The use of personal protection equipment does not negatively affect paramedics’ attention and dexterity: a prospective triple-cross over randomized controlled non-inferiority trial

Abstract Background The COVID-19 pandemic led to widespread use of personal protection equipment (PPE), including filtering face piece (FFP) masks, throughout the world. PPE. Previous studies indicate that PPE impairs neurocognitive performance in healthcare workers. Concerns for personnel safety have led to special recommendations regarding basic life support (BLS) in patients with a potential SARS-CoV-2 infection, including the use of PPE. Established instruments are available to assess attention and dexterity in BLS settings, respectively. We aimed to evaluate the influence of PPE with different types of FFP masks on these two neuropsychological components of EMS personnel during BLS. Methods This was a randomized controlled non-inferiority triple-crossover study. Teams of paramedics completed three 12-min long BLS scenarios on a manikin after having climbed three flights of stairs with equipment, each in three experimental conditions: (a) without pandemic PPE, (b) with PPE including a FFP2 mask with an expiration valve and (c) with PPE including an FFP2 mask without an expiration valve. The teams and intervention sequences were randomized. We measured the shift in concentration performance using the d2 test and dexterity using the nine-hole peg test (NHPT). We compared results between the three conditions. For the primary outcome, the non-inferiority margin was set at 20 points. Results Forty-eight paramedics participated. Concentration performance was significantly better after each scenario, with no differences noted between groups: d2 shift control versus with valve − 8.3 (95% CI − 19.4 to 2.7) points; control versus without valve − 8.5 (− 19.7 to 2.7) points; with valve versus without valve 0.1 (− 11.1 to 11.3) points. Similar results were found for the NHPT: + 0.3 (− 0.7 to 1.4), − 0.4 (− 1.4 to 0.7), 0.7 (− 0.4 to 1.8) s respectively. Conclusion Attention increases when performing BLS. Attention and dexterity are not inferior when wearing PPE, including FFP2 masks. PPE should be used on a low-threshold basis.

Download Full-text

A randomised crossover simulation study comparing the impact of chemical, biological, radiological or nuclear substance personal protection equipment on the performance of advanced life support interventions

Anaesthesia ◽

10.1111/anae.13842 ◽

2017 ◽

Vol 72 (5) ◽

pp. 592-597 ◽

Cited By ~ 13

Author(s):

J. Schumacher ◽

J. Arlidge ◽

F. Garnham ◽

I. Ahmad

Keyword(s):

Simulation Study ◽

Life Support ◽

Advanced Life Support ◽

Personal Protection ◽

Personal Protection Equipment ◽

The Impact

Download Full-text

Outbreak Of Nipah Encephalitis In Greater Faridpur District

Faridpur Medical College Journal ◽

10.3329/fmcj.v5i2.6825 ◽

1970 ◽

Vol 5 (2) ◽

pp. 63-65

Author(s):

MY Ali ◽

SA Fattah ◽

MM Islam ◽

MA Hossain ◽

SY Ali

Keyword(s):

Health Personnel ◽

Viral Encephalitis ◽

Review Article ◽

Personal Protection ◽

Emerging Infections ◽

College Hospital ◽

Personal Protection Equipment ◽

Medical College ◽

History Of ◽

Deadly Disease

Nipah viral encephalitis is one of the fatal re-emerging infections especially in southeast Asia. After its outbreak in Malaysia and Singapore; repeated outbreaks occurred at western part of Bangladesh especially in Faridpur region. Besides, sporadic attacks appear to occur in the country throughout the year. Here two Nipah outbreaks in greater Faridpur district in 2003 and 2004 are described along with brief review on transmission of the virus. Where the history of illness among patients are very much in favour of man to man transmission. Moreover the death of an intern doctor from Nipah encephalitis who was involved in managing such patients in Faridpur Medical College Hospital strongly suggests man to man transmission of this virus. So, aim of this review article to make the health personnel and general people be aware about man to man transmission of virus, so that they can adapt personal protection equipment (PPE) for their protection against this deadly disease. DOI: 10.3329/fmcj.v5i2.6825Faridpur Med. Coll. J. 2010;5(2):63-65

