Design optimization and validation of UV-C illumination chamber for filtering facepiece respirators.

In this study, we constructed an UV-C illumination chamber using commercially available germicidal lamps and other locally available low-cost components for general-purpose biological decontamination purposes. The illumination chamber provides uniform illumination of around 1 J/cm2 in under 5 min across the chamber. The control mechanism was developed to automate the on/off process and make it more secure minimizing health and other electrical safety. To validate the decontamination efficacy of the UV-C Illumination Chamber we performed the Geobacillus spore strip culture assay. Additionally, we performed the viral load measurement by identifying the COVID-19-specific N-gene and ORF1 gene on surgical masks. The gold standard RT-qPCR measurement was performed to detect and quantify the COVID-19-specific gene on the mask sample. The biochemical assay was conducted on the control and test group to identify the presence of different types of bacteria, and fungi before and after exposure under the illumination chamber. The findings of our study revealed satisfactory decontamination efficacy test results. Therefore, it could be an excellent device in healthcare settings as a disinfection tool for biological decontamination such as SAR-CoV-2 virus, personal protection equipment (PPE), (including n95, k95 respirators, and surgical masks), and other common pathogens.

Evaluation of novel radiation protection devices during radiologically guided interventions.

BACKGROUND: In radiologically guided interventions, medical practitioners are subjected to radiation exposure, which may lead to radiation-induced diseases. In this study, novel radiation shields for the head and neck were evaluated for their potential to reduce radiation exposure. METHOD: An anthropomorphic phantom was exposed on its left side to scattered radiation from beneath to simulate the exposure of an operator in a x-ray operating room. Thermoluminescent dosimeters (TLDs) were positioned at different depths in five slices in the phantom, measuring personal dose equivalent. Two different set up situations were evaluated: a head protector designed to reduce radiation in the upper section of the head; and a novel thyroid protector prototype extended in the front and on both sides, designed to reduce radiation in the lower and middle sections of the head. A standard thyroid collar prototype and a ceiling mounted lead glass shield were used as comparisons. Furthermore, the head protector was evaluated in a clinical study in which TLDs were positioned to measure scattered radiation exposure to the heads of operators during endovascular interventions. RESULTS: The extended thyroid protector reduced the scattered radiation in the throat, chin, and ear slices. Some shielding effect was seen in the brain and skull slices. The head protector showed a shielding effect in the skull slice up to two cm depth where it covered the phantom head. As expected, the ceiling mounted lead glass shield reduced the scattered radiation in all measuring points. CONCLUSIONS: A ceiling mounted lead glass shield is an effective radiation protection for the head, but in clinical practice, optimal positioning of a ceiling mounted lead shield may not always be possible, particularly during complex cases when radiation protection may be most relevant. Added protection using these novel guards may compliment the shielding effect of the ceiling mounted lead shield. The head protector stand-alone did not provide sufficient protection of the head. The extended thyroid protector stand-alone provided sufficient protection in the lower and middle sections of the head and neck.

Personal protection equipment: Preliminary evidence of effectiveness from a three-phase simulation program.

Background: Healthcare providers carry the occupational risk of being exposed to pathogens. Personal Protection Equipment (PPE) requires proficiency whenever used. Yet, evidence shows significant errors and variation in competency when applying PPE. Objective: In this study, we developed a three-phase intervention to promote PPE proficiency. Methods: Education and assessment of participants' PPE knowledge and skills occurred at a large academic university in Western Canada. Participants first completed an online module; second, they experienced one-on-one coaching and deliberate practice with infection control professionals; and third, participants managed a COVID-19 clinical simulation scenario. The measured outcomes include a 15-item pre- and post-knowledge test and a pre- and post-skills assessment of donning and doffing behaviors. These behaviors were observed from video recordings and were assessed using two standardized checklists. Results: Knowledge and donning/doffing post-test scores (11.73, 0.95, and 0.96, respectively) were significantly higher after completing all three phases of the educational intervention, p < .001. Conclusions: An online module alone is insufficient for PPE knowledge and skill development. Rather, a module followed by practice and simulation allows learners to gain proficiency.

