Adverse skin reactions to personal protective equipment against severe acute respiratory syndrome – a descriptive study in Singapore

Abstract

Severe acute respiratory syndrome (SARS) was first recognized in February 2003. It is the first severe and readily transmissible new disease to emerge in the 21st century. Healthcare workers in affected countries were exposed to the regular use of personal protective equipment (PPE) such as the N95 mask, gloves, and gowns. Our aim was to study the prevalence of adverse skin reactions to PPE among healthcare workers in Singapore during the SARS outbreak. Healthcare staff in the National Skin Centre and Tan Tock Seng Hospital were surveyed using questionnaires. Of those asked to participate, 322 (94.7%) agreed. 14.3% of the respondents were doctors, 73.0% nurses, and 12.7% other ancillary staff. Mean age of respondents was 32.4 years, with the majority being women (85.7%) and Chinese (53.7%). 109 (35.5%) of the 307 staff who used masks regularly reported acne (59.6%), facial itch (51.4%), and rash (35.8%) from N95 mask use. 64 (21.4%) of the 299 who used gloves regularly reported dry skin (73.4%), itch (56.3%), and rash (37.5%). The use of PPE is associated with high rates of adverse skin reactions. There is a need to find suitable alternatives for affected staff and to encourage awareness among staff of the role of dermatologists in their care.

The impact of illness and the impact of school closure on social contact patterns.

“…All five retrospective cohort studies had high risk of bias (Doherty 1998;Foo 2006;Isaacs 1991;Ou 2003; Yen 2006). In general, retrospective designs are prone to recall bias.…”

“…Four retrospective cohort studies exploring the effect of barrier interventions (Doherty 1998;Isaacs 1991;Ou 2003;Yen 2006) and one study reporting on adverse effects of barrier interventions (Foo 2006) had high risk of bias.…”

Estado de conservação de respiradores PFF-2 após uso na rotina hospitalar

“…These professionals' socalled "experience" is frequently used as an argument to grant them a false feeling of self-protection and self-sufficiency, with IPE often being considered unnecessary and superfluous (7) . Another argument against the use of N95 respirators is related to the discomfort of the equipment itself (7)(8)(9) . Some foreign studies have appointed low adherence levels to the use of N95 masks (ranging from 30% to 50%), even in highrisk situations, such as procedures involving airway manipulation or in more susceptible hospital sectors, such as respiratory isolation wards (10)(11) .…”

Health hazard evaluation report: HETA-2007-0261-3122, evaluation of contact dermatitis among ink ribbon manufacturing employees - New York.

“…For example, the addition of ferrous sulfate to cement to reduce the hexavalent chromium content has been effective in reducing occupational allergic contact dermatitis in Europe. Protective gloves can reduce or eliminate skin exposure to hazardous substances if used correctly, but may actually cause or worsen hand dermatitis (by permeation and penetration) if selected poorly and used improperly (by contamination) [Foo et al 2006]. The use of PPE may occlude irritants or allergens next to the skin, and PPE components may directly irritate the skin, so the correct use of PPE is at least as important as the correct selection of materials [Kwon et al 2006].…”