Choice Of Personal Protective Equipment Research Articles

On the Choice of Personal Protective Equipment Taking into Account the Occupational Risk

The article contains recommendations on modernization of the methodology of provision of personal protective equipment based on a risk-based approach in the Republic of Kazakhstan. The experience of providing personal protective equipment using the United States as examples is presented. The Russian experience in providing PPE is analyzed and typical features of their issuance are highlighted. The procedure for providing PPE is given, taking into account the assessment of occupational risk. An algorithm for providing PPE according to the new nomenclature is proposed, taking into account various factors of the working environment and classes of working conditions. An algorithm for selecting personal protective equipment has been developed. The procedure for providing PPE is outlined when employers develop local acts on PPE at their discretion in accordance with the labor legislation of the Republic of Kazakhstan. A model is described that is based on the assessment of occupational risks and offers numerous possibilities to take into account the interests of the state, the employer and the employees. The results of scientific researches received during the scientific and technical program on a theme: «Risk-oriented organizational-economic mechanisms of ensuring of safe labor in conditions of modern Kazakhstan» (IRN OR11865833) within the limits of program target financing of researches of the Republican research institute for occupational safety and health under MLSPP of the Republic of Kazakhstan have been presented.

Main Parameters Influencing the Level of Labile Contamination and the Removal Factor

Abstract Several nuclear facilities are currently being decommissioned in France, on CEA and EDF sites. The decommissioning process as a whole, with cutting operations and nuclear waste management presents workers with significant risks of exposure. The aim of this study was therefore to improve risk assessments of internal exposure in operations where the main uncertainties are the removal factor and the airborne release factor. A new method is presented to assess the risk of internal exposure and optimize the choice of personal protective equipment to use during nuclear dismantling operations. The main forces and parameters influencing the level of labile contamination and particle resuspension were identified from a literature review and feedback. A manageable set of parameters was then obtained based on literature data and on-site information. The effects of the drying temperature, relative humidity, roughness of the contaminated surface, and wiping pressure were thus investigated on labile contamination and removal factor measurements. Successive wipings with cotton pads were performed on surfaces contaminated with simulated contaminants to estimate the influence of the different parameters. Results highlight the importance of surface roughness over the other considered parameters.

Maskne-Dermatosis of a Pandemic. A Survey on the Impact of PPE on Facial Skin Among HCW and N-HCW in Poland.

IntroductionDuring the SARS-CoV-2 pandemic, personal protective equipment (PPE) became the new social norm for preventing COVID-19, but with an impact on the skin barrier. This study aimed to analyze the factors influencing PPE wearing, following hygiene rules, and effect on facial skin, including onset or exacerbation of dermatoses among healthcare workers (HCW) and non-healthcare workers (N-HCW).MethodsIn 2020, an original survey was carried out among 300 N-HCW and 60 HCW with 60 questions about using PPE and skin lesions experienced before and during the pandemic. Cross-sectional statistical analysis was completed to assess the interplay between environmental factors and maskne occurrence.ResultsThe N-HCW group included 74% females and 26% males with an average age 24.67 ± 0.74. Among HCW respondents 91.7% were women and 8.3% were men, with an average age of 30.07 ± 0.36. All participants used PPE. Volunteers for N-HCW mainly chose a disposable (53.3%) and reusable masks (37.3%), while HCW preferred surgical (66.7%) and FFP2/FFP3/N95 masks (30%) and almost never used reusable masks (3.3%). HCW mainly spent 5–8 h with PPE, and N-HCW spent 1–4 h with PPE/day. Respondents with dermatological problems before the pandemic were more aware of the maskne and paid more attention to hygiene with PPE. Significantly, HCW experienced more severe facial skin lesions than N-HCW (p < 0.0001). There was statistical significance in following the basic hygienic rules of wearing PPE between both groups, where HCW practiced them more.ConclusionsMaskne is a current and urgent problem to be cured. HCW should receive help if they develop maskne, such as limited time spent in PPE and treatment of the results of wearing it, as it is the main trigger of developing maskne. In addition, education about the correct use and choice of PPE should be improved.Supplementary InformationThe online version contains supplementary material available at 10.1007/s13555-022-00796-w.

