculty of the Arts, Social Sciences and Humanities, School of Health and Society, University of Wollongong, Building 29, Room 242, Wollongong, NSW 2522 Australia
| | - Brian Davies
- Faculty of the Arts, Social Sciences and Humanities, School of Health and Society, Centre for Occupational Public and Environmental Research in Safety and Health (COPERSH), University of Wollongong, Building 29, Room 116, Wollongong, NSW 2522 Australia
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Ting M, Molinari JA, Suzuki JB. Current SARS-CoV-2 Protective Strategies for Healthcare Professionals. Biomedicines 2023; 11:808. [PMID: 36979786 PMCID: PMC10044750 DOI: 10.3390/biomedicines11030808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 02/12/2023] [Accepted: 02/24/2023] [Indexed: 03/09/2023] Open
Abstract
Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is responsible for the Coronavirus disease 2019 (COVID-19). COVID-19 was first reported in China in December 2019. SARS-CoV-2 is highly contagious and spread primarily via an airborne route. Hand hygiene, surgical masks, vaccinations and boosters, air filtration, environmental sanitization, instrument sterilization, mouth rinses, and social distancing are essential infection control measures against the transmission of SARS-CoV-2. This paper aims to provide healthcare professionals with evidence-based protective strategies.
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Affiliation(s)
- Miriam Ting
- Department of Periodontics, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - John A. Molinari
- School of Dentistry, University of Detroit Mercy, Detroit, MI 48221, USA
| | - Jon B. Suzuki
- Department of Graduate Periodontics, University of Maryland, Baltimore, MD 20742, USA
- Department of Graduate Prosthodontics, University of Washington, Seattle, WA 98195, USA
- Department of Graduate Periodontics, Nova Southeastern University, Fort Lauderdale, FL 33314, USA
- Department of Microbiology and Immunology (Medicine), Temple University, Philadelphia, PA 19140, USA
- Department of Periodontology and Oral Implantology (Dentistry), Temple University, Philadelphia, PA 19140, USA
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Hirata Y, Iida S, Arashiro T, Nagasawa S, Saitoh H, Abe H, Ikemura M, Makino Y, Sawa R, Iwase H, Ushiku T, Suzuki T, Akitomi S. Impact of the COVID-19 pandemic on pathological autopsy practices in Japan. Pathol Int 2023; 73:120-126. [PMID: 36598024 DOI: 10.1111/pin.13306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Accepted: 12/19/2022] [Indexed: 01/05/2023]
Abstract
During the coronavirus disease 2019 (COVID-19) pandemic, autopsies have provided valuable insights into the pathogenesis of COVID-19. The precise effect of this pandemic on autopsy procedures in Japan, especially in instances unrelated to COVID-19, has not yet been established. Therefore, we conducted a questionnaire survey from December 2020 to January 2021 regarding the status of pathological autopsy practices in Japan during the first year of the COVID-19 pandemic. The questionnaire was sent to 678 medical facilities with pathologists, of which 227 responded. In cases where a confirmed diagnosis of COVID-19 was not made at the time of autopsy, many facilities counted them as suspected COVID-19 cases if pneumonia was suspected clinically. At around half of the sites, autopsies were prohibited for suspected COVID-19 cases. In addition, the number of autopsies of non-COVID-19 cases during the pandemic period was also investigated, and a significant decrease was observed compared with the incidence in the pre-pandemic period. The COVID-19 pandemic has affected not only the autopsies of COVID-19 cases but also the entire practice of pathological autopsies. It is necessary to establish a system that supports the implementation of pathological autopsy practices during the pandemic of an emerging infectious disease.
