Introduction: The professional use of personal protective equipment (PPE) eliminates occupational exposure of personnel to pathogens that cause infectious diseases, including COVID-19. Apart from the risk of exposure to biological hazards, healthcare workers are at risk of impaired work performance and work-related diseases posed by adverse health effects of PPE itself. Objective: To make a physiological and hygienic assessment of personal protective equipment against biological hazards used by healthcare professionals. Materials and methods: We evaluated the thermal state of the body in 13 volunteers under simulated conditions of the Tabai temperature and humidity chamber (Japan). The study design included a physiological and hygienic assessment of four variants of protective suits, all compliant with recommendations of the Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing (Rospotrebnadzor) for use when working with microorganisms of risk groups I and II. We studied the physiological response of the thermoregulatory system to heat exposures in terms of indicators characterizing the temperature of the “core”, the temperature of the “shell”, and their integral indicators (weighted mean skin and body temperatures). Changes in the fluid and electrolyte metabolism and the functional state of the cardiorespiratory system were assessed based on objective (sweat and heart rates) and subjective (heat sensation) indicators. Results: At the air temperatures of 25 and 30 °C, the maximum thermal exposure was registered in the volunteers wearing coveralls made of nonwoven material of the Tyvek type (China). A suit made of polyester fabric with a polyurethane membrane coating (Russia) had a less pronounced effect on the thermal state of the body. The minimum core and shell temperatures were noted for the suits made of polymer-viscose dustproof, water-repellent twill weave fabric (Russia) and Barrier 2X fabric (Russia). Conclusion: The excess of established values of the thermal state of the body during medium work was observed for all types of the studied suits both in permissible (25 °C) and harmful (30 °C) microclimate conditions. To prevent ill-being of medical personnel, it is necessary to schedule work taking into account the type of PPE used, the intensity of physical activity, and indoor microclimate parameters.
Relevance. Workers in medical organizations are at risk of developing occupational diseases, including coronavirus infection through frequent contacts with patients and colleagues in the course of their professional activities. Analysis of the causes of infection associated with the pathogen SARS-CoV-2 is the basis for development of preventive measures aimed at minimizing the risk of infection. Intention – development of the main directions for the prevention of COVID-19 morbidity among medical personnel based on a hygienic assessment of occupational risk factors. Methodology. An analysis of cases of a new coronavirus infection among employees of a military medical organization was carried out. An assessment was made of the factors that increase the risk of personnel infection, based on the study of materials from epidemiological investigations and the results of a survey. Results and Discussion. Research has identified factors that increase the risk of COVID-19. An analysis of the causes of the disease showed that in 60 % of cases, infection of personnel is associated with infection at the workplace (contacts with patients – 53.1 %, contacts personnel – 6.9 %), in 38.7 % of cases the cause was not established, in 1.3 % – contacts with sick relatives were registered. A number of specialists from certain professional groups have a higher incidence rate (traumatologists, surgeons, urologists, specialists who carry out sanitary and epidemiological surveillance). It was found that, regardless of the category of work and specialty, during the pandemic, the staff had contacts with sick patients – 78.2 %, contacts with sick colleagues – 53.7 %. Contacts with sick patients increased the risk of developing the disease (RR 1.26; 95 % CI: 1.02–1.55; p = 0.01). The required degree of personnel protection was not provided in this case, which affected the significance of the factor of violation of the rules for the use of PPE (RR 1.66; 95 % CI: 1.11–2.48; p = 0.006) in the risk of developing disease. At the same time, the involvement of personnel to the work in the “red zone” increased the likelihood of the disease (RR 2.98; 95 % CI: 1.24–7.17; p = 0.005). Conclusion. The conducted studies made it possible to establish differences in the level of potential risk for certain categories of medical specialists in non-infectious departments (traumatologists, surgeons, urologists; specialists in charge of sanitary and epidemiological surveillance) and to develop directions for preventive measures based on their analysis.
BACKGROUND: The use of personal protective equipment in contact with patients with new coronavirus infection is the basic measure to ensure the safety of medical personnel. It is known that the use of protective equipment made of materials with low hygroscopicity, air and vapor permeability, under high ambient temperatures and physical activity, can cause overheating of the body. Objectively, during the pandemic, medical personnel reported a deterioration in the functional state up to and even fainting, caused by prolonged use of protective suits. Protective equipment made it difficult to perform routine tasks and led to a reduction in the quality of work performed. PURPOSE OF THE STUDY: Assessment of the effect of personal protective equipment on the functional status of medical personnel. MATERIALS AND METHODS: A survey of 156 medical workers of military medical organizations was carried out using the original questionnaire. The ease of use of protective equipment was assessed, and at the same time the negative aspects of its use were identified. A study of the thermal condition of 6 volunteers during the use of reusable and disposable personal protective equipment sets was carried out under laboratory conditions. RESULTS AND DISCUSSION: The majority of respondents reported a negative impact on the functional state of the body when using personal protective equipment. According to questionnaire data, skin damage occurred in 88% of cases; fogging of safety glasses in 81%; visual impairment in 70%; inadequate suit size in 61%; subjective feeling of heat at work in 61%; headaches in 45% of cases. An assessment of the thermal condition of the reusable and disposable suits at a temperature of 25C and light physical work indicated that the body heat levels of the volunteers were within acceptable normative values. CONCLUSIONS: The use of personal protective equipment has a negative effect on the functional state of the medical workers body, which requires a rational approach to the selection of protective the provision of an optimal regime of work and rest Considering the possibility of using personal protective equipment under different conditions, including increased ambient temperatures (over +30С) and/or intense physical exertion, there is a need for further study of their effects in order to develop preventive measures.
Relevance. Personal protective equipment plays a leading role in reducing risks of infection and ensuring the safety of medical personnel during the COVID-19 pandemic. However, along with the positive “barrier” effect, personal protective equipment has a negative impact on human ergonomics, thus affecting the functional state and performance. Occupational activities of medical workers are often associated with complex, sometimes time-consuming operations; therefore, decreased functional state when using personal protective equipment can lead to errors and increase the health risks in both staff and patients. Intention is to develop the main directions of preserving occupational performance of medical personnel when using personal protective equipment based on the study of the functional state. Methodology. A sociological survey of 339 medical workers of the “red zone” of military medical organizations was conducted using an original questionnaire. Ergonomic indicators of personal protective equipment were assessed along with its negative influence. Results and Discussion. All the survey participants mentioned negative impact on the functional state and performance when using personal protective equipment. The most frequent complaints included discomfort due to fogging of protective glasses (83 %), as well as damage to the skin from eye protection (82 %), respiratory protection (69 %), skin protection (suit, overalls) (38 %). According to the survey, headaches were statistically significantly associated with wearing personal protective equipment for more than 6 hours per shift (OR 1.66; 95 % CI: 1.07-2.56; p = 0.02), the age over 35 years (OR 2.44; 95 % CI: 1.49-4.00; p = 0.001), body mass index above 25 (OR 1.98; 95 % CI: 1.24-3.15; p = 0.003), overheating of the body (OR 2.27; 95 % CI: 1.41-3.66; p = 0.001). Conclusion. The use of personal protective equipment when providing care to COVID-19 patients has a negative impact on the functional state and reduces the efficiency of medical personnel. Based on the results of the research, the main directions of preventive measures have been developed: selection of high-quality protective equipment, taking into account the anthropometric indicators of employees; ensuring optimal work and rest modes (no more than 4 hours of continuous work in personal protective equipment), monitoring and correction of the functional state of personnel at risk.
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