Perceived exertion is as effective as the perceptual strain index in predicting physiological strain when wearing personal protective clothing

Borg, David N; Costello, Joseph; Bach, Aaron J.E.; Stewart, Ian B.

doi:10.1016/j.physbeh.2016.12.009

Cited by 25 publications

(30 citation statements)

References 37 publications

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“…Studies have analyzed the use of PPE and how they affect fine motor skills ( Merchan & Clemente-Suárez, 2019 ; Schumacher, Arlidge, Garnham, & Ahmad, 2017 ) or how the use of PPE influences the quality of resuscitation ( Chen, Lu, Yi, & Chen, 2016 ). In line with our study, other studies addressed the issues of thermal perception and perceived effort when working under these conditions ( Borg, et al., 2017 ) ( Borg, Stewart, & Costello, 2015 ), the increase in HR more than recommended maximum levels ( Martín Rodríguez et al, 2018 ), and the relationship between PPE and headaches ( Ong et al, 2020 ).…”

Section: Discussionsupporting

confidence: 87%

“…The use of PPE by health professionals guarantees performance with tolerable safety margins but, at the same time, generates physiological and psychological stress because of the constraints imposed by reduced breathability, increased body temperature (T), decreasing visibility, and so forth ( Maynard, Kao, & Craig, 2016 ; Martín Rodríguez et al, 2018 ). Studies have analyzed the potential contamination faced by professionals during the removal of PPE ( Kang et al, 2017 ; Tomas et al, 2015 ) and how the body T increases with PPE use ( Borg, Costello, Bach, & Stewart, 2017 ; Buller, Tharion, Duhamel, & Yokota, 2015 ). A recent cross-sectional study focused on the association between PPE and headaches ( Ong et al, 2020 ).…”

Section: Introductionmentioning

confidence: 99%

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Predicting Health Care Workers' Tolerance of Personal Protective Equipment: An Observational Simulation Study

Martin-Rodríguez

Sanz-García

López-Izquierdo

et al. 2020

Clinical Simulation in Nursing

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Background: More recently, due to the coronavirus disease 2019 pandemic, health care workers have to deal with clinical situations wearing personal protective equipment (PPE); however, there is a question of whether everybody will tolerate PPE equally. The main objective of this study was to develop a risk model to predict whether health care workers will tolerate wearing PPE, C category, 4B/5B/6B type, during a 30-minute simulation. Methods: A nonexperimental simulation study was conducted at the Advanced Simulation Center, Faculty of Medicine, Valladolid University (Spain) from April 3rd to 28th, 2017. Health care students and professionals were equipped with PPE and performed a 30-minute simulation. Anthropometric, physiological, and analytical variables and anxiety levels were measured before and after simulation. A scoring model was constructed. Results: Ninety-six volunteers participated in the study. Half the sample presented metabolic fatigue in the 20 minutes after finishing the simulation. The predictive model included female sex, height, muscle and bone mass, and moderate level of physical activity. The validity of the main model using all the variables presented an area under the curve of 0.86 (95% confidence interval: 0.786e0.935), and the validity of the model had an area under the curve of 0.725 (95% confidence interval: 0.559e0.89). Conclusions: Decision-making in biohazard incidents is a challenge for emergency team leaders. Knowledge of health care workers' physiological tolerance of PPE could improve their performance.

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Section: Discussionsupporting

confidence: 87%

Section: Introductionmentioning

confidence: 99%

Predicting Health Care Workers' Tolerance of Personal Protective Equipment: An Observational Simulation Study

Martin-Rodríguez

Sanz-García

López-Izquierdo

et al. 2020

Clinical Simulation in Nursing

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“…Massive sweating for this protocol was defined as standard upper body clothing (two layers: T-shirt, long sleeve shirt) being still visibly wet after around 30 min after the effort. No easy to apply objective heat exposure rating exists, but subjective rating which we used for this report has been shown to be just as effective [ 50 , 51 ]. Physical strain was typically not restricted only to WS in his role as field forensic pathologist: other specialists, such as forensic scientists, all working in protective gear, were usually soaked, too.…”

Section: Forensic Medicine As a Work Environmentmentioning

confidence: 99%

Case-study of a user-driven prosthetic arm design: bionic hand versus customized body-powered technology in a highly demanding work environment