Download Full-text

Eye in COVID-19: A Brief Review

Pakistan Journal of Ophthalmology ◽

10.36351/pjo.v36i3.1040 ◽

2020 ◽

Vol 36 (3) ◽

Author(s):

Muhammad Mohsin Ali ◽

Qudsia Anwar Dar ◽

Zahid Kamal ◽

Alishba Khan

Keyword(s):

Infection Control ◽

Respiratory Symptoms ◽

Literature Search ◽

Control Measures ◽

Transmission Route ◽

Ocular Manifestation ◽

Personal Protection ◽

Personal Protection Equipment ◽

Ocular Manifestations ◽

Infection Control Measures

This is a brief review covering the currently available literature on ocular manifestations of COVID-19, andprevention strategies for ophthalmologists. A literature search was carried out of Pubmed, Google Scholar andWHO database of publications on COVID. Keywords used in the search were eye, ocular manifestations,ophthalmology, COVID-19, nCoV-2019, and coronavirus disease. All available articles were reviewed and thosepertinent to the study topic were included. Considering the dearth of information available, ophthalmology journals were also searched separately for relevant articles. Major ocular manifestation of COVID reported in literature is red eye, which usually presents before the onset of respiratory symptoms. Since the eye can be a possible transmission route for SARS-CoV-2, infection control measures should be undertaken by ophthalmologists, including use of personal protection equipment and eye/face covering. A framework for structuring ophthalmological services during the COVID pandemic is also presented in this review.

Download Full-text

Income, wealth and use of personal protection equipment in the Mekong Delta

Environmental Science and Pollution Research ◽

10.1007/s11356-021-13449-w ◽

2021 ◽

Author(s):

Matteo Migheli

Keyword(s):

Low Income ◽

Mekong Delta ◽

Developed Countries ◽

Household Wealth ◽

Protective Equipment ◽

Personal Protection ◽

Personal Protection Equipment ◽

Management Techniques ◽

Using Data ◽

Developing And Developed Countries

AbstractBoth in developing and developed countries, farmers often do not protect themselves adequately, especially when applying agrochemicals that are dangerous for their health. The issue is relevant because insufficient protection is between the causes leading to intoxication of farmers and workers who handle these products. The literature suggests that both lack of training and information and low income may explain why, especially in developing countries, protective equipment is under-used. Using data from the Mekong Delta, this study addresses the issue of whether income and household wealth may help explaining the use of incomplete protections against pesticides. The results suggest that income, more than wealth, is a reason why Vietnamese farmers operating in the Mekong Delta fail in using adequate protections. In particular, the data suggest that they may prefer to divert resources to increasing the production of their fields or to buying goods that may be used both as protection and as everyday garments. This behaviour leads to underinvestment in some important protective goods. Possible public interventions to mitigate the problem are suggested; in particular, the promotion of integrated pest management techniques could be useful.

Download Full-text

Self-Collection of Saliva Specimens as a Suitable Alternative to Nasopharyngeal Swabs for the Diagnosis of SARS-CoV-2 by RT-qPCR

Journal of Clinical Medicine ◽

10.3390/jcm10020299 ◽

2021 ◽

Vol 10 (2) ◽

pp. 299

Author(s):

Camino Trobajo-Sanmartín ◽

Marta Adelantado ◽

Ana Navascués ◽

María J. Guembe ◽

Isabel Rodrigo-Rincón ◽

...

Keyword(s):

