Individual Protection Equipment Research Articles

Relato de experiência da participação de estudantes voluntários no inquérito soroepidemiológico da COVID-19 no Município de Jundiaí, Brasil

ObjectiveExperience report of medical and nursing students on participation in the seroepidemiological investigation of COVID-19 in the city of Jundiaí.MethodsIn the survey, resident of 1260 households were tested, and a questionnaire was filled out with information about the individual and family in June/20. The students clarified the situation of the pandemic, providing guidance on general preventive care. To assess the students’ perception of participation in the survey, a questionnaire was available online, including questions about the satisfaction, adherence to the survey proposal, feeling of security and risk, availability of individual protective equipment and personal motivation.ResultsThe 50 volunteers answered the form (100%). In the evaluation, they were very satisfied, with the health team, 86% (n=43); regarding the organization of activities, 66% (n=33); and with the availability of protection personal equipment, 64% (n=32); 70% said they did not feel afraid at any time and 45% (n=46) stated their main motivation for the desire to contribute to the pandemic, followed by the desire to learn (29%, n=30).ConclusionIt was evident the motivation of academics to act in the face of the pandemic of COVID-19, combined with satisfaction and the opportunity to include practical learning in activities with the population. Emphasis is placed on the importance of community outreach activities as a tool for social change and university education.

The use of aramids and para-aramids in the manufacture of individual protective equipment

The paper presents the possibility of using aramids and para-aramids in order to increase the mechanical and thermal quality of individual protective equipment and the possibility of being used in harsh environments. The work will highlight the physico-chemical characteristics of aramids and para-aramids in comparison with the classic materials from which individual protective equipment is made in the present. The utility of the equipment will also be taken into account for their use underground in mining operations, a condition that is fulfilled by their chemical treatment.

Practical training of rescuers in high temperature and humidity environments in the training facility

Heat is normally generated as a result of metabolic processes taking place in the body. As a result of muscle activity, when working or exercising, a considerable amount of heat is released. The amount of heat generated is proportional to the intensity of activities. Intervention and rescue activities in special conditions can be carried out exclusively by personnel trained and authorized in this regard, personnel using individual breathing protection equipment. The decisive factor in ensuring the success of an intervention and rescue operation in toxic or chemically aggressive environments resides in the optimal and efficient design of a training process of personnel, in correlation, among others, with their testing in high temperatures and humidity environments. The current paper presents the structuring of rescuers’ physical effort during training, taking into account high temperature and humidity environments, structuring that aims to make the training process of intervention and rescue personnel in toxic / explosive / flammable environments more efficient. The paper analyses a correlation between changes in the physiological parameters of intervention and rescue personnel and different values of temperature and humidity of the training environment.

STUDYING THE APPLICATION OF CAD/CAM/CAE SYSTEMS IN THE DESIGN OF COMPONENTS FOR PERSONAL BALLISTIC PROTECTION EQUIPMENT

The article presents a study of the possibilities for applying the virtual set of tools for 3D modeling, manipulation, and testing of components that are part of individual ballistic protection equipment.

Effects of Ionizing Radiation Exposure on Cataract among Radiation Workers of Interventional Cardiology in Indonesia

Abstract Purpose The aim of this study was to determine the prevalence of radiation-induced cataracts and its correlation with radiation exposure dose and radiation protection equipment use among radiation workers of interventional cardiology. Methods This is a cross-sectional and retrospective case–control study. We included 180 subjects. The prevalence of radiation-induced cataracts was assessed using Scheimpflug analysis on the Pentacam-Oculus device. Individual cumulative radiation exposure dose and radiation protection equipment use were identified from questionnaires and personal dosimeters. Results The prevalence of radiation-induced cataracts was 16.7%. The median cumulative radiation dose was 0.8 (0.1–35.6) Gy. A positive correlation was found between cumulative radiation dose and lens density (R Spearman = 0.64). We found 83.9% of subjects used ceiling-suspended shields in 71 to 100% of their working period. However, most subjects (40.6%) did not wear protective eyewear. There was a statistically significant increasing risk of radiation-induced cataracts and unresponsive use of radiation protection equipment. Subjects using ceiling-suspended shield in only 31 to 50% of their working period increased their cataract risk by 10.8 times (95% confidence interval [CI]: 1.05–111.49, p = 0.044). Meanwhile, subjects using protective eyewear in only 51 to 70% of their working period increased their cataract risk by 8.64 times (p = 0.001). Subjects who did not wear protective eyewear had an odd ratio of 164.3 (95% CI: 19.81–1363) compared to those who did. Conclusion Radiation-induced cataracts among radiation workers of interventional cardiology depended on the radiation exposure dose and the use of radiation protection equipment.

