ABSTRACT
Introduction: The professional use of personal protective equipment (PPE) eliminates occupational exposure of personnel to pathogens that cause infectious diseases, including COVID-19. Apart from the risk of exposure to biological hazards, healthcare workers are at risk of impaired work performance and work-related diseases posed by adverse health effects of PPE itself. Objective: To make a physiological and hygienic assessment of personal protective equipment against biological hazards used by healthcare professionals. Materials and methods: We evaluated the thermal state of the body in 13 volunteers under simulated conditions of the Tabai temperature and humidity chamber (Japan). The study design included a physiological and hygienic assessment of four variants of protective suits, all compliant with recommendations of the Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing (Rospotrebnadzor) for use when working with microorganisms of risk groups I and II. We studied the physiological response of the thermoregulatory system to heat exposures in terms of indicators characterizing the temperature of the "core”, the temperature of the "shell”, and their integral indicators (weighted mean skin and body temperatures). Changes in the fluid and electrolyte metabolism and the functional state of the cardiorespiratory system were assessed based on objective (sweat and heart rates) and subjective (heat sensation) indicators. Results: At the air temperatures of 25 and 30 °C, the maximum thermal exposure was registered in the volunteers wearing coveralls made of nonwoven material of the Tyvek type (China). A suit made of polyester fabric with a polyurethane mem-brane coating (Russia) had a less pronounced effect on the thermal state of the body. The minimum core and shell temperatures were noted for the suits made of polymer-viscose dustproof, water-repellent twill weave fabric (Russia) and Barrier 2X fabric (Russia). Conclusion: The excess of established values of the thermal state of the body during medium work was observed for all types of the studied suits both in permissible (25 °C) and harmful (30 °C) microclimate conditions. To prevent ill-being of medical personnel, it is necessary to schedule work taking into account the type of PPE used, the intensity of physical activity, and indoor microclimate parameters. © 2022, Federal Center for Hygiene and Epidemiology. All rights reserved.
ABSTRACT
Relevance. Personal protective equipment plays a leading role in reducing risks of infection and ensuring the safety of medical personnel during the COVID-19 pandemic. However, along with the positive “barrier” effect, personal protective equipment has a negative impact on human ergonomics, thus affecting the functional state and performance. Occupational activities of medical workers are often associated with complex, sometimes time-consuming operations;therefore, decreased functional state when using personal protective equipment can lead to errors and increase the health risks in both staff and patients. Intention is to develop the main directions of preserving occupational performance of medical personnel when using personal protective equipment based on the study of the functional state. Methodology. A sociological survey of 339 medical workers of the “red zone” of military medical organizations was conducted using an original questionnaire. Ergonomic indicators of personal protective equipment were assessed along with its negative influence. Results and Discussion. All the survey participants mentioned negative impact on the functional state and performance when using personal protective equipment. The most frequent complaints included discomfort due to fogging of protective glasses (83 %), as well as damage to the skin from eye protection (82 %), respiratory protection (69 %), skin protection (suit, overalls) (38 %). According to the survey, headaches were statistically significantly associated with wearing personal protective equipment for more than 6 hours per shift (OR 1.66;95 % CI: 1.07–2.56;p = 0.02), the age over 35 years (OR 2.44;95 % CI: 1.49–4.00;p = 0.001), body mass index above 25 (OR 1.98;95 % CI: 1.24–3.15;p = 0.003), overheating of the body (OR 2.27;95 % CI: 1.41–3.66;p = 0.001). Conclusion. The use of personal protective equipment when providing care to COVID-19 patients has a negative impact on the functional state and reduces the efficiency of medical personnel. Based on the results of the research, the main directions of preventive measures have been developed: selection of high-quality protective equipment, taking into account the anthropometric indicators of employees;ensuring optimal work and rest modes (no more than 4 hours of continuous work in personal protective equipment), monitoring and correction of the functional state of personnel at risk. © 2022 Nikiforov Russian Center of Emergency and Radiation Medicine, EMERCOM of Russia
ABSTRACT
Personal protective equipment has become the last line of protection for medical personnel during the pandemic of thenew coronavirus infection since it allows minimizing risks of biological contagion. Given the existing staffing shortage,medical wo rkers have to spend from 4 to 12 hours a day in the “red zone” where they necessarily wear personal protectiveequipment. Protective clothing is known to produce negative effects on functional state of the body and personnel’s workingcapacities. Assessment of up-to-date protective suits will allow developing recommendations on their suitable applicationbearing in mind a balance between necessary protection, providing favorable ergonomics, and reducing risks of adverseeffects on functional state and working capacities.Our research aim was to hygienically assess health risks for medical workers who had to wear reusable protective suits.Our research object was a reusable suit made from polyether fabric with polyurethane membrane coating and antistaticthreads. We performed an experiment aimed at evaluating thermal state of the body, psychophysiological state, and responsesby the volunteers’ cardiorespiratory system in laboratory conditions during an 8 hour working shift under controlledmicroclimate. Participants in the experiment were questioned in order to assess suits’ ergonomics.Heat exchange dynamics and amount of changes in thermal physiological parameters caused by wearing a protectivesuit determined heat contents of volunteers’ bodies that conformed to optimal standard values. Data on psychophysiologicaland mental state taken in research dynamics didn’t have any statistically significant changes. Gas exchange indicators naturallygrew during the “load” phase;however, there were no significant changes detected in any phase in the research.Hygienic assessment of the thermal state, functional state of the cardiovascular and respiratory systems, and psychophysiologicalindicators confirmed that wearing a protective suit was quite safe and didn’t involve any health risks for volunteers. © 2021,Health Risk Analysis. All Rights Reserved.
ABSTRACT
Relevance. During the pandemic of new coronavirus infection, healthcare professionals have increased occupational risks of exposure to the pathogen SARS-CoV-2, as well as physical and psychological stress, especially when treating Covid patients in “red zones”. Such a change in working conditions wasn't reflected in the results of a special assessment, which requires the development of an individual scientifically based approach to its organization in conditions equated to emergency situations. Intention. Evaluate the results of a special assessment of working conditions and their compliance with actual working conditions, taking into account the health risks for healthcare professionals taking care of Covid patients. Methodology. We retrospectively conducted a comparative analysis of 295 cards for a special assessment of the working conditions of medical personnel of military medical organizations of therapeutic and infectious profile over 2015-2019, and 266 cards from the same organizations for 2020. Results and Discussion. Study of cards for special assessment of working conditions of medical personnel of military medical organizations for 2015-2020 showed the leading role of biological factors for all categories of medical personnel. Working in the “Red zone” should be assessed as 3.3 (Degree III harmful) based on biological hazard or 4 (dangerous) due to risks of acute occupational diseases and death. This should be reflected in the results of special assessment of working conditions and compensated via reduction of working hours. However, in the context of the pandemic, actual working hours of healthcare professionals exceeded the established 39 hours per week (Article 350 of the Labor Code of the Russian Federation), and the medical personnel were allowed to work with the pathogen of Group II pathogenicity without preliminary medical examinations. Conclusion. Analysis of the results of special assessment of the working conditions of medical personnel showed that they do not reflect the actual harmful (dangerous) working conditions of employees involved in providing care to patients with new coronavirus infection in these medical and preventive institutions. © 2021 Medico-Biological and Socio-Psychological Issues of Safety in Emergency Situations. All rights reserved.