ABSTRACT
Introduction: The need for healthcare workers (HCWs) to wear personal protective equipment (PPE) during the coronavirus disease 2019 (COVID-19) pandemic heightens their risk of thermal stress. Objective(s): To determine knowledge regarding heat stress and practice of PPE among HCWs during the COVID-19 pandemic. Material(s) and Method(s): A cross-sectional observational study was done among 115 HCWs using a self-designed questionnaire to identify their thoughts on heat stress caused by PPE wear during the COVID-19 pandemic. The ambient temperature, relative humidity (RH), and dew point in their respective locations were recorded using data loggers (EL-USB-2-LCD+, Lascar Electronics, Salisbury, UK). R version 3.6.2 was used to examine the frequency and descriptive statistics from the survey findings. Pearson's chi-square was used to determine associations. A p value of <0.05 was considered statistically significant. Result(s): The average wet bulb globe temperature (WBG) reported was 30.0oC (IQR 29.1-31.8oC) according to the heat exposure data. The majority of the 115 HCWs were involved in medical consulting (39%), followed by nursing (29%). The researchers discovered that 50% of the workers (n=57) were wearing 5-6 PPEs and had a fourteen-fold increased risk of developing an undesirable thermal health symptom (95 % CI: 0.77 to 280.24;p=0.0737). In addition, 36% of the participants (n=42) worked between 8 and 10 hours every shift with little or no rest. It was also important to note that 76% (n=88) of them worked in non-air-conditioned environments, and 33% (n=38) of them had excessive workloads, which could add to the employees' heat burden. More than half of them agreed that wearing PPE is extremely inconvenient, and they avoided taking breaks to maintain infection control. The impression of thermal stress was reported by 96% of the participants (n=111), and it was found to be substantially linked with the job they were engaged [OR 0.0654 (95% CI: 0.003- 1.246) P=0.001]. More than half of the participants strongly agreed that appropriate rest and hydration before work could help them lower their thermal stress. Conclusion(s): HCWs are cognizant of the effects of heat stress but might not adopt best practices due to various constraints. Ice slurry ingestion could be a practical and effective method for promoting thermal comfort. Adverse effects of heat stress on productivity and judgment of HCWs warrant further investigation.
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
This study explored the degradation behavior of three types of disposable face masks in simulated seawater via the accelerated aging experiments. Microplastics (MPs) and dissolved organic carbon (DOC) were monitored in UV- and thermal-treated mask suspensions and their concentrations increased slowly in the early stage at 50 ℃ and 58 ℃. Owing to the high energy supply, the release rates of MPs and DOC at 76 ℃ were much faster than the above two temperatures. The time-temperature superposition principle (TTSP) was used to superpose the MPs/DOC release kinetics from other tested temperatures to the reference temperature and its applicability was verified by the similar activation energy. Then, a release kinetics model was established and fitted well with the superposed MP data (R2 ≥ 0.96). Since less than 0.1 % of carbon was leached, the superposed DOC data was roughly modelled by the exponential function (R2 ≥ 0.90). According to the TTSP and the established kinetics models, about 15 years were estimated to decompose half of a certain marine mask waste, together with leaching 0.21 ± 0.02 mg∙g-mask−1 of DOC. If mask consumption remains the same before 2025, they would contribute 40000–230000 tonnes of MPs and 13–97 tonnes of DOC to the ocean by 2040. © 2022
ABSTRACT
CASE: A 59 years old male with past medical history of type 2 diabetes presented in August of 2020 after 2 weeks of leg cramps, nausea, and dark urine that followed several weeks of poor fluid intake during his job as a construction worker. Patient reported that he had a similar episode in 2011, and was diagnosed with rhabdomyolysis with a CK value of 3442. Physical examination revealed a blood pressure of 138/79 mmHg, a pulse of 99 beats/min, respiratory rate of 16 breaths/min, temperature of 36.9 °C, and oxygen saturation of 96% on room air. He was alert and oriented, able to ambulate with pain, and no other significant cardiovascular, pulmonary, neurologic, and gastrointestinal findings. Notable elevation