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Affiliation(s)
- Yuichiro Hirata
- Department of Pathology, National Institute of Infectious Diseases, Tokyo, Japan
- Department of Legal Medicine, Graduate School of Medicine, Chiba University, Chiba City, Japan
| | - Shun Iida
- Department of Pathology, National Institute of Infectious Diseases, Tokyo, Japan
| | - Takeshi Arashiro
- Department of Pathology, National Institute of Infectious Diseases, Tokyo, Japan
- Center for Surveillance, Immunization, and Epidemiologic Research, National Institute of Infectious Diseases, Tokyo, Japan
| | - Sayaka Nagasawa
- Department of Legal Medicine, Graduate School of Medicine, Chiba University, Chiba City, Japan
| | - Hisako Saitoh
- Department of Legal Medicine, Graduate School of Medicine, Chiba University, Chiba City, Japan
| | - Hiroyuki Abe
- Department of Pathology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Masako Ikemura
- Department of Pathology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yohsuke Makino
- Department of Legal Medicine, Graduate School of Medicine, Chiba University, Chiba City, Japan
- Department of Forensic Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Rintaro Sawa
- Japan Medical Association Research Institute, Tokyo, Japan
| | - Hirotaro Iwase
- Department of Legal Medicine, Graduate School of Medicine, Chiba University, Chiba City, Japan
- Department of Forensic Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Tetsuo Ushiku
- Department of Pathology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Tadaki Suzuki
- Department of Pathology, National Institute of Infectious Diseases, Tokyo, Japan
| | - Shinji Akitomi
- Department of Forensic Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Japan Medical Association Research Institute, Tokyo, Japan
- International Medical Institute, Medical Safety Promotion Organization, Tokyo, Japan
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40
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Patel S, Mohapatra E, Suganthy AK, Shah S, Abraham J, Nanda R, Behera AK, Gupta A. A pilot study to evaluate the changes in venous blood gas parameters and hypoxia biomarkers in health care workers using different kinds of masks. Lung India 2023; 40:134-142. [PMID: 37006097 PMCID: PMC10174648 DOI: 10.4103/lungindia.lungindia_343_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 07/21/2022] [Accepted: 08/01/2022] [Indexed: 03/05/2023] Open
Abstract
Background The study is aimed to investigate the metabolic alterations and changes in biochemical parameters associated with extended mask. Methods It was a prospective comparative study conducted on 129 participants comprised of 37 healthy controls and 92 health care workers using different kind of masks like, cloth mask, surgical masks and N95-FFR/PPE. Two samples on day-1 and day-10 were collected for analysis of blood gas parameters, serum hypoxia-inducible factor-α (HIF-α), and erythropoietin (EPO). Results Oxygen saturation percentage (sO2) of 72.68 (P = 0.033) was significantly low, whereas, Na+ (P = 0.05) and Ca2+ (P < 0.001) were raised in exposed individuals than the healthy controls. The serum HIF-α level of 3.26 ng/mL, was considerable higher in the exposed individuals than controls (P = 0.001). pO2 and sO2 were the lowest and HIF-α and EPO were raised in N95-FFR/PPE of all mask users (P < 0.01). A significant difference was evidenced for pCO2, pH, Na+, Ca2+, and EPO in the exposed group. A positive correlation between the duration of mask use (in hours) with HIF-α (r = 0.247, P = 0.005) and Ca2+ (r = 0.306, P < 0.001) was observed. The major complaints in N95-FFR/PPE users were headache (15.2%) and polydipsia (33.3%). Conclusion The study findings depicted a significant metabolic alterations in PPE/N95 users which could be due to chronic hypoxic exposure of the tissues.
