Modelling effectiveness of PPE on aerosol exposure for healthcare workers during typical ENT procedures

BACKGROUND: Previous studies report environmental aerosolization with various endonasal procedures, but do not specifically measure intranasal levels of inhaled aerosolized particles in healthcare providers (HCP) performing such procedures. The purpose of this study is to measure the impact of various types of personal protective equipment (PPE) worn by HCP during a variety of office-based endonasal procedures. METHODOLOGY: Simulated sneeze and office-based procedures were performed in a test model and aerosol levels were quanti- fied in the middle meatus of a simulated HCP model wearing various forms of PPE by using a laser diode-based particle counter. Endoscopic exam, balloon sinus dilation, suction and irrigation, simulated tissue resection with a microdebrider, and routine debridement procedures were evaluated. The aerosol levels were evaluated with and without the use of PPE to assess HCP aerosol exposure. RESULTS: A simulated sneeze represents a worst-case aerosol generating event when compared to other common office-based procedures (approximately 1,000 times greater than baseline particle count). Common endoscopic procedures did not generate significantly greater particle counts above baseline. When compared to no mask, a surgical mask reduces particle counts experi- enced by HCP in the middle meatus by 69%, while an N95 mask significantly reduced particles by 93%. CONCLUSIONS: The levels of aerosols generated during common office-based procedures are consistent with the background aerosol levels measured at baseline. Masks are effective, with the N95 mask most effective at reducing HCP exposure to aerosols generated during a simulated sneeze.

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Impact of enhanced personal protective equipment on the physical and mental well-being of healthcare workers during COVID-19

Postgraduate Medical Journal ◽

10.1136/postgradmedj-2020-139150 ◽

2020 ◽

pp. postgradmedj-2020-139150 ◽

Cited By ~ 1

Author(s):

Ramanathan Swaminathan ◽

Bimantha Perera Mukundadura ◽

Shashi Prasad

Keyword(s):

Personal Protective Equipment ◽

Healthcare Workers ◽

Healthcare Professionals ◽

Negative Impact ◽

Well Being ◽

Cross Sectional Study ◽

Protective Equipment ◽

Cross Sectional ◽

The Impact ◽

Mental Well Being

BackgroundThe COVID-19 pandemic has necessitated the use of enhanced personal protective equipment (PPE) in healthcare workers in patient-facing roles. We describe the impact on the physical and mental well-being of healthcare professionals who use enhanced PPE consistently.MethodsWe conducted a single-centre, cross-sectional study among healthcare professionals who use enhanced PPE. A web-based questionnaire was disseminated to evaluate the effects on individuals’ physical and mental well-being. Physical and mental impact was assessed through a visual analogue scale.ResultsProspective analysis of the views of 72 respondents is reported. 63.9% were women and 36.1% were men. Physical impact included exhaustion, headache, skin changes, breathlessness and a negative impact on vision. Communication difficulties, somnolence, negative impact on overall performance and difficulties in using surgical instrumentation were reported.ConclusionOur study demonstrates the undeniable negative impact on the front-line healthcare workers using enhanced PPE and lays the ground for larger multicentric assessments given for it to potentially be the norm for the foreseeable future.

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Healthcare Workers in Brazil during the COVID-19 Pandemic: A Cross-Sectional Online Survey

INQUIRY The Journal of Health Care Organization Provision and Financing ◽

10.1177/0046958020963711 ◽

2020 ◽

Vol 57 ◽

pp. 004695802096371

Author(s):

Paula Cotrin ◽

Wilana Moura ◽

Caroline Martins Gambardela-Tkacz ◽

Fernando Castilho Pelloso ◽

Lander dos Santos ◽

...

Keyword(s):

Healthcare Workers ◽

Online Survey ◽

Protective Equipment ◽

Front Line ◽

Cross Sectional ◽

The Social ◽

Proper Training ◽

Level Of Concern ◽

The Impact ◽

Care Behavior

Brazil is in a critical situation due to the COVID-19 pandemic. Healthcare workers that are in the front line face challenges with a shortage of personal protective equipment, high risk of contamination, low adherence to the social distancing measures by the population, low coronavirus testing with underestimation of cases, and also financial concerns due to the economic crisis in a developing country. This study compared the impact of COVID-19 pandemic among three categories of healthcare workers in Brazil: physicians, nurses, and dentists, about workload, income, protection, training, feelings, behavior, and level of concern and anxiety. The sample was randomly selected and a Google Forms questionnaire was sent by WhatsApp messenger. The survey comprised questions about jobs, income, workload, PPE, training for COVID-19 patient care, behavior and feelings during the pandemic. The number of jobs reduced for all healthcare workers in Brazil during the pandemic, but significantly more for dentists. The workload and income reduced to all healthcare workers. Most healthcare workers did not receive proper training for treating COVID-19 infected patients. Physicians and nurses were feeling more tired than usual. Most of the healthcare workers in all groups reported difficulties in sleeping during the pandemic. The healthcare workers reported a significant impact of COVID-19 pandemic in their income, workload and anxiety, with differences among physicians, nurses and dentists.

