Full-face Shield Research Articles

Enhanced personal protective equipment and dental students' experience and quality of a restorative procedure in a simulated clinical setting.

To evaluate the effects of enhanced personal protective equipment (Enhanced_PPE) on student-operator's experience and restorative procedure. Student-operators (N=29 Year 3 dental students) performed Class II composite restorations (SimpliShade, Kerr) in typodont upper molars (OneDental) equipped with N95 respirators, full-face shields, disposable headwear and gowns (Enhanced_PPE) or surgical masks, protective glasses/goggles and non-disposable gowns (Standard_PPE) 2 weeks later. Cavity dimensions were measured on cone beam computed tomography images. The quality of composite restorations was assessed using selected FDI criteria and Vickers hardness. A questionnaire assessed the operators' discomfort, anxiety, confidence, ability to perform, and procedure outcome. Data were analyzed using paired t-test and McNemar test (alpha=0.05). Student-operators experienced greater discomfort and anxiety, reduced confidence and ability to perform, and rated the procedure as less satisfactory with Enhanced_PPE (p<0.05). Differences in proximal box width were marginally significant (Enhanced_PPE 1.8±0.4mm, Standard_PPE 1.6±0.3mm) (p=0.047). Other cavity dimensions were similar between groups (p>0.05) as were restorations regarding surface luster, anatomical form, marginal adaptation, proximal contour, and contact (p>0.05). There were no differences in the hardness of composite restorations (top p=0.349, bottom p=0.334). Enhanced_PPE led to student-operator discomfort, anxiety, and reduced confidence, but did not impact the quality of Class II preparation and composite restorations versus Standard_PPE.

COVID-19 prevalence and infection control practices among dentists in Andhra Pradesh State, India.

The coronavirus 2019 (COVID-19) pandemic posed a new challenge not only to public health but also to the health care systems and dentists are one of the highly vulnerable health care professionals for COVID-19 infection. To assess the COVID-19 prevalence, associated factors, and infection control practices among dentists in Andhra Pradesh State, India. A cross-sectional web-based questionnaire survey was conducted among dentists in Andhra Pradesh State, India. 21-item pretested questionnaire was used for data collection between January 30, 2021 and February 21, 2021. 3700 dentists from the Andhra Pradesh state were selected from the Dentists Register of India through systematic random sampling method. Out of 3700 dentists invited to participate in this study, responses from 1876 dentists were received with response rate of 51%. Prevalence of 8 among the study population was 9%. Patients were the primary source of infection for 60.5% of the COVID-19 positive study participants. 65.8% of total respondents using full face shield and two-third of them using N95 or equivalent mask while providing dental care. This study found a high prevalence rate of COVID-19 among the dentists. Among the associated factors, being into active practice during the pandemic was found to be statistically significant. This study recommend for additional infection control protocols specific to the COVID-19 pandemic.

Real work experiences, practices and adverse events associated with long term usage of N95 respirators during the COVID-19 pandemic – A cross-sectional survey amongst Indian physicians

Introduction: Doctors are at increased risk of exposure to SARS-CoV-2 virus, and use of N95 respirators has emerged as a key preventive measure. This study aimed to study the real-world experiences, practices and adverse effects of N95 respirator usage amongst doctors of India. Methods: An analytical, cross-sectional online survey was conducted between November 2020 and January 2021. Real-world usage characteristics of N-95 respirators were collected via a pre-validated questionnaire (use, reuse, wearing and disposal practices) and compared amongst different sub-cohorts. Results: 453 responses from physicians were analyzed. The most important adjunct to the N95 respirator perceived by the respondents was the full-face shield (81.9%). Most doctors had to purchase extra mask per month (median = 5) and this was more amongst the medical specialties (p = 0.006). Highest mean VAS scores for adverse events were reported for breathing on exertion (6.62 ± 2.25) and ear pain (6.34 ± 2.69). VAS ear pain was higher in ages &lt; 40 and doctors working in the public sector (p = 0.017 and p = 0.019 respectively). Conclusion: There are many inadequacies with regard to proper mask removal and doffing techniques among doctors in India. The major adverse effects faced by the doctors on prolonged mask usage were ear pain and breathing on exertion. However, it can be noted in spite of these deficiencies; there is generally good adherence to protocols and good practices of mask usage in hospital setting.

