Occupational Heat Stress and Practical Cooling Solutions for Healthcare and Industry Workers During the COVID-19 Pandemic

Foster, Josh; Hodder, Simon; Goodwin, James; Havenith, George

doi:10.1093/annweh/wxaa082

Cited by 36 publications

(40 citation statements)

References 53 publications

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“…The discrepancy between our perceptual heat strain results and those of the online survey in the UK may be due to differences in PPE wear time, as ~73% of health care personnel in the UK have work bouts longer than four hours compared to ~2.5 hours in our study population. Besides, the environmental conditions in healthcare settings in the UK, especially in old buildings, are demonstrated to be more severe with higher ambient air temperatures (24-29°C)23 compared to our study (~23°C).Physiological heat strainThe link between PPE use and physiological heat strain in occupational work is well established24 . The high evaporative resistance of PPE materials markedly limits the heat exchange with the environment through convection and evaporation of sweat[1][2][3] , causing T gi to increase in proportion to working intensity.…”

mentioning

confidence: 37%

Cooling vests alleviate perceptual heat strain perceived by COVID-19 nurses

Korte¹,

Bongers²,

Catoire³

et al. 2021

Temperature

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Cooling vests alleviate heat strain. We quantified the perceptual and physiological heat strain and assessed the effects of wearing a 21°C phase change material cooling vest on these measures during work shifts of COVID-19 nurses wearing personal protective equipment (PPE). Seventeen nurses were monitored on two working days, consisting of a control (PPE only) and a cooling vest day (PPE + cooling vest). Sub-PPE air temperature, gastrointestinal temperature (T gi ), and heart rate (HR) were measured continuously. Thermal comfort (2 [1–4] versus 1 [1–2], p condtition < 0.001) and thermal sensation (5 [4–7] versus 4 [2–7], p condition < 0.001) improved in the cooling vest versus control condition. Only 18% of nurses reported thermal discomfort and 36% a (slightly) warm thermal sensation in the cooling vest condition versus 81% and 94% in the control condition (OR (95%CI) 0.05 (0.01–0.29) and 0.04 (<0.01–0.35), respectively). Accordingly, perceptual strain index was lower in the cooling vest versus control condition (5.7 ± 1.5 versus 4.3 ± 1.7, p condition < 0.001, respectively). No differences were observed for the physiological heat strain index T gi and rating of perceived exertion across conditions. Average HR was slightly lower in the cooling vest versus the control condition (85 ± 12 versus 87 ± 11, p condition = 0.025). Although the physiological heat strain among nurses using PPE was limited, substantial perceptual heat strain was experienced. A 21°C phase change material cooling vest can successfully alleviate the perceptual heat strain encountered by nurses wearing PPE.

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mentioning

confidence: 37%

Cooling vests alleviate perceptual heat strain perceived by COVID-19 nurses

Korte¹,

Bongers²,

Catoire³

et al. 2021

Temperature

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“…Offering opportunities and implementing the right policies appears important also because in our study, the overwhelming majority of nurses and healthcare workers were not able to effectively deploy countermeasures against heat stress on their own. As two thirds of study participants (67%) reported that they drank more water, it may make sense for healthcare centres to offer extra water or ice slurries, as has been recommended in one recent study [9]. Offering cold water temperatures has both a cooling effect and increases the likelihood that nurses take up more fluid during their shifts.…”

Section: Discussionmentioning

confidence: 99%

“…Offering cold water temperatures has both a cooling effect and increases the likelihood that nurses take up more fluid during their shifts. Moreover, training staff to frequently drink water will not only help during heat waves but will in general work against another common danger in the workplace - dehydration [9]. One possibility to incorporate this into the nursing shifts would be for the employer or hospital to inform nurses of this option and offering boxes filled with ice for everyone to use.…”

Section: Discussionmentioning

confidence: 99%

“…In cases where it is difficult to implement air conditioning, mobile cooling devices can help; less than a fifth of hospitals, nursing homes and ambulatory care settings had those available at the time of our survey. Foster et al recommend a combination of ingestion of water and ice slurries, air conditioning - if financially possible for the corresponding institution - and shading in areas that are strongly impacted by heat [9].…”