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The development of GAMA Swab sampling chamber for walk-through sampling in patients with COVID-19 at Gadjah Mada Hospital

Journal of Community Empowerment for Health ◽

10.22146/jcoemph.57547 ◽

2020 ◽

Vol 3 (2) ◽

pp. 94

Author(s):

Hera Nirwati ◽

Dwi Aris Agung Nugrahaningsih ◽

Siswanto Siswanto ◽

Mahatma Sotya Bawono ◽

Titien Budhiaty ◽

...

Keyword(s):

Healthcare Worker ◽

Healthcare Workers ◽

Positive Pressure ◽

Protective Equipment ◽

Cross Contamination ◽

Rt Pcr ◽

Chain Reaction ◽

Aerosol Exposure ◽

Asymptomatic Patients ◽

Polymerase Chain

Collecting swab samples from the nasopharynx and oropharynx of patients with COVID-19 is essential in detecting SARS-CoV-2. This procedure potentially produces sufficient droplets. Since SARS-CoV-2 is transmitted through droplets, swab sampling has to be done carefully to prevent the risk of transmission to healthcare workers or the cross-contamination to the environment. The GAMA Swab Sampling Chamber (GSSC) is a positive-pressure chamber designed for collecting swab samples involving the healthcare worker positioned inside, while the patient is outside the chamber. The chamber is designed to minimize the risk of aerosol exposure to the healthcare worker due to leakage or when opening or closing the door. Accordingly, the healthcare worker does not need to use complete personal protective equipment (PPE) as they do when collecting swab samples without the chamber. After several tests to check the safety and the chamber’s function, the GSSC was used at Gadjah Mada Hospital. This chamber had been used to swab 51 asymptomatic patients, 72 suspected patients, and 284 voluntary persons for ten weeks. The results of reverse transcription-polymerase chain reaction (RT-PCR) examination of all samples from asymptomatic patients were negative, while 2 of 72 suspected patients (2.8%) and 4 of 284 voluntary persons (1.4%) had positive RT-PCR results. The use of GSSC can simplify the swab sampling, also reduces the need for PPE usage and a negative pressure isolation room which are limited in the current pandemic situation.

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A Survey of Psychiatric Healthcare Workers' Perception of Working Environment and Possibility to Recover Before and After the First Wave of COVID-19 in Sweden

Frontiers in Psychiatry ◽

10.3389/fpsyt.2021.770955 ◽

2021 ◽

Vol 12 ◽

Author(s):

Eirini Alexiou ◽

Steinn Steingrimsson ◽

Magnus Akerstrom ◽

Ingibjörg H. Jonsdottir ◽

Linda Ahlstrom ◽

...

Keyword(s):

Personal Protective Equipment ◽

Healthcare Workers ◽

Negative Impact ◽

Working Environment ◽

University Hospital ◽

Protective Equipment ◽

Web Based ◽

Before And After ◽

Survey Responses ◽

The Impact

Objective: This study aimed to investigate the impact of the first wave of the COVID-19 pandemic on perceived working environment, including the possibility to recover, among psychiatric healthcare workers (PHCWs) in comparison with pre-pandemic measures.Method: A link to an anonymous, web-based COVID-19 related survey was sent via email to all PHCWs at a university hospital in Sweden (n = 1,618) in September 2020. The response rate was 38% (566 of 1,507 eligible participants). Working environment survey responses collected in 2019 were used as pre-pandemic comparators. Statistical analyses were performed to assess overall impact over time on work demands, support, motivation, and recovery, stratified by professional role, and considering variables such as access to personal protective equipment.Results: The percentage of individuals responding negatively to statements about working environment increased significantly for most items after the first wave. Similarly, the increase of five of the investigated factors indicated a more negative perception of recovery during the pandemic. Registered nurses reported a greater negative impact of the pandemic on perceived working conditions and ability to recover than other professional groups. PHCWs working with patients with COVID-19 (35%) who reported being worried about becoming infected (12%) or infecting others (17%), or lacking adequate personal protective equipment (22%) were more negatively impacted regarding work environment-related items than those who did not.Conclusions: PHCWs' working environment and possibility for recovery were impacted by the first wave of the COVID-19 pandemic, nurses being most affected. Although psychiatric services do not directly care for patients with severe COVID-19 infection, the results from this study suggests that mental health services should also prepare for future pandemics.

