Physiological measurements of facial skin response under personal protective equipment

Peko, Lea; Ovadia‐Blechman, Zehava; Hoffer, Oshrit; Gefen, Amit

doi:10.1016/j.jmbbm.2021.104566

Cited by 18 publications

(30 citation statements)

References 14 publications

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“…The majority of studies in the literature have confirmed that respirators such as N95 are the most harmful type of mask to the skin, with prolonged use time [ 8 , 9 , 17 , 34 ]. Peko et al [ 35 ] showed that the surgical mask is potentially less irritating to the facial skin than the KN95 mask, as it applies less pressure and facilitates the faster return of increased temperature in the facial area to its basal levels [ 35 ]. However, in a different study, it was emphasized that deformations in the structure of surgical masks, examined with an electron microscope after short but continuous use, may damage the moisture and temperature balance of the skin, increasing the susceptibility to the development of inflammatory skin diseases [ 36 ].…”

Section: Discussionmentioning

confidence: 99%

Skin-related problems associated with the use of personal protective equipment among health care workers during the COVID-19 pandemic: A online survey study

Kısacık

Özyürek

2022

Journal of Tissue Viability

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Aim The aim of this study was to determine the skin-related problems caused by personal protective equipment (PPE) use in health care workers (HCWs) and to identify the factors contributing to their occurrence. Materials and Methods This descriptive and cross-sectional online survey study was carried out with 297 HCWs working in a university hospital in Turkey between March 20, 2021, and May 20, 2021. The study data was collected using an online questionnaire consisting of 3 parts. Descriptive statistics, Pearson's Chi-square, and Fisher's Exact Chi-square tests were used to analyze the data. Results Among the HCWs, 95.6% reported that skin-related problems associated with at least one PPE use. Skin-related problems that develop due to PPE use were mostly associated with the use of Surgical/N95 masks (97.1%) and gloves (96.8%). The most commonly reported problems were ''dryness'' (%74.0) and ''itching'' (%72.1) when wearing gloves, ''perspiration and moisture'' (73.6%), ''formation of equipment traces'' (53.9%), and ''skin lesions'' (52.8%) when wearing a surgical/N95 mask, ''perspiration and moisture'' (89.7%) when wearing protective overalls/gowns. Wearing PPE for more than 4h (p=0.001), taking additional precautions to increase the sense of protection (p=0.026), and not applying preventive measures while using PPE (p=0.003) significantly increase the risk of skin-related problems. Conclusion The results suggest that skin-related problems due to the use of PPE are common among HCWs.

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Section: Discussionmentioning

confidence: 99%

Skin-related problems associated with the use of personal protective equipment among health care workers during the COVID-19 pandemic: A online survey study

Kısacık

Özyürek

2022

Journal of Tissue Viability

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“…Direct comparison with previous studies is limited by the nature of the pressure sensing device. In a recent study, Peko et al 15 investigated the contact force at both the nasal bridge and cheeks. However, as opposed to our findings, they reported that cheeks were subjected to a higher force.…”

Section: Discussionmentioning

confidence: 99%

“…12 Recent studies investigated the effect on skin physiology and microclimate of a single-use respirator device of the type KN95 or KF94. [13][14][15] Results showed changes in the skin barrier function and microclimate at specific facial locations such as the cheek, even after relatively short periods. An accumulation effect was also observed, with skin physiology parameters and temperature increasing over time, and returning to baseline levels after prolonged periods of non-use (>12 hours).…”

Section: Introductionmentioning

confidence: 99%

“… 13 , 14 Limitations of these studies include the fact that the nasal bridge was not included as investigation site, despite being a frequently reported site of RPE-related facial injuries. 11 By contrast, Peko et al 15 investigated the contact force at the respirator interface at both nasal bridge and cheeks, with the latter subjected to a higher force. However, investigating a single respirator design precludes generalising findings to the variety of RPE devices that are used by the healthcare workforce.…”