Refocusing on work-based hazards for the anaesthesiologist in a post-pandemic era.

The coronavirus pandemic has raised public awareness of one of the many hazards that healthcare workers face daily: exposure to harmful pathogens. The anaesthesia workplace encompasses the operating room, interventional radiology suite, and other sites that contain many other potential occupational and environmental hazards. This review article highlights the work-based hazards that anaesthesiologists and other clinicians may encounter in the anaesthesia workplace: ergonomic design, physical, chemical, fire, biological, or psychological hazards. As the anaesthesia work environment enters a post-COVID-19 pandemic phase, anaesthesiologists will do well to review and consider these hazards. The current review includes proposed solutions to some hazards and identifies opportunities for future research.

Avoiding SARS-CoV-2 infection in healthcare workers: is behavioral change the answer?

Background: The COVID-19 pandemic has become an important cause of morbimortality, and healthcare workers are at the highest risk of infection. As a result, policies and guidelines have been issued, and behavioral changes have been crucial in hospitals. Among these measures, the implementation of personal protective equipment (PPE) and its appropriate use in the workplace is key to avoiding contagion, as is understanding new measures regarding patient admission, distribution, constant education on virtual platforms, among others, and changing conduct to reduce contagion. However, behavioral change interventions in healthcare workers are challenging as contextual characteristics, attributes of the intervention, and psychological factors are involved. Study objectives: The issue under investigation is the impact of COVID-19 on frontline healthcare workers in the emergency department of the Fundación Cardioinfantil (FCI). The objective was to describe their behavioral changes by studying and monitoring SARS-CoV-2 infection and their relationship through the tracing process in 2020. Methods: We conducted a case study to identify and relate the SARS-CoV-2 infection rate within the personnel in the department and the response of healthcare workers to the implementation and adherence to the use of PPE through the analysis of the different variables that contributed to behavioral change. Data were collected by a single author and analyzed by two authors using both the individual-level logic model technique and the triangulation of information, with approval from the institutional review board. Discussion: Several interventions for behavior change were registered in the data collection process. The data obtained indicated that implementation, embedding, and integration were perceived as collective and individual behavioral processes. This was supported by evidence from healthcare interventions, such as education, incentivization, training, restriction, environmental restructuring, modeling, and enablement. Conclusion: Behavioral science should be part of public health responses, as the theoretical basis suggests that change may modify the response to avoid the transmission of infectious diseases. Therefore, individuals at the highest risk appear to adopt guidance with targeted behavior adaptation interventions. Efforts to inform, instruct, and motivate healthcare workers must be continuous, and actions at the community level must be strengthened, as it is human behavior that determines the spread and mortality of infectious diseases, where community compliance to preventive behaviors plays a crucial role.

The hidden inequality: the disparities in the quality of daily use masks associated with family economic status.

Wearing high-quality masks plays a critical role in reducing COVID-19 transmission. However, no study has investigated socioeconomic inequality in the quality of masks. Addressing this gap, this paper explored the relationships between mask's quality and family economic status. The cross-sectional survey was conducted in two Chinese universities by distributing structured questionnaires to assess participants' characteristics including family economic status, and meanwhile collecting their masks to evaluate the quality by measuring particle filtration efficiency. The valid responses were obtained from 912 students with mean age of 19.556 ± 1.453 years and were analyzed by using fractional or binary logistic regression. Three main findings were presented. First, inequality existed in the quality of masks. 36.07% of students were using unqualified masks with average filtration efficiency of 0.795 ± 0.119, which was much lower than China's national standard (0.9). Of those masks with identified production date, 11.43% were manufactured during COVID-19 outbreak when market was flooded with counterfeit production, and thus were of poor quality with average filtration efficiency of 0.819 ± 0.152. Second, better family economic status was associated with better masks' filtration efficiency and greater probability of using qualified masks. Third, students with better family economic status tend to use masks with individual packaging, and unique patterns and special designs, which may lead to inequality on a psychological level. Our analysis reveals the hidden socioeconomic inequality that exist behind cheap masks. In facing the challenges of future emerging infectious diseases, it is important to address the inequity to ensure equal access to affordable qualified personal protection equipment.

