ABSTRACT
Background Healthcare workers (HCWs) are most at risk of contracting SARS-CoV-2 and COVID-19 infection. Their preparedness, as a result of provision and access to personal protective equipment (PPE), training programmes and awareness and practices on infection prevention and control measures, is integral for the prevention of infectious disease transmission. Objectives This study was conducted to assess the preparedness and practices of HCWs during COVID-19 first wave outbreak in Brunei Darussalam. Methods A cross-sectional study using a pre-designed and self-administered web-based questionnaire was conducted among HCWs from government and private health sectors ranging from primary to tertiary health facilities in Brunei Darussalam. Data were analysed using descriptive statistics, and chi-square test was used for statistical significance. Results A total of 511 HCWs participated in the study. Nurses (64%) and HCWs based at hospitals (66%) made up the majority of the study participants, with 74% having occupational exposure to COVID-19 cases. More than 99% of HCWs used respiratory PPE, and 94% used gloves. 74% had undergone respirator fit testing and 65% had received PPE awareness session within the last one year. Coverage in training programmes was found to be low among HCWs from private health facilities. Conclusions Majority of HCWs who had received updated training programmes and therefore were better prepared came from government health facilities. HCWs from private health facilities lacked preparedness training programmes and as such, there needs to be improvement to enhance preparedness measures in light of the ongoing COVID-19 pandemic and for future infectious disease outbreaks.
ABSTRACT
Background: Healthcare workers (HCWs) are most at risk of contracting SARS-CoV-2 and COVID-19 infection. Their preparedness, as a result of provision and access to personal protective equipment (PPE), training programmes and awareness and practices on infection prevention and control measures, is integral for the prevention of infectious disease transmission. Objective(s): This study was conducted to assess the preparedness and practices of HCWs during COVID-19 first wave outbreak in Brunei Darussalam. Method(s): A cross-sectional study using a pre-designed and self-administered web-based questionnaire was conducted among HCWs from government and private health sectors ranging from primary to tertiary health facilities in Brunei Darussalam. Data were analysed using descriptive statistics, and chi-square test was used for statistical significance. Result(s): A total of 511 HCWs participated in the study. Nurses (64%) and HCWs based at hospitals (66%) made up the majority of the study participants, with 74% having occupational exposure to COVID-19 cases. More than 99% of HCWs used respiratory PPE, and 94% used gloves. 74% had undergone respirator fit testing and 65% had received PPE awareness session within the last one year. Coverage in training programmes was found to be low among HCWs from private health facilities. Conclusion(s): Majority of HCWs who had received updated training programmes and therefore were better prepared came from government health facilities. HCWs from private health facilities lacked preparedness training programmes and as such, there needs to be improvement to enhance preparedness measures in light of the ongoing COVID-19 pandemic and for future infectious disease outbreaks. Copyright © The Author(s) 2021.