Hospital Pharmacy: Comprehensive management of medical devices during SARS-CoV-2

Medical devices have become essential to the prevention and control of the COVID-19 pandemic, being crucial for health professionals and patients in particular, and the population in general.It is important to be aware of the laws that regulate the management, distribution, and control of medical devices. Article 82 of the Spanish Law 29/2006 on Guarantees and Rational Use of Medicines and Medical Devices establishes that it is the responsibility of Hospital Pharmacy Services “to participate and coordinate management of purchase of medicines and medical devices in the hospital to ensure an efficient acquisition and rational use of medical devices”. For this reason, working groups of the Spanish Society of Hospital Pharmacy and other scientific societies have issued technical guidelines and consensus statements to provide technical support and updated information on the use of masks, individual protection equipments and other medical devices.In addition, the shortage of medical devices caused by the high demand has resulted in the uncontrolled production and distribution of medical devices. This phenomenon, added to the fraudulent selling of medical devices, highlights the need for a closer surveillance of the market to guarantee the efficacy and safety of available medical devices.A rational use of medical devices is necessary to ensure the availability and safety of these products, which requires the involvement of different stakeholders, including hospital pharmacists. Thus, it is essential that hospital pharmacists receive specific training in technical aspects concerning the possession and use of medical devices. This will help guarantee an effective and safe use of medical products. The acquisition and use of medical devices requires a keen understanding of the technical and legal aspects concerning these products, which makes hospital pharmacists essential for the integral management of medical devices.

Maintaining Vascular Access Response in a Severely COVID-19 Hit Country.

The COVID-19 pandemic has caused an unprecedented disruption in healthcare systems worldwide, and Portugal was no exception. We analyze the impact of the COVID-19 pandemic in activity of our Vascular Access Center (Grupo Estudos Vasculares - GEV). This is a retrospective study, during March 2019 and February 2021. An analysis of surgical and appointments records in 2,495 patients from 25 hemodialysis centers followed by GEV was performed. Patients were divided into two periods: non-pandemic (NPP) (March 2019 to February 2020) and pandemic periods (PP) (March 2020 to February 2021). The number of surgeries and appointments were analyzed per month and per week. The number of thrombosis were analyzed in both periods. Normality was tested by the Shapiro-Wilk test and by the Lilliefors (Kolmogorov-Smirnov) test. Comparisons were made by the t-test (paired samples) when normality was not rejected and by the Wilcoxon test otherwise. All the variables (normal or otherwise) were described by the usual descriptive measures such as the mean, median and quartiles. No categorical data were collected. To avoid COVID-19 infection a set of measures were created: Sars-cov-2 PCR test for every patient, individual protection equipment for staff, rotating teams and schedules, and only one patient allowed in the circuit to the intervention room. A descriptive statistical analysis was performed with SPSS version28. The statistical significance was confirmed for p-value < 0.05. A total of 1756 surgeries and 800 appointments were made in both PP and NPP. Comparing the periods, we performed 914 (52%) interventions in the NPP and 842 (48%) in PP, 423 (53%) consultations in NPP and 377 (47%) at PP. Comparing the NPP and PP by months we observed more appointments in the NPP (p=0.004). However, the difference in the number of surgeries did not reach statistical significance (p=0.533). There were more thrombosis during the summer and fall in the NPP and PP. A total of 138 in NPP and 131 in PP thrombosis were observed in the 2 years period. There was no record of COVID-19 infections between all GEV staff (n=25). Due to timed and tight set of measures taken in the pandemic lockdown by GEV, a similar clinical and surgical activity regarding hemodialysis patients was obtained in both periods (PP and NPP). The hypothesis that the PP could diminish vascular access assessment/intervention or more thrombosis could occur was not verified at our institution. The set of measures established to deal with the COVID-19 pandemic was also effective to prevent infection in staff members.