Application of Inorganic Nanomaterials in Cultural Heritage Conservation, Risk of Toxicity, and Preventive Measures.

Nanotechnology has allowed for significant progress in architectural, artistic, archaeological, or museum heritage conservation for repairing and preventing damages produced by deterioration agents (weathering, contaminants, or biological actions). This review analyzes the current treatments using nanomaterials, including consolidants, biocides, hydrophobic protectives, mechanical resistance improvers, flame-retardants, and multifunctional nanocomposites. Unfortunately, nanomaterials can affect human and animal health, altering the environment. Right now, it is a priority to stop to analyze its advantages and disadvantages. Therefore, the aims are to raise awareness about the nanotoxicity risks during handling and the subsequent environmental exposure to all those directly or indirectly involved in conservation processes. It reports the human-body interaction mechanisms and provides guidelines for preventing or controlling its toxicity, mentioning the current toxicity research of main compounds and emphasizing the need to provide more information about morphological, structural, and specific features that ultimately contribute to understanding their toxicity. It provides information about the current documents of international organizations (European Commission, NIOSH, OECD, Countries Normative) about worker protection, isolation, laboratory ventilation control, and debris management. Furthermore, it reports the qualitative risk assessment methods, management strategies, dose control, and focus/receptor relationship, besides the latest trends of using nanomaterials in masks and gas emissions control devices, discussing their risk of toxicity.

Industrial exoskeletons from bench to field: Human-machine interface and user experience in occupational settings and tasks.

Objective: Work-related musculoskeletal disorders (WRMSDs) are considered nowadays the most serious issue in the Occupational Health and Safety field and industrial exoskeletons appear to be a new approach to addressing this medical burden. A systematic review has been carried out to analyze the real-life data of the application of exoskeletons in work settings considering the subjective responses of workers. Methods: The review was registered on PROSPERO. The literature search and its report have been performed following the PRISMA guidelines. A comprehensive literature search was performed in PubMed, EMBASE, Web of Science, and Scopus. Results: Twenty-four original studies were included in the literature review; 42% of the papers retrieved included automobilist industry workers, 17% of the studies evaluated the use of exoskeletons in logistic facilities, and 17% of articles involved healthcare. The remaining six papers recruited farmers, plasterers, wasting collectors, construction workers, and other workmen. All the papers selected tested the use of passive exoskeletons, supporting upper arms or back. Usability, perceived comfort, perceived exertion and fatigue, acceptability and intention to use, occupational safety and health, and job performance and productivity were the main topic analyzed. Conclusion: Exoskeletons are not a fix-all technology, neither for workers nor for job tasks; they tend to show more of their potential in static activities, while in dynamic tasks, they can obstacle regular job performance. Comfort and easiness of use are the key factors influencing the user's experience. More research is needed to determine the most effective and safe ways to implement exoskeleton use in occupational settings. Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=275728, identifier CRD42021275728.

Study on airway assessment practices for elective procedures during pre-anesthetic evaluation in COVID-19 pandemic- A national online survey (SAFE PAC Survey).

Background and Aims: A pilot study among anesthesiologists, revealed a wide variation among individual practices including skipping pre-anesthetic airway assessment during COVID-19 pandemic because of the fear of getting infected. Risk of infection during pre-anesthetic airway assessment has not been studied. The primary objective of the survey was to evaluate the practices of airway examination by anesthesiologists during this pandemic period. Secondary objectives were to study the effects of institutional factors and other individual practices on risk modification and the incidence of COVID-19 infection among anesthesiologists. Material and Methods: A survey was conducted using a pre-validated questionnaire comprising of 35 questions. The questionnaire was circulated among 4676 members of the Indian Society of Anaesthesiologists (ISA) through Google Forms by email. Results: Of the 4676 members contacted via email, 470 were returned undelivered. From the remaining 4206 questionnaire recipients, 456 completed responses were obtained giving a response rate of 10.8%. Percentage, mean and standard deviation were calculated using EZR software. The conduct of pre-anesthetic airway assessment has decreased by 31.7% during the pandemic, leading to 5.2% of participants encountering unanticipated difficult airway. Among the respondents, eight percent were infected. Conclusion: Avoidance of preoperative airway assessment by anesthesiologists during the COVID-19 pandemic has led to rising unanticipated difficult airway undermining the patient safety. Adherence to recommended practices ensures safety from risk of COVID-19 infection.