Experience in International Cooperation on Organization of Anti-Epidemic Measures by Health Care Institutions under COVID-19 Pandemic in the Republic of Uzbekistan

The results of the joint work of a panel of experts from Rospotrebnadzor and healthcare professionals of the Republic of Uzbekistan on organizing activities to counter the spread of the SARS-CoV-2 virus are described in the paper.The goal of the study was to determine the main driving forces of COVID-19 spread in the Republic of Uzbekistan and develop an action plan to reduce the incidence of coronavirus infection caused by the SARS-CoV-2 virus.Materials and methods. The organization of work in 14 health care institutions in Tashkent and Samarkand, as well as in Tashkent and Samarkand Regions, was analyzed: in 7 laboratories, 6 hospitals and 1 polyclinic. The routes for the movement of personnel, the demarcation of green and red zones, the features of disinfection and the use of personal protective equipment were studied. Attention is drawn to the diagnosis of COVID-19, the use of therapy aimed at reducing the period of virus shedding, the criteria for lifting quarantine restrictions for patients.Results and discussion. The main factors in the organization of work of institutions that contribute to the spread of COVID-19 among medical personnel and the population have been identifed: the lack of equipped gateways between the red and green zones with the accessibility of adequate disinfection, the wrong choice of personal protective equipment, monitoring of contact persons for 10 days, discharge from hospitals based on clinical improvement. The incorrect use of antiviral therapy, the lack of differentiated approaches to the selection of optimal regimens have been noted. Proposals are formulated for organizing the work of healthcare institutions, taking into account the requirements of biological safety. The introduction of targeted measures in addition to those previously adopted has led to a signifcant improvement in the epidemic situation: the total number of active cases in the Republic of Uzbekistan, despite the increase in testing volumes, decreased from 3,686 people on August 23 to 2335 on October 27. Towards December 20, 2020, 97 % of patients recovered completely. All diagnostic triage centers in the Republic of Uzbekistan are closed due to the absence of patients with COVID-19, most of the country’s medical institutions previously re-profled for patients with coronavirus infection have returned to the routine operations.

Безпека праці при виконанні робіт із пестицидами: стан правового забезпечення

The article is devoted to the analysis of the current state of legal protection of labor protection when performing work with pesticides, as well as the formulation on its basis of conclusions and proposals aimed at improving the current legislation in this area. It is established that the process of updating labor legislation is currently underway in Ukraine. In particular, through the adoption of regulations governing the rules of labor protection when working with certain types of chemicals (for example, ammonium nitrate). As a result of the study of current legislation in the field of labor protection when working with pesticides, it was concluded that the basic documents (State Sanitary Rules 8.8.1.2.001-98 «Transportation, storage and use of pesticides in the national economy» and State Sanitary Rules and Norms 8.8.1.2.3.4-000-2001 «Permissible doses, concentrations, quantities and levels of pesticides in agricultural raw materials, foodstuffs, air of the working area, atmospheric air, water of reservoirs, soil») are not able to regulate properly appropriate relations due to the obsolescence of their provisions. The main shortcomings of State Sanitary Rules 8.8.1.2.001-98 are determined: references in its content to already invalid regulations on labor protection, inconsistency with modern developments in the field of hygiene and toxicology of pesticides; unreasonably detailed regulation, which results in an excessive burden on business entities and leads to formalism in the implementation of the provisions of this document by employers; incorrect «rigid» regulation of the choice of personal protective equipment for work with pesticides. The directions of improvement of the legislation in the field of labor protection at performance of works with pesticides are defined. Among them: introduction of a risk-oriented approach to the organization of labor protection, including in the field of agriculture; borrowing positive international experience in the field of awareness of stakeholders on the hygienic regulation of pesticide use, the necessary safety measures for work with the use of such substances. Keywords: occupational safety, dangerous production factor, labor protection regulations, labor protection, pesticides, legal support, agriculture

Analysis of Droplet Splatter Patterns During Coblation Tonsil Surgery in the Covid-19 Pandemic.

