Physiological Evaluation of Personal Protective Ensembles Recommended for Use in West Africa

Coca, Aitor; Quinn, Tyler D.; Kim, Jung-Hyun; Wu, Tianzhou; Powell, Jeff; Roberge, Raymond J.; Shaffer, Ronald E.

doi:10.1017/dmp.2017.13

Cited by 42 publications

(27 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Similar result was found by MacFarlane, Chapman, Benke,et al (2008) where they found , up to 10-40% of farmers routinely do not use PPE at all 10 . Besides discomfort, PPE introduces additional physiological burden to the user in terms increase in heat stress, heart rate and core temperature significantly 11 . This could affect compliance to the recommended PPEs unless there is system for cooling the room.…”

Section: Figure 1 Problem Of Ppe Usage Discussionmentioning

confidence: 99%

Barriers and factors affecting personal protective equipment usage in St. Mary’s Hospital Lacor in Northern Uganda

Okello¹,

Kansime²,

Odora³

et al. 2017

East. Cent. Afr. J. Surg.

View full text Add to dashboard Cite

Background: To protect health workers (HCWs) from risky occupation exposure, CDC developed the universal precautions (Ups) including Personal Protective Equipment (PPEs). However compliance to it by HCWs has remained poor even in high-risk clinical situation . The objective of this study was to identify and describe the factors that influence a HCWs' decision to wear PPEs and the barriers that exist in preventing their use Methods: A cross-sectional survey was carried out in the St. Mary's Hospital Lacor in all the wards to collected quantitative information as well as qualitative and observational data on PPE use Results: Out of the total 59 respondents, 2% do not know the purpose of PPE, 23.7% do not know how to don and doff PPEs, 13.6% do not use PPE even when indicated and 10% are not using an appropriate PPE. The main barriers relates to poor fitting and weak domestic gloves, few of aprons, frequent stock out and inadequate PPE as well as lack of training in PPE Conclusion: This study provides a baseline for measuring the effectiveness of interventions to improve compliance.

show abstract

Section: Figure 1 Problem Of Ppe Usage Discussionmentioning

confidence: 99%

Barriers and factors affecting personal protective equipment usage in St. Mary’s Hospital Lacor in Northern Uganda

Okello¹,

Kansime²,

Odora³

et al. 2017

East. Cent. Afr. J. Surg.

View full text Add to dashboard Cite

show abstract

“…This is an important issue given that comfort can influence both PPE use compliance and duration of work cycles. [1,2] An oft-cited contributor to respiratory protective equipment-related discomfort is the perception of increased warmth, either regional (i.e., facial area) or global. [1] Recently, much interest has been directed towards the role of powered air-purifying respirators (PAPRs) in healthcare settings during infectious disease outbreaks, based upon multiple advantageous features, [3] including possible amelioration of some heat-related issues via cooling effects of PAPR air currents.…”

Section: Introductionmentioning

confidence: 99%

Powered air-purifying respirator use in healthcare: Effects on thermal sensations and comfort

Powell

Kim

Roberge

2017

Journal of Occupational and Environmental Hygiene

Self Cite

View full text Add to dashboard Cite

Twelve subjects wore an N95 filtering facepiece respirator (N95 FFR), one tight-fitting full facepiece powered air-purifying respirator (PAPR), two loose-fitting PAPRs, and one elastomeric/PAPR hybrid for 1 hr each during treadmill walking at 5.6 km/hr while undergoing physiological and subjective response monitoring. No significant interaction (p ≥ .05) was noted between the five respirators in heart rate, respiratory rate, oxygen saturation, transcutaneous carbon dioxide, and perceptions of breathing effort or discomfort, exertion, facial heat, and overall body heat. Respirator deadspace heat/humidity were significantly greater for the N95 FFR, whereas tympanic forehead skin temperatures were significantly greater for the hybrid PAPR. Temperature of the facial skin covered by the respirator was equivalent for the N95 FFR and hybrid PAPR, and both were significantly higher than for the other three PAPRs. Perception of eye dryness was significantly greater for a tight-fitting full facepiece PAPR than the N95 FFR and hybrid PAPR. At a low-moderate work rate over 1 hr, effects on cardiopulmonary variables, breathing perceptions, and facial and overall body heat perceptions did not differ significantly between the four PAPRs and a N95 FFR, but the tight-fitting, full facepiece PAPR increased perceptions of eye dryness. The two loose-fitting PAPRs and the full facepiece tight-fitting PAPR ameliorated exercise-induced increases in facial temperature, but this did not translate to improved perception of facial heat and overall body heat.