Human-to-human transmission of severe fever with thrombocytopenia syndrome virus through potential ocular exposure to infectious blood.

Severe fever with thrombocytopenia syndrome (SFTS), an emerging infectious disease with high mortality, was first reported in 2009 in China and subsequently endemic to South Korea, Japan, Vietnam, and Myanmar. This disease is transmitted predominantly by tick bites and potentially human-to-human. Personal protective equipments (PPEs) have been recommended to prevent SFTS human-to-human transmission, whereas the specific use of PPEs and the effect on viral transmission have rarely been reported. This report identified a family cluster of six patients with SFTS virus (SFTSV) infection. All five secondary patients had been wearing gloves and masks when exposed to the blood of the index patient, but none of them wore goggles or face shields for eye protection. Ocular route was suggested as a highly possible mode for SFTSV transmission through epidemiological, serological, and phylogenetic analysis. Eye protection should be stressed for clinicians when exposed to blood or bloody secretions.

[Research progress on the occupational health and personal protection of emergency responders].

To meet the requirement from the economy and society, China's emergency rescue has been developing towards specialization and professionalization. The working environment for emergency responders is special accompanying with tremendous challenges and uncertainties. To promote the research on occupational health and personal protection is an important guarantee for the workers in China to realize the goal of "decent work". This paper reviews the hazards that affect the occupational health of emergency rescue workers, the research progress of adverse outcomes caused from exposure to these hazards, and the related development issues of personal protection. In order to ensure the safety and health of emergency rescue workers, the direction of further research on occupational health of emergency rescue workers is put forward.

Associations between Awareness of the Risk of Exposure to Pollutants Occurring at Fire Scenes and Health Beliefs among Metropolitan Firefighters in the Republic of Korea.

Firefighters are repeatedly exposed to various pollutants that occur at fire scenes. There are three levels of exposure: primary exposure to pollutants, secondary exposure to pollutants on personal protective equipment (PPE), and tertiary exposure to contaminated fire stations and fire engines due to pollutants on PPE. Therefore, it is important for firefighters to be aware of the risk of exposure to pollutants and to practice health behaviors such as appropriate PPE management. No clear association has been established in the existing literature between firefighters' risk perception level and their health beliefs about the health impact of awareness of exposure to hazardous substances at fire scenes. This study aims to evaluate the relationship between awareness of the exposure risk to primary, secondary, and tertiary pollutants and health beliefs. It was designed as a cross-sectional study, in which a web-based survey was conducted from 13 May to 31 May 2021. The analysis was conducted in 1940 firefighters working in the Seoul metropolis who agreed to participate in the research. Participants who perceived susceptibility were likely to be aware of the primary (adjusted odds ratio (AOR) = 2.10, 95% confidence interval (CI) 1.16-3.80), secondary (AOR = 2.77, 95% CI 1.77-4.32), and tertiary (AOR = 2.73, 95% CI 1.85-4.03) exposure risks. Participants who perceived barriers were unlikely to be aware of the risk of exposure to primary (AOR = 0.67, 95% CI 0.49-0.91), secondary (AOR = 0.77, 95% CI 0.61-0.96), and tertiary (AOR = 0.75, 95% CI 0.62-0.91) pollutants. Educational intervention is recommended to improve perceived susceptibility and awareness of the risk of exposure to pollutants and reduce perceived barriers. Consequently, educational intervention is expected to positively impact firefighters' management of appropriate PPE. We confirmed an association between occupational exposure risk and firefighters' health beliefs. In the health belief model (HBM), health beliefs that affect health behavior also affect awareness of the exposure risk level. Therefore, an intervention for health beliefs can also be used to raise job-related exposure risk awareness. Regular training on the health impacts of fire scenes is necessary for both newcomers and incumbents to enable firefighters to better recognize the risks of each occupational exposure level. Additionally, laws and regulations are necessary for the removal of harmful substances that contaminate PPE, such as self-contained breathing apparatus (SCBA), during exposure to a fire scene. Our research can be used as a basis for improving fire policies and education programs in the future.

