Limiting factors for wearing personal protective equipment (PPE) in a health care environment evaluated in a randomised study

Abstract

Pandemics and re-emerging diseases put pressure on the health care system to prepare for patient care and sample logistics requiring enhanced personnel protective equipment (PPE) for health care workers. We generated quantifiable data on ergonomics of PPE applicable in a health care setting by defining error rates and physically limiting factors due to PPE-induced restrictions. Nineteen study volunteers tested randomly allocated head- or full body-ventilated PPE suits equipped with powered-air-purifying-respirators and performed four different tasks (two laboratory tutorials, a timed test of selective attention and a test investigating reaction time, mobility, speed and physical exercise) during 6 working hours at 22°C on one day and 4 working hours at 28°C on another day. Error rates and physical parameters (fluid loss, body temperature, heart rate) were determined and ergonomic-related parameters were assessed hourly using assessment sheets. Depending on the PPE system the most restrictive factors, which however had no negative impact on performance (speed and error rate), were: reduced dexterity due to multiple glove layers, impaired visibility by flexible face shields and back pain related to the respirator of the fully ventilated suit. Heat stress and liquid loss were perceived as restrictive at a working temperature of 28°C but not 22°C.

Occupational stress, job satisfaction, and intent to leave: nurses working on front lines during COVID-19 pandemic in Zagazig City, Egypt

“…On the other hand, although employing strict biosecurity measures is a must to prevent spread of infection to self and others, it was a significant stressor for nurses of ZFH. This is consistent with Loibner et al (2019) who reported that reduced dexterity due to multiple glove layers, impaired visibility by flexible face shields and back pain related to the respirator of the fully ventilated suit, heat stress, and liquid loss were perceived as strong stressors especially at high working temperature. Other significant COVID-19-associated stressors for nurses in both ZFH and ZGH were the personal fears of being isolated, transmitting the disease to families or friends, the unknown duration of the epidemic, lack of treatment for the disease, news of new cases of COVID-19 reported in TV/newspaper, and predictable shortages of staff, supplies, and adequate protective measures.…”

Personal protective equipment and intensive care unit healthcare worker safety in the COVID-19 era (PPE-SAFE): An international survey

“…Pictures of HCWs' faces bruised by wearing masks for extended periods have been used to illustrate the extreme work conditions when caring for such patients. While pain, heat stress and fluid loss with using Powered Air-Purifying Respirators (PAPR) were predicted by experimental data [14], there are no real-life reports of this issue when using PPE that is available to HCWs.…”

Awareness, Attitudes, Prevention, and Perceptions of COVID-19 Outbreak among Nurses in Saudi Arabia

“…An international study reported that when nurses wear personal protective equipment (PPE), they usually take 4-6 working hours without a break. This is very critical to nurses' well-being, since longer hours wearing PPE can cause fatigue, stress, and exhaustion, making healthcare providers prone to causing medical errors [26]. Hence, nursing administration should organize staffing and scheduling to avoid mental and physical health impairment.…”