show abstract

“…(27) It is easy to demonstrate that work with protective equipment against biological hazard complicates technical procedures; however, so far, no extensive studies have shown that the use of PPE requires highly intense physical effort that prohibits working for large time intervals. (28) We can conclude that the parameters studied reveal a metabolic pattern of poor physiological tolerance after the use of individual protection equipment level D in the observed sample. Consequently, future studies could derive a predictive rule that allows us to assess which professionals may tolerate and adapt better to work in a biological incident.…”

Section: Discussionmentioning

confidence: 56%

Metabolic fatigue in resuscitators using personal protection equipment against biological hazard

Martin-Rodríguez¹

2019

Invest Educ Enferm

View full text Add to dashboard Cite

Objective. To describe the effects of wearing individual protection equipment against biological hazard when performing a simulated resuscitation.Methods. Uncontrolled quasi-experimental study involving 47 volunteers chosen by random sampling stratified by sex and professional category. We determined vital signs, anthropometric parameters and baseline lactate levels; subsequently, the volunteers put on level D individual protection equipment against biological hazard and performed a simulated resuscitation for 20 minutes. After undressing and 10 minutes of rest, blood was extracted again to determine lactate levels. Metabolic fatigue was defined as a level of lactic acid above 4 mmol/L at the end of the intervention.Results. 25.5% of the participants finished the simulation with an unfavorable metabolic tolerance pattern. The variables that predict metabolic fatigue were the level of physical activity and bone mass -in a protective formand muscle mass. People with a low level of physical activity had ten times the probability of metabolic fatigue compared to those with higher levels of activity (44% versus 4.5%, respectively).Conclusion. Professionals who present a medium or high level of physical activity tolerate resuscitation tasks better with a level D individual biological protection suit in a simulated resuscitation.Descriptors: cardiopulmonary resuscitation; personal protective equipment; anaerobic threshold; containment of biohazards; stress, physiological.How to cite this article: Martín-Rodríguez F. Metabolic fatigue in resuscitators using personal protection equipment against biological hazard. Invest. Educ. Enferm. 2019; 37(2):e04ReferencesBarsuk JH, Cohen ER, Wayne DB, Siddall VJ, McGaghie WC. Developing a Simulation-Based Mastery Learning Curriculum: Lessons from 11 Years of Advanced Cardiac Life Support. Simul. Healthc. 2016; 11(1):52–9. Kwon JH, Burnham CAD, Reske KA, Liang SY, Hink T, Wallace MA, et al. Assessment of Healthcare Worker Protocol Deviations and Self-Contamination During Personal Protective Equipment Donning and Doffing. Infect. Control Hosp. Epidemiol. 2017; 38(9):1077-83. Schoch-Spana M, Cicero A, Adalja A, Gronvall G, Kirk Sell T, Meyer D, et al. Global Catastrophic Biological Risks: Toward a Working Definition. Health Secur. 2017; 15(4):323-8. Millett P, Snyder-Beattie A. Existential Risk and Cost-Effective Biosecurity. Health Secur. 2017; 15(4):373-83. Fogel I, David O, Balik CH, Eisenkraft A, Poles L, Shental O, et al. The association between self-perceived proficiency of personal protective equipment and objective performance: An observational study during a bioterrorism simulation drill. Am. J. Infect. Control. 2017; 45(11): 1238-42. Calfee MW, Tufts J, Meyer K, McConkey K, Mickelsen L, Rose L, et al. Evaluation of standardized sample collection, packaging, and decontamination procedures to assess cross-contamination potential during Bacillus anthracis incident response operations. J. Occup. Environ. Hyg. 2016; 13(12): p. 980-92. Narayanan N, Lacy CR, Cruz JE, Nahass M, Karp J, Barone JA, et al. Disaster Preparedness: Biological Threats and Treatment Options. Pharmacotherapy. 2018; 38(2):217-34. Hunt L, Gupta-Wright A, Simms V, al. e. Clinical presentation, biochemical, and haematological parameters and their association with outcome in patients with Ebola virus disease: an observational cohort study. Lancet Infect. Dis. 2015; 15(11):1292–9. Nicaise V. The Sensitivity And Specificity Of The IPAQ For Detecting Intervention Related Changes In Physical Activity. Med. Sci. Sports Exerc. 