Influence of different protection levels of PPE on nurses' physical fatigue during the COVID-19 pandemic.

BACKGROUND: The continuous spread of COVID-19 globally has led to busier medical practices and nurses are having to provide medical services to patients while suffering from high levels of fatigue. OBJECTIVE: This study experimentally investigated the influence of different levels of personal protection equipment (PPE) on nurses' physical fatigue. METHODS: We collected data from 12 participants by simulating a series of nursing tasks. The participants wore one of three different protection levels of PPE, and data recording their heart rate (HR), oral temperature, task completion time, and subjective fatigue were collected. Following this, relationship models between subjective fatigue and objective fatigue indices was established using multiple linear regression analysis. RESULTS: By analyzing the variation trends of single indices of HR, oral temperature, task completion time, and subjective fatigue, it was found that the higher the level of protection levels of PPE worn by the participants, the higher the degree of fatigue experienced by them. In addition, taking subjective fatigue variation as the dependent variable and objective fatigue indices as independent variables, relationship models of the three different protection levels of PPE were established. CONCLUSIONS: The results confirmed the influence of different protection levels of PPE on nurses' physical fatigue levels. They also provide a basis for medical administrators to monitor the degree of fatigue experienced by nurses, attempt to arrange nurses' work content accordingly, and schedule suitably to combat and manage recorded increases in fatigue.

Headache related to personal protective equipment in healthcare workers during COVID-19 pandemic in Mexico: baseline and 6-month follow-up.

BACKGROUND AND AIM: Headaches related to the use of personal protective equipment (PPE) could affect performance at work in healthcare personnel. Our aim was to describe the prevalence and risk factors for headaches related to PPE, in the personnel of a specialized coronavirus disease 2019 (COVID-19) tertiary hospital. METHODS: In this cross-sectional survey study, we invited healthcare workers from COVID-19 referral center in Mexico (May 22-June 19, 2020) to answer a standardized structure questionnaire on characteristics of new-onset PPE-related headache or exacerbation of primary headache disorder. Participants were invited regardless of whether they had a current headache to avoid selection bias. This is the primary analysis of these data. RESULTS: Two hundred and sixty-eight subjects were analyzed, 181/268 (67.5%) women, 177/268 (66%) nurses, mean age 28 years. The prevalence of PPE-related headache was 210/268 (78.4%). Independent risk factors were occupation other than physician (OR 1.59, 95% CI 1.20-2.10), age > 30 years (OR 2.54, 95% CI 1.25-5.14), and female sex (OR 3.58, 95% CI 1.86-6.87). In the 6-month follow-up, 13.1% of subjects evolve to chronic headache, with stress as predictive risk factor. CONCLUSION: The frequency of PPE-associated headache is high, and a subgroup could evolve to chronic headache. More studies are necessary to improve the knowledge about this condition.

A Global Sharing Mechanism of Resources: Modeling a Crucial Step in the Fight against Pandemics.

