Combination Of Personal Protective Equipment Research Articles

Comparative analysis of the regulations of humanitarian demining in a radiation-contaminated area

A comparative analysis of the regularities of the implementation of a control typical operation of humanitarian demining in a radiation-contaminated area was carried out by comparing the time of implementation of the method of jerking an anti-tank mine, which is located at a distance of 50 meters from the shelter, where the sapper is located during the execution of the most dangerous stage, in three different options for the use of a complex of means individual protection by sappers of the State Emergency Service of Ukraine under various conditions of possible radiation exposure: a combination of a protective suit L-1, armor protection of the type of protective body armor of the IV level of protection, a protective armor helmet of the level of protection III-A, and a respirator of the type ZM 6200 ffp3; a combination of L-1 protective suit, armor protection of the IV level of protection type protective body armor, III-A level of protection armor helmet, and GP-5 type filter gas mask; a combination of L-1 pro-tective suit, armor protection type IV protective vest, III-A protective helmet, and compressed air apparatus Dräger 7000. This was caused by the fact that an important and unsolved part of the problem of humanitarian demining is the lack of regularities in the operational activity of sappers of the State Emergency Service in conditions of radiation contamination. The uniqueness of the considered situation is that only in Ukraine there is a need for humanitarian demining of radiation-contaminated area. The analysis of the obtained regularities showed that the time of execution of typical operations of the considered process is described by a normal distribution regardless of the combination of personal protective equipment in which sappers work. At the same time, if the time of performing typical operations in a set of protective equipment, which includes an isolating device, differs significantly from their performance in a set that includes a filtering gas mask, then the time of performing it in a set with a respirator of class ffp3 is practically no different from the time of performing it in a set with filter gas mask.

Health Care Personnel Exposures to Subsequently Laboratory-Confirmed Monkeypox Patients - Colorado, 2022.

The risk for monkeypox transmission to health care personnel (HCP) caring for symptomatic patients is thought to be low but has not been thoroughly assessed in the context of the current global outbreak (1). Monkeypox typically spreads through close physical (often skin-to-skin) contact with lesions or scabs, body fluids, or respiratory secretions of a person with an active monkeypox infection. CDC currently recommends that HCP wear a gown, gloves, eye protection, and an N95 (or higher-level) respirator while caring for patients with suspected or confirmed monkeypox to protect themselves from infection† (1,2). The Colorado Department of Public Health and Environment (CDPHE) evaluated HCP exposures and personal protective equipment (PPE) use in health care settings during care of patients who subsequently received a diagnosis of Orthopoxvirus infection (presumptive monkeypox determined by a polymerase chain reaction [PCR] DNA assay) or monkeypox (real-time PCR assay and genetic sequencing performed by CDC). During May 1-July 31, 2022, a total of 313 HCP interacted with patients with subsequently diagnosed monkeypox infections while wearing various combinations of PPE; 23% wore all recommended PPE during their exposures. Twenty-eight percent of exposed HCP were considered to have had high- or intermediate-risk exposures and were therefore eligible to receive postexposure prophylaxis (PEP) with the JYNNEOS vaccine§; among those, 48% (12% of all exposed HCP) received the vaccine. PPE use varied by facility type: HCP in sexually transmitted infection (STI) clinics and community health centers reported the highest adherence to recommended PPE use, and primary and urgent care settings reported the lowest adherence. No HCP developed a monkeypox infection during the 21 days after exposure. These results suggest that the risk for transmission of monkeypox in health care settings is low. Infection prevention training is important in all health care settings, and these findings can guide future updates to PPE recommendations and risk classification in health care settings.

Exploring the appropriate test methods to examine the effects of firefighter personal protective equipment on mobility

This study aimed to ascertain the appropriate test methods for the investigation of the effect of personal protective equipment on mobility of firefighters. Nine male volunteers performed a physical performance test (crawl, obstacle course, side-to-side jumps, heavy-object drag, and step-ups), functional balance test (functional reach, timed up and go, and wooden plank time), range of motion test, and subjective evaluation under four clothing conditions with different weights and combinations of personal protective equipment. The results showed that physical performance, functional balance ability, and joint angles significantly declined with increased weight of personal protective equipment. On subjective evaluation, wearing heavy personal protective equipment increased perceived exertion and discomfort on movement. Our results proved that some of our test methods, including the obstacle course, side-to-side jumps, functional reach, timed up and go, range of motion test, and subjective evaluation, can be used to examine the mobility of personal protective equipment wearers. The findings of this study provide an effective guide for researchers and firefighters regarding the evaluation of mobility with personal protective equipment, as well as for manufacturers in the development of enhanced, comfortable personal protective equipment.