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Affiliation(s)
- Suprava Patel
- Department of Biochemistry, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India
| | - Eli Mohapatra
- Department of Biochemistry, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India
| | - Asha K. Suganthy
- Department of Biochemistry, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India
| | - Seema Shah
- Department of Biochemistry, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India
| | - Jessy Abraham
- Department of Biochemistry, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India
| | - Rachita Nanda
- Department of Biochemistry, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India
| | - Ajoy K. Behera
- Department of Pulmonary Medicine, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India
| | - Ashish Gupta
- Department of Pathology and Laboratory Medicine, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India
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Greaves SW, Alter SM, Ahmed RA, Hughes KE, Doos D, Clayton LM, Solano JJ, Echeverri S, Shih RD, Hughes PG. A Simulation-based PPE orientation training curriculum for novice physicians. Infect Prev Pract 2023; 5:100265. [PMID: 36536774 PMCID: PMC9753485 DOI: 10.1016/j.infpip.2022.100265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 10/24/2022] [Accepted: 12/09/2022] [Indexed: 12/23/2022] Open
Abstract
Background Personal protective equipment (PPE) is effective in preventing coronavirus disease (COVID-19) infection. Resident knowledge of proper use and effective training methods is unknown. We hypothesise that contamination decreases and knowledge increases after a formalised PPE educational session. Methods Participants included first year interns during their residency orientation in June 2020. Before training, participants took a knowledge test, donned PPE, performed a simulated resuscitation, and doffed. A standardised simulation-based PPE training of the donning and doffing protocol was conducted, and the process repeated. Topical non-toxic highlighter tracing fluid was applied to manikins prior to each simulation. After doffing, areas of contamination, defined as discrete fluorescent areas on participants' body, was evaluated by ultraviolet light. Donning and doffing were video recorded and asynchronously rated by two emergency medicine (EM) physicians using a modified Centers for Disease Control and Prevention (CDC) protocol. The primary outcome was PPE training effectiveness defined by contamination and adherence to CDC sequence. Results Forty-eight residents participated: 24 internal medicine, 12 general surgery, 6 EM, 3 neurology, and 3 psychiatry. Before training, 81% of residents were contaminated after doffing; 17% were contaminated after training (P<0.001). The most common contamination area was the wrist (50% pre-training vs. 10% post-training, P<0.001). Donning sequence adherence improved (52% vs. 98%, P<0.001), as did doffing (46% vs. 85%, P<0.001). Participant knowledge improved (62%-87%, P <0.001). Participant confidence (P<0.001) and preparedness (P<0.001) regarding using PPE increased with training. Conclusion A simulation-based training improved resident knowledge and performance using PPE.
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Affiliation(s)
- Spencer W. Greaves
- Department of Emergency Medicine, Florida Atlantic University Charles E. Schmidt College of Medicine, USA
| | - Scott M. Alter
- Department of Emergency Medicine, Florida Atlantic University Charles E. Schmidt College of Medicine, USA
| | - Rami A. Ahmed
- Department of Emergency Medicine, Division of Simulation, Indiana University School of Medicine, USA
| | - Kate E. Hughes
- Department of Emergency Medicine, University of Arizona, USA
| | - Devin Doos
- Department of Emergency Medicine, Division of Simulation, Indiana University School of Medicine, USA
| | - Lisa M. Clayton
- Department of Emergency Medicine, Florida Atlantic University Charles E. Schmidt College of Medicine, USA
| | - Joshua J. Solano
- Department of Emergency Medicine, Florida Atlantic University Charles E. Schmidt College of Medicine, USA
| | - Sindiana Echeverri
- Clinical Skills Simulation Center, Florida Atlantic University Charles E. Schmidt College of Medicine, USA
| | - Richard D. Shih
- Department of Emergency Medicine, Florida Atlantic University Charles E. Schmidt College of Medicine, USA
| | - Patrick G. Hughes
- Department of Emergency Medicine, Florida Atlantic University Charles E. Schmidt College of Medicine, USA,Corresponding author. Florida Atlantic University at Bethesda Health, Department of Emergency Medicine, GME Suite, Lower Level, 2815 South Seacrest Blvd, Boynton Beach, FL 33435, USA. Tel.: +(561) 733 5933; fax: +(866) 617 8268
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42
