ABSTRACT
Worldwide, healthcare systems had to respond to an exponential increase in COVID-19 patients with a noteworthy increment in intensive care units (ICU) admissions and invasive mechanical ventilation (IMV). The aim was to determine low intensity respiratory muscle training (RMT) effects in COVID-19 patients upon medical discharge and after an ICU stay with IMV. A retrospective case-series study was performed. Forty COVID-19 patients were enrolled and divided into twenty participants who received IMV during ICU stay (IMV group) and 20 participants who did not receive IMV nor an ICU stay (non-IMV group). Maximal expiratory pressure (PEmax), maximal inspiratory pressure (PImax), COPD assessment test (CAT) and Medical Research Council (MRC) dyspnea scale were collected at baseline and after 12 weeks of low intensity RMT. A greater MRC dyspnea score and lower PImax were shown at baseline in the IMV group versus the non-IMV group (p < 0.01). RMT effects on the total sample improved all outcome measurements (p < 0.05; d = 0.38-0.98). Intragroup comparisons after RMT improved PImax, CAT and MRC scores in the IMV group (p = 0.001; d = 0.94-1.09), but not for PImax in the non-IMV group (p > 0.05). Between-groups comparison after RMT only showed MRC dyspnea improvements (p = 0.020; d = 0.74) in the IMV group versus non-IMV group. Furthermore, PImax decrease was only predicted by the IMV presence (R2 = 0.378). Low intensity RMT may improve respiratory muscle strength, health related quality of life and dyspnea in COVID-19 patients. Especially, low intensity RMT could improve dyspnea level and maybe PImax in COVID-19 patients who received IMV in ICU.
ABSTRACT
In response to the current state of the COVID-19 pandemic, healthcare providers are using common surgical masks and filtering respirators in conjunction with the presence of facial hair, which could lead to a large number of particles passing into their respiratory system. The purpose of this study was to determine the fit factor effectiveness of filtering respirators and surgical masks in bearded versus non-bearded healthcare providers. A controlled randomized clinical trial (NCT04391010) was carried out, analyzing a sample of 63 healthcare providers. The fit factors of surgical masks and FFP3 filtering respirators for healthcare providers with (n = 32) and without (n = 31) facial hair were compared. Fit factors were measured during an exercises protocol in which healthcare providers wore surgical masks and FFP3 filtering respirators. Surgical mask fit factor comparisons did not show significant differences (p > 0.05) between healthcare providers with and without facial hair. In contrast, filtering respirator fit factor comparisons showed statistically significant differences (p < 0.01) between both groups, indicating that healthcare providers with facial hair showed lower fit factor scores, which implies a worse fit factor with respect to healthcare providers without facial hair. The fit factor effectiveness of filtering respirators was reduced in healthcare providers with facial hair. The authors of this paper encourage healthcare providers to trim their beards during filtering respirator use or wear full-mask filtering facepiece respirators, especially during the COVID-19 pandemic.
ABSTRACT
AIMS: To determine the fit factor and compliance with American Industrial Hygiene Association (AIHA) and Occupational Safety and Health Administration (OSHA) requirements of surgical masks and filtering respirators in male versus female nurses. DESIGN: A case-control gender study performed from 2016 to 2019. METHODS: A gender and age matched-paired sample of 74 nurses was recruited and divided into men (n = 37) and women (n = 37). FFP3 filtering respirators and surgical masks fit factors were compared between male and female nurses by Mann-Whitney U tests. These measurements were tested to pass or fail according to the OSHA (≥100) and AIHA (≥50) criteria by Fisher exact tests for a 95% confidence interval. RESULTS: Global fit factor mean (standard deviation) was 2.86 (2.73) and 3.55 (6.34) for male and female nurses wearing surgical masks (p = .180), respectively, and nobody passed neither OSHA nor AIHA criteria (p = 1.00). Nevertheless, global fit factor were 30.82 (28.42) and 49.65 (43.04) for male and female nurses wearing FFP3 respirators, respectively, being significantly lower and worse in male nurses (p = .037). According to OSHA criteria, only 2.70% and 13.51% of male and females nurses, respectively, passed with non-significant difference (p = .199), meanwhile 21.62% and 48.64% of male and female nurses, respectively, passed AIHA criteria showing significant differences (p = .027) wearing FFP3 respirators. CONCLUSIONS: All male and female nurses wearing surgical masks failed to pass OSHA and AIHA criteria. Global fit factor of the proposed FFP3 filtering respirators was decreased and worse in male than female nurses. IMPACT: Our recommendation is to avoid surgical masks use for protective purposes and use the proposed FFP3 filtering respirators among nurses. Each nurse should be fit tested for its own respirator with special caution in male nurses due to their lower fit factor achieved and most of them failed to pass OSHA and AIHA criteria, especially during COVID-19 pandemic.
Subject(s)
COVID-19 , Nurses , Case-Control Studies , Female , Humans , Male , Masks , Pandemics , SARS-CoV-2 , Ventilators, MechanicalABSTRACT
Worldwide, the burden of musculoskeletal disorders is increasing with great variations between-countries, which makes it difficult for policymakers to provide resources and adequate interventions in order to provide for their appropriate management [...].