Effect of Ivermectin prophylaxis in prevention of COVID 19: Meta-analysis and systematic review.

Ivermectin was popular drug on trial for preventive and therapeutic role in COVID-19. However, there is disagreement concerning the validity of its clinical efficacy. Hence, we conducted a Meta-analysis and Systematic review for effect of Ivermectin Prophylaxis in prevention of COVID-19. The online databases of PubMed (Central), Medline, and Google scholar for randomized controlled trials, non-randomized trial and prospective cohort study were searched up to March 2021. Nine studies were included for analysis, out of which four were Randomized controlled Trial (RCTs), Two Non-RCTs and three cohort studies. Four randomized trial evaluated prophylactic drug Ivermectin, two combination of topical nasal carrageenan and oral Ivermectin two study used in combination of personal protective equipment (PPE) one with Ivermectin and one with Ivermectin/ Iota-Carrageenan (IVER/IOTACRC). In the pooled analysis we observed non-significant less COVID-19 positivity rate in the prophylaxis group as compared with non-prophylaxis group (Relative Risk (RR) = 0.27 and Confidence Interval (CI) = 0.05, 1.41) with significant heterogeneity (I2 = 97.1%, P < 0.001) The pooled analysis involving the Non-RCTs studies also did not observe significant reduction in the COVID-19 positivity rate in the prophylaxis group as compared with non-prophylaxis group (RR = 0.01 and CI = 0.00, 7.97) with significant heterogeneity between the studies (P < 0.001).Hence,we conclude that Ivermectin is not the 'magical silver weapon' against COVID-19.

Efficacy of personal protective equipment against coronavirus transmission via dental handpieces

BackgroundThis laboratory study was done to evaluate the efficacy of personal protective equipment (PPE) and high-volume evacuation (HVE) against the spread of human coronavirus type 229E (HCoV-229E) during a standard dental procedure. MethodsPatient and operator manikins were used to recreate a dental setting inside a custom-built class III cabinet–like chamber. The mouth of the patient manikin was inoculated with an HCoV-229E suspension, the viral load of which was similar to that of asymptomatic people infected with severe acute respiratory syndrome coronavirus 2. The dental procedure was performed with an air turbine handpiece and HVE for 10 seconds. The efficacy of surgical masks, N95 (filtering facepiece class 2) and filtering facepiece class 3 respirators, and face shields was tested via quantitative real-time polymerase chain reaction. ResultsThe wide surface on which the inoculum was spread caused low contamination. Over the external surfaces of masks and respirators, when a face shield was not worn, viral loads ranged from 1.2 through 1.4 log10 mean gene copies per cm2. When the shield was worn, viral loads dropped below the detection limit (< 0.317 log10 gene copies/cm2) for all PPE. On the operator’s forehead, viral loads were 0.6 through 0.8 log10 gene copies/cm2. Inside the operator manikin’s mouth, viral loads were under the detection limit when using any PPE, with or without the shield. HVE did not significantly change viral loads. ConclusionsAll PPE combinations significantly reduced viral loads in the operator manikin’s mouth to below the detection limit, but HVE did not decrease viral contamination. Practical ImplicationsAlthough caution is suggested when removing and disposing of PPE to avoid self-contamination, the combination of PPE and face shields drastically decreases the risk of transmitting human coronavirus during aerosol-generating dental procedures.

Evaluating the contributions of strategies to prevent SARS-CoV-2 transmission in the healthcare setting: a modelling study

IntroductionSince its onset, the COVID-19 pandemic has caused significant morbidity and mortality worldwide, with particularly severe outcomes in healthcare institutions and congregate settings. To mitigate spread, healthcare systems have been...

