Hot days and Covid-19 – unusual heat stress for nursing professions in Germany

Abstract

ObjectivesOur aim was to identify whether working during hot days alongside with Covid-19 related personal protective equipment causes heat stress for nursing professionals in Germany.MethodsUsing an online survey, we assessed the impact of hot weather on nursing staff performing in personal protective equipment. A random selection of nursing staff from hospitals, nursing homes and outpatient care participated in the survey.ResultsOut of 428 participants, 6.3% were between 16 and 25 years old, 22.8% between 26 and 35 years, 21.9% between 36 and 45 years, 30.5% between 45 and 55 years, 18.2% between 56 and 65 years, and 0.3% were older than 65 years. Out of all participants, 18.2% were male and 82.5% female. The results of the survey showed that 48.3% had more than 20 years of experience in nursing and 46.2% cardiac, pulmonary, or other pre-existing conditions. Work was found exhaustive while working in PPE by 96.5% of the participants, and 93% complained of worse breathing. We found out that 85.8% reported difficulties to focus. Many workplaces turned out to lack adequate heat protection, with distinct differences concerning the amount of prophylactic and heat mitigating measures across institutions.ConclusionsOur results clearly show that employers must make more of an effort to provide adequate heat protection for their nursing staff. In order to secure the public health care, there is a need for action, especially in the case of previous conditions of caregivers.What is already known about this subject?►Working in personal protective equipment is often needed during pandemics, to protect nurses, doctors and staff from an infection.►However, the equipment can also hamper efficiency and productivity of healthcare workers and lead to personal discomfort, for example, during heat waves.What are the new findings?►According to our study, nurses and nursing assistants in Germany are often older than 45 years and, in many cases, suffer from pre-existing conditions, which exacerbate the problems with personal protective equipment during periods of hot temperatures.►Many healthcare institutions do not offer adequate ways to mitigate heat stress for their staff.How might this impact on policy or clinical practice in the foreseeable future?►The results from this study can inform policy makers and clinical practitioners to modify their protocols to include better protective measures during extreme heat or other adverse environmental conditions.

A Web Survey to Evaluate the Thermal Stress Associated with Personal Protective Equipment among Healthcare Workers during the COVID-19 Pandemic in Italy

“…This is a real concern for the assessment of the thermal stress associated with personal protective equipment among workers, too. Results of this survey confirmed a strong impact of COVID-19 s PPE in the heat stress perception of HCW, in line with the results obtained from similar studies carried out in England [27], in Germany [33], in Asia [6] but also in studies with wider participation [28]. The PCA identified 3 fundamental issues that represent the key elements on which to intervene in the management of the risk related to thermal stress in the health care sector:…”

“…This aspect is certainly linked to the use of PPE for a high number of hours per day, as confirmed by Lee et al [6] in two Asian countries, and which also determines important heat-related symptoms such as thirst, excessive sweating, fatigue, headache, difficulty concentrating, skin reactions and general discomfort conditions, with potential important effects on both the health and productivity of HCW. Some studies also described dark-colored urine, dizziness, muscle or abdominal cramps, gastrointestinal disturbance, rapid heartbeat [27] and mental symptoms [33] as phenomena associated with the use of PPE. Tabah et al [28] showed that adverse effects of PPE (headaches, thirst and exhaustion) were associated with longer shift durations.…”

“…demographic data and characteristics of the worker (question from 1 to 8) -relevant work information (9-13) -heat-exposure-related questions and information about PPE' usage at work (14-20) -worker's adaptation to heat stress and behavioral with PPE (21-27) -worker's knowledge about thermal stress and attitudes towards the PPE's use (28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44)(45)(46) A 5-point Likert scale (1 for strongly disagree and 5 for strongly agree) was used for questions from 28 to 46 concerning the worker's knowledge about thermal stress and attitudes towards the PPE's use.…”