Physiological Evaluation of Cooling Devices in Conjunction With Personal Protective Ensembles Recommended for Use in West Africa

2017 ◽  
Vol 11 (5) ◽  
pp. 573-579 ◽  
Author(s):  
Tyler Quinn ◽  
Jung-Hyun Kim ◽  
Amanda Strauch ◽  
Tianzhou Wu ◽  
Jeffery Powell ◽  
...  

AbstractObjectiveCooling devices (CDs) worn under personal protective equipment (PPE) can alleviate some of the heat stress faced by health care workers responding to the Ebola outbreak in West Africa.MethodsSix healthy, young individuals were tested while wearing 4 different CDs or no cooling (control) under PPE in an environmental chamber (32°C/92% relative humidity) while walking (3 METs, 2.5 mph, 0% grade) on a treadmill for 60 minutes. Exercise was preceded by a 15-minute stabilization period and a 15-minute donning period.ResultsThe control condition resulted in a significantly higher rectal temperature (Tre) at the end of the exercise than did all CD conditions (CD1,P=0.004; CD2,P=0.01; CD3,P=0.000; CD4,P=0.000) with CD1 and CD2 resulting in a higher Trethan CD3 and CD4 (P<0.05). The control condition resulted in a higher heart rate (HR) at the end of exercise than did the CD3 (P=0.01) and CD4 (P=0.009) conditions, whereas the HR of the CD1 and CD2 conditions was higher than that of the CD3 and CD4 conditions (P<0.05). Weight loss in the control condition was higher than in the CD3 (P=0.003) and CD4 (P=0.01) conditions. Significant differences in subjective measurements of thermal stress were found across conditions and time.ConclusionsUse of CDs can be advantageous in decreasing the negative physiological and subjective responses to the heat stress encountered by health care workers wearing PPE in hot and humid environments. (Disaster Med Public Health Preparedness. 2017;11:573–579)


2017 ◽  
Vol 11 (5) ◽  
pp. 580-586 ◽  
Author(s):  
Aitor Coca ◽  
Tyler Quinn ◽  
Jung-Hyun Kim ◽  
Tianzhou Wu ◽  
Jeff Powell ◽  
...  

ABSTRACTObjectivePersonal protective equipment (PPE) provides health care workers with a barrier to prevent human contact with viruses like Ebola and potential transmission of the disease. However, PPE can also introduce an additional physiological burden from potentially increased heat stress. This study evaluated the human physiological and subjective responses to continuous light exercise within environmental conditions similar to those in West Africa while wearing 3 different, commonly used PPE ensembles (E1, E2, and E3).MethodsSix healthy individuals were tested in an environmental chamber (32°C, 92% relative humidity) while walking (3 METs, 2.5 mph, 0% incline) on a treadmill for 60 minutes. All subjects wore medical scrubs and PPE items. E1 also had a face shield and fluid-resistant surgical gown; E2 additionally included goggles, coverall, and separate hood; and E3 also contained a highly impermeable coverall, separate hood, and surgical mask cover over the N95 respirator.ResultsHeart rate and core temperature at the end of the exercise were significantly higher for E2 and E3 than for E1. Subjective perceptions of heat and exertion were significantly higher for E2 and E3 than for E1.ConclusionsHeat stress and PPE training, as well as the implementation of a work-to-rest ratio that avoids dehydration and possible heat stress issues, are recommended. (Disaster Med Public Health Preparedness. 2017;11:580–586)



2011 ◽  
Vol 3 (1) ◽  
Author(s):  
Olugbenga-Bello Adenike Iyanuoluwa ◽  
Asekun-Olarinmoye O Esther ◽  
Adeomi A Adeleye


2015 ◽  
Vol 9 (5) ◽  
pp. 536-542 ◽  
Author(s):  
Aitor Coca ◽  
Travis DiLeo ◽  
Jung-Hyun Kim ◽  
Raymond Roberge ◽  
Ronald Shaffer