To assess droplet splatter around the surgical field and surgeon during simulated Coblation tonsil surgery to better inform on mitigation strategies and evaluate choice of personal protective equipment. This was an observational study performed using a life-size head model to simulate tonsil surgery and fluorescein-soaked strawberries to mimic tonsils. The Coblation wand was activated over the strawberries for 5 minutes. This was repeated 5 times with 2 surgeons (totalling 10 data sets). The presence of droplet around the surgical field and anatomical subsites on the surgeon was assessed in binary fashion: present or not present. The results were collated as frequency of droplet detection and illustrated as a heatmap; 0 = white, 1-2 = yellow, 3-4 = orange, and 5 = red. Fluorescein droplets were detected in all 4 quadrants of the surgical field. The frequency of splatter was greatest in the upper (nearest to surgeon) and lower quadrants. There were detectable splatter droplets on the surgeon; most frequently occurring on the hands followed by the forearm. Droplets were also detected on the visor, neck, and chest albeit less frequently. However, none were detected on the upper arms. Droplet splatter can be detected in the immediate surgical field as well as on the surgeon. Although wearing a face visor does not prevent splatter on the surgical mask or around the eyes, it should be considered when undertaking tonsil surgery as well as a properly fitted goggle. 5.

Impact of Face-to-Face Teaching in Addition to Electronic Learning on Personal Protective Equipment Doffing Proficiency in Student Paramedics: Protocol for a Randomized Controlled Trial.

BackgroundThe COVID-19 pandemic has brought attention to the importance of correctly using personal protective equipment (PPE). Doffing is a critical phase that increases the risk of contamination of health care workers. Although a gamified electronic learning (e-learning) module has been shown to increase the adequate choice of PPE among prehospital personnel, it failed to enhance knowledge regarding donning and doffing sequences. Adding other training modalities such as face-to-face training to these e-learning tools is therefore necessary to increase prehospital staff proficiency and thus help reduce the risk of contamination.ObjectiveThe aim of this study is to assess the impact of the Peyton 4-step approach in addition to a gamified e-learning module for teaching the PPE doffing sequence to first-year paramedic students.MethodsParticipants will first follow a gamified e-learning module before being randomized into one of two groups. In the control group, participants will be asked to perform a PPE doffing sequence, which will be video-recorded to allow for subsequent assessment. In the experimental group, participants will first undergo face-to-face training performed by third-year students using the Peyton 4-step approach before performing the doffing sequence themselves, which will also be video-recorded. All participants will then be asked to reconstruct the doffing sequence on an online platform. The recorded sequences will be assessed independently by two investigators: a prehospital emergency medicine expert and an infection prevention and control specialist. The assessors will be blinded to group allocation. Four to eight weeks after this first intervention, all participants will be asked to record the doffing sequence once again for a subsequent skill retention assessment and to reconstruct the sequence on the same online platform to assess knowledge retention. Finally, participants belonging to the control group will follow face-to-face training.ResultsThe study protocol has been presented to the regional ethics committee (Req-2020-01340), which issued a declaration of no objection as such projects do not fall within the scope of the Swiss federal law on human research. Study sessions were performed in January and February 2021 in Geneva, and will be performed in April and June 2021 in Bern.ConclusionsThis study should help to determine whether face-to-face training using the Peyton 4-step approach improves the application and knowledge retention of a complex procedure when combined with an e-learning module.International Registered Report Identifier (IRRID)PRR1-10.2196/26927

Pediatric Endoscopy During the COVID-19 Pandemic: Implications of Universal Preprocedural Testing for PPE Utilization.

Pediatric Endoscopy During the COVID-19 Pandemic: Implications of Universal Preprocedural Testing for PPE Utilization.