Numerical Study of the Effect of Grout Material Properties on Ground Deformation during Shallow TBM Tunneling

The full-face shield tunnel boring machine (TBM) has been widely used to build tunnels in urban area. Ground deformations usually occur during tunnelling processes, which is closely related to engineering geological property. A large ground deformation may lead to large-scale surface settlement or ground collapse, especially for shallow buried tunnels. In general, synchronous grouting is adopted to reduce the ground deformation. The temporal and spatial distribution of the grout pressure and consolidation processes of grouting have a significant influence on the deformation. For a better understanding the relationship between the grout material type and the ground deformation, the present study models a complex numerical model in FLAC3D based on the Guangzhou Metro line 18. A numerical method is proposed to reproduce the tunnelling process and the consolidation process of grout material. The effect of grouting material on ground deformation is discussed, i.e., immediately solidified type, quick hardening type, and good mobility type. The ground deformation of the numerical simulation are compared to those monitored in the field. The results indicate that the immediately solidified type grout can reduce the ground settlement effectively and is mainly applicable to secondary grouting. The quick hardening type can make the ground upheaval, which is smaller than that induced by immediately solidified type. The good mobility type can reduce the ground settlement and well control the ground deformation. The good mobility type recommends using in the numerical study for simulating the synchronous grouting.

Reopening Oral Health Services during the COVID-19 Pandemic through a Knowledge Exchange Coalition.

Background:The COVID-19 novel coronavirus closed oral health care in Nova Scotia (NS) Canada in March 2020. Preparing for a phased reopening, a knowledge exchange coalition (representing government, academia, hospitals, oral health professions, and regulators) developed return-to-work (RTW) guidelines detailing the augmentation of standard practices to ensure safety for patients, oral health care providers (OHPs), and the community. Using online surveys, this study explored the influence of the RTW guidelines and related education on registered NS OHPs during a phased return to work.Methods:Dissemination of R2W guidelines included website or email communiques and interdisciplinary education webinars that coincided with 2 RTW phases approved by the government. Aligned with each phase, all registered dentists, dental hygienists, and dental assistants were invited to complete an online survey to gauge the influence of the coalition-sponsored education and RTW guidelines, confidence, preparedness, and personal protective equipment use before and after the pandemic.Results:Three coalition-sponsored multidisciplinary webinars hosted 3541 attendees prior to RTW. The response to survey 1 was 41% (881/2156) and to survey 2 was 26% (571/2177) of registrants. Survey 1 (82%) and survey 2 (89%) respondents “agreed/strongly agreed” that R2W guidelines were a primary source for guiding return to practice, and most were confident with education received and had the skills needed to effectively treat patients during the COVID-19 pandemic. Confidence and preparedness improved in survey 2. Gowns/lab coat use for aerosol-generating procedures increased from 26% to 93%, and the use of full face shields rose from 6% to 93% during the pandemic.Conclusions:A multistakeholder coalition was effective in establishing and communicating comprehensive guidelines and web-based education to ensure unified reintegration of oral health services in NS during a pandemic. This multiorganizational cooperation lay the foundation for responses to subsequent waves of COVID-19 and may serve as an example for collaboratively responding to future public health threats in other settings.Knowledge Transfer Statement:The return-to-work strategy that was developed, disseminated, and assessed through this COVID-19 knowledge exchange coalition will benefit oral health practitioners, professional regulators, government policy makers, and researchers in future pandemic planning.

Penetrating Ocular Trauma Caused by Steel Wire from a Rotating Wire Brush: A Case Report with Review of Literature

A 19-year-old young man came to emergency department with a complaint of injury in the left eye with a wire, while cleaning the car engine parts in the workshop with motorized rotating wire brush. He was referred immediately to the eye clinic. On examination of the left eye, a thin steel wire was seen penetrating at the nasal limbus which was projecting forwards. The wire was removed (33 mm in length) under aseptic precautions using topical anaesthesia. Postoperatively, he was treated with ciprofloxacin eye drops. The patient had no ocular morbidity; the vision was normal, and he was asymptomatic in the left eye. Eye injuries from rotating wire brushes are caused by detached fragments. These eyes should be examined in detail for the involvement of different structures of the eye; and should be treated adequately in-time to prevent visual loss/ blindness. Wearing of safety glasses/ full face shield while working is recommended to prevent such injuries.

The Use of Modified Snorkel Masks as Personal Protective Equipment During Aerosol-Generating Procedures: COVID-19 Necessity.