ABSTRACT
Purpose of Study This project was developed to find a quick and effective way for frontline workers to obtain a well-fitting N95 in resource limited settings when a fit test may not be plausible. The goal was to determine if facial shape could be used as a predictor of N95 fit. Methods Used Forty volunteers were given a facial shape selfassessment questionnaire which asked them to subjectively determine their own facial shape and then measure several dimensions with a disposable tape measure: half facial height (nasion to menton), full facial height (trichion to menton), and facial width (bizygomatic breadth). Two free facial assessment phone applications, 'Face Shape' and 'Zennioptical', were used as an additional assessment for facial shape. Participants were then fit tested with an AccuFIT 9000 Respirator Fit Test Machine using an OSHA standardized technique to assess the quantitative fit of four different N95's - a small and regular sized duckbill type mask, and a small and regular sized cup style mask. Pass/fail criteria was determined per OSHA standards and was set at a fit factor greater than or equal to 100. Summary of Results There was no association between face shape and best fitting mask based on either self-assessment (p= 0.51), the zenni app (p=0.59), or the Face Shape app (p=0.095). Correlation was not seen even when grouping face shapes into curved and angular. Face shape based on the 3 self-measured objective facial dimensions can be predicted with about 65% accuracy. Self-assigned face shape correlated with Zenni app face shape 40% of the time and with the Face Shape app 37.5% of the time (p>0.1). All three correlated 25% of the time, however the mutual face shape was 'oval' which was the most common facial shape identified in this study by both the applications and self-assessment. Forty-four percent of the participants did not pass fit testing per OSHA standards with their routinely worn N95's. The participants in this group also generally had poorer fit testing overall, with 50% of this group failing fit testing for all four masks. In addition, 33% of the entire study group only passed fit testing with one of the available N95's in this study. Conclusions Data from this pilot study shows that there is no correlation between N95 fit and face shape, largely due to the variability and subjectivity in the determination of facial shape by either app, self-assessment, or objective self-measurement. However, the researchers learned that nearly half of the participants did not pass fit testing for their regularly used N95's during the COVID pandemic. This illustrates a significant concern for the safety of healthcare workers and the inability for them to access appropriate, well-fitting respirators in resource limited settings. Furthermore, it highlights the importance of personalized fit testing prior to exposure to airborne particles and the need for access to multiple styles and sizes of respirators.
ABSTRACT
In order to provide the optimal respiratory protection for the users;particularly, the frontline healthcare workers (HCWs) while performing the aerosol-generating procedures (AGPs), it is required to conduct fit testing during the COVID-19 pandemic. A total of 90 HCWs (35 males and 55 females) of were participated in the study voluntarily. All participants were randomly allocated into six available filtering face-piece respirators (FFRs) with two kinds of styles (cup-shaped and flat-fold). Then, they underwent quantitative fit testing (QNFT) using the TSI PortaCount® respirator fit tester and qualitative fit testing (QLFT) procedures using the Moldex® Bitrex® fit test kit. The outcomes were the qualitative fit factors (QLFFs=100) and quantitative fit factors (QNFFs≥100). The overall passing rates of the QLFT and QNFT procedures were %35.17 and %29.33. One imported and domestic respirators had highest proportions of the QLFF (%48 and %45) and QNFF (%43 and 38%) and QNFF values of all. Furthermore, the mean FFs for the mentioned respirators were 120 and 103, respectively. Moreover, no significant difference was found between the whether females and males or between imported and domestic respirators by the passing rates (p>0.05). Overall, the passing rates obtained from both QNFT and QLFT procedures were low. One reason could be due to all studied respirators only came in one size or style. An optimal fit test panel should also be developed for the Iranian people to determine the appropriate face sizes and shapes in order to select the well-fitting respirator. Besides, the manufacturers are required make the respirators w
ABSTRACT
Most respirators employed in health care settings, and often in first responder and industrial settings, are intended for single-use: the user dons the respirator, performs a work activity, and then doffs and discards the respirator. However, in the current COVID-19 pandemic, in the presence of persistent shortages of personal protective equipment, extended use and reuse of filtering facepiece respirators are routinely contemplated by many health care organizations. Further, there is considerable current effort to understand the effect of sterilization on the possibility of reuse, and some investigations of performance have been conducted. While the ability of such a respirator to continue to provide effective protection after repeated sanitization cycles is a critical component of implementing its reuse, of equal importance is an understanding of the impact that reusing the respirator multiple times in a day while performing work tasks, and even extending its wear over multiple days, has on the workplace protective performance. In this study, we subjected a stockpiled quantitatively fitted surgical style N95 filtering facepiece respirator device to extreme reuse and extended wear conditions (up to 19 uses over a duration of 5 days) and measured its protective performance at regular intervals, including simulated workplace protection factor measurements using total inward leakage. With this respirator, it was shown to be possible to maintain protection corresponding to an assigned protection factor greater than 10 under extreme usage conditions provided an individual is properly trained in the use of, and expertly fitted in, the respirator. Other factors such as hygiene and strap breakage are likely to place limits on reuse.