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Bonner EM, Horn GP, Smith DL, Kerber S, Fent KW, Tidwell LG, Scott RP, Adams KT, Anderson KA. Silicone passive sampling used to identify novel dermal chemical exposures of firefighters and assess PPE innovations. Int J Hyg Environ Health 2023; 248:114095. [PMID: 36508961 PMCID: PMC9930175 DOI: 10.1016/j.ijheh.2022.114095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 11/13/2022] [Accepted: 12/01/2022] [Indexed: 12/14/2022]
Abstract
A plethora of chemicals are released into the air during combustion events, including a class of compounds called polycyclic aromatic hydrocarbons (PAHs). PAHs have been implicated in increased risk of cancer and cardiovascular disease, both of which are disease endpoints of concern in structural firefighters. Current commercially available personal protective equipment (PPE) typically worn by structural firefighters during fire responses have gaps in interfaces between the ensemble elements (e.g., hood and jacket) that allow for ingress of contaminants and dermal exposure. This pilot study aims to use silicone passive sampling to assess improvements in dermal protection afforded by a novel configuration of PPE, which incorporates a one-piece liner to eliminate gaps in two critical interfaces between pieces of gear. The study compared protection against parent and alkylated PAHs between the one-piece liner PPE and the standard configuration of PPE with traditional firefighting jacket and pants. Mannequins (n = 16) dressed in the PPE ensembles were placed in a Fireground Exposure Simulator for 10 min, and exposed to smoke from a combusting couch. Silicone passive samplers were placed underneath PPE at vulnerable locations near interfaces in standard PPE, and in the chamber air, to measure PAHs and calculate the dermal protection provided by both types of PPE. Silicone passive sampling methodology and analyses using gas chromatography with mass-spectrometry proved to be well-suited for this intervention study, allowing for the calculation and comparison of worker protection factors for 51 detected PAHs. Paired comparisons of the two PPE configurations found greater sum 2-3 ring PAH exposure underneath the standard PPE than the intervention PPE at the neck and chest, and at the chest for 4-7 ring PAHs (respective p-values: 0.00113, 0.0145, and 0.0196). Mean worker protection factors of the intervention PPE were also greater than the standard PPE for 98% of PAHs at the neck and chest. Notably, the intervention PPE showed more than 30 times the protection compared to the standard PPE against two highly carcinogenic PAHs, dibenzo[a,l]pyrene and benzo[c]fluorene. Nine of the detected PAHs in this study have not been previously reported in fireground exposure studies, and 26 other chemicals (not PAHs) were detected using a large chemical screening method on a subset of the silicone samplers. Silicone passive sampling appears to be an effective means for measuring dermal exposure reduction to fireground smoke, providing evidence in this study that reducing gaps in PPE interfaces could be further pursued as an intervention to reduce dermal exposure to PAHs, among other chemicals.
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Affiliation(s)
- Emily M Bonner
- Department of Environmental and Molecular Toxicology, Oregon State University, 1007 Agricultural & Life Sciences Building, Corvallis, OR, 97331, USA.
| | - Gavin P Horn
- Fire Safety Research Institute, UL Research Institutes, Columbia, MD, 21045, USA; Illinois Fire Service Institute, University of Illinois at Urbana-Champaign, IL, 61820, USA.
| | - Denise L Smith
- Department of Health and Human Physiological Sciences, Skidmore College, 815 N Broadway St, Saratoga Springs, NY, 12866, USA; Illinois Fire Service Institute, University of Illinois at Urbana-Champaign, IL, 61820, USA.
| | - Steve Kerber
- Fire Safety Research Institute, UL Research Institutes, Columbia, MD, 21045, USA.
| | - Kenneth W Fent
- Division of Field Studies and Engineering, National Institute for Occupational Safety & Health (NIOSH), Centers for Disease Control and Prevention (CDC), 1090 Tusculum Ave, Cincinnati, OH, 45226, USA.
| | - Lane G Tidwell
- Department of Environmental and Molecular Toxicology, Oregon State University, 1007 Agricultural & Life Sciences Building, Corvallis, OR, 97331, USA.
| | - Richard P Scott
- Department of Environmental and Molecular Toxicology, Oregon State University, 1007 Agricultural & Life Sciences Building, Corvallis, OR, 97331, USA.
| | - Kaley T Adams
- Department of Environmental and Molecular Toxicology, Oregon State University, 1007 Agricultural & Life Sciences Building, Corvallis, OR, 97331, USA.
| | - Kim A Anderson
- Department of Environmental and Molecular Toxicology, Oregon State University, 1007 Agricultural & Life Sciences Building, Corvallis, OR, 97331, USA.