Chronic Conditions ◽

Saliva Sample ◽

Virus Detection ◽

Kappa Coefficient ◽

Nasopharyngeal Swab ◽

Personal Protection ◽

Personal Protection Equipment ◽

Suitable Alternative ◽

Lysis Buffer ◽

Sensitivity Specificity

A nasopharyngeal swab is a sample used for the diagnosis of SARS-CoV-2 infection. Saliva is a sample easier to obtain and the risk of contagion for the professional is lower. This study aimed to evaluate the utility of saliva for the diagnosis of SARS-CoV-2 infection. This prospective study involved 674 patients with suspected SARS-CoV-2 infection. Paired nasopharyngeal and saliva samples were processed by RT-qPCR. Sensitivity, specificity, and kappa coefficient were used to evaluate the results from both samples. We considered the influence of age, symptoms, chronic conditions, and sample processing with lysis buffer. Of the 674 patients, 636 (94.4%) had valid results from both samples. The virus detection in saliva compared to a nasopharyngeal sample (gold standard) was 51.9% (95% CI: 46.3%–57.4%) and increased to 91.6% (95% CI: 86.7%–96.5%) when the cycle threshold (Ct) was ≤ 30. The specificity of the saliva sample was 99.1% (95% CI: 97.0%–99.8%). The concordance between samples was 75% (κ = 0.50; 95% CI: 0.45–0.56). The Ct values were significantly higher in saliva. In conclusion, saliva sample utility is limited for clinical diagnosis, but could be a useful alternative for the detection of SARS-CoV-2 in massive screening studies, when the availability of trained professionals for sampling or personal protection equipment is limited.

Download Full-text

Sources of SARS-CoV-2 and Other Microorganisms in Dental Aerosols

Journal of Dental Research ◽

10.1177/00220345211015948 ◽

2021 ◽

pp. 002203452110159

Author(s):

A.P. Meethil ◽

S. Saraswat ◽

P.P. Chaudhary ◽

S.M. Dabdoub ◽

P.S. Kumar

Keyword(s):

Infection Control ◽

Dental Treatment ◽

Quantitative Polymerase Chain Reaction ◽

The United States ◽

Control Measures ◽

Personal Protection ◽

Personal Protection Equipment ◽

Linear Discriminant ◽

16S Sequencing ◽

Asymptomatic Patients

On March 16, 2020, 198,000 dentists in the United States closed their doors to patients, fueled by concerns that aerosols generated during dental procedures are potential vehicles for transmission of respiratory pathogens through saliva. Our knowledge of these aerosol constituents is sparse and gleaned from case reports and poorly controlled studies. Therefore, we tracked the origins of microbiota in aerosols generated during ultrasonic scaling, implant osteotomy, and restorative procedures by combining reverse transcriptase quantitative polymerase chain reaction (to identify and quantify SARS-CoV-2) and 16S sequencing (to characterize the entire microbiome) with fine-scale enumeration and source tracking. Linear discriminant analysis of Bray-Curtis dissimilarity distances revealed significant class separation between the salivary microbiome and aerosol microbiota deposited on the operator, patient, assistant, or the environment ( P < 0.01, analysis of similarities). We also discovered that 78% of the microbiota in condensate could be traced to the dental irrigant, while saliva contributed to a median of 0% of aerosol microbiota. We also identified low copy numbers of SARS-CoV-2 virus in the saliva of several asymptomatic patients but none in aerosols generated from these patients. Together, the bacterial and viral data encourage us to conclude that when infection control measures are used, such as preoperative mouth rinses and intraoral high-volume evacuation, dental treatment is not a factor in increasing the risk for transmission of SARS-CoV-2 in asymptomatic patients and that standard infection control practices are sufficiently capable of protecting personnel and patients from exposure to potential pathogens. This information is of immediate urgency, not only for safe resumption of dental treatment during the ongoing COVID-19 pandemic, but also to inform evidence-based selection of personal protection equipment and infection control practices at a time when resources are stretched and personal protection equipment needs to be prioritized.

Download Full-text

Achieving equitable uptake of handwashing and sanitation by addressing both supply and demand-based constraints: findings from a randomized controlled trial in rural Bangladesh

International Journal for Equity in Health ◽

10.1186/s12939-020-01353-7 ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Sarker Masud Parvez ◽

Musarrat Jabeen Rahman ◽

Rashidul Azad ◽

Mahbubur Rahman ◽

Leanne Unicomb ◽

...