How COVID-19 pandemic contingency measures impacted on environmental practices in Food Service

INTRODUCTION: Food Service units achieved importance and responsibility in feeding the population. In addition to its socioeconomic impact, the Food Service industry has a strong environmental impact and for several years, changes have been made to produce meals complying with sustainability. Concerns have addressed energy efficiency of equipment, use of reusable material, purchase of local products, less use of processed and packaged goods, proper selection and disposal of solid waste and use of strategies to avoid food waste. OBJECTIVES: This study aimed to assess the impact of the implementation of the contingency measures for the COVID-19 pandemic on the environmental practices of food services throughout the Portuguese territory. METHODOLOGY: The sample was obtained by convenience, requesting food service companies to fulfil a questionnaire with multiple choice and open questions. RESULTS: A sample of 139 participants was obtained. Results show a decrease in the number of meals served, accompanied by a great increase in the use of disposable items, such as plates, paper towels, bags, packages as well as individual packaging for cutlery, bread and fruit, and individual protective equipment and hygiene products (face masks, face shields and hand-sanitiser). CONCLUSIONS: This study highlights the severe setback that the contingency measures for COVID-19 represent for the food service sector. Policymakers should evaluate the adopted practices that are still in place and keep the ones that may be proven to be efficient and positive and abandon or relieve the unnecessary ones. Other measures such as the reinforcement of hygiene procedures, should be kept to ensure food and environment safety and consumer confidence in food service establishments.

Conversion of low-density polyethylene into monocyclic aromatic hydrocarbons through continuous microwave pyrolysis with ex-situ dual-catalyst beds

The single-use of polyolefins-based individual protective equipment has led to the rapid generation of substantial plastic waste. This study aimed at cleaner disposal of the polyolefin waste, and carried out the continuous microwave pyrolysis (CMP) of low-density polyethylene (LDPE) over dual-catalyst beds of MCM-41 and HY. The dual-catalyzed trial was able to produce more condensate fractions with higher selectivity of monocyclic aromatic hydrocarbons (MAHs), compared with using only MCM-41 or HY zeolite. It was because the larger pore size of the MCM-41 catalyst (4.00 nm) could crack long-chain polyolefin intermediates into shorter chains. This alleviates steric and diffusional resistance while entering and exiting the micropores of the HY zeolite (0.74 × 0.74 nm). The maximum liquid yield (63.75 wt%) and MAHs selectivity (78.21%) were achieved at a catalysis temperature of 450 °C, feedstock to catalyst ratio of 8:3, and HY to MCM-41 ratio of 2:1. In addition, the performance of the CMP reactor was also compared favorably with the batch microwave pyrolysis (BMP) reactor under the same conditions. It has been found that the CMP reactor generated more MAHs products, whereas the BMP reactor was more selective for the generation of polycyclic aromatic hydrocarbons (PAHs) and gas products. The combination of CMP and the co-catalysis process offers new insight into sustainable management and value-added recovery of medical plastic waste.