of plasma creatinine of 10.23 mg/dL, BUN of 90mg/dL, sodium of 123 mmol/L, potassium of 5.4 mmol/L, bicarbonate of 15 mmol/L, CRP of 115.4, D-dimer of 4305, Ferritin of 7927, Serum myoglobin of 5320 mcg/L, and total CK of 365148 U/L were noted. Nasopharyngeal swab at presentation was positive for Sars-CoV-2. Patient's urine drug/toxicology screen were negative. The patient was placed on intermittent hemodialysis, and IV fluids were administered. Given his unusually high CK level and COVID-19 positive status, viral myositis associated with COVID-19 was initially suspected. Muscle biopsy showed necrotizing myositis, and ANA titer and myositis specific antibodies were negative. Patient's sole complaint continued to be bilateral lower extremity spasm that gradually improved. The patient was discharged 13 days later with improving kidney functions and total CK of 1683. Patient did not follow up until January of 2021 when he presented to our emergency department for a gunshot wound. His kidney function was back to his baseline at the time. IMPACT/DISCUSSION: Multiple reports in the past 2 years have noted some relationship between rhabdomyolysis and SARS-CoV2 infection, including cases of rhabdomyolysis as a presenting and late complication of severe and mild COVID-19 pneumonia (Valente-Acosta et al, Min et al, and Suwanwongse et a). This case shows both an non- respiratory COVID-19 patient presenting with rhabdomyolysis as well as extremely high presenting CK of 365148 in a non-exercise associated adult rhabdomyolysis. While there are studies that suggests SARS-CoV2 can cause a direct viral injury on muscles, patient's muscle biopsy showing necrotizing myositis rather than direct viral injury suggests that this is not the likely mechanism that aggravated the disease. Rather, given that patient had significantly elevated d-dimer, ferritin, and CRP at presentation, the mechanism may be due to the significant inflammatory responses seen in COVID-19 patients. CONCLUSION: COVID-19 infection, regardless of severity, can significantly exacerbate rhabdomyolysis. Proper inpatient management in such cases can lead to no lasting musculoskeletal or renal complications despite severity. The relationship between COVID-19 infection and severe rhabdomyolysis may be based on the inflammatory responses.
ABSTRACT
The era of sudden eruption of the COVID-19 infection, since January 2020, drew much attention of the world due to its impact turning into a large-scale issue for all the countries, and thus an alarm of Corona Pandemic was declared all across, by February 2020. The same adverse effect was sensed by the middle of March 2020 in India too, when the declaration of total lockdown in the country was left as the only option which was implemented on 24th March 2020, by the Government of India. Such sudden development of hopes and apprehensions in the minds of all in India, sparked a thought of reducing the scope of spread of and infection due to this deadly virus to a considerable amount, mainly in the process of the exchange of various kinds of reading materials including books, by the students, in the post COVID-19 scenario.As a preparatory measure, this thought got converted into the development of a book sanitizer to be housed in the Library of the North-Eastern Hill University, Shillong, on the initiatives shown by the Dy. Librarian, which led the authors, in My 2020 to take up the project of developing an appropriate device The objective was to generate a device which sanitizes the books and other hard form reading materials maintained in the Library and remains free from contamination of the Corona virus to the maximum. For that, a book sanitizing machine is developed in a span of nearly three months. The device, named as Automated Book Sanitizing Composite Machine (ABSCoM) works on the technique based on the principle of UV-ray irradiation, integrated with the thermal exposure of the books in a controlled manner. A special feature of automation is employed to monitor the parameters of critical temperature set for the exposure at which the SARS virus is reported to get destroyed. Additionally, the time of thermal exposure of book and the relative humidity level of each book in the stack of books loaded in the device for sanitization is also monitored through microcontroller system and a bell alarming component. Sufficient care for maintaining the quality of the book post sanitization, as original, is the additional key factor in developing this device. © 2021 IEEE.