Does the fit of personal protective equipment affect functional performance? A systematic review across occupational domains

Abstract

Objective To explore the effect of personal protective equipment (PPE) fit on functional performance across a range of occupational domains. Background PPE introduces an ergonomic, human systems integration, and mass burden to the wearer, and these factors are thought to be amplified if PPE is ill-fitting. However, few studies have considered the role of fit (static, dynamic, and cognitive) when evaluating PPE-related performance detriments in occupational settings. Method A systematic literature review was conducted to identify relevant studies, which were then critically appraised based on methodological quality and collated to compare key findings and present evidence-based recommendations for future research directions across a range of occupational domains. Results 16 published studies met the inclusion criteria, 88% of which found that the fit of PPE had a statistically significant effect on occupational performance. Poorly sized PPE resulted in slower or increased reaction time; decreased range of motion or mobility; decreased endurance or tolerance; decreased pulmonary function; and altered muscle activation. Limited research met the inclusion criteria and those that did had risks of bias in methodology quality. Conclusion Future research evaluating the effect of PPE on performance in occupational settings should aim to recruit a more representative population; consider sex as a covariate; quantify and evaluate PPE fit and performance when integrated with all relevant equipment items; include outcome measures related to all three categories of fit (static, dynamic, cognitive); and assess performance of operationally relevant tasks.

COVID-19: Masks do not influence neurocognitive performance during a shift at the emergency department

“…None of the participants had experience with the NHPT or a similar test. The number of patients treated during the shift was 22 (IQR: [15][16][17][18][19][20][21][22][23][24][25][26].…”

“…Other studies investigated the fit of PPE on functional performance across various occupational domains. [18] Studies investigating healthcare personnel focused on the effects of gloves. [19,20] To our knowledge, no study has investigated the effects of FFP2 masks in real-life emergency medical care settings using standardized psychometric tests.…”

Impact of COVID‐19 on occupational injuries and illnesses among nursing care facility workers: Analysis of California workers' compensation data, 2019–2021

“…[25][26][27] Wearing PPE, such as full-body protective clothing and face shields, can also affect workers' body movements, comfort, and visibility. [28][29][30] The increased physical and psychological job demands may increase the risk of injury for workers. However, there has been a paucity of research on how the COVID-19 pandemic affected the risk of occupational injury, whereas considerable research has addressed its negative effects on mental health in healthcare workers.…”

“…Moreover, several studies reported high or increased prevalence of adverse skin reactions from the prolonged use of PPE 25–27 . Wearing PPE, such as full‐body protective clothing and face shields, can also affect workers' body movements, comfort, and visibility 28–30 …”