Personal protective equipment-related occupational dermatoses during COVID-19 among health care workers: A worldwide systematic review

Abstract

Background Occupational dermatoses caused by personal protective equipment (PPE) in the current COVID-19 pandemic are emerging occupational health challenges which must be promptly and effectively addressed to ease the burden on our healthcare workers (HCWs). Objective A systematic review was conducted to determine common PPE-related dermatoses, affected body sites, and implicated occupational contactants. We further proposed solutions to mitigate this problem. Methods Online databases were searched for articles on PPE-related dermatoses in HCWs during COVID-19, written in English and published from January 1, 2020 to January 30, 2021. Results 16 studies, involving a total of 3958 participants, were included. The most common dermatoses were xerosis, pressure-related erythema, and contact dermatitis, mainly affecting the face and hands. The most widely implicated contactants were increased frequency of hand hygiene, gloves, N95 masks, and goggles. Proposed solutions were categorized into individual self-care, protection of the workforce, and long-term preventative measures. Conclusion Through measures such as regular basic skincare education, early access to specialty clinics via telemedicine, and the design of better-fit PPE, the challenges posed by PPE-related occupational dermatoses can be significantly reduced.

P2/N95 respirators & surgical masks to prevent SARS-CoV-2 infection: Effectiveness & adverse effects

“…Thus, seeing greater odds of HCWs wearing respirators experiencing pressure sores, facial itching or irritation, headaches and shortness of breath or respiratory distress is unsurprising. These effects might also be exacerbated the longer the mask is worn for ( 19 , 47 ). Although these findings are supported by similar recently published literature ( 48 ), the small number of studies, wide confidence intervals, small sample sizes and the substantial potential for confounding (i.e.…”

“…Mitigation strategies used by HCWs include medical assessments to identify pre-existing skin or respiratory problems, early medical assessment should any AEs develop, fit-testing by a person competent in identifying the best-fitting respirator for the HCW, use of well-designed respirators (e.g. those that fit the face well, preventing the need to excessively tighten straps), taking breaks from respirator wearing or interchanging between mask types as appropriate (i.e., avoiding universal use), working shorter shifts, and using topical creams and washes to prevent and treat skin complaints ( 32 , 34 , 39 , 41 , 42 , 47 , 49 , 50 , 51 ). The use of hydrogel patches and similar dressings can also reduce the prevalence and subjective experience of skin injuries ( 52 ).…”

Protective equipment-related pressure ulcers in healthcare workers during COVID-19 pandemic: A systematic review

“…Healthcare professionals comply with the policies regarding the use of PPEs in many countries. The use of PPEs in healthcare systems has increased during this period and their usage time by healthcare professionals has prolonged [ 32 ]. Long working hours and extended use of PPE increase the risk for PPE-related pressure ulcers in the healthcare workers [ 5 ].…”

“…Some cases have been examined to identify and prevent the risk factors for PPE-related DRPUs in the literature [ [6] , [7] , [8] , [9] , [10] , [11] , [12] ]. In the literature, it has been emphasized that PPE-related pressure ulcers and skin lesions may affect life quality and operability of healthcare professionals and thus; they may unwillingly violate PPE protection while getting rid of such symptoms and lead to an increase in COVID-19 transmission risk [ 32 ]. Therefore, there is a need for emergency solutions for preventing PPE-related skin ulcers.…”

Assessment of Hygiene Indicators When Using Gloves by Transport Workers in Russia during the COVID-19 Pandemic

“…Consideration should be given to the available data on the prevalence of adverse skin reactions caused by gloves, including contact dermatitis, erythema, xerosis, pruritus, desquamation, and/or hyperpigmentation of the skin of the hands [27][28][29]. Wearing gloves in the workplace affects the prevalence of occupational eczema.…”