Field investigation of the heat stress in outdoor of healthcare workers wearing personal protective equipment in South China

Zhu, Yong; Mao, Yudong; Li, Yanling; Tang, Ting; Jiang, Hangjin; Qiao, Sicheng; Lin, Shaopeng; Zheng, Zhimin; Fang, Zhaosong; Chen, Xiaohui

doi:10.3389/fpubh.2023.1166056

Cited by 3 publications

(2 citation statements)

References 62 publications

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“…This provided an opportunity for researchers to engage in studies related to outdoor thermal comfort. For example, there have been studies regarding the impact of personal protective equipment such as masks on outdoor thermal comfort [98][99][100][101]. Therefore, the research in China during the pandemic was not significantly impacted by external factors.…”

Section: Changes In the Annual Number Of Publications Between China A...mentioning

confidence: 99%

A Comparative Analysis of Outdoor Thermal Comfort Indicators Applied in China and Other Countries

Tao,

Zhu,

et al. 2023

Sustainability

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Outdoor thermal comfort is an important criterion for evaluating the quality of outdoor activity environments and is also a significant indicator for assessing sustainable building design. Over the past century, more than 165 indoor and outdoor thermal comfort indexes have been developed to define human thermal comfort conditions under various circumstances and to quantify indoor and outdoor thermal environmental conditions. However, in the process of outdoor thermal comfort indicators becoming widely used worldwide, it remains a pressing research issue to compare the current state of application in China and other countries, identify the key areas of application for both sides, and outline the trends in outdoor thermal comfort index application. This study analyzed 346 articles on outdoor thermal comfort indicators. Employing bibliometric methods, we outline the general landscape of outdoor thermal comfort index applications in China and other countries. Additionally, we utilize comparative analysis to uncover similarities and differences in the research focus on outdoor thermal comfort. The research findings indicate the following: (1) Compared to China, other countries started outdoor thermal comfort index application research earlier. Their papers have higher average citation counts and engage in close academic collaborations. However, the quantity of published papers is fewer than in China. (2) The top five frequently used indexes in both China and other countries are PET (including mPET), UTCI, PMV, SET* (including OUT_SET*), and THI (including DI). China tends to use PET and UTCI more frequently than other countries. (3) The potential future directions for outdoor thermal comfort index applications in both China and other countries include: “monitoring and controlling regional outdoor thermal comfort at the temporal and spatial scales”, “multi-factors coupling effects on outdoor thermal comfort”, “human health assessment and prediction based on outdoor thermal comfort”, and “utilizing computational algorithms to calculate outdoor thermal comfort”. This study can serve as a reference for researchers and designers in the industry, contributing to the creation of sustainable outdoor environments.

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Section: Changes In the Annual Number Of Publications Between China A...mentioning

confidence: 99%

A Comparative Analysis of Outdoor Thermal Comfort Indicators Applied in China and Other Countries

Tao,

Zhu,

et al. 2023

Sustainability

View full text Add to dashboard Cite

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“…Inthavong et al [31] also showed a cooling effect on nasal mucosa from the latent heat of evaporation. Facial temperature and discomfort in healthcare workers were studied by Lembo et al [32], Zhu et al [33,34], and Beonell et al [35]; all reported a significant increase in facial temperature, but the increasing magnitude varied with the mask type, length of wearing time, and the individual's physical activity. Surgical facemasks were rated significantly lower for heat perception and overall discomfort than both N95 facemasks [36].…”

Section: Introductionmentioning

confidence: 99%

Impacts of Mask Wearing and Leakages on Cyclic Respiratory Flows and Facial Thermoregulation