AbstractObjectiveExperience with the use of personal protective equipment (PPE) ensembles by health care workers responding to the Ebola outbreak in the hot, humid conditions of West Africa has prompted reports of significant issues with heat stress that has resulted in shortened work periods.MethodsA sweating thermal manikin was used to ascertain the time to achievement of a critical core temperature of 39°C while wearing 4 different PPE ensembles similar to those recommended by the World Health Organization and Médecins Sans Frontières (Doctors Without Borders) at 2 different ambient conditions (32°C/92% relative humidity and 26°C/80% relative humidity) compared with a control ensemble.ResultsPPE ensembles that utilized coveralls with moderate to high degrees of impermeability attained the critical core temperature in significantly shorter times than did other ensembles. Encapsulation of the head and neck region resulted in higher model-predicted subjective impressions of heat sensation.ConclusionsTo maximize work capacity and to protect health care workers in the challenging ambient conditions of West Africa, consideration should be given to adjustment of work and rest schedules, improvement of PPE (e.g., using less impermeable and more breathable fabrics that provide the same protection), and the possible use of cooling devices worn simultaneously with PPE. (Disaster Med Public Health Preparedness. 2015;9:536–542)



2015 ◽  
Vol 9 (5) ◽  
pp. 586-590 ◽  
Author(s):  
Hilarie Cranmer ◽  
Miriam Aschkenasy ◽  
Ryan Wildes ◽  
Stephanie Kayden ◽  
David Bangsberg ◽  
...  

AbstractThe unprecedented Ebola Virus Disease (EVD) outbreak in West Africa, with its first cases documented in March 2014, has claimed the lives of thousands of people, and it has devastated the health care infrastructure and workforce in affected countries. Throughout this outbreak, there has been a critical lack of health care workers (HCW), including physicians, nurses, and other essential non-clinical staff, who have been needed, in most of the affected countries, to support the medical response to EVD, to attend to the health care needs of the population overall, and to be trained effectively in infection protection and control. This lack of sufficient and qualified HCW is due in large part to three factors: 1) limited HCW staff prior to the outbreak, 2) disproportionate illness and death among HCWs caused by EVD directly, and 3) valid concerns about personal safety among international HCWs who are considering responding to the affected areas. These guidelines are meant to inform institutions who deploy professional HCWs. (Disaster Med Public Health Preparedness. 2015;9:586–590)



Author(s):  
Sarah Lee Davey ◽  
Ben James Lee ◽  
Timothy Robbins ◽  
Harpal Randeva ◽  
Charles Doug Thake

Background: The impermeable nature of PPE worn by health care workers (HCWs) during the SARS-CoV-2 (COVID-19) pandemic can potentiate heat stress which may negatively impact the performance, safety and well-being of HCWs. Aim: The aim of this study was to evaluate perceived levels of heat stress and its consequences in HCWs required to wear PPE during the COVID-19 pandemic in the UK. Method: An anonymous online survey was distributed to HCWs required to wear Type 1 or 2 PPE in NHS settings to evaluate the perceived impact of PPE on: (1) physical and cognitive performance; (2) heat stress and heat-related symptoms; (3) frequency of removing PPE due to discomfort caused by heat stress; and (4) general working-life and well-being. Results: The survey received 224 responses from 192 (85.7%) women and 32 (14.3%) men. Even though 71.9% of respondents wore the less thermally challenging PPE (i.e. Type 2), a median of 3 (IQR: 2,5) heat-related symptoms were reported including syncope (7.7%). A median of 1 (IQR: 0-3) cognitive task was adversely affected with attentional focus being the most affected. To relieve discomfort, 32.6% reported removing PPE on five or more occasions in a shift. Ninety two percent reported PPE made their job more difficult and 76.2% advised that physical performance was impaired. Respondents also highlighted concerns of dermatitis and pressure sores in the facial region (22.3%) amongst other factors. Conclusion: Heat stress experienced when PPE is worn negatively impacts the performance, safety and well-being of HCWs and patients. Therefore, modification to current working practices and current design of PPE is urgently required to improve HCWs resilience to pandemics of infectious diseases. Results suggest modifications to the design of the protective face mask and strict enforcement of specific work/rest ratios to limit the duration of PPE use would be immediate impactful interventions.



2013 ◽  
Author(s):  
Jane Lipscomb ◽  
Jeanne Geiger-Brown ◽  
Katherine McPhaul ◽  
Karen Calabro




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