Research on Energy Absorption Characteristics of Bouligand Biomimetic Structure Based on CFRP Composite Materials

Enhancing the impact resistance performance of carbon fiber-reinforced polymer (CFRP) laminates stands as a prominent research focus among various nations. Existing studies have shown a tendency towards arbitrary selection of the inter-ply helix angle values in CFRP laminates, which is accompanied by a limited number of samples representing the chosen helix angles. However, existing studies have shown a relatively random selection of spiral angle values between CFRP laminates, and the sample size of selected spiral angles is limited, posing certain limitations. In order to tackle this problem, we have employed a systematic arrangement of combinations to select the optimal helix angle for CFRP laminates. Inspired by the biological structures of Bouligand, we have sequentially chosen 19 distinct sets of helix angles, aiming to overcome the inherent limitations and enhance the research outcomes in this field. In this study, we established 19 finite element models to investigate the behavior of Bouligand-inspired CFRP composite panels under high-velocity bullet impact. The models were created by selecting 19 sets of helix angles within the range of 0 to 90° with a 5° interval. The results show that the energy absorption of the Bouligand layer-stacking composite plate is better than that of the conventional plate. The optimal spiral angles of the CFRP laminate are 25° and 30°, and the energy absorption characteristics of the laminate are the best at these angles. The impact resistance is also the best at these angles. The energy absorption of the Bouligand layer-stacking composite plate is 396% higher in absorbed internal energy and 361% higher in absorbed kinetic energy compared to the conventional layer-stacking composite plate, significantly improving the ballistic performance of the CFRP bulletproof material and providing a reference for the design of individual protection equipment.

Standard precautions should include 'safe ventilation' to minimise far-afield airborne transmission in health and social care settings.

Standard precautions should include 'safe ventilation' to minimise far-afield airborne transmission in health and social care settings.

INDIVIDUAL RESPIRATORY PROTECTION EQUIPMENT: INNOVATIONS TO REDUCE THE RISK OF OCCUPATIONAL DISEASES

Individual respiratory protective equipment (PPE) is the last barrier to protect workers when performing production tasks in harmful and dangerous working conditions. The article analyzes modern innovative designs of personal respiratory protective equipment, which increase the level of protection of users during their operation. The method of morphological analysis is applied. This method based on the selection of possible solutions for assessing the manufacturability of PPE models (if there is a system of criteria) and making a rational decision regarding the features of their application in production conditions. As a result, it was established that in order to ensure the appropriate duration of the protective action of gas and dust filters and to avoid both poisoning of workers due to the ingress of harmful aerosols into the sub-mask space of the filter respirator, and excessive physical exhaustion due to the increase in pressure drop above the standard substances, it is recommended to equip the filters with special indicators for determining air pollution and pressure drop values. It was determined that in order to increase the reliability of the protection of workers, it is necessary to equip filter respirators with the functions of operational control of breathing resistance, place a headrest to control the occurrence of possible gaps behind the obturation band when performing various production operations, and establish the real term of the protective effect of the filters. The practical value of the work is innovative solutions to improve the designs of existing filter respirators, which will allow control over technological parameters during operation. In particular, the density along the obturation strip and the magnitude of the tension force of the respirator headgear. Recommendations are also given for controlling the term of the protective action of gas filters, since determining the specified indicators based on the organoleptic abilities of the user is dangerous for health. Keywords: risk, means of individual protection of respiratory organs, filtering respirator.

Pollution and occupational protection of diesel particulate matter in underground space.

To address the diesel particulate matter pollution problem at the 12,306 continuous mining face of Shangwan coal mine, the spatial and temporal evolution law of diesel particulate matter generated at the three locations of the shuttle car head tunnel, contact alley, and support tunnel under the pressure-in ventilation condition of the double lane of the continuous mining face was studied by numerical simulation. The results show that the highest diesel particulate matter concentration at the shuttle car discharge is about 144.17mg/m3, which seriously affects the health of miners. The highest diesel particulate matter concentration at the shuttle car tunnel is 52.58mg/m3, and at the contact alley, the diesel particulate matter diffusion space is limited by the compression of the space inside the contact alley by the shuttle car machine body and the alley wall, which makes the diesel particulate matter accumulate here, forming a high diesel particulate matter concentration distribution area with a concentration value of 112.75mg/m3. When supporting the roadway at the shuttle, diesel particulate matter accumulates in the range of X = 55m ~ 60m, Y = 0m ~ 4m, and Z = 23.4m ~ 29.4m. According to the degree of DPM pollution in different areas, different individual protective equipment is used to obtain different levels of pollution protection.