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43
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Le AB, Shkembi A, Tadee A, Sturgis AC, Gibbs SG, Neitzel RL. Characterization of perceived biohazard exposures, personal protective equipment, and training resources among a sample of formal U.S. solid waste workers: A pilot study. J Occup Environ Hyg 2023; 20:129-135. [PMID: 36786831 DOI: 10.1080/15459624.2023.2179060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
In the United States, the majority of waste workers work with solid waste. In solid waste operations, collection, sorting, and disposal can lead to elevated biohazard exposures (e.g., bioaerosols, bloodborne and other pathogens, human and animal excreta). This cross-sectional pilot study aimed to characterize solid waste worker perception of biohazard exposures, as well as worker preparedness and available resources (e.g., access to personal protective equipment, level of training) to address potential biohazard exposures. Three sites were surveyed: (1) a family-owned, small-scale waste disposal facility, (2) a county-level, recycling-only facility, and (3) an industrial-sized, large-scale facility that contains a hauling and landfill division. Survey items characterized occupational biohazards, resources to mitigate and manage those biohazards, and worker perceptions of biohazard exposures. Descriptive statistics were generated. The majority of workers did not report regularly coming into contact with blood, feces, and bodily fluids (79%). As such, less than one-fifth were extremely concerned about potential illness from biological exposures (19%). Yet, most workers surveyed (71%) reported an accidental laceration/cut that would potentially expose workers to biohazards. This study highlights the need for additional research on knowledge of exposure pathways and perceptions of the severity of exposure among this occupational group.
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Affiliation(s)
- Aurora B Le
- Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, Michigan
| | - Abas Shkembi
- Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, Michigan
| | - Anupon Tadee
- Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, Michigan
| | - Anna C Sturgis
- Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, Michigan
| | - Shawn G Gibbs
- Department of Environmental and Occupational Health, School of Public Health, Texas A&M University, College Station, Texas
| | - Richard L Neitzel
- Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, Michigan
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44
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D'Souza C, Kishore U, Tsolaki AG. The PE- PPE Family of Mycobacterium tuberculosis: Proteins in Disguise. Immunobiology 2023; 228:152321. [PMID: 36805109 DOI: 10.1016/j.imbio.2022.152321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 12/22/2022] [Accepted: 12/27/2022] [Indexed: 12/31/2022]
Abstract
Mycobacterium tuberculosis has thrived in parallel with humans for millennia, and despite our efforts, M. tuberculosis continues to plague us, currently infecting a third of the world's population. The success of M. tuberculosis has recently been attributed, in part, to the PE-PPE family; a unique collection of 168 proteins fundamentally involved in the pathogenesis of M. tuberculosis. The PE-PPE family proteins have been at the forefront of intense research efforts since their discovery in 1998 and whilst our knowledge and understanding has significantly advanced over the last two decades, many important questions remain to be elucidated. This review consolidates and examines the vast body of existing literature regarding the PE-PPE family proteins, with respect to the latest developments in elucidating their evolution, structure, subcellular localisation, function, and immunogenicity. This review also highlights significant inconsistencies and contradictions within the field. Additionally, possible explanations for these knowledge gaps are explored. Lastly, this review poses many important questions, which need to be addressed to complete our understanding of the PE-PPE family, as well as highlighting the challenges associated with studying this enigmatic family of proteins. Further research into the PE-PPE family, together with technological advancements in genomics and proteomics, will undoubtedly improve our understanding of the pathogenesis of M. tuberculosis, as well as identify key targets/candidates for the development of novel drugs, diagnostics, and vaccines.
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Affiliation(s)
- Christopher D'Souza
- Biosciences, Department of Life Sciences, College of Health, Medicine and Life Sciences, Brunel University London, Uxbridge UB8 3PH, United Kingdom
| | - Uday Kishore
- Department of Veterinary Medicine, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Anthony G Tsolaki
- Biosciences, Department of Life Sciences, College of Health, Medicine and Life Sciences, Brunel University London, Uxbridge UB8 3PH, United Kingdom.