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A Web Survey to Evaluate the Thermal Stress Associated with Personal Protective Equipment among Healthcare Workers during the COVID-19 Pandemic in Italy †

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18083861 ◽

2021 ◽

Vol 18 (8) ◽

pp. 3861

Author(s):

Alessandro Messeri ◽

Michela Bonafede ◽

Emma Pietrafesa ◽

Iole Pinto ◽

Francesca de’Donato ◽

...

Keyword(s):

Thermal Stress ◽

Personal Protective Equipment ◽

Healthcare Workers ◽

Productivity Loss ◽

Working Hours ◽

Point Of View ◽

The Body ◽

Protective Equipment ◽

Web Survey ◽

The Impact

The pandemic has been afflicting the planet for over a year and from the occupational point of view, healthcare workers have recorded a substantial increase in working hours. The use of personal protective equipment (PPE), necessary to keep safe from COVID-19 increases the chances of overheating, especially during the summer seasons which, due to climate change, are becoming increasingly warm and prolonged. A web survey was carried out in Italy within the WORKLIMATE project during the summer and early autumn 2020. Analysis of variance (ANOVA) was used to evaluate differences between groups. 191 questionnaires were collected (hospital doctor 38.2%, nurses 33.5%, other healthcare professionals 28.3%). The impact of PPE on the thermal stress perception declared by the interviewees was very high on the body areas directly covered by these devices (78% of workers). Workers who used masks for more than 4 h per day perceived PPE as more uncomfortable (p < 0.001) compared to the others and reported a greater productivity loss (p < 0.001). Furthermore, the study highlighted a high perception of thermal stress among healthcare workers that worn COVID-19-PPE and this enhances the need for appropriate heat health warning systems and response measures addressed to the occupational sector.

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Management of epistaxis during COVID-19 pandemic

Romanian Journal of Rhinology ◽

10.2478/rjr-2021-0010 ◽

2021 ◽

Vol 11 (42) ◽

pp. 50-52

Author(s):

Rahul Mishra ◽

Anjan Kumar Sahoo ◽

Priyanka Gosain

Keyword(s):

Emergency Department ◽

Viral Load ◽

High Risk ◽

Healthcare Workers ◽

Healthcare Providers ◽

High Viral Load ◽

Protective Equipment ◽

Special Focus ◽

Bleeding Control ◽

Upper Airways

Abstract Epistaxis represents a commonly encountered manifestation in the ENT Emergency Department. Healthcare providers working in the ENT Emergency Department are at high risk of COVID-19 infection both because of the high viral load in the upper airways and because of the asymptomatic presentation of COVID-19 disease. Special focus is needed for managing the balance between appropriate patient care and ensuring the safety of healthcare workers. Adequate preparation and modification of the procedures for bleeding control to minimize risk of spread is necessary. While managing, attention should be kept on less invasive methods with avoidance of aerosol-generating activities. Nonetheless, proper use and disposal of personal protective equipment is of utmost importance in stopping the spread of COVID-19.

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Hospital-wide SARS-CoV-2 antibody screening of staff in a university psychiatric centre in Belgium

BJPsych Open ◽

10.1192/bjo.2020.172 ◽

2021 ◽

Vol 7 (1) ◽

Author(s):

Kawtar El Abdellati ◽

Violette Coppens ◽

Jobbe Goossens ◽

Heidi Theeten ◽

Pierre Van Damme ◽

...

Keyword(s):

General Population ◽

Immunoglobulin G ◽

Personal Protective Equipment ◽

Healthcare Workers ◽

Healthcare Providers ◽

Protective Equipment ◽

Antibody Screening ◽

Limited Availability ◽

Staff Members ◽

Psychiatric Facilities

In this first serosurvey among psychiatric healthcare providers, only 3.2% of a sample of 431 staff members of a Belgian University Psychiatric Centre, screened 3–17 June 2020, had SARS-CoV-2 immunoglobulin G antibodies, which is considerably lower compared with both the general population and other healthcare workers in Belgium. The low seroprevalence was unexpected, given the limited availability of personal protective equipment and the high amount of COVID-19 symptoms reported by staff members. Importantly, exposure at home predicted the presence of antibodies, but exposure at work did not. Measures to prevent transmission from staff to patients are warranted in psychiatric facilities.

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Reuse of Filtering Facepiece Respirators in the COVID-19 Era

Sustainability ◽

10.3390/su13020797 ◽

2021 ◽

Vol 13 (2) ◽

pp. 797

Author(s):

Joren Van Loon ◽

Lore Veelaert ◽

Sander Van Goethem ◽

Regan Watts ◽

Stijn Verwulgen ◽

...