COVID-19, Personal Protective Equipment, and Human Performance.

Clinicians who care for patients infected with coronavirus disease 2019 (COVID-19) must wear a full suite of personal protective equipment, including an N95 mask or powered air purifying respirator, eye protection, a fluid-impermeable gown, and gloves. This combination of personal protective equipment may cause increased work of breathing, reduced field of vision, muffled speech, difficulty hearing, and heat stress. These effects are not caused by individual weakness; they are normal and expected reactions that any person will have when exposed to an unusual environment. The physiologic and psychologic challenges imposed by personal protective equipment may have multiple causes, but immediate countermeasures and long-term mitigation strategies can help to improve a clinician’s ability to provide care. Ultimately, a systematic approach to the design and integration of personal protective equipment is needed to improve the safety of patients and clinicians.

THE EFFICACY OF RADPAD AS A RADIATION PROTECTION TOOL IN CT FLUOROSCOPY GUIDED LUNG BIOPSIES.

Computed tomography fluoroscopy is now the preferred technique for percutaneous lung biopsies. However, concern regarding operator and patient radiation dose remains, which warrants further exploration into dose optimisation tools. This phantom-study aims to assess the dose reduction capabilities of RADPAD, a single-use patient drape designed to decrease staff exposure to scattered radiation. Dosemeters at the waist and eye levels were used to determine the whole-body and lens exposure during simulated lung biopsy procedures while using RADPAD and other combinations of personal protective equipment. RADPAD resulted in a 36% and 38% dose reduction for whole-body and eye exposure, respectively. However, when used in combination with radioprotective eyewear and aprons, RADPAD did not reduce the radiation dose further. Consequently, the use of standard personal protective equipment is a more cost-effective option for staff dose reduction. RADPAD is useful in the reduction of radiation dose to unprotected regions.

COVID-19 outbreak impact on plastic surgery residents from Romania

The COVID-19 outbreak triggered a global crisis with long-term effects on people’s daily lives. It has altered surgical practice and education and imposed major changes in healthcare systems and resources. In order to analyze the impact the COVID-19 pandemic has had on Romanian Plastic Surgery residents, we carried out an anonymous questionnaire through Google forms. Survey items addressed aspects such as how the pandemic has affected their surgical practice, their exposure to the virus, and the protective measures that have been implemented to minimize risk. Among other results, our study found that nearly 1 in 5 respondents had contact with a coronavirus patient, that most of the patients were tested at admission, mostly using RT-PCR, and that various combinations of personal protective equipment had been used. Most participants also felt that their surgical training has been negatively affected, despite attendance at online courses and webinars. Although the pandemic has brought significant changes to the daily lives of residents and to the residency training, the Plastic Surgery community has been brought closer than ever and reminded that, through unified efforts, such obstacles can be overcome.

Personal protective equipment for preventing highly infectious diseases due to exposure to contaminated body fluids in healthcare staff.

Personal protective equipment for preventing highly infectious diseases due to exposure to contaminated body fluids in healthcare staff.

Personal protective equipment for preventing highly infectious diseases due to exposure to contaminated body fluids in healthcare staff.

Personal protective equipment for preventing highly infectious diseases due to exposure to contaminated body fluids in healthcare staff.

Combating the COVID-19 battle with personal protective equipment (PPE) armamentarium.

Combating the COVID-19 battle with personal protective equipment (PPE) armamentarium.

Molecular assessment of visitor personal protective equipment contamination with the Aleutian mink disease virus and porcine circovirus-2 in mink and porcine farms.