Schweitzer

Thali

Egger

2018

J NeuroEngineering Rehabil

114

124

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BackgroundProsthetic arm research predominantly focuses on “bionic” but not body-powered arms. However, any research orientation along user needs requires sufficiently precise workplace specifications and sufficiently hard testing. Forensic medicine is a demanding environment, also physically, also for non-disabled people, on several dimensions (e.g., distances, weights, size, temperature, time).MethodsAs unilateral below elbow amputee user, the first author is in a unique position to provide direct comparison of a “bionic” myoelectric iLimb Revolution (Touch Bionics) and a customized body-powered arm which contains a number of new developments initiated or developed by the user: (1) quick lock steel wrist unit; (2) cable mount modification; (3) cast shape modeled shoulder anchor; (4) suspension with a soft double layer liner (Ohio Willowwood) and tube gauze (Molnlycke) combination. The iLimb is mounted on an epoxy socket; a lanyard fixed liner (Ohio Willowwood) contains magnetic electrodes (Liberating Technologies). An on the job usage of five years was supplemented with dedicated and focused intensive two-week use tests at work for both systems.ResultsThe side-by-side comparison showed that the customized body-powered arm provides reliable, comfortable, effective, powerful as well as subtle service with minimal maintenance; most notably, grip reliability, grip force regulation, grip performance, center of balance, component wear down, sweat/temperature independence and skin state are good whereas the iLimb system exhibited a number of relevant serious constraints.ConclusionsResearch and development of functional prostheses may want to focus on body-powered technology as it already performs on manually demanding and heavy jobs whereas eliminating myoelectric technology’s constraints seems out of reach. Relevant testing could be developed to help expediting this. This is relevant as Swiss disability insurance specifically supports prostheses that enable actual work integration. Myoelectric and cosmetic arm improvement may benefit from a less forgiving focus on perfecting anthropomorphic appearance.

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“…Previous studies have analyzed the use of PPE and how these protective devices affect fine motor skills [18,19], or how the use of PPE influences the performance of a quality resuscitation [20]. Other types of studies addressed the issues of thermal perception and the perceived effort when working under these conditions [21,22], or the increase in the HR above the recommended maximum levels [23]. However, we were unable to found equivalent studies to the one presented here..…”

Section: Discussionmentioning

confidence: 80%

“…[6,7], that certainly may affect the performance and security of the worker. Although some studies analyze the potential contamination of professionals during the removal of the PPE [8,9], or how body temperature increases with the use of these equipments [10,11], no study until now has focused on how wearing PPE affect the physiological status or what is the recommended time for wearing the PPE.…”

Section: Introductionmentioning

confidence: 99%

Fatigue among health care workers during emergency interventions using biological personal protective equipment: an observational simulation study

Martin-Rodríguez

Sanz-García

López-Izquierdo

et al. 2020

Preprint

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Background : Biohazard incidents are ordinary situations usually managed by health systems with the mandatory priority of preventing the spread of the pathogen. Health care workers in charge of dealing with these situations must be equipped with personal protective equipment (PPE) for her/his own security. The main objective of this study was developing a risk model to predict whether health care workers will tolerate wearing PPE, III category, 4B / 5B / 6B type, against biological risks during a 30 minutes intervention. Methods : A preliminary, prospective, simulation study, without intervention was conducted at the Advanced Simulation Center at the Medicine Faculty of Valladolid University (Spain) from April 3rd to 28th, 2017. Students and professional's health care were equipped with a PPE and performed a 30 minutes-long biohazard simulation. Anthropometric, physiological, analytical variables, and anxiety levels were measured pre- and post-simulation. A scoring model was constructed by using the estimate regression coefficients of the significant variables obtained from a multivariate model of the logistic regression for the outcome variable. Results : 96 volunteers with median age of 26 years (25th-75th percentile: 22-41 years) of which 56 (58.3%) were women enter into the test. Half of the sample presented metabolic fatigue after 20 minutes of finishing the simulation. The predictive model included female sex, height, both muscle and bone mass and moderate level of physical activity. The validity of the main model using all the variables presented an area under the curve (AUC) of 0.86 (95%CI: 0.786-0.935), and the validity of the model presented an AUC of 0.725 (95%CI: 0.559-0.89). Conclusions : Decision-making in biohazard incidents is a challenge for emergency team leaders. An a priori knowledge of physiological tolerance of wearing a PPE of the health care workers could improve their performance. The model presented here could help in the assessment of the worker response under biohazard conditions.

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Perceived exertion is as effective as the perceptual strain index in predicting physiological strain when wearing personal protective clothing

Cited by 25 publications

References 37 publications

Predicting Health Care Workers' Tolerance of Personal Protective Equipment: An Observational Simulation Study

Predicting Health Care Workers' Tolerance of Personal Protective Equipment: An Observational Simulation Study

Case-study of a user-driven prosthetic arm design: bionic hand versus customized body-powered technology in a highly demanding work environment

Fatigue among health care workers during emergency interventions using biological personal protective equipment: an observational simulation study

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