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EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-314989


Background: The need for healthcare workers (HCWs) to wear personal protective equipment (PPE) during the COVID-19 pandemic heightens thermal stress. We assessed the knowledge, attitudes, and practices of HCWs from developed and developing countries on PPE usage and heat stress when performing treatment and care.Methods: One hundred and sixty-five HCWs from India (n=110) and Singapore (n=55) participated in this survey. Thirty-seven HCWs from Singapore provided thermal comfort ratings before and after ice slurry ingestion. Responses between India and Singapore HCWs were compared. A p- value cut-off of 0·05 depicted statistical significance.Results: Median wet-bulb globe temperature was higher in India (30·2°C [IQR 29·1-31·8°C]) than in Singapore (22·0°C [IQR 18·8-24·8°C]) ( p <0·001). Majority of the respondents reported thirst (144;87%), excessive sweating (145;88%), exhaustion (128;78%), and desire to go to comfort zones (136;84%). In Singapore, reports of air-conditioning at worksites (34;62%), dedicated rest area availability (55;100%) and PPE removal during breaks (54;98.2%) were higher than in India (27;25%, 46;42%, and 66;60%, respectively) ( p <0·001). Median thermal comfort rating improved from 2 (IQR 1-2) to 0 (IQR 0-1) after ice slurry ingestion in Singapore ( p <0·001). Conclusion: HCWs are cognisant of the effects of heat stress but might not adopt best practices due to various constraints. Thermal stress management is better in Singapore than in India. Ice slurry ingestion is shown to be practical and effective in promoting thermal comfort under these conditions. Adverse effects of heat stress on productivity and judgement of HCWs warrant further investigation.Funding: This study was not funded in part or whole by any companies or agencies.Declaration of Interests: The authors declare that there are no competing financial interests.Ethics Approval Statement: In India, ethics approval was granted by Sri Ramachandra Institution of Higher Education and Research (Reference No.: IECNI/17/APR/59/54). In Singapore, ethics approval was granted by the National Healthcare Group Domain Specific Review Board (NHG DSRB;Reference No.: 2020/00590).