Background: The available personal protective equipment (PPE) is insufficient to provide adequate protection during high-risk aerosol-generating procedures, and their shortage was reported. The full-face snorkel masks were modified to be used as PPE. However, little is known about their use in medical practice. Methods: The available masks were assessed and compared in terms of safety, comfort, visual acuity, and communication with team members during the aerosol-generating surgical and endoscopic procedures. The masks were compared with a standard option (full-face shield and N95 mask). The score was assigned to each domain to compare the masks. The aim of the study was to assess the modified full-face snorkel masks as PPE during surgical and endoscopic aerosol-generating procedures. Results: Four modified snorkel masks were assessed and compared with the standard option. All masks provided a good seal, comfort, vision, and protection. Communication was the biggest problem and improved after modification. Suggestions for the mask's selection and on further improvements were made. Conclusion: The modified snorkel masks seem a good alternative to the standard PPE during aerosol-generating procedures. However, additional improvements are still needed. More studies are required to prove the benefits of the modified snorkel masks over the standard PPE.

Protection Level and Reusability of a Modified Full-Face Snorkel Mask as Alternative Personal Protective Equipment for Healthcare Workers during the COVID-19 Pandemic.

The worldwide outbreak of COVID-19 has drastically increased pressure on medical resources and highlighted the need for rapidly available, large-scale, and low-cost personal protective equipment (PPE). In this work, an alternative full-face mask is adapted from a modified snorkel mask to be used as PPE with two medical-grade filters and a 3D-printed adapter. Since the mask covers the eyes, mouth, and nose, it acts as a full-face shield, providing additional protection to healthcare workers. The SARS-CoV-2 has a size between 60 nm and 140 nm, and airborne viral particles can be carried by larger droplets with sizes up to several millimeters. The minimum filtration efficiency of mechanical and electrostatic filters is usually reached between 30 nm and 300 nm. The filtration efficiency of different medical filters is measured for particles below 300 nm to cover the size of the SARS-CoV-2 and small virus-laden droplets, and determine the minimum efficiency. The filtration performance of the adapted full-face mask is characterized using NaCl particles below 500 nm and different fitting scenarios to determine the minimum protection efficiency. The mask is compared to a commercial respirator and characterized according to the EN 149 standard, demonstrating that the protection fulfills the requirements for the FFP2 level (filtering face-piece 2, stopping at least 94% of airborne particles). The device shows a good resistance to several cycles of decontamination (autoclaving and ethanol immersion), is easy to be produced locally at low cost, and helps to address the shortage in FFP2 masks and face shields by providing adequate protection to healthcare workers against particles <500 nm in size.

A survey assessing the early effects of COVID-19 pandemic on oral and maxillofacial surgery training programs

ObjectiveThe coronavirus disease 2019 (COVID-19) pandemic has specific implications for oral and maxillofacial surgeons because of an increased risk of exposure to the virus during surgical procedures involving the aerodigestive tract. The objective of this survey was to evaluate how the COVID-19 pandemic affected oral and maxillofacial surgery (OMFS) training programs during the early phase of the pandemic.Study DesignDuring the period April 3 to May 6, 2020, a cross-sectional survey was sent to the program directors of 95 of the 101 accredited OMFS training programs in the United States. The 35-question survey, designed by using Qualtrics software, aimed to elicit information about the impact of the COVID-19 pandemic on OMFS residency programs and the resulting specific modifications made to clinical care, PPE, and resident training/wellness.ResultsThe survey response rate from OMFS program directors was 35% (33 of 95), with most responses from the states with a high incidence of COVID-19. All OMFS programs (100%) implemented guidelines to suspend elective and nonurgent surgical procedures and limited ambulatory clinic visits by third week of March, with the average date being March 16, 2020 (date range March 8–23). The programs used telemedicine (40%) and modified in-person visit (51%) protocols for dental and maxillofacial emergency triage to minimize the risk of exposure of HCP to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Shortage of personal protective equipment (PPE) was experienced by 51% of the programs. Almost two-thirds (63%) of the respondents recommended the use of a filtered respirator (i.e., N95 respirator) with full-face shield and stated that it was their preferred PPE, whereas 21% recommended the use of powered air-purifying respirators (PAPRs) during OMFS procedures. Only (73%) of the programs had resources for resident wellness and stress reduction. Virtual didactic training sessions conducted on digital platforms, most commonly Zoom, formed a major part of education for all programs.ConclusionsAll programs promptly responded to the pandemic by making appropriate changes, including suspending elective surgery and limiting patient care to emergent and urgent services. OMFS training programs should give more consideration to providing residents with adequate stress reduction resources to maintain their well-being and training and to minimize exposure risk during an evolving global epidemic.

