Physical problems of prolonged use of personal protective equipment during the COVID‐19 pandemic: A scoping review

Abstract

Background It is widely believed that using personal protective equipment (PPE) provides high levels of protection for healthcare workers (HCWs) in the fight against coronavirus disease (COVID‐19). However, the long‐term use of PPE is inconvenient for HCWs and may cause physical discomfort. These factors could result in poor compliance and disrupt the health and safety of HCWs, which may negatively affect the patient's safety. Objective This study aimed to investigate the literature for the purpose of collecting convincing evidence of HCWs' physical problems associated with PPE use during the COVID‐19 pandemic. Methods This scoping review was conducted using PubMed, Embase, ProQuest, Science Direct, Springer, Biomed Central, and Google Scholar to identify the related literature. Results HCWs have experienced various physical disorders including skin, respiratory, musculoskeletal, nervous, urinary, and circulatory system problems that are associated with PPE in various body systems. Among these, skin problems were the most frequent physical problems. Conclusions The literature demonstrated the adverse impacts of using PPE on HCWs. Therefore, healthcare policymakers should take the appropriate measures to improve the work environment during the COVID‐19 pandemic, which could consequently prevent and mitigate the adverse effects of using PPE.

The Relationship Between Mindfulness, Fatigue, and Perceived Symptoms Among Frontline Nurses Who Performed Nucleic Acid Sample Collection During the COVID-19 in China: A Cross-Sectional Study

“…41 It has also been found in previous studies that while protective gear reduces the risk of infection for medical personnel, a variety of physical health problems can occur, including skin, respiratory, musculoskeletal, neurological, urinary, and circulatory problems, with skin problems being the most common. 42 These findings are consistent with those of previous studies on the spread of severe acute respiratory syndrome (SARS). 43 Long-term use of the facial protective gear is associated with a high rate of adverse skin reactions.…”

Health Experiences of Nurses during the COVID-19 Pandemic: A Mixed Methods Study

“…This mixed-methods study addressed the impact of caring for hospitalized COVID-19 patients on both the physical and mental health of nurses, whereas the majority of prior studies focused only on nurses’ mental health ( Chutiyami et al, 2021 ; Feingold et al, 2021 ; Giorgi et al, 2020 ; Gordon et al, 2021 ; Grailey et al, 2021 ; Joo & Liu, 2021 ; Ness et al, 2021 ; Peccoralo et al., 2022 ; Preti et al., 2020 ; Shah et al., 2021 ). Furthermore, studies that examined the impact on physical health focused on specific symptoms (e.g., headaches, fever, cough, insomnia) or adverse events secondary to PPE use (e.g., skin breakdown) rather than general health using a standardized health assessment tool such as the SF-12 ( Chew et al, 2020 ; Chutiyami et al, 2021 ; Galanis et al, 2021a ; Häussl et al., 2021 ; Manookian et al, 2022 ; Namikawa et al, 2021 ; Shaukat et al, 2020 ). Furthermore, this study revealed significant declines in general health and role performance from physical and mental health problems heretofore not addressed in previous research.…”

“…Nurses reported skin breakdown, dehydration, and skin infections from PPE use. Adverse effects on physical health secondary to PPE use reported by others include pressure injuries, dermatitis, dehydration, and headaches ( Galanis et al, 2021a ; Manookian et al., 2022 ).…”

“…Nurses shared with us that resources to provide care to COVID-19 patients were in scarce supply, including PPE and staffing. Some recommendations to address resource shortages include (1) use of nontraditional staffing models to maximize efficiency of nurses and assistive personnel; (2) scheduling more time between shifts for physical and emotional recovery; (3) frequent short breaks from clinical duties; (4) adjustment of shift duration to account for high demands of infection control practices; (5) promoting voluntary redeployment of staff whenever possible; (6) instituting hazard pay; and (7) providing resources to help with family responsibilities such as child or elder care, and lodging for staff away from family (Bambi et al, 2020; Galanis et al, 2021a; Halms et al, 2021; Manookian et al, 2022; Norman et al, 2021; Schwartz et al, 2020; Shuman & Costa, 2020; Sriharan et al, 2021). It is imperative, going forward, that organizations and administrators have plans in place to accommodate rapid surges in the need for PPE and human resources.…”

“…A meta-analysis of the psychological burden on frontline health care workers during pandemics (SARS, H1N1, MERS, Ebola, COVID) demonstrated the most significant and prevalent concerns were about transmission of COVID to their family (60.4%), stress (56.8%), one’s own health (46%), sleeping difficulties (39.9%), burnout (31.8%), depression (25.7%), anxiety (25.4%), and symptoms of PTSD (24.5%) ( Busch et al, 2021 ). Less attention has been given to the impact on nurses’ general health (beyond contracting COVID and the subsequent sequalae) but the following have been reported: fatigue/exhaustion, skin breakdown from personal protective equipment (PPE) use, dehydration, headaches, and muscle tension ( Chew et al, 2020 ; Chutiyami et al, 2021 ; Galanis et al, 2021a ; Häussl et al, 2021 ; Manookian et al, 2022 ).…”