Abstract
IntroductionThe coronavirus 2019 (COVID-19) pandemic has reinforced the importance of facial protection against droplet transmission of diseases. Healthcare workers wear personal protection equipment (PPE), including face shields and masks. Plastic face shields may have advantages over regular medical masks. Although many designs of face shields exist, there is a paucity of evidence regarding the efficacy of shield designs against droplet transmissions. There is even less published evidence comparing various face shields. Due to the urgency of the pandemic and the health and safety of healthcare workers, we aimed to study the efficacy of various face shields against droplet transmission.MethodsWe simulated droplet transmission via coughing using a heavy-duty chemical spray bottle filled with fluorescein. A standard-adult sized mannequin head was used. The mannequin head wore various face shields and was positioned to face the spray bottle at either a 0°, 45°, or 90° angle. The spray bottle was positioned at and sprayed from 30 centimeters (cm), 60 cm, or 90 cm away from the head. These steps were repeated for all face shields used. Control was a mannequin that wore no PPE. A basic mask was also tested. We collected data for particle count, total area of particle distribution, average particle size, and percentage area covered by particles. We analyzed percent covered by particles using a repeated measures mixed-model regression with Tukey-Kramer pairwise comparison.ResultsWe used least square means to estimate the percentage area covered by particles. Wearing PPE regardless of the design reduced particle transmission to the mannequin compared to the control. The LCG mask had the lowest square means of 0.06 of all face-shield designs analyzed. Tukey-Kramer pairwise comparison showed that all PPEs had a decrease in particle contamination compared to the control. LCG shield was found to have the least contamination compared to all other masks (P < 0.05).ConclusionResults suggest the importance of wearing a protective covering against droplet transmission. The LCG shield was found to decrease facial contamination by droplets the most of any tested protective equipment.
Highlights
The coronavirus 2019 (COVID-19) pandemic has reinforced the importance of facial protection against droplet transmission of diseases
Due to the urgency of the pandemic and the health and safety of healthcare workers, we aimed to study the efficacy of various face shields against droplet transmission
Specific to the novel coronavirus, the US Centers for Disease Control and the Occupational Safety and Health Administration have recommended that healthcare workers use full-face shields to protect against exposure to COVID-19.6,7 This recommendation is secondary to their covering of the three major areas of transmissibility: the eyes, nose, and mouth
Summary
The coronavirus 2019 (COVID-19) pandemic has reinforced the importance of facial protection against droplet transmission of diseases. Healthcare workers wear personal protection equipment (PPE), including face shields and masks. Due to the urgency of the pandemic and the health and safety of healthcare workers, we aimed to study the efficacy of various face shields against droplet transmission. Efficacy of Various Facial PPE in a Healthcare Setting performing hand hygiene, and wearing a medical mask have been recommended.[3] in healthcare settings providers frequently perform aerosolizing procedures (ie, tracheal intubation, non-invasive ventilation, bronchoscopy, etc) and provide clinical care requiring close physical contact. Specific to the novel coronavirus, the US Centers for Disease Control and the Occupational Safety and Health Administration have recommended that healthcare workers use full-face shields to protect against exposure to COVID-19.6,7 This recommendation is secondary to their covering of the three major areas of transmissibility: the eyes, nose, and mouth
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