Awake tracheal intubation during the COVID-19 pandemic - an aerosol-minimising approach.

We recently needed to perform awake tracheal intubation (ATI) for a patient undergoing urgent maxillofacial surgery at our secondary hospital. During the coronavirus disease 2019 (COVID-19) pandemic all maxillofacial surgery patients are treated as suspected COVID-19 and ATI is widely regarded as high-risk for aerosol generation. We sought early multidisciplinary input and were informed by Ahmad et al.’s recent case report [1]. Our operating theatres have positive-pressure airflow. Negative-pressure rooms are available elsewhere in the hospital but we felt managing a difficult airway in an unfamiliar environment posed significant risk. Our available personal protective equipment comprised a disposable gown; N95 mask; goggles; full-face shield; and double gloves. We administered glycopyrrolate intravenously and used a topicalisation process designed to minimise aerosol generation: Pacey’s paste to the posterior tongue [2]; lidocaine 10% sprays to the oropharynx; lidocaine 4% via a mucosal atomiser device; and internal superior laryngeal nerve blocks using lidocaine 4%-soaked gauze and Jackson laryngeal forceps [3]. Following Difficult Airway Society guidelines [4], the total dose of lidocaine administered was < 9 mg.kg-1 (lean body weight) and a second anaesthetist administered remifentanil for conscious sedation by target-controlled infusion at 2 ng.ml−1. Oxygen 4 l.min−1 was given via Hudson mask with end-tidal carbon dioxide monitoring and a cut-out permitting oral access. Excellent topicalisation was achieved. First-pass orotracheal intubation was performed without complication using a disposable Ambu® aScope™ 4 Broncho size Regular (Ambu A/S, Ballerup, Denmark). A Shiley™ Lo-Contour flexible reinforced endotracheal tube of size 7.0 mm (Covidien Ireland Limited, Tullamore, Ireland) was used and the tracheal tube cuff was gently inflated before the induction of anaesthesia. We describe an effective aerosol-minimising approach to ATI. This process varied from our usual practise which typically includes high-flow nasal oxygen, the EZ-100m™ disposable atomiser (Alcove Medical inc., Houston, TX, USA) nasotracheal intubation and cuff inflation after induction of anaesthesia – these were avoided due COVID-19 aerosolisation concerns. Published with the written consent of the patient. No external funding or competing interests declared.

Review of practical recommendations for otolaryngologists and head and neck surgeons during the COVID-19 pandemic

IntroductionOtolaryngologists are at very high risk of COVID-19 infection while performing examination or surgery. Strict guidelines for these specialists have not already been provided, while currently available recommendations could presumably change in course of COVID-19 pandemic as the new data increases. ObjectivesThis study aimed to synthesize evidence concerning otolaryngology during COVID‐19 pandemic. It presents a review of currently existing guidelines and recommendations concerning otolaryngological procedures and surgeries during COVID-19 pandemic, and provides a collective summary of all crucial information for otolaryngologists. It summarizes data concerning COVID-19 transmission, diagnosis, and clinical presentation highlighting the information significant for otolaryngologists. MethodsThe Medline and Web of Science databases were searched without time limit using terms ‘‘COVID-19”, “SARS-CoV-2” in conjunction with “head and neck surgery”, “otorhinolaryngological manifestations”. ResultsPatients in stable condition should be consulted using telemedicine options. Only emergency consultations and procedures should be performed during COVID-19 pandemic. Mucosa-involving otolaryngologic procedures are considered high risk procedures and should be performed using enhanced PPE (N95 respirator and full face shield or powered air-purifying respirator, disposable gloves, surgical cap, gown, shoe covers). Urgent surgeries for which there is not enough time for SARS-CoV-2 screening are also considered high risk procedures. These operations should be performed in a negative pressure operating room with high-efficiency particulate air filtration. Less urgent cases should be tested for COVID-19 twice, 48 h preoperatively in 24 h interval. ConclusionsThis review serves as a collection of current recommendations for otolaryngologists for how to deal with their patients during COVID-19 pandemic.

Turkish Thoracic Society Experts Consensus Report: Recommendations for Pulmonary Function Tests During and After COVID 19 Pandemic.