Impact of an e-learning module on personal protective equipment knowledge in student paramedics: a randomized controlled trial

BackgroundPrehospital professionals such as emergency physicians or paramedics must be able to choose and adequately don and doff personal protective equipment (PPE) in order to avoid COVID-19 infection. Our aim was to evaluate the impact of a gamified e-learning module on adequacy of PPE in student paramedics.MethodsThis was a web-based, randomized 1:1, parallel-group, triple-blind controlled trial. Student paramedics from three Swiss schools were invited to participate. They were informed they would be presented with both an e-learning module and an abridged version of the current regional prehospital COVID-19 guidelines, albeit not in which order. After a set of 22 questions designed to assess baseline knowledge, the control group was shown the guidelines before answering a set of 14 post-intervention questions. The e-learning group was shown the gamified e-learning module right after the guidelines, and before answering post-intervention questions. The primary outcome was the difference in the percentage of adequate choices of PPE before and after the intervention.ResultsThe participation rate was of 71% (98/138). A total of 90 answer sets was analyzed. Adequate choice of PPE increased significantly both in the control (50% [33;83] vs 25% [25;50], P = .013) and in the e-learning group (67% [50;83] vs 25% [25;50], P = .001) following the intervention. Though the median of the difference was higher in the e-learning group, there was no statistically significant superiority over the control (33% [0;58] vs 17% [− 17;42], P = .087). The e-learning module was of greatest benefit in the subgroup of student paramedics who were actively working in an ambulance company (42% [8;58] vs 25% [− 17;42], P = 0.021). There was no significant effect in student paramedics who were not actively working in an ambulance service (0% [− 25;33] vs 17% [− 8;50], P = .584).ConclusionsThe use of a gamified e-learning module increases the rate of adequate choice of PPE only among student paramedics actively working in an ambulance service. In this subgroup, combining this teaching modality with other interventions might help spare PPE and efficiently protect against COVID-19 infection.

Effect of an E-Learning Module on Personal Protective Equipment Proficiency Among Prehospital Personnel: Web-Based Randomized Controlled Trial.

BackgroundTo avoid misuse of personal protective equipment (PPE), ensure health care workers’ safety, and avoid shortages, effective communication of up-to-date infection control guidelines is essential. As prehospital teams are particularly at risk of contamination given their challenging work environment, a specific gamified electronic learning (e-learning) module targeting this audience might provide significant advantages as it requires neither the presence of learners nor the repetitive use of equipment for demonstration.ObjectiveThe aim of this study was to evaluate whether a gamified e-learning module could improve the rate of adequate PPE choice by prehospital personnel in the context of the coronavirus disease (COVID-19) pandemic.MethodsThis was an individual-level randomized, controlled, quadruple-blind (investigators, participants, outcome assessors, and data analysts) closed web-based trial. All emergency prehospital personnel working in Geneva, Switzerland, were eligible for inclusion, and were invited to participate by email in April 2020. Participants were informed that the study aim was to assess their knowledge regarding PPE, and that they would be presented with both the guidelines and the e-learning module, though they were unaware that there were two different study paths. All participants first answered a preintervention quiz designed to establish their profile and baseline knowledge. The control group then accessed the guidelines before answering a second set of questions, and were then granted access to the e-learning module. The e-learning group was shown the e-learning module right after the guidelines and before answering the second set of questions.ResultsOf the 291 randomized participants, 176 (60.5%) completed the trial. There was no significant difference in baseline knowledge between groups. Though the baseline proportion of adequate PPE choice was high (75%, IQR 50%-75%), participants’ description of the donning sequence was in most cases incorrect. After either intervention, adequate choice of PPE increased significantly in both groups (P<.001). Though the median of the difference in the proportion of correct answers was slightly higher in the e-learning group (17%, IQR 8%-33% versus 8%, IQR 8%-33%), the difference was not statistically significant (P=.27). Confidence in the ability to use PPE was maintained in the e-learning group (P=.27) but significantly decreased in the control group (P=.04).ConclusionsAmong prehospital personnel with an already relatively high knowledge of and experience with PPE use, both web-based study paths increased the rate of adequate choice of PPE. There was no major added value of the gamified e-learning module apart from preserving participants' confidence in their ability to correctly use PPE.