To face crises like the COVID-19 pandemic, resources such as personal protection equipment (PPE) are needed to reduce the infection rate and protect those in close contact with patients. The increasing demand for those products can, together with pandemic-related disruptions in the global supply chain, induce major local resource scarcities. During the first phase of the COVID-19 pandemic, we witnessed a reflex of 'our people first' in many regions. In this paper, however, we show that a cooperative sharing mechanism can substantially improve the ability to face epidemics. We present a stylized model in which communities share their resources such that each can receive them whenever a local epidemic flares up. Our main finding is that cooperative sharing can prevent local resource exhaustion and reduce the total number of infected cases. Crucially, beneficial effects of sharing are found for a large range of possible community sizes and cooperation combinations, not only for small communities being helped by large communities. Furthermore, we show that the success of sharing resources heavily depends on having a sufficiently long delay between the onsets of epidemics in different communities. These results thus urge for the pairing of a global sharing mechanism with measures to slow down the spread of infections from one community to the other. Our work uses a stylized model to convey an important and clear message to a broad public, advocating that cooperative sharing strategies in international resource crises are the most beneficial strategy for all. It stresses essential underlying principles of and contributes to designing a resilient global supply chain mechanism able to deal with future pandemics by design, rather than being subjected to the coincidental and unequal distribution of opportunities per community that we see at present.

Prevalence of SARS-CoV-2 Infection Among COVID-19 Reverse Transcription-Polymerase Chain Reaction (RT-PCR) Laboratory Workers in Bangladesh.

BACKGROUND: Healthcare workers (HCWs) at the frontline are confronting a substantial risk of infection during the COVID-19 pandemic. This emerging virus created specific hazards to researchers and laboratory staff in a clinical setting, underlined by rapid and extensive worldwide transmission. OBJECTIVES: This study aimed to investigate the prevalence of SARS-CoV-2 infection among COVID-19 reverse transcription-polymerase chain reaction (RT-PCR) laboratory health workers in Bangladesh. MATERIALS AND METHODS: This retrospective study was conducted between October 2 to December 2, 2020. A total of 508 participants, including doctors, scientific officers, medical technologists, and cleaners working in several COVID-19 RT-PCR laboratories, were included in this study. Data were collected from each participant using a semi-structured questionnaire prepared in the format of an anonymous Google form. All statistical analyses were performed using SPSS, version 25.0 (SPSS Inc., Chicago, IL, USA). RESULTS: Out of the 508 participants, 295 tested positive for SARS-CoV-2 RT-PCR. Among the positive cases, 202 were men, and 93 were women, with a median age of 30 years. The most positive cases were medical technologists (53.22%) followed by doctors (28.8%). Out of the 271 symptomatic positive cases, the most typical symptoms were fever (78.5%), fatigue (70%), loss of smell and taste (65%), and cough (64%). Hypertension, obesity, and diabetes were found in 8.8%, 8.8%, and 7.1% positive cases. A + blood group was present in 37% of the positive cases, followed by the B+ blood group (27%) and O+ blood group (25%). Inadequate supply of personal protective equipment (PPE), absence of negative pressure ventilation, laboratory contamination, and no training on molecular test methods were found in 13.8%, 67.8%, 44.7%, and 40.6% of positive cases, respectively. CONCLUSION: Evaluating the infection status of laboratory HCWs is crucial for drawing attention from the public, providing practical suggestions for government agencies, and increasing protective measures for laboratory HCWs.

Head and facial dimensions of Chilean workers for design purposes and the differences with other populations.

BACKGROUND: An appropriate match between a product and its end-users requires anthropometric data, which show variations among different countries. Proper Personal Protection Equipment (PPE) fit is key for safety and comfort. Chile had no head and facial anthropometric data available in order to design face/head PPE. OBJECTIVE: To describe face/head anthropometric characteristics of Chilean workers. Additionally, this study compared those dimensions against other populations (United States (US), South Korea and China). METHODS: An anthropometric survey involving 21 measures was conducted between September 2013 to May 2016 using stratified sampling. The measurements were based on ISO/TS 16976-2 and ISO 15535 to ensure the highest standards possible, and a total of 474 workers, aged from 18 to 66 years old, participated in the survey. RESULTS: The biggest differences were in Neck circumference, Weight, Nose breadth, Nose protrusion, Bitragion chin arc, Face length, Subnasale-sellion length, Face width, Bigonial breadth and Bitragion subnasal arc. Head length of Chileans were longer than Chinese and South Korean ones, but shorter than US Head length. Chilean Head breadth is smaller than Chinese and South Korean ones. Chileans Face length was the largest observed. Face width of Chileans was smaller than US and Chinese ones. Gender specific differences were also observed in the inter-country comparisons. Chilean males had larger anthropometric dimensions than females. CONCLUSION: Chilean Head and face dimensions differed significantly when compared against US, South Korean and Chines Head and Face dimensions. Chileans have longer and narrower faces with wider mouths, with a head size in between the US and Asian heads. Face and head PPE for Chileans should use dimensions in the current paper in order to ensure proper fit.