Personal protective equipment (PPE) is an element of biosecurity intended to prevent the access or spread of diseases in farms. Nevertheless, to date no extensive reports exist about the effectiveness of different available PPE on farms. Thus, our aim was to estimate the degree of protection of PPE from viral contamination during farm visits. Two farms, infected with Aleutian mink disease virus and porcine circovirus–2 respectively, were visited by six visitors wearing different combinations of PPE: coveralls with hood and bootcovers, both with a certified barrier to infective agents (certified PPE group) and non-certified bootcover and coverall without hood (non-certified PPE group). Seventy-two swab samples from PPE and both hair and street clothes under PPE were taken after the visit and analysed by qPCR. Our results reveal viral exposure during visits, and the external protections of body and shoes were contaminated in all cases (24/24). In addition, protection from viral contamination varied noticeably according to the biosecurity elements used. A higher number of positives were detected in the non-certified PPE group than in the certified PPE group, both in elements under external protections (14/18 vs 3/18) and also in hair (4/6 vs 0/6). In fact, non-certified bootcovers broke during visits, resulting in viral contamination of the internal elements under them; these are consequently not suitable for using with wrinkled surfaces usually found in farm facilities. Thus, certified coveralls should be used in order to prevent contaminations, and workers and personnel of farms should be trained in their proper use. qPCR is a useful tool in the risk management of biosecurity programmes, and our results may serve as a model to evaluate different biosecurity measures.

Personal protective equipment solution for UK military medical personnel working in an Ebola virus disease treatment unit in Sierra Leone

SummaryThe combination of personal protective equipment (PPE) together with donning and doffing protocols was designed to protect British and Canadian military medical personnel in the Kerry Town Ebola Treatment Unit (ETU) in Sierra Leone. The PPE solution was selected to protect medical staff from infectious risks, notably Ebola virus, and chemical (hypochlorite) exposure. PPE maximized dexterity, enabled personnel to work in hot temperatures for periods of up to 2 h, protected mucosal membranes when doffing outer layers, and minimized potential contamination of the doffing area with infectious material by reducing the requirement to spray PPE with hypochlorite.The ETU was equipped to allow medical personnel to provide a higher level of care than witnessed in many existing ETUs. This assured personnel working as part of the international response that they would receive as close to Western treatment standards as possible if they were to contract Ebola virus disease (EVD). PPE also enabled clinical interventions that are not seen routinely in West African EVD treatment regimens, whilst providing a robust protective barrier. Competency in using PPE was developed during a nine-day pre-deployment training programme. This allowed over 60 clinical personnel per deployment to practice skills in PPE in a simulated ETU and in classrooms. Overall, the training provided: (i) an evidence base underpinning the PPE solution chosen; (ii) skills in donning and doffing of PPE; (iii) personnel confidence in the selected PPE; and (iv) quantifiable testing of each individual's capability to don PPE, perform tasks and doff PPE safely.

Personal Protective Equipment for Infectious Disease Preparedness: A Human Factors Evaluation.

OBJECTIVE To identify issues during donning and doffing of personal protective equipment (PPE) for infectious diseases and to inform PPE procurement criteria and design. DESIGN A mixed methods approach was used. Usability testing assessed the appropriateness, potential for errors, and ease of use of various combinations of PPE. A qualitative constructivist approach was used to analyze participant feedback. SETTING Four academic health sciences centers: 2 adult hospitals, 1 trauma center, and 1 pediatric hospital, in Toronto, Canada. PARTICIPANTS Participants (n=82) were representative of the potential users of PPE within Western healthcare institutions. RESULTS None of the tested combinations provided a complete solution for PPE. Environmental factors, such as anteroom layout, and the design of protocols and instructional material were also found to impact safety. The study identified the need to design PPE as a complete system, rather than mixing and matching components. CONCLUSIONS Healthcare institutions are encouraged to use human factors methods to identify risk and failure points with the usage of their selected PPE, and to modify on the basis of iterative evaluations with representative end users. Manufacturers of PPE should consider usability when designing the next generation of PPE. Infect Control Hosp Epidemiol 2016;37:1022-1028.

Comfort of personal protective equipment

The degree of comfort of personal protective equipment (PPE) was investigated in an automobile encapsulating plant. Up to 96.2% of employees used one or a combination of PPE. Only 8% of the workers felt their respirators were comfortable, 30% tolerated their respirators, and 62% rated them as uncomfortable. The percentage of employees who rated their PPE (other than a respirator) as comfortable ranged from 32 to 52%. For comfort factor, coveralls/aprons rated 52%, safety glasses 51%, rubber gloves 42%, and hearing protectors 36%. PPE was tolerable (just acceptable) for about 30% of the employees. To increase the effectiveness and safety of PPE, the human-factor aspects of PPE design should be emphasized more and quality improvement should cover the wearability of PPE.