Considerations for Pediatric Heart Programs During COVID-19: Recommendations From the Congenital Cardiac Anesthesia Society.

Considerations for Pediatric Heart Programs During COVID-19: Recommendations From the Congenital Cardiac Anesthesia Society.

Best Practice Guidelines for the Management of Acute Craniomaxillofacial Trauma During the COVID-19 Pandemic.

Coronavirus disease 2019 (COVID-19) is an infectious disease that is caused by severe respiratory syndrome coronavirus 2. Although elective surgical procedures are being cancelled in many parts of the world during the COVID-19 pandemic, acute craniomaxillofacial (CMF) trauma will continue to occur and will need to be appropriately managed. Surgical procedures involving the nasal, oral, or pharyngeal mucosa carry a high risk of transmission due to aerosolization of the virus which is known to be in high concentration in these areas. Intraoperative exposure to high viral loads through aerosolization carries a very high risk of transmission, and the severity of the disease contracted in this manner is worse than that transmitted through regular community transmission. This places surgeons operating in the CMF region at particularly high risk during the pandemic. There is currently a paucity of information to delineate the best practice for the management of acute CMF trauma during the COVID-19 pandemic. In particular, a clear protocol describing optimal screening, timing of intervention and choice of personal protective equipment, is needed. The authors have proposed an algorithm for management of CMF trauma during the COVID-19 pandemic to ensure that urgent and emergent CMF injuries are addressed appropriately while optimizing the safety of surgeons and other healthcare providers. The algorithm is based on available evidence at the time of writing. As the COVID-19 pandemic continues to evolve and more evidence and better testing becomes available, the algorithm should be modified accordingly.

Personal Protective Equipment for Healthcare Workers during the COVID-19 Pandemic.

The coronavirus disease (COVID-19) pandemic has posed a challenge for healthcare systems, and healthcare workers (HCWs) are at high risk of exposure. Protecting HCWs is of paramount importance to maintain continuous patient care and keep healthcare systems functioning. Used alongside administrative and engineering control measures, personal protective equipment (PPE) is the last line of defense and the core component of protection. Current data suggest that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is mainly transmitted through respiratory droplets and close contact. Airborne transmission may occur during aerosol-generating procedures. However, the modes of transmission still remain uncertain, especially regarding the possibility of airborne transmission when aerosol-generating procedures are not performed. Thus, there are some inconsistencies in the respiratory protective equipment recommended by international and national organizations. In Korea, there have been several modifications to PPE recommendations offering options in choosing PPE for respiratory and body protection, which confuses HCWs; they are often unsure what to wear and when to wear it. The choice of PPE is based on the risk of exposure and possible modes of transmission. The level of protection provided by PPE differs based on standards and test methods. Thus, understanding them is the key in selecting the proper PPE. This article reviews evidence on the mode of SARS-CoV-2 transmission, compares the current PPE recommendations of the World Health Organization with those in Korea, and discusses standard requirements and the proper selection of PPE.

Application of miniaturized sensors to Unmanned Aerial Vehicles, a new pathway for the survey of critical areas