The recommendation of conducting pulmonary function tests (PFTs) from different societies during and after the coronavirus disease (COVID-19) pandemic was rated by the experts of the Turkish Thoracic Society (TTS) and presented as the TTS experts consensus report. Information about the topic has been provided.Globally, as of mid-May 2020, there have been over 4.4 million confirmed cases of COVID-19. There are two main routes of transmission of COVID-19: respiratory droplets and contact transmission. PFTs are non-invasive tests that are commonly performed in routine assessment and follow-up of patients in the pulmonology units. However, PFTs may generate aerosols and require sharing common surfaces. With regard to the high prevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the community, PFTs should not be performed routinely in confirmed or suspected patients with COVID-19 during the pandemic. Because of the risk of human-to-human transmission of COVID-19, PFTs should be restricted to a small patient population with selected indications. Triage for COVID-19 should be performed prior to testing. Only essential PFTs such as spirometry, diffusion capacity of the lungs for carbon monoxide (DLCO), arterial blood gas analysis, or pulse oximetry should be performed in the selected cases. Tests should be scheduled to allow sufficient time for donning and doffing of the technical personnel with the full personal protective equipment (PPE) (gown, a filtering respirator mask, goggles or full-face shield, and disposable gloves), ventilation of the room, and application of post-test cleaning and disinfection procedures of the equipment and the testing room.

COVID-19: Common Critical and Practical Questions.

COVID-19: Common Critical and Practical Questions.

Respiratory Protection Considerations for Healthcare Workers During the COVID-19 Pandemic.

The COVID-19 pandemic has resulted in a surge of patients that exceeds available human and physical resources in many settings, triggering the implementation of crisis standards of care. High-quality respiratory protection is essential to reduce exposure among healthcare workers, yet dire shortages of personal protective equipment in the United States threaten the health and safety of this essential workforce. In the context of rapidly changing conditions and incomplete data, this article outlines 3 important strategies to improve healthcare workers' respiratory protection. At a minimum, healthcare workers delivering care to patients with confirmed or suspected COVID-19 should wear N95 respirators and full-face shields. Several mechanisms exist to boost and protect the supply of N95 respirators, including rigorous decontamination protocols, invoking the Defense Production Act, expanded use of reusable elastomeric respirators, and repurposing industrial N95 respirators. Finally, homemade facial coverings do not protect healthcare workers and should be avoided. These strategies, coupled with longer-term strategies of investments in protective equipment research, infrastructure, and data systems, provide a framework to protect healthcare workers immediately and enhance preparedness efforts for future pandemics.

Pediatric Endoscopy in the Era of Coronavirus Disease 2019: A North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition Position Paper.

ABSTRACTThe delivery of endoscopic care is changing rapidly in the era of Coronavirus Disease 2019 (COVID-19). The North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN) Endoscopy and Procedures Committee has formulated this statement to offer practical guidance to help standardize endoscopy services for pediatric patients with the aim of minimizing COVID-19 transmission to staff, patients, and caregivers and to conserve personal protective equipment (PPE) during this critical time. Appropriate use of PPE is essential to minimize transmission and preserve supply. Pediatric endoscopic procedures are considered at high risk for COVID-19 transmission. We recommend that all pediatric endoscopic procedures are done in a negative pressure room with all staff using proper airborne, contact, and droplet precautions regardless of patient risk stratification. This includes appropriate use of a filtering face-piece respirator (N95, N99, FFP2/3, or PAPR), double gloves, facial protection (full visor and/or face shield), full body water-resistant disposable gown, shoe covers and a hairnet. In deciding which endoscopic procedures should proceed, it is important to weigh the risks and benefits to optimize healthcare delivery and minimize risk. To inform these decisions, we propose a framework for stratifying procedures as emergent (procedures that need to PROCEEED), urgent (PAUSE, weigh the benefits and risks in deciding whether to proceed) and elective (POSTPONE procedures). This statement was based on emerging evidence and is meant as a guide. It is important that all endoscopy facilities where pediatric procedures are performed follow current recommendations from public health agencies within their jurisdiction regarding infection prevention and control of COVID-19.

Management of Hemodialysis Patients with Suspected or Confirmed COVID-19 Infection: Perspective of Two Nephrologists in the United States.