Interpretable Deep Learning for Discriminating Pneumonia from Lung Ultrasounds

Lung ultrasound images have shown great promise to be an operative point-of-care test for the diagnosis of COVID-19 because of the ease of procedure with negligible individual protection equipment, together with relaxed disinfection. Deep learning (DL) is a robust tool for modeling infection patterns from medical images; however, the existing COVID-19 detection models are complex and thereby are hard to deploy in frequently used mobile platforms in point-of-care testing. Moreover, most of the COVID-19 detection models in the existing literature on DL are implemented as a black box, hence, they are hard to be interpreted or trusted by the healthcare community. This paper presents a novel interpretable DL framework discriminating COVID-19 infection from other cases of pneumonia and normal cases using ultrasound data of patients. In the proposed framework, novel transformer modules are introduced to model the pathological information from ultrasound frames using an improved window-based multi-head self-attention layer. A convolutional patching module is introduced to transform input frames into latent space rather than partitioning input into patches. A weighted pooling module is presented to score the embeddings of the disease representations obtained from the transformer modules to attend to information that is most valuable for the screening decision. Experimental analysis of the public three-class lung ultrasound dataset (PCUS dataset) demonstrates the discriminative power (Accuracy: 93.4%, F1-score: 93.1%, AUC: 97.5%) of the proposed solution overcoming the competing approaches while maintaining low complexity. The proposed model obtained very promising results in comparison with the rival models. More importantly, it gives explainable outputs therefore, it can serve as a candidate tool for empowering the sustainable diagnosis of COVID-19-like diseases in smart healthcare.

The Importance of Workplace- Occupational Safety in the Perspective of Enterprise Sustainable Development and Performance

Workplace- Occupational health and safety has grown more vital in order to safeguard the sustainability of firms' manufacturing operations in order to adapt to competitive pressures circumstances and quick consumption. Recognizing the destruction of productivity and image, as well as the money and spiritual expenses due to workplace fatalities and occupational diseases, implementing measures and improving workplace health and protection would bring major benefits to individuals, businesses, and the country 's business. Unsafe conditions, depending to studies, may be influenced through variables such as physical and technological environmental circumstances, as well as personnel characteristics. Conditions including the framework of the technology and manufacturing industry, the specifics of mining, development, and transportation lines of enterprise, ignorant and underqualified manufacturing workers, incapacity to adjust to technological advancements, environmental degradation, production organization layout, and the failure to use individual protective equipment and equipment guardians could all lead to occupational fatalities, particularly in underdeveloped and emerging nations.. These circumstances are significant in the likelihood of workplace accidents. Throughout the scope of this research, investigation is performed on the workspace functioning system, ergonomically design, and occupational physiological variables, which are considered the drivers of occupational disasters in generally. A continuous improvement, Total Abilities and Accomplishment (5S and Total Productive Maintenance) Implementation is provided to enhance occupational security and functional productivity in a business that manufactures white appliances. As a consequence of the specific application, an assessment was carried out in the perspective of worker productivity and commercial performance of the operations.

Readiness of Community Health Agents for COVID19

Abstract Brazil is one of the countries with the highest COVID19 mortality numbers. COVID19 deaths affected disproportionally different populations/communities, tending to be higher among more vulnerable ones. Brazil has a public-funded unified health system (SUS) built on the aegis of equity and social control. Its Primary Health Care (PHC) is organized by the Family Health Strategy (FHS) through Family Health Teams (FHT), which comprise a family doctor, a nurse, a dentist, nurse auxiliaries and Community Health Agents (CHAs). CHAs are individuals from the community trained to provide a range of services in the territories, including home visits, health promotion activities, and serve as liaisons between health units and communities. In this context, CHAs have the potential to play an important role in fighting the pandemic by working on contact tracing, collecting information on infected people, and providing guidance to them and the community in order to contain community transmission. However, not much is known about their readiness regarding the COVID19 pandemic in one of the Brazil's poorest regions. Thus, this study evaluated, though CHA perspective, aspects related to their preparedness for COVID19 in Brazil's northeast region. Questionnaires were applied to CHAs from 8 different municipalities - 4 capitals and 4 country-side municipalities. A total of 1935 CHAs were interviewed at their workplace in 2021. 77.8% said that they were acting in the COVID19 frontline, but only 16% referred to have received training for this function. Furthermore, only 13.7% mention to have had access to adequate individual protective equipment during their work, and 91.6% believe that they can get infected by SAR-COV-2 during their work duties. Additionally, 93.9% considered themselves a transmission vehicle due to work. Despite their potential in the fight against COVID19, CHAs did not received enough training, nor were equipped adequately during the COVID19 pandemic. Key messages • CHAs did not received enough training, nor were equipped adequately during the COVID19 pandemic. • Addequate trainning and work environment are essencial for proper work development.

