Impact of personal protective equipment use on health care workers’ physical health during the COVID-19 pandemic: a systematic review and meta-analysis

Abstract

Background: During the COVID-19 pandemic, health care workers (HCWs) caring for patients with coronavirus disease 2019 (COVID-19) in high-risk clinical settings have been obliged to wear personal protective equipment (PPE). Aim: To assess the impact of PPE use on HCWs physical health during the COVID-19 pandemic. Also, we examined factors related to a greater risk of adverse events among HCWs due to PPE use. Methods: We applied the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines and the Cochrane criteria for this systematic review and meta-analysis. We searched PubMed, Medline, Scopus, ProQuest, CINAHL, and pre-print services (medRxiv) from January 1, 2020 to December 27, 2020. Findings: Our review included 14 studies with 11,746 HCWs from 16 countries. The estimated overall prevalence of adverse events among HCWs was 78% (95% CI: 66.7-87.5%) with a range from 42.8% to 95.1% among studies. The prevalence of adverse events was higher for the studies with poor quality compared to those with moderate quality (83.5% vs. 67.1%), while increased sample size was related to decreased prevalence (p<0.001). The most frequent adverse events were headache (55.9%), dry skin (54.4%), dyspnoea (53.4%), pressure injuries (40.4%), itching (39.8%), hyperhidrosis (38.5%), and dermatitis (31.0%). Among others, the following factors were related to the risk of adverse events among HCWs due to PPE use: female gender, younger age, obesity, diabetes mellitus, smoking pre-existing headache, longer duration of shifts wearing PPE, increased consecutive days with PPE, and increased exposure to confirmed or suspected COVID-19 patients. Conclusion: The frequency of adverse events amongst HCWs due to PPE use is very high. Further studies should be conducted since the limitations of this review do not allow us to infer conclusive results especially in case of risk factors for the occurrence of adverse events. Healthcare facilities should take the necessary precautions and change the working conditions during the COVID-19 pandemic to prevent adverse events associated with PPE use and minimize harm to HCWs.

Health effects among COVID-19 frontline health care professionals using level III personal protective equipment: A hospital-based descriptive study

“…In a meta-analysis carried out by Galanis et al, 19 commonest physiological challenge faced was Headache, pressure and sweating related skin reactions and breathing discomfort.…”

“…First case of novel corona virus disease (COVID- 19) was reported on 8 th of December 2019 in China, which later evolved into a global pandemic, finally affecting 218 counties and territories around the world including India. 1 The World Health Organization declared COVID-19 a pandemic and declared it a public health emergency of international concern and named it as novel coronavirus disease 2019.…”

Needlestick and sharp injuries among healthcare workers prior to and during the coronavirus disease 2019 (COVID-19) pandemic

“…HCWs often experience difficulties in delivering a high level of care to patients while wearing multilayered PPE, and their performance may be affected to a significant degree, especially affecting their dexterity, visual impairment, communication, and risk of injury. [3][4][5] A non-significantly higher proportion of inadequately HBVimmunized personnel experienced NSIs during the pandemic period. This could indicate the higher proportion of nonprepared medical professionals that had to be engaged in the care of COVID-19 patients, which may have additionally contributed to the higher NSI rate.…”