Barari,

Si,

2023

Fluids

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Elevated face temperature due to mask wearing can cause discomfort and skin irritation, making mask mandates challenging. When thermal discomfort becomes intolerable, individuals instinctively or unknowingly loosen or remove their facemasks, compromising the mask’s protective efficacy. The objective of this study was to numerically quantify the microclimate under the mask and facial thermoregulation when wearing a surgical mask with different levels of misfit. An integrated ambient–mask–face–airway computational model was developed with gaps of varying sizes and locations and was validated against complementary experiments. The low Reynolds number (LRN) k-ω turbulence model with porous media was used to simulate transient respiratory flows. Both skin convective heat transfer and tissue heat generation were considered in thermoregulation under the facemask, besides the warm air exhaled from the body and the cool air inhaled from the ambient. The results of this study showed that when wearing a surgical mask with a perfect fit under normal breathing, the temperature at the philtrum increased by 4.3 °C compared to not wearing a mask. A small gap measuring 0.51 cm2 (gap A) at the nose top resulted in 5.6% leakage but reduced the warming effect by 28% compared to zero gap. Meanwhile, a gap of 4.3 cm2 (R1L1) caused 42% leakage and a 62% reduction in the warming effect. Unique temporospatial temperature profiles were observed at various sampling points and for different gap sizes, which correlated reasonably with the corresponding flow dynamics, particularly close to the gaps. The temperature change rate also exhibited patterns unique to the gap site and sampling point, with distinctive peaks occurring during the inspiratory–expiratory flow transitions. These results have the significant implications that by using the temporospatial temperature profiles at several landmark points, the gap location can potentially be pinpointed, and the gap size and leakage fractions can be quantified.

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Filovirus outbreak responses and occupational health effects of chlorine spraying in healthcare workers: a systematic review and meta-analysis of alternative disinfectants and application methods

Fontana,

Stabile,

Caracci

et al. 2024

Preprint

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Objective: In the context of filovirus outbreaks, chlorine spraying has been the standard for infection prevention and control. Due to potential occupational health risks, public health institutions now recommend wiping, which is labor-intensive and may increase the risk of heat stress for healthcare workers wearing personal protective equipment. This systematic review and meta-analysis quantified the health effects of occupational exposure to chlorine-based products compared to other disinfectants, and the effects of spraying compared to general disinfection tasks (GDTs) like wiping and mopping, in healthcare settings. Data sources, design and eligibility criteria: MEDLINE, Scopus, and ScienceDirect were searched for studies addressing the association between exposure to disinfectants applied by different application methods and occupational diseases in healthcare settings. Risk of bias was assessed by two independent reviewers using a validated tool. Data extraction and synthesis: Two reviewers independently screened and performed data extraction and synthesis. A third reviewer resolved disagreements. Meta-analyses were conducted using fixed- and random-effects models based on the Higgins I2 statistic. Results: 30 studies investigating chlorine-based products (7,123 participants), glutaraldehyde (6,256 participants), peracetic acid, acetic acid and hydrogen peroxide (4,728 participants), quaternary ammonium compounds (QACs) (9,270 participants), use of spray (4,568 participants) and GDTs (3,480 participants) were included. Most had a cross-sectional design and high risk of bias. Meta-analysis indicates a significant association between respiratory conditions and exposure to chlorine-based products (OR 1.71, 95%CI 1.41-2.08), glutaraldehyde (OR 1.44, 95%CI 1.14-1.81), QACs (OR 1.30, 95%CI 1.06-1.60), use of spray (OR 2.25, 95%CI 1.61-3.14) and GDTs (OR 2.20, 95%CI 1.66-2.90). The relative odds ratio (ROR) of respiratory conditions for chlorine-based products compared to QACs was 0.76 (95%CI 0.62-0.94). The ROR for the use of spray compared to GDTs was 0.98 (95%CI 0.74-1.29). Strengths include evaluating respiratory health risks of disinfectants, applying a validated tool, using both fixed- and random-effects models, and comparing pooled effect sizes. Limitations include high risk of bias for the majority of included articles, varying confounder adjustments, underreported non-respiratory outcomes, and unspecified disinfectants and PPE use for spray and GDTs articles. Conclusion: Chlorine-based disinfectants significantly increase respiratory risk compared to QACs. Sprays and general disinfection tasks present similar risks. Our findings advocate for using less hazardous products like QACs, rather than banning sprays in filovirus outbreak responses to enhance disinfection safety.

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Field investigation of the heat stress in outdoor of healthcare workers wearing personal protective equipment in South China

Cited by 3 publications

References 62 publications

A Comparative Analysis of Outdoor Thermal Comfort Indicators Applied in China and Other Countries

A Comparative Analysis of Outdoor Thermal Comfort Indicators Applied in China and Other Countries

Impacts of Mask Wearing and Leakages on Cyclic Respiratory Flows and Facial Thermoregulation

Filovirus outbreak responses and occupational health effects of chlorine spraying in healthcare workers: a systematic review and meta-analysis of alternative disinfectants and application methods

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