Combining microwave and ultraviolet energy for sample preparation of polymer-based materials for further halogen determination

In this work, a microwave-assisted ultraviolet wet digestion (MAWD-UV) protocol was used to digest polymer-based materials (e-waste, food packing, medical-care materials, and individual protection equipment) for further halogen determination. Digests were suitable for Cl, Br, and I determination by inductively coupled plasma mass spectrometry (ICP-MS) or inductively coupled plasma optical emission spectrometry (ICP-OES). Fluorine determination was performed with ion selective electrode (ISE). The power radiation and the digestion solution were evaluated. The accuracy was evaluated by comparing the results with those obtained after neutron activation analysis (NAA) for Cl and Br or using microwave-induced combustion (MIC) as sample preparation for F and I. Two certified reference materials (CRM) of low-density polyethylene (ERM EC680k and EC681k) were evaluated, and no differences were observed (t-test, 95% confidence level) between the results and the certified values. Quantitative recoveries for Cl, Br, and I were obtained using 200 mg of the sample using diluted acid solution (15 mL of 0.5 mol L−1 HNO3 plus 10.6 mol L−1 of H2O2), with a 40 min radiation program (700 W, 25 min ramp). No statistical differences (ANOVA, 95% confidence level) were observed between the MAWD-UV and ICP-MS results and the reference values for Cl, Br, and I for several samples. However, results were lower than the reference values for fluorine, indicating that digestion efficiency was poor for this analyte, which was probably as an organic molecule (likely polytetrafluoroethylene). The limit of quantification (LOQ) was 0.216 mg g−1 for Cl, 3.33 µg g−1 for Br, and 0.036 µg g−1 for I using ICP-MS. The main advantage of MAWD-UV is that it enables decomposing several polymer-based matrices using diluted acid without halogen losses. The developed method represents an important contribution to the digestion of these hard-to-digest matrices and in compliance with green analytical chemistry, thereby being an advance in sample preparation.

Studies of Acceleration of the Human Body during Overturning and Falling from a Height Protected by a Self-Locking Device.

The use of individual fall protection equipment is one of the most commonly applied methods of protecting workers whose worksites are located above the floor level. The safety of the user in such a situation depends on both the proper selection and correct use of such equipment. Additionally, aspects such as minimizing the free-fall distance before the fall arrest, as well as quick notification of an accident and efficient rescue operation, are important factors influencing safety. This paper presents a new testing method for fall arrest equipment using a test stand consisting of the Hybrid III 50th Pedestrian ATD anthropomorphic manikin and measuring set with three-axis acceleration transducers. The proposed method and test stand were developed for the design and testing of new fall protection devices equipped with electronic detection and alarm systems, for which it is necessary to determine acceleration limits in order to determine the alarm threshold. The proposed method is based on the measurement of accelerations that occur during tipping and falling from the height of an anthropomorphic manikin secured by a self-locking device. Two places of attachment of the measuring set with a three-axis acceleration sensor were analyzed at the waist belt of the manikin (abdomen and back). Moreover, the self-locking device lanyard was attached to the two points of the safety harnesses (the front and back point). The aim of the research was to check whether the acceleration values depend on the places of attachment of the measuring and anchored system, as well as to determine their maximum values. Acceleration values corresponding to fall arrest and tipping were analyzed. Limits of acceleration have been established in order to determine the threshold of alarm triggering. The non-parametric Mann–Whitney U test was used to check whether the location of the three-axis acceleration transducer and the position of the self-locking device lanyard attachment affect the value of the recorded acceleration. For results of acceleration measurements when testing the behavior of the manikin during fall arrest, no statistically significant differences were found. For results of acceleration measurements when testing the tipping behavior of the manikin, statistically significant differences occurred. This means that during fall arrest, the location of the three-axis acceleration transducer and the position of the self-locking device lanyard attachment do not matter. This work is a continuation of previous research on accelerations characterizing human body positions occurring during normal physical activities (ADL—activities of daily living).