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45
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Deen B. Respiratory infectious disease isolation During the COVID-19 pandemic. Am J Infect Control 2023; 51:718-719. [PMID: 36764581 PMCID: PMC9908429 DOI: 10.1016/j.ajic.2023.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 02/02/2023] [Accepted: 02/03/2023] [Indexed: 02/11/2023]
Abstract
Respiratory infectious disease transmission decreased within the United States during the COVID-19 pandemic. Within emergency departments, use of personal protective equipment along with masking requirements for COVID-19 helped in this reduction. This report focuses on how COVID-19 precautions reduced the risk of emerging infectious diseases transmission in emergency departments, specifically with patients suspected of measles and mumps.
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Affiliation(s)
- Briar Deen
- Infection Prevention, Texas Health Resources Harris Methodist Azle, Azle, TX; Department of Epidemiology, College of Public Health, University of Nebraska Medical Center, Omaha, NE.
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46
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Joshi A, Chatada J, Kummari S, Tripathy R. Knowledge, Attitude and Practice of Personnel Involved in Bio Medical Waste Handling about COVID-19 & Its Bio-Medical Waste Management: A Descriptive Analysis. Hosp Top 2023:1-10. [PMID: 36745003 DOI: 10.1080/00185868.2023.2176389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Background: The COVID-19 pandemic has led to an increased amount of biomedical waste, worsening the already strained biomedical waste management system in India. As biomedical waste handlers are the core of biomedical waste handling, their knowledge, attitude, and practices regarding sorting, segregation, transport, and storage of the waste are of prime concern. This study aims to evaluate the knowledge, attitude and practices of personnel involved in biomedical waste handling about COVID-19 and its biomedical waste management at All India Institute of Medical Sciences Mangalagiri. Design: Cross-sectional survey. Setting: AIIMS Mangalagiri and common bio-medical waste treatment facility at Guntur. Participants- Personnel involved in bio-medical waste handling Methodology: The study enrolled a total of 139 participants from December 2020 to January 2021. A convenient sampling technique was used and a questionnaire was administered by face-to-face interview. Results: The study showed that half of the participants had favorable knowledge about bio-medical waste management (average score 5.08 and range 1-9). Two-thirds of the respondents felt that handling COVID-19 waste is necessary to contain the infection. Conversely, the practices regarding COVID-19 and its biomedical waste management were not in conformity with attitudes and knowledge. Fewer participants knew the exact sequence of donning (15.80%) and doffing (31.70%). Majority of participants (72.7%) desired a hands-on training for handling biomedical waste. Conclusion: Participants have good knowledge and attitudes regarding COVID-19 bio-medical waste management, but are not adhering to it. This explains the need for comprehensive training programs for all those involved in bio-medical waste management of COVID-19.
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Affiliation(s)
- Arvind Joshi
- Nursing Officer, All India Institute of Medical Sciences - Mangalagiri, Mangalagiri, Andhra Pradesh, India
| | - Joshna Chatada
- Nursing Officer, All India Institute of Medical Sciences - Mangalagiri, Mangalagiri, Andhra Pradesh, India
| | - Sobha Kummari
- Nursing Officer, All India Institute of Medical Sciences - Mangalagiri, Mangalagiri, Andhra Pradesh, India
| | - Roli Tripathy
- Assistant Professor College of Nursing, NRI Academy of Sciences, Mangalagiri, Andhra Pradesh, India
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47
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Manchanda A, Lee K, Poznanski GD, Hassani A. Automated Adjustment of PPE Masks Using IoT Sensor Fusion. Sensors (Basel) 2023; 23:1711. [PMID: 36772747 PMCID: PMC9921841 DOI: 10.3390/s23031711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 01/13/2023] [Accepted: 02/01/2023] [Indexed: 06/18/2023]
Abstract
The COVID-19 pandemic has led to a dramatic increase in the use of PPE by the general public as well as health professionals. Scientists and health organizations have developed measures to protect people and minimize the catastrophic outcomes of COVID, including social distancing, frequent and periodic sanitizing, vaccinations, protective coverings, and face masks. During this time, the usage of protective face masks has increased dramatically. A mask only provides full safety to the user if it is a proper fit on their face. The aim of this paper is to automatically analyze and improve the fit of a face mask using IoT sensors. This paper describes the creation of a 3D-printed smart face mask that uses sensors to determine the current mask fit and then automatically tightens mask straps. This is evaluated using adjustment response time and the quality of fit achieved using the automatic adjustment approach with a range of sensor types.