During the latest decades, an increasing of threats associated to Chemical, Biological, Radiological and Nuclear events (CBRNe) took place. For what regards break-out of chemical and radiological compounds, several episodes have occurred, such as unwanted industrial leakage, intentional use of chemical weapons by non-state actors or smuggling of nuclear material, that, by materializing a global threat, have conducted to casualties the actors involved, inter alia fire brigades and military first responders. Concerning the equipment provided to these operators, huge progresses have been done in portable detectors, now able to employ numerous different working principles and technologies. Nonetheless, especially during the survey phase after a CBRN release, the operators enter in a potentially contaminated area without knowing type and amount of the contamination, running the risk of losses during the reconnaissance. On the other hand, nowadays we are witnessing a worldwide spread development of Unmanned Aerial Vehicles (UAV), with countless uses in different fields. They have founded fruitful implementation across civil and military ground in aerial photography, express shipping, gathering information during disaster management, thermal sensor drones for search and rescue operations, geographic mapping of inaccessible locations, severe weather forecasting. What if we could send one or more of these flying platforms equipped with CBRN sensors, geo-localized, able to collect samples and to detect in real time a contamination. Subsequently, once the CBRN incident occurrence is confirmed, after the analysis of collected samples is likely to determine the chemical compound or the radiation emitter involved and the level of contamination. If all this is made feasible, we will be able to minimize or completely avoid the exposure of personnel, moreover it will be determined the exact position of the hotspot and better supported the choice of personal protective equipment to be used to enter in the hazard area. Finally, time will be saved by an early UAV survey, while waiting to obtain the safety permissions for entry in the area.

Use of ultraviolet-fluorescence-based simulation in evaluation of personal protective equipment worn for first assessment and care of a patient with suspected high-consequence infectious disease

Variations currently exist across the UK in the choice of personal protective equipment (PPE) used by healthcare workers when caring for patients with suspected high-consequence infectious diseases (HCIDs). To test the protection afforded to healthcare workers by current PPE ensembles during assessment of a suspected HCID case, and to provide an evidence base to justify proposal of a unified PPE ensemble for healthcare workers across the UK. One 'basic level' (enhanced precautions) PPE ensemble and five 'suspected case' PPE ensembles were evaluated in volunteer trials using 'Violet'; an ultraviolet-fluorescence-based simulation exercise to visualize exposure/contamination events. Contamination was photographed and mapped. There were 147 post-simulation and 31 post-doffing contamination events, from a maximum of 980, when evaluating the basic level of PPE. Therefore, this PPE ensemble did not afford adequate protection, primarily due to direct contamination of exposed areas of the skin. For the five suspected case ensembles, 1584 post-simulation contamination events were recorded, from a maximum of 5110. Twelve post-doffing contamination events were also observed (face, two events; neck, one event; forearm, one event; lower legs, eight events). All suspected case PPE ensembles either had post-doffing contamination events or other significant disadvantages to their use. This identified the need to design a unified PPE ensemble and doffing procedure, incorporating the most protective PPE considered for each body area. This work has been presented to, and reviewed by, key stakeholders to decide on a proposed unified ensemble, subject to further evaluation.

Personal Protective Equipment for Filovirus Epidemics: A Call for Better Evidence.

Personal protective equipment (PPE) is an important part of worker protection during filovirus outbreaks. The need to protect against a highly virulent fluid-borne pathogen in the tropical environment imposes a heat stress on the wearer that is itself a safety risk. No evidence supports the choice of PPE employed in recent outbreaks, and standard testing procedures employed by the protective garment industry do not well simulate filovirus exposure. Further research is needed to determine the appropriate PPE for filoviruses and the heat stress that it imposes.

Weapons of mass destruction events with contaminated casualties: effective planning for health care facilities.

Biological and chemical terrorism is a growing concern for the emergency preparedness community. While health care facilities (HCFs) are an essential component of the emergency response system, at present they are poorly prepared for such incidents. The greatest challenge for HCFs may be the sudden presentation of large numbers of contaminated individuals. Guidelines for managing contaminated patients have been based on traditional hazardous material response or military experience, neither of which is directly applicable to the civilian HCF. We discuss HCF planning for terrorist events that expose large numbers of people to contamination. Key elements of an effective HCF response plan include prompt recognition of the incident, staff and facility protection, patient decontamination and triage, medical therapy, and coordination with external emergency response and public health agencies. Controversial aspects include the optimal choice of personal protective equipment, establishment of patient decontamination procedures, the role of chemical and biological agent detectors, and potential environmental impacts on water treatment systems. These and other areas require further investigation to improve response strategies.