A pilot study of core body temperatures in healthcare workers wearing personal protective equipment in a high-level isolation unit

Herstein, Jocelyn J.; Abdoulaye, Abdoulaziz A.; Jelden, Katelyn C.; Beam, Elizabeth L.; Gibbs, Shawn G.; Hewlett, Angela; Vasa, Angela; Boulter, Kathleen C.; Stentz, Terry L.; Kopocis-Herstein, Kelli R.; ElRayes, Wael; Wichman, Chris; Lowe, John J.

doi:10.1080/15459624.2021.1949459

Cited by 9 publications

(5 citation statements)

References 15 publications

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“…This T re limit is within the range of general recommendation of measures against excessive heat strain by ACGIH regarding the body core temperature of 38.0 • C for unselected unacclimatised workers and 38.5 for medically selected and acclimatized personnel [32]. In similar studies on work in PPE in hot environments, comparable maximum body core temperatures above 38 [35], or even up to 39.9 • C [36] were observed in the real work environment. For extreme situations, the PTS tool presents a limit of T re = 39 • C also, which is completely unbearable for most PPE users and can even be considered as a highly health-threatening condition.…”

Section: Discussionsupporting

confidence: 69%

Applicability of Human Thermophysiological Model for Prediction of Thermal Strain in PPE

et al. 2023

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The use of personal protective equipment (PPE) is essential to protect the human body in hazardous environments or where there is a risk of CBRN agents. However, PPE also poses a barrier to evaporative heat dissipation, therefore increasing heat accumulation in the body. In our research, we investigated the applicability of thermophysiological models for the prediction of thermal strain and the permissible working time in a contaminated environment when the usage of protective ensembles is required. We investigated the relationship between the thermal insulation characteristics of four types of PPE against CBRN agents and the induced thermal strain in a set of real physiological strain tests with human probands wearing the PPE in a climatic chamber. Based on the results, we compared the predictions using two thermophysiological models—Predicted Heat Strain Index (PHS) and FIALA-based model of thermal comfort (FMTK)—with the experimental data. In order to provide a user-friendly platform for the estimation of thermal stress in PPE, a user-friendly computational tool, Predictor of Thermal Stress (PTS), was developed. The PTS tool is based on an extensive database of simulated calculations using an FMTK model based on PPE characteristics, environmental conditions, individual parameters, and expected workload. The PTS tool was validated by means of the results from real tests in a climatic chamber. The PTS was shown to be an easy-to-use computational tool, which can be run on a regular PC, based on real data applicable for the estimation of the permissible work time limit with regard to thermal strain in PPE under various conditions.

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Section: Discussionsupporting

confidence: 69%

Applicability of Human Thermophysiological Model for Prediction of Thermal Strain in PPE

et al. 2023

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“…Therefore, we opted for the T core , T sk , and HR parameters as sensitive physiological indicators, which aligns with prior research. 31,32…”

Section: Resultsmentioning

confidence: 99%

“…Therefore, we opted for the T core , T sk , and HR parameters as sensitive physiological indicators, which aligns with prior research. 31,32 Prediction of Safe Working Hours Gray system theory possesses unparalleled advantages in addressing low-information and small sample fuzzy systems. A DGM(1,1) model, the first-order univariate model, provides a theoretical foundation for transforming the DGM(1,1) model into a continuous form, thus increasing its prediction capacity.…”

Section: Selection Of Physiological Indicesmentioning

confidence: 99%

Determining Safe Working Hours of Wearing Medical Disposable Protective Clothing From Physiological Thermal Limits: A Pilot Study

Li,

Cui,

Huang

et al. 2024

AATCC Journal of Research

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Despite the mandatory use of medical disposable protective clothing to protect against infectious hazards, how to determine optimal safe working hours induced by physical fatigue while wearing medical disposable protective clothing remains unknown. Driven by these questions, here we quantify the extent of physical fatigue experienced by medical staff wearing medical disposable protective clothings in isolation wards to identify a safe work duration. Eight healthy males were subjected to light (2.1 km/h) and moderate (4.3 km/h) treadmill exercises while wearing two different ensembles. Four physiological (tympanic temperature Tcore, mean skin temperature Tsk, heart rate, and sweat loss) and two subjective indicators (thermal sensation and humidity sensation) were measured. We then introduced a discrete gray model(1,1) to determine safe working hours. The study indicated that even at lower temperatures, prolonged wearing of medical disposable protective clothing could significantly affect physiological indicators such as Tcore and Tsk ( p < 0.001), with Tcore being the predominant factor limiting safe working hours. Regarding medical disposable protective clothing-1-light, medical disposable protective clothing-1-moderate, medical disposable protective clothing-2-light, and medical disposable protective clothing-2-moderate intensity activities, the safe working hours were 6.33, 2.83, 2.83, and 2.25 h. This article presented a new approach to determining safe working hours for wearing medical disposable protective clothing from physiological thermal limits with small sample data. However, this is a preliminary study, and further validation of the prediction model through additional experiments is necessary.

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“…Key risks related to PPE in HLIUs include impairment of occupational well-being, performance and contamination of PPE, or the environment during donning, doffing and care 40. A previous investigation demonstrated raised core body temperature in HCWs performing care in an HLIU, a subset of whom reported symptoms of heat exhaustion 41. Another investigation demonstrated that HCWs experience an increase in physical load while doffing PPE 40.…”

Section: Resultsmentioning

confidence: 99%

“… 40 A previous investigation demonstrated raised core body temperature in HCWs performing care in an HLIU, a subset of whom reported symptoms of heat exhaustion. 41 Another investigation demonstrated that HCWs experience an increase in physical load while doffing PPE. 40 Restricting the number of hours HCWs are permitted to wear PPE and including balancing aids are strategies that have been employed to mitigate the physical effects of PPE on HCWs.…”

Section: Resultsmentioning

confidence: 99%

A narrative review of high-level isolation unit operational and infrastructure features

et al. 2023

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High-level isolation units (HLIUs) are specially designed facilities for care and management of patients with suspected or confirmed high-consequence infectious diseases (HCIDs), equipped with unique infrastructure and operational features. While individual HLIUs have published on their experiences caring for patients with HCIDs and two previous HLIU consensus efforts have outlined key components of HLIUs, we aimed to summarise the existing literature that describes best practices, challenges and core features of these specialised facilities. A narrative review of the literature was conducted using keywords associated with HLIUs and HCIDs. A total of 100 articles were used throughout the manuscript from the literature search or from alternate methods like reference checks or snowballing. Articles were sorted into categories (eg, physical infrastructure, laboratory, internal transport); for each category, a synthesis of the relevant literature was conducted to describe best practices, experiences and operational features. The review and summary of HLIU experiences, best practices, challenges and components can serve as a resource for units continuing to improve readiness, or for hospitals in early stages of developing their HLIU teams and planning or constructing their units. The COVID-19 pandemic, a global outbreak of mpox, sporadic cases of viral haemorrhagic fevers in Europe and the USA, and recent outbreaks of Lassa fever, Sudan Ebolavirus, and Marburg emphasise the need for an extensive summary of HLIU practices to inform readiness and response.

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A pilot study of core body temperatures in healthcare workers wearing personal protective equipment in a high-level isolation unit

Cited by 9 publications

References 15 publications

Applicability of Human Thermophysiological Model for Prediction of Thermal Strain in PPE

Applicability of Human Thermophysiological Model for Prediction of Thermal Strain in PPE

Determining Safe Working Hours of Wearing Medical Disposable Protective Clothing From Physiological Thermal Limits: A Pilot Study

A narrative review of high-level isolation unit operational and infrastructure features

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