A Survey of Personnel Protective equipment’s (PPE) Use and Comfort Levels Among Surgeons During Routine Cancer Surgery in the COVID-19 Pandemic

Abstract

Personnel protective equipment (PPE) are recommended during surgery even in COVID-19 negative patients especially in a highprevalence region due to its higher false-negative rates. However, the use of PPE has not been universal mainly due to the perception of discomfort and associated stress and fatigue. This study was done to understand the pattern of PPE use by cancer surgeons during the pandemic and the associated discomfort, stress, and fatigue with its use. The survey, consisting of 29 questions, was circulated widely across the country by email and chat groups among cancer surgeons. The study was registered with the Clinical Trials Registry of India (CTRI/2020/08/027050). We received a total of 342 evaluable responses that could be included for analysis. All the respondents used appropriate PPE in different combinations. N-95 mask and the face shield were the two components of the PPE that gave rise to a lot of discomforts. Fogging (of face shields) (p < 0.001,OR 3.61), dryness of mouth (p < 0.001,OR 3.35), and breathing difficulty/feeling of suffocation (p = 0.034,OR 1.68) contributed to the stress, whereas headache (p < 0.001,OR 11.34) and breathing difficulty/feeling of suffocation (p < 0.001,OR 4.24) contributed to the fatigue associated with PPE use the most. PPE was routinely used during cancer surgery in COVID-19 negative patients during the pandemic. However, most surgeons experienced different degrees of discomfort, especially with the N-95 masks and eye protection.

The contribution of respiratory and hearing protection use to psychological distress in the workplace: a scoping review

“…This study reported that those who interacted with those who wore PPE experienced negative impacts on their psychological health, with increasing levels of anxiety. Additionally, four articles assessed for psychological factors and described similar findings (Kratzke et al 2021 ; Sakuma and Ikeda 2021 ; Thiagarajan et al 2021 ; Wong et al 2013 ). PPE that occluded a part of the face resulted in negative psychological impacts, specifically increasing stress, fatigue, and perceiving someone who wore PPE in a more negative light.…”

“…Most of these articles assessed the impact on speech intelligibility, facial and emotion recognition, and listening effort when PPE is worn. Studies also evaluated the impact on psychological health factors, such as stress, fatigue, and emotional state (5 articles, 19%) (Hoedl et al 2020 ; Kratzke et al 2021 ; Sakuma and Ikeda 2021 ; Thiagarajan et al 2021 ; Wong et al 2013 ). Two articles investigated the effect of PPE use on psychological illness symptoms, specifically anxiety and depression (2 articles, 8%) (Emanuel et al 2017 ; Tavakolizadeh et al 2019 ).…”

“…A small number of articles addressed the potential cognitive impact on those who use PPE, including concentration, reaction time and decision-making (3 articles, 6%) (Benítez et al 2020 ; İpek et al 2021 ; Tornero-Aguilera and Clemente-Suárez, 2021 ). The remaining studies assessed psychosocial stressors generally, including physical symptoms and other perceived subjective impacts related to PPE which we have grouped together as ‘perceived PPE-related impacts’ (7 articles, 27%) (Benítez et al 2020 ; Cheok et al 2021 ; Choudhury et al 2020 ; İpek et al 2021 ; Rebmann et al 2013 ; Singh et al 2021 ; Thiagarajan et al 2021 ).…”

“…There were seven articles that reported individuals’ perceived PPE impacts (Benítez et al 2020 ; Cheok et al 2021 ; Choudhury et al 2020 ; İpek et al 2021 ; Rebmann et al 2013 ; Singh et al 2021 ; Thiagarajan et al 2021 ). These articles reported on the physical and subjective symptoms associated with wearing PPE.…”

Surgical Masks Affect the Peripheral Oxygen Saturation and Respiratory Rate of Anesthesiologists

“…During the COVID-19 outbreak, medical staff had headaches due to the use of masks. In addition, symptoms, such as shortness of breath, sleep disorders, and fatigue, increased significantly ( 35 , 36 ).…”