The coronavirus disease 2019 (COVID-19) pandemic is unprecedented and information about the severe acute respiratory syndrome coronavirus 2 is evolving rapidly. New York is one of the epicenters of the COVID-19 outbreak in the United States, reporting >1000 confirmed cases as of March 17, 2020, and cases are escalating exponentially. The majority of cases are in Westchester County ( n =220) and New York City (NYC; n =463), which includes Bronx (1). The local index patient case was a Westchester man who became ill on February 22, was not associated with a recent travel exposure to a country on the watch list (China, Iran, South Korea, and Italy), or known to have had direct contact with a COVID-19–confirmed patient. At the present time it is estimated that community-wide transmission accounts for 87% of confirmed cases. Nephrologists in the Bronx have been handicapped in managing patients with ESKD during the early weeks of the COVID-19 pandemic due to the limitations of available rapid testing for severe acute respiratory syndrome coronavirus 2. Montefiore Medical Center, located in the north Bronx in close proximity to Westchester, has been one of the main tertiary care hospitals in NYC caring for persons under investigation (PUIs) and for COVID-19–confirmed patients. Our nephrology division’s clinical faculty care for approximately 850 patients with ESKD (approximately 800 on hemodialysis and approximately 50 on peritoneal dialysis) in 12 outpatient hemodialysis facilities (two Fresenius and 10 DaVita facilities) in the Bronx. We report our experience with caring for the ESKD population and patients who are hospitalized with AKI in the Bronx during the first 3 weeks of the local NYC COVID-19 pandemic. Strategies proposed for the prevention and management of COVID-19 transmission for patients with ESKD in the outpatient dialysis facilities have been dynamic. The American Society of Nephrology’s (ASN’s) Nephrologists Transforming …

Prevalence and severity of pterygium among commercial motorcycle riders in south eastern Nigeria.

Pterygium is common among outdoor workers who are daily exposed to sunlight and dust due to repeated conjunctival /corneal drying and micro-trauma especially in the tropics. Commercial motorcyclists in Nigeria are outdoor workers who spend the greater part of the day outdoors under the intense heat and dust characteristic of this part of the world and would therefore be largely predisposed to developing this conjunctival disorder. The aim of this study is to determine the prevalence and severity of pterygium among these workers and relate these findings to their duration of work. A cross sectional study with a multi stage random sampling design was used to choose the 615 subjects enrolled in the study. The prevalence for pterygium was 19.3% (206 eyes) with stage 1 occurring mostly (52%) followed by stage 2(46%). Pterygium was common among riders who had been riding for 5 years or less. The relationship between duration of riding and pterygium severity was significant (p=0.009). This prevalence was unaffected by the use of regular sun glasses (p=0.188). A strong relationship exists between commercial motorcycle riding and development of pterygium not affected by using regular sunglasses. We recommend that helmets with full face shields and/or proper UV protected riding goggles where the helmets have no face shield be enforced by the regulation bodies so as to reduce the prevalence of these disorders.

Safety goggles: are they adequate to prevent eye injuries caused by rotating wire brushes?

Rotating wire brushes can cause severe ocular injuries. Wearing safety goggles has been recommended to prevent injury. A case is described of a superficial penetrating eye injury secondary to the...

Paintball injury causing temporal artery pseudoaneurysms—A case for better protection

Paintballing is an increasingly popular recreational outdoor sport. Injuries related to paintballing are well recognised and appropriate eye and face shields are recommended by accredited organisations such as the UK Paintball Sports Federation. Here we present a case of paintball injury causing temporal artery pseudoaneurysms and recommend the use of full head and face shields for protection against this potentially serious injury.

Floodwater exposure and the related health symptoms among firefighters in New Orleans, Louisiana 2005

Concerns over increased reports of physical health symptoms thought to be related to floodwater exposure among New Orleans firefighters prompted a health hazard evaluation of firefighters following Hurricane Katrina. A questionnaire assessing health symptoms possibly related to the response to Hurricane Katrina was administered to all New Orleans Fire Department (NOFD) personnel within 3 months of the disaster. Descriptive statistics were compiled and prevalence ratios (PR) were estimated for covariates using generalized linear models with Log link and Poisson distribution. Of the 525 firefighters who completed the questionnaire (77% participation), 201 (38%) reported one or more new-onset respiratory symptoms, such as sinus congestion (145 [28%]), throat irritation (92 [17%]), and cough (124 [24%]). Skin rash was reported by 258 (49%) of respondents, 414 (79%) reported skin contact with floodwater, and 165 (32%) reported contact with floodwater on multiple days. In multivariate analyses adjusting for age, gender, and smoking, firefighters who had floodwater contact with skin and either nose/mouth or eyes (224, 44%) had an increased rate of new-onset upper respiratory symptoms (PR = 1.9; 95% confidence interval [CI], 1.1, 3.1), and skin rash (PR = 2.1; 95% CI, 1.4, 3.2) compared to those not exposed to the floodwater. Response workers involved with floodwater should minimize direct skin and mucosal contact with floodwater if possible through the use of appropriate personal protective equipment, such as goggles, safety glasses with side shields, or full-face shields.