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Affiliation(s)
- Ashish Manchanda
- School of Information Technology, Deakin University, Geelong, VIC 3220, Australia
| | - Kevin Lee
- School of Information Technology, Deakin University, Geelong, VIC 3220, Australia
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48
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Flora RMN, Palani S, Kowsalya P, Chamundeeswari M. Sunlight-driven antibacterial activity of a novel zinc oxide quantum dot and its optimization using Box-Behnken design-A medicament for communicable disease protective wearables. Biotechnol Appl Biochem 2023; 70:221-237. [PMID: 35398918 DOI: 10.1002/bab.2345] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 03/25/2022] [Indexed: 11/06/2022]
Abstract
The current study focuses on microwave-assisted zinc oxide quantum dots synthesis (ZnO-QDs) from zinc oxide bionanocomposite (ZnO-BC) preparation. The novelty lies in the preparation of ZnO-QDs, since the natural elements present in ZnO-BC itself acted as a surface penetration enhancer without using any chemical agent. Under ultraviolet (UV) light ZnO-QDs emitted a blue glow, confirming the fluorescence property. Using Box-Behnken design, the experimental factors of ZnO-QDs were optimized, yielding a positive response of 350 nm absorbance and these results also matched with the UV-visible spectroscopy characterization studies of ZnO-QDs. Using Escherichia coli, the antibacterial activity of ZnO-BC in comparison to ZnO-QDs was determined using the well diffusion method and an inhibition zone ranging from 11 to 23 mm and in the broth assay the OD values were reduced by almost seven and 10 times for ZnO-BC and ZnO-QDs, respectively, when compared to the control (untreated). The antibacterial activity demonstrated that our newly prepared BC and its QDs have superior activity when compared to the standard antibiotics such as ampicillin. This type of nanomaterial can be used as a new bioactive natural material with light-assisted activity for antibacterial coatings in the manufacture of personal protective equipment.
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Affiliation(s)
| | - Subramani Palani
- Department of Biotechnology, Arunai Engineering College, Tiruvannamalai, Tamil Nadu, India
| | - Palanimuthu Kowsalya
- Department of Biotechnology, St. Joseph's College of Engineering, Chennai, Tamil Nadu, India
| | - Munusamy Chamundeeswari
- Department of Biotechnology, St. Joseph's College of Engineering, Chennai, Tamil Nadu, India
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Thiel CL, Sreedhar P, Silva GS, Greene HC, Seetharaman M, Durr M, Roberts T, Vedanthan R, Lee PH, Andrade G, El-Shahawy O, Hochman SE. Conservation Practices for Personal Protective Equipment: A Systematic Review with Focus on Lower-Income Countries. Int J Environ Res Public Health 2023; 20:2575. [PMID: 36767940 PMCID: PMC9915410 DOI: 10.3390/ijerph20032575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 01/05/2023] [Accepted: 01/06/2023] [Indexed: 06/18/2023]
Abstract
During the start of the COVID-19 pandemic, shortages of personal protective equipment (PPE) necessitated unprecedented and non-validated approaches to conserve PPE at healthcare facilities, especially in high income countries where single-use disposable PPE was ubiquitous. Our team conducted a systematic literature review to evaluate historic approaches for conserving single-use PPE, expecting that lower-income countries or developing contexts may already be uniquely conserving PPE. However, of the 50 included studies, only 3 originated from middle-income countries and none originated from low-income countries. Data from the included studies suggest PPE remained effective with extended use and with multiple or repeated use in clinical settings, as long as donning and doffing were performed in a standard manner. Multiple decontamination techniques were effective in disinfecting single use PPE for repeated use. These findings can inform healthcare facilities and providers in establishing protocols for safe conservation of PPE supplies and updating existing protocols to improve sustainability and overall resilience. Future studies should evaluate conservation practices in low-resource settings during non-pandemic times to develop strategies for more sustainable and resilient healthcare worldwide.