2011; 43(Sup. 1):607. van Poppel MNM, Chinapaw MJM, Mokkink LB, van Mechelen W, Terwee CB. Physical activity questionnaires for adults: A systematic review of measurement properties. Sports Med. 2010; 40(7):565-600. Baur DA, Bach CW, Hyder WJ, Ormsbee MJ. Fluid retention, muscle damage, and altered body composition at the Ultraman triathlon. Eur. J. Appl. Physiol. 2016; 116(3):447-58. Spartano LN, Lyass GA, Larson DM, Lewis SG, Vasan SR. Abstract 19256: Predicting Exercise Systolic Blood Pressure and Heart Rate at 20 Years of Follow-up: Correlates in the Framingham Heart Study. Circulation. 2015; 132(3):A19256-A19256. Jayasinghe S, Lambert G, Torres S, Fraser S, Eikelis N, Turner A. Hypothalamo-pituitary adrenal axis and sympatho-adrenal medullary system responses to psychological stress were not attenuated in women with elevated physical fitness levels. Endocrine. 2016; 51(2):369-79. Pattani R, Marquez C, Dinyarian C, Sharma M, Bain J, Moore JE, et al. The perceived organizational impact of the gender gap across a Canadian department of medicine and proposed strategies to combat it: a qualitative study. BMC Medicine. 2018; 16(1): p. 48. ¿Morales‐Alamo D, Losa‐Reyna J, Torres‐Peralta R, Martin‐Rincon M, Perez‐Valera M, Curtelin D, ¿et al. What limits performance during whole‐body incremental exercise to exhaustion in humans? J. Physiol. 2015; 593(20):4631–48. Hall MM, Rajasekaran S, Thomsen TW, Peterson AR. Lactate: Friend or Foe. PM R. 2016; 8(3):S8-S15. Ekkekakis P, Hall EE, Petruzzello SJ. Practical markers of the transition from aerobic to anaerobic metabolism during exercise: rationale and a case for affect-based exercise prescription. Prev. Med. 2014; 38(2):149-59. Vikmoen O, Raastad T, Seynnes O, Bergstrøm K, Ellefsen S, Rønnestad BR. Effects of Heavy Strength Training on Running Performance and Determinants of Running Performance in Female Endurance Athletes. PLoS One. 2016; 11(3):e0150. Devlin J, Paton B, Poole L, Sun W, Ferguson C, Wilson J, et al. d lactate clearance after maximal exercise depends on active recovery intensity. J. Sports Med. Phys. Fitness. 2014; 54(3):271-8. Szarpak L, Madziała M, Smereka J. Comparison of endotracheal intubation performed with 3 devices by paramedics wearing chemical, biological, radiological, and nuclear personal protective equipment. Am. J. Emerg Med. 2016; 34(9):1902-3. Szarpak L, Ramirez JG, Buljan D, Drozd A, Madziała M, Czyzewski L. Comparison of Bone Injection Gun and Jamshidi intraosseous access devices by paramedics with and without chemical-biological-radiological-nuclear personal protective equipment: a randomized, crossover, manikin trial. Am. J. Emerg. Med. 2016; 34(7):1307-8. Szarpak L, Truszewski Z, Smereka J, Madziała M, Czyzewski L. Comparison of two intravascular access techniques when using CBRN-PPE: A randomized crossover manikin trial. Am. J. Emerg. Med. 2016; 34(6):1170-2. Szarpak L, Truszewski Z, Gałązkowski R, Czyzewski L. Comparison of two chest compression techniques when using CBRN-PPE: a randomized crossover manikin trial. Am. J. Emerg. Med. 2016; 34(5): 913-5. Stein C, Makkink A, Vincent-Lambert C. The effect of physical exertion in chemical and biological personal protective equipment on physiological function and reaction time. Prehosp Emerg Care. 2010; 14(1):36-44. Ji T, Qian X, Yuan M, Jiang J. Experimental study of thermal comfort on stab resistant body armor. Springerplus. 2016; 5(1):1168. Carter H, Amlôt R. Mass Casualty Decontamination Guidance and Psychosocial Aspects of CBRN Incident Management: A Review and Synthesis. PLoS Curr. 2016; September 27; 8. Verbeek JH. Personal protective equipment for preventing highly infectious diseases due to exposure to contaminated body fluids in healthcare staff. Cochrane Database Syst. Rev. 2016; 4:CD011621. Coca A. Physiological Evaluation of Personal Protective Ensembles Recommended for Use in West Africa. Disaster Med. Public Health Prep. 2017; 11(5): 580-6.

show abstract

Physiological Evaluation of Personal Protective Ensembles Recommended for Use in West Africa

Abstract: Heat stress and PPE training, as well as the implementation of a work-to-rest ratio that avoids dehydration and possible heat stress issues, are recommended. (Disaster Med Public Health Preparedness. 2017;11:580-586).

Cited by 42 publications

References 16 publications

Barriers and factors affecting personal protective equipment usage in St. Mary’s Hospital Lacor in Northern Uganda

Barriers and factors affecting personal protective equipment usage in St. Mary’s Hospital Lacor in Northern Uganda

Powered air-purifying respirator use in healthcare: Effects on thermal sensations and comfort

Metabolic fatigue in resuscitators using personal protection equipment against biological hazard

Contact Info

Product

Resources

About