Section: Introductionmentioning

confidence: 99%

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Biomechanical and Physiological Evaluation of Respiratory Protective Equipment Application

Caggiari¹,

Bader²,

Foxell³

et al. 2022

MDER

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Respiratory protective equipment is widely used in healthcare settings to protect clinicians whilst treating patients with COVID-19. However, their generic designs do not accommodate the variability in face shape across genders and ethnicities. Accordingly, they are regularly overtightened to compensate for a poor fit. The present study aims at investigating the biomechanical and thermal loads during respirator application and the associated changes in local skin physiology at the skin-device interface. Materials and Methods: Sixteen healthy volunteers were recruited and reflected a range of gender, ethnicities and facial anthropometrics. Four single-use respirators were evaluated representing different geometries, size and material interfaces. Participants were asked to wear each respirator in a random order while a series of measurements were recorded, including interface pressure, temperature and relative humidity. Measures of transepidermal water loss and skin hydration were assessed pre-and post-respirator application, and after 20 minutes of recovery. Statistical analysis assessed differences between respirator designs and associations between demographics, interface conditions and parameters of skin health. Results: Results showed a statistically significant negative correlation (p < 0.05) between the alar width and interface pressures at the nasal bridge, for three of the respirator designs. The nasal bridge site also corresponded to the highest pressures for all respirator designs. Temperature and humidity significantly increased (p < 0.05) during each respirator application. Significant increases in transepidermal water loss values (p < 0.05) were observed after the application of the respirators in females, which were most apparent at the nasal bridge. Conclusion:The results revealed that specific facial features affected the distribution of interface pressures and depending on the respirator design and material, changes in skin barrier function were evident. The development of respirator designs that accommodate a diverse range of face shapes and protect the end users from skin damage are required to support the long-term use of these devices.

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“…To prevent the entry of viruses between the edges of a mask and the face, the gap between each edge and the face can be reduced by tightening the mask when it is worn, but the negative effect of tightening on the skin has also been pointed out. Peko et al, reported that common nonwoven masks were less irritating to the face than KN95 masks [ 5 ]. The reason for this is that nonwoven masks apply less force to the face and face temperature returns to its basic level quickly.…”

Section: Introductionmentioning

confidence: 99%

Infection Prevention Mask Consisting of Nanofiber Filter and Habutae Silk Fabrics

et al. 2021

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To reduce skin irritation and allergic symptoms caused by long-term mask use, we produced a mask with a filter effect by laminating nanofibers on habutae silk fabric, a specialty of Japan’s Fukui Prefecture, using the electrospinning method. We investigated the filter characteristics of silk fabrics with different weave structures (habutae, flat crepe, and twill). We found that woven fabrics alone could not sufficiently block particles finer than 1 μm, even when the fabric layers were overlapped. Therefore, we had a nanofiber filter layer fabricated on the surface of habutae fabric by the electrospinning method at a weight of 1 g/m2. The nanofibers removed more than 94% of 0.3 μm-particles, which are similar to the size of virus particles. However, the nanofiber layer was so dense that it caused an increase in pressure drop, so we made the nanofiber layer thinner and fabricated the filter on the surface of the habutae fabric at 0.5 g/m2. A three-dimensional mask consisting of two woven fabrics, one with a nanofiber layer on the inside and the other with a normal woven fabric without a nanofiber layer on the outside, was fabricated and tested on 95 subjects. The subjects reported that the nanofiber habutae masks were more comfortable than nonwoven masks. Moreover, the silk woven masks did not cause allergic symptoms such as skin irritation.

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Physiological measurements of facial skin response under personal protective equipment

Cited by 18 publications

References 14 publications

Skin-related problems associated with the use of personal protective equipment among health care workers during the COVID-19 pandemic: A online survey study

Skin-related problems associated with the use of personal protective equipment among health care workers during the COVID-19 pandemic: A online survey study

Biomechanical and Physiological Evaluation of Respiratory Protective Equipment Application

Infection Prevention Mask Consisting of Nanofiber Filter and Habutae Silk Fabrics

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