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Affiliation(s)
- Cassandra L. Thiel
- Department of Population Health, NYU Grossman School of Medicine, New York, NY 10016, USA
| | | | - Genevieve S. Silva
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Hannah C. Greene
- Social Science Division, New York University Abu Dhabi, Abu Dhabi P.O. Box 129188, United Arab Emirates
| | - Meenakshi Seetharaman
- College of Literature, Science, and Arts, University of Michigan, Ann Arbor, MI 48109, USA
| | - Meghan Durr
- Department of Population Health, NYU Grossman School of Medicine, New York, NY 10016, USA
| | - Timothy Roberts
- Health Sciences Library, NYU Grossman School of Medicine, New York, NY 10016, USA
| | - Rajesh Vedanthan
- Department of Population Health, NYU Grossman School of Medicine, New York, NY 10016, USA
| | - Paul H. Lee
- Department of Oral and Maxillofacial Surgery, NYU Grossman School of Medicine, New York, NY 10016, USA
| | - Gizely Andrade
- Department of Emergency Medicine, Lewis Katz School of Medicine, Temple University, Philadelphia, PA 19140, USA
| | - Omar El-Shahawy
- Department of Population Health, NYU Grossman School of Medicine, New York, NY 10016, USA
| | - Sarah E. Hochman
- Department of Medicine, Division of Infectious Diseases and Immunology, NYU Grossman School of Medicine, New York, NY 10016, USA
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50
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Choi S, Ekpe OD, Sim W, Choo G, Oh JE. Exposure and Risk Assessment of Korean Firefighters to PBDEs and PAHs via Fire Vehicle Dust and Personal Protective Equipment. Environ Sci Technol 2023; 57:520-530. [PMID: 36539350 DOI: 10.1021/acs.est.2c06393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
In this study, the levels of polycyclic aromatic hydrocarbons (PAHs) and polybrominated diphenyl ethers (PBDEs) were characterized in firefighters' personal protective equipment (PPE) (i.e., jackets, pants, hoods, and gloves) and vehicle dust wipe samples to assess the exposure and potential risk of firefighters to these combustion-related toxic pollutants. The mean levels of ∑PBDEs in the fire vehicle dust samples (778 and 449 pg/cm2 for pump trucks and command cars, respectively) were significantly higher than those in the private vehicles (31.2 pg/cm2) (Kruskal-Wallis test, p < 0.05), which was similar to the ∑PAH levels (521, 185, and 46.8 pg/cm2 for pump trucks, command cars, and private vehicles, respectively). In the case of firefighters' PPE, the levels of ∑PBDEs and ∑PAHs in used jackets and pants were found to be, respectively, 70- to 2242-folds and 11- to 265-folds higher than those in their unused counterparts. Biomass/petroleum combustion was found to be the main source of PAH contamination in fire vehicle dust and used PPE in the present study. Both carcinogenic and noncarcinogenic risks via vehicle dust ingestion and dermal absorption from wearing of PPE were within permissible limits, although the relative risk evaluation showed that PAH/PBDE absorption via wearing of PPE could pose a higher likelihood of carcinogenic and noncarcinogenic risks than the ingestion of pollutants via fire vehicle dust, warranting the need for appropriate management of firefighters' personal protective ensembles.
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Affiliation(s)
- Sol Choi
- Department of Civil and Environmental Engineering, Pusan National University, Busan46241, Republic of Korea
| | - Okon Dominic Ekpe
- Department of Civil and Environmental Engineering, Pusan National University, Busan46241, Republic of Korea
| | - Wonjin Sim
- Institute for Environment and Energy, Pusan National University, Busan46241, Republic of Korea
| | - Gyojin Choo
- Department of Civil and Environmental Engineering, Pusan National University, Busan46241, Republic of Korea
- School of Natural Resources and Environmental Science, Kangwon National University, Chuncheon24341, Republic of Korea
| | - Jeong-Eun Oh
- Department of Civil and Environmental Engineering, Pusan National University, Busan46241, Republic of Korea
- Institute for Environment and Energy, Pusan National University, Busan46241, Republic of Korea
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