Keyword(s):

Controlled Trial ◽

Supply And Demand ◽

Efficacy Trial ◽

Experimental Conditions ◽

Randomized Controlled ◽

Link Type ◽

Education Levels ◽

Change Promotion ◽

And Control ◽

The Impact

Abstract Background Supply driven programs that are not closely connected to community demand and demand-driven programs that fail to ensure supply both risk worsening inequity. Understanding patterns of uptake of behaviors among the poorest under ideal experimental conditions, such as those of an efficacy trial, can help identify strategies that could be strengthened in routine programmatic conditions for more equitable uptake. WASH Benefits Bangladesh was a randomized controlled efficacy trial that provided free-of cost WASH hardware along with behavior change promotion. The current paper aimed to determine the impact of the removal of supply and demand constraints on the uptake of handwashing and sanitation behaviors across wealth and education levels. Methods The current analysis selected 4 indicators from the WASH Benefits trial— presence of water and soap in household handwashing stations, observed mother’s hand cleanliness, observed visible feces on latrine slab or floor and reported last child defecation in potty or toilet. A baseline assessment was conducted immediately after enrolment and endline assessment was conducted approximately 2 years later. We compared change in uptake of these indicators including wealth quintiles (Q) between intervention and control groups from baseline to endline. Results For hand cleanliness, the poorest mothers improved more [Q1 difference in difference, DID: 16% (7, 25%)] than the wealthiest mothers [Q5 DID: 7% (− 4, 17%)]. The poorest households had largest improvements for observed presence of water and soap in handwashing station [Q1 DID: 82% (75, 90%)] compared to the wealthiest households [Q5 DID: 39% (30, 50%)]. Similarly, poorer household demonstrated greater reductions in visible feces on latrine slab or floor [Q1DID, − 25% (− 35, − 15) Q2: − 34% (− 44, − 23%)] than the wealthiest household [Q5 DID: − 1% (− 11, 8%). For reported last child defecation in potty or toilet, the poorest mothers showed greater improvement [Q1–4 DID: 50–54% (44, 60%)] than the wealthier mothers [Q5 DID: 39% (31, 46%). Conclusion By simultaneously addressing supply and demand-constraints among the poorest, we observed substantial overall improvements in equity. Within scaled-up programs, a separate targeted strategy that relaxes constraints for the poorest can improve the equity of a program. Trial registration WASH Benefits Bangladesh: ClinicalTrials.gov, identifier: NCT01590095. Date of registration: April 30, 2012 ‘Retrospectively registered’.

Download Full-text

Slinger Personal Protection System at Load-Lifting Mechanism Operation Employing Radio-Frequency Identification Devices

Occupational Safety in Industry ◽

10.24000/0409-2961-2021-9-38-44 ◽

2021 ◽

pp. 38-44

Author(s):

A.A. Korotkiy ◽

◽

E.V. Egelskaya ◽

V.V. Egelskiy ◽

A.A. Maslennikov ◽

...

Keyword(s):

Radio Frequency Identification ◽

Information Technologies ◽

Industrial Safety ◽

Personal Protection ◽

Personal Protection Equipment ◽

Usual Practice ◽

Hazardous Production ◽

Special Rules ◽

Hazardous Zone ◽

Special Working

The rapid implementation of information technologies into all strata of the civil society activities has already significantly modified lives of every citizen, including production processes. The usual practice is using electronic safety devices in the technical units, including hoisting cranes. The consumer market offers remote control systems for equipment; continuous video surveillance over workflows is widely employed. Unmanned productions and unmanned technologies are being implemented, which is especially relevant at operation of potentially harmful and hazardous units. However, for a human actively participating in workflows, control and maintenance of technical devices, his/her safety during fulfillment of working functions is still a matter of great importance. In Russia, the requirements to production employees safety are determined by legislative and regulatory documents in the sphere of labor protection. Special rules of industrial safety are applied to hazardous production facilities. An important aspect of slinger protection against hazardous and harmful factors of production during operation of a hoisting crane as well as observing production discipline is using personal protection equipment and special working clothes. The constant monitoring of safety requirements in order to ensure their implementation in the real-time mode via the RFID-tags integrated into the elements of personal protection equipment and special working clothes is substantiated. The information on slinger location and availability of the required protection equipment within the hazardous zone of hoisting crane operation received to a mobile device of a person responsible for safe operation enables control of the situation, prevention of adverse events and minimization of risk of injury.

Download Full-text