Keyword(s):

Quality Control ◽

Healthcare Workers ◽

Control Method ◽

Protective Equipment ◽

Quality Control Method ◽

Different Types ◽

Fit Testing ◽

Product Reuse ◽

The Impact ◽

Different Parts

The current COVID-19 pandemic has resulted in an immense and unforeseen increase in demand for personal protective equipment (PPE) for healthcare workers worldwide. Amongst other products, respirator masks are crucial to protect the users against transmission of the virus. Decontamination and reuse of the existing stock could be a solution to the shortage of new respirators. Based upon existing studies, it was found that (I) a solid quality control method is essential to test product reuse, (II) in-depth evaluation of the different parts of the filtering facepiece respirator (FFR) should be considered, and (III) communication of the reuse cycle is essential to take track of the amount of reuse, as this is limited to ensure quality. The goal of this paper is two-fold. First, we identify the impact of decontamination on the different parts of the FFRs and how the quality control should be performed. Two different types of FFRs are analysed within this paper, resulting in the recommendation of combining quantitative respirator mask fit testing with a thorough sensory evaluation of decontaminated FFRs to qualify them for reuse. Secondly, the possibilities of communication of this reuse to the eventual user are mapped through in-depth reasoning.

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Early experiences of radiographers in Ireland during the COVID-19 crisis

Insights into Imaging ◽

10.1186/s13244-020-00910-6 ◽

2020 ◽

Vol 11 (1) ◽

Author(s):

Shane J. Foley ◽

Anne O’Loughlin ◽

Jill Creedon

Keyword(s):

Healthcare Workers ◽

Early Experience ◽

Descriptive Statistics ◽

Protective Equipment ◽

Negative Consequences ◽

First Line ◽

Early Experiences ◽

Anxiety Levels ◽

The Impact

Abstract Background Imaging is crucial for assessing the severity and progression of COVID-19. Radiographers are amongst the first-line health professionals that may be exposed to infected persons. This work describes the early experience of radiographers in Ireland to the impact of COVID-19 using two electronic surveys distributed 6 weeks apart. Results were analysed using descriptive statistics and thematic analysis. Results A total of 370 responded to the first survey and 276 the second, with all six Irish health regions represented. Three quarters of radiographers (77%) reported having adequate personal protective equipment (PPE) available to them. However, almost half of the radiographers were inadvertently exposed to COVID-19-positive patients without appropriate PPE, largely attributed to poor communication and testing. Anxiety levels while initially high, reduced substantially 6 weeks into the crisis period. However, obvious distress was noted amongst some respondents. Forty percent of radiographers reported burnout symptoms due to the COVID-19 crisis and 30% reported considering changing jobs or retiring since the COVID-19 outbreak. Conclusion Clear communication regarding changing protocols and importantly patients’ infectious status are essential to safeguard healthcare workers and to minimise unnecessary anxiety and distress. Attention is required to staff mental health including the identification of burnout symptoms to prevent long-term negative consequences of the pandemic on radiography services.

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The Impact of Community Generated PPE During the SARS-COV-2 Pandemic in Southeast Alabama and Gulfport Mississippi

Frontiers in Health Services ◽

10.3389/frhs.2021.786062 ◽

2021 ◽

Vol 1 ◽

Author(s):

Benjamin Buttars ◽

Leigh Fountain ◽

Joseph Goodwin ◽

Jessica McLean ◽

John Olsen ◽

...

Keyword(s):

Community Involvement ◽

Personal Protective Equipment ◽

Healthcare Workers ◽

Psychosocial Health ◽

Protective Equipment ◽

Hospital Systems ◽

Strongly Agree ◽

Healthcare Associated ◽

Frontline Healthcare Workers ◽

The Impact

Background: The early stages of the SARS-COV-2 pandemic left many hospital systems devoid of personal protective equipment. Community-driven groups manufactured Personal Protective Equipment (PPE) as a form of temporary replacement until supply could increase to frontline healthcare workers. The purpose of this study was to survey hospital systems in Alabama and Mississippi who requested and received PPE to determine recipient opinions concerning community involvement.Methods: A 15-question Qualtrics survey was distributed to hospital systems who requested and received community-generated PPE (CGPPE) from the group known as Alabama Fighting COVID. 275 responses were gathered over a period of 6 months.Results: Survey data showed that most respondents from healthcare and healthcare-associated professions responded that wearing community generated personal protective equipment provided them with the perception of added protection (55.31% of participants selected either “Agree” or “Strongly Agree”), and that it improved their outlook and desire to work during the pandemic (51.77% of participants selected either “Agree” or “Strongly Agree”).Conclusions: Most respondents reported that wearing community generated personal protective equipment not only provided them with the perception of added protection, but that it improved their outlook and desire to work during the pandemic. With these responses in mind, our study raises questions concerning whether local CGPPE distribution could improve well-ness outcomes of healthcare workers (HCWs) not only in relation to decreased viral transmission, but also in favorable psychosocial health assessments. Further implications for research concerning community involvement during future medical crises are indicated, especially with the current rise of the delta variant strain.

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