Mathematical optimization models for reallocating and sharing health equipment in pandemic situations

In this paper we provide a mathematical programming based decision tool to optimally reallocate and share equipment between different units to efficiently equip hospitals in pandemic emergency situations under lack of resources. The approach is motivated by the COVID-19 pandemic in which many Heath National Systems were not able to satisfy the demand of ventilators, sanitary individual protection equipment or different human resources. Our tool is based in two main principles: (1) Part of the stock of equipment at a unit that is not needed (in near future) could be shared to other units; and (2) extra stock to be shared among the units in a region can be efficiently distributed taking into account the demand of the units. The decisions are taken with the aim of minimizing certain measures of the non-covered demand in a region where units are structured in a given network. The mathematical programming models that we provide are stochastic and multiperiod with different robust objective functions. Since the proposed models are computationally hard to solve, we provide a divide-et-conquer math-heuristic approach. We report the results of applying our approach to the COVID-19 case in different regions of Spain, highlighting some interesting conclusions of our analysis, such as the great increase of treated patients if the proposed redistribution tool is applied.

Safety of Endoscopy Units during the COVID-19 Pandemic

Introduction: The COVID-19 pandemic drastically changed the daily routine of all healthcare systems worldwide, and endoscopy units were no exception. Endoscopic exams were considered to have a high risk of transmission, and therefore, the safety of endoscopy units and the consequent need for pre-endoscopy SARS-CoV-2 screening were questioned early on. The aim of our study was to assess the safety of endoscopy units during the COVID-19 pandemic, as well as the effectiveness/necessity for SARS-CoV-2 screening prior to endoscopies. Material and Methods: This is a retrospective and single-center study carried out in a Portuguese tertiary hospital. All patients who underwent endoscopic procedures between September 1, 2020 and February 28, 2021 were included. The pre-endoscopy screening consisted of a specific questionnaire or a RT-PCR test for SARS-CoV-2 (nasal and oropharyngeal swab). Data were obtained through patient’s clinical records and the Trace COVID platform. Results: A total of 2,166 patients were included. Patients had a mean age of 61.8 years and were predominantly male (56.2%, n = 1,218). Eighty-one (3.7%) patients had previous SARS-CoV-2 infection, with a median difference of 74 days (IQ 40.5:160.5) between infection and endoscopy. Most patients (70.2%, n = 1,521) underwent PCR screening for SARS-CoV-2 up to 72 h before the procedure, with the remaining patients (29.8%, n = 645) answering a questionnaire of symptoms and risk contacts up to 3 days before endoscopy. Of the patients who underwent RT-PCR screening for SARS-CoV-2, 21 (1.4%) tested positive, and all were asymptomatic at the time of the screening. The evaluation for SARS-CoV-2 infection up to 14 days after the endoscopic exams identified 9 positive patients (0.42%) for SARS-CoV-2. The median difference in days between endoscopy and the diagnosis of infection was 10 days. Discussion/Conclusion: Pre-endoscopy screening with RT-PCR test for SARS-CoV-2 identified a very small number of patients with COVID-19 infection as well as patients with COVID-19 infection in the following 14 days. Therefore, the risk of infection in endoscopy units is negligible if screening of symptoms and risk contacts is applied and individual protective equipment is used.