Section: Discussionmentioning

confidence: 99%

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Hot days and Covid-19 – unusual heat stress for nursing professions in Germany

Lagally

Mertes

et al. 2021

Preprint

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ObjectivesOur aim was to identify whether working during hot days alongside with Covid-19 related personal protective equipment causes heat stress for nursing professionals in Germany.MethodsUsing an online survey, we assessed the impact of hot weather on nursing staff performing in personal protective equipment. A random selection of nursing staff from hospitals, nursing homes and outpatient care participated in the survey.ResultsOut of 428 participants, 6.3% were between 16 and 25 years old, 22.8% between 26 and 35 years, 21.9% between 36 and 45 years, 30.5% between 45 and 55 years, 18.2% between 56 and 65 years, and 0.3% were older than 65 years. Out of all participants, 18.2% were male and 82.5% female. The results of the survey showed that 48.3% had more than 20 years of experience in nursing and 46.2% cardiac, pulmonary, or other pre-existing conditions. Work was found exhaustive while working in PPE by 96.5% of the participants, and 93% complained of worse breathing. We found out that 85.8% reported difficulties to focus. Many workplaces turned out to lack adequate heat protection, with distinct differences concerning the amount of prophylactic and heat mitigating measures across institutions.ConclusionsOur results clearly show that employers must make more of an effort to provide adequate heat protection for their nursing staff. In order to secure the public health care, there is a need for action, especially in the case of previous conditions of caregivers.What is already known about this subject?►Working in personal protective equipment is often needed during pandemics, to protect nurses, doctors and staff from an infection.►However, the equipment can also hamper efficiency and productivity of healthcare workers and lead to personal discomfort, for example, during heat waves.What are the new findings?►According to our study, nurses and nursing assistants in Germany are often older than 45 years and, in many cases, suffer from pre-existing conditions, which exacerbate the problems with personal protective equipment during periods of hot temperatures.►Many healthcare institutions do not offer adequate ways to mitigate heat stress for their staff.How might this impact on policy or clinical practice in the foreseeable future?►The results from this study can inform policy makers and clinical practitioners to modify their protocols to include better protective measures during extreme heat or other adverse environmental conditions.

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“…Many Western countries already have adopted and implemented heat health action plans ( Bittner et al, 2014 ; Casanueva et al, 2019 ). With the Covid-19 pandemic, is it necessary to adapt these plans to address the conflicting advice for protection against Covid-19 and for heat management ( Daanen et al, 2020 ; Foster et al, 2020 ; Lee et al, 2020 ; Martinez et al, 2020 ; Morabito et al, 2020 ). Information addressing this issue was compiled and the first recommendations have been published on national and international levels (Global Heat Health Information Network (GHHIN), 2020).…”

Section: Introductionmentioning

confidence: 99%

COVID-19 and heat waves: New challenges for healthcare systems

Blüml

Daanen

Deering³

et al. 2021

Environmental Research

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Heat waves and Covid-19 overlap, as this pandemic continues into summer 2021. Using a narrative review, we identified overlapping risk groups and propose coping strategies. The high-risk groups for heat-related health problems as well as for high-risk COVID-19 groups overlap considerably (elderly with pre-existing health conditions). Health care facilities will again be challenged by Covid-19 during such heat waves. Health care personnel are also at risk of developing heat related health problems during hot periods due to the use of personal protective equipment to shield themselves from SARS-CoV-2 and must therefore be protected from excessive heat periods. Some existing recommendations for heat health protection contradict recommendations for COVID-19 protection. This paper provides a preliminary overview of possible strategies and interventions to tackle these ambiguities. The existing recommendations for protection against heat-related illnesses need revisions to determine whether they include essential aspects of infection control and occupational safety and how they may be supplemented.

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Occupational Heat Stress and Practical Cooling Solutions for Healthcare and Industry Workers During the COVID-19 Pandemic

Cited by 36 publications

References 53 publications

Cooling vests alleviate perceptual heat strain perceived by COVID-19 nurses

Cooling vests alleviate perceptual heat strain perceived by COVID-19 nurses

Hot days and Covid-19 – unusual heat stress for nursing professions in Germany

COVID-19 and heat waves: New challenges for healthcare systems

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