Risk of Dehydration Due to Sweating While Wearing Personal 2 Protective Equipment in COVID-19 Clinical Care: A Pilot Study.

OBJECTIVE: The objectives of this study were (a) to determine the physical impact of the personal protective equipment (PPE) used in COVID-19 care, specifically the impact on the hydration state of the temperature and the comfort of the healthcare workers who use it, and (b) to show the high-fidelity simulated environment as an appropriate place to test the experimental designs to be developed in real environments for COVID-19. BACKGROUND: All healthcare staff use full PPE in the care of COVID-19 patients. There are problems, such as excessive sweating, which have not been quantified thus far. METHODS: A descriptive pilot design was used in a simulated high-fidelity setting. There was paired activity, with mild-moderate physical activity, between 45 and 60 min continuously, with the COVID-19 PPE. Sixteen intensive care nurses were selected. The before-after differential of weight, thirst, weight use of the PPE, body temperature, thermal body image, general and facial warmth sensation, and perspiration sensation were measured. RESULTS: All subjects lost weight in the form of sweat with both PPEs during the simulation scenario, with a mean of 200 g (0.28% of initial weight), and increased thirst sensation. Body thermal image increased by 0.54 °C in people using the full COVID-19 PPE. CONCLUSIONS: The use of PPE in the management of critically ill COVID-19 patients generates weight loss related to excessive sweating. The weight loss shown in this pilot test is far from the clinical limits of dehydration. The use of ventilated PPE, such as PAPR, reduce the body temperature and heat sensation experienced by the users of it; at the same time, it improves the comfort of those who wear it. The simulated environment is a suitable place to develop the piloting of applicable research methodologies in future studies in a real environment.

Body pain - An unheeded personal health hazard in interventional cardiologists: A national online cross-sectional survey study in China.

INTRODUCTION: Interventional cardiology procedures (ICPs) have become the mainstay treatments in cardiology diseases and increased rapidly. This study aims to assess the occupational health hazards (OHHs) related to the long-time wearing of lead personal protective equipment and reveal health protection needs in interventional cardiologists. METHODS AND RESULTS: We invited interventional and non-interventional cardiologists in tertiary hospitals in China to participate in an online cross-sectional survey on their health status, utilization of personal protective equipment (PPE), and personal health protection (PHP) needs. Propensity score methods were used for comparisons of OHHs between the matched interventional and non-interventional cardiologists. Totally, 642 interventional and 402 non-interventional cardiologists completed the survey. The interventional cardiologists had significantly higher incidence of body pain (56.6% vs. 24.2%, p < 0.001), bone and joint disease (21.7% vs. 8.6%, p = 0.001), cataract (3.5% vs. 0%, p = 0.039), and anxiety (8.1% vs. 2.5%, p = 0.029) than the matched non-interventional cardiologists. The risk of back pain was independently associated with female gender, performing percutaneous coronary intervention procedure or ≥ 2 types of ICP, and the personal annual volume of ICPs. Only 3.3% of interventional cardiologists were satisfied with PPE and 83.0% of them complained of physical toll caused by heavy PPE. 90.7% were willing to conduct ICP without radiation exposure. CONCLUSIONS: Body pain was the main OHH in interventional cardiologists likely due to wearing heavy lead PPE for long working hours. Besides training more interventional cardiologists, the adoption of emerging technologies without heavy lead PPE will be a promising way to reduce the OHH burden.