Personal Protective Equipment Items Research Articles

Availability of basic infection control items and personal protection equipment in 7948 health facilities in eight low- and middle-income countries: Evidence from national health system surveys.

Hundreds of millions of people become infected globally every year while seeking care in health facilities that lack basic needs like infection control measures and personal protective equipment (PPE). We aimed to evaluate the availability of infection control items and PPE in eight low- and middle-income countries and identify disparities in the availability of those items. In this study, we combined publicly available nationally representative cross-sectional health system surveys (Service Provision Assessments by the Demographic and Health Survey Programme) conducted in eight countries between 2013 and 2018: Afghanistan, Bangladesh, the Democratic Republic of the Congo, Haiti, Malawi, Nepal, Senegal, and Tanzania. The availability of infection control items was evaluated using a list of six items (a waste receptacle, a sharps container, disinfectant, single-use disposable or auto-disposable syringes, soap and running water, or an alcohol-based hand rub, and guidelines for standard precautions). PPE includes four items: gloves, medical masks, gowns, and eye protection. We considered these items available in a facility if they were observed in general outpatient areas or any service-specific area (i.e. delivery room). We analysed data from 7948 health facilities (694 hospitals and 7254 health centres/clinics). Overall, among the infection control items and PPE, most surveyed facilities had high availability of single-use disposable or auto-disposable syringes (91.40%) and latex gloves (92.56%). Of infection control measures, guidelines for infection control were the least available during the survey, with the lowest (6.15%) in Nepal and the highest (68.18%) in Malawi. Of the PPE items, eye protection was the least available during the survey, with the lowest (5.4% in Senegal) and the highest (28.17%) in Haiti. Only 1567 (19.71%) facilities looked to have all the basic infection control materials, and 1023 (12.87%) of the analysed facilities possessed all of the PPE. Within the same country, the availability of items varied more between hospitals and health centres/clinics than between them. All eight of our study countries experience shortages of the most fundamental standard precaution items to avert infection. Steps must be taken in each of these countries to reduce inadequacies and disparities and enhance efficiency in the conversion of health-system inputs into the facility's availability of standard precaution items for infection control - to curb the risk of infectious disease transmission.

Personal protective equipment (PPE) litter in terrestrial urban areas of Iligan City, Philippines.

In recent years, many countries have relied on the massive use of personal protective equipment (PPE) following the recommendation of the World Health Organization (WHO) to combat COVID-19, an infectious disease caused by the SARS-CoV-2 virus. These PPEs include facemasks, face shields, disinfectant wipes, and disposable gloves. While PPE serves as protection, it can also be a source of pollution. This study is the first to establish a baseline monitoring and assessment of the spatial distribution of COVID-19-related PPE litter approaching the post-pandemic from the urban areas in Iligan City, Philippines. A total of 1632 COVID-19 PPE litter were gathered in all surveyed locations, predominantly facemasks (90.7%) and disinfectant wipes (8.8%). Among the surveyed areas, the location that recorded the highest count and density of PPE litter is in a residential zone (52.14%; n = 851; 0.0317 item m-2); the lowest was determined in recreational parks (2.57%; n = 42; 0.0016 item m-2). The significant difference in the total count of PPE items in each location could be traced to the varying land uses and ecosystems as well as the human behavior and activities. FTIR results reveal that all types of facemasks sampled are principally made of polypropylene, a material that threatens environmental sustainability and low recyclability. As the country is embracing the new normal and somewhat returning to pre-pandemic activities, this study calls for the prioritization of the government agendas on ecological solid waste management in the country.

Prevalence and distribution of personal protective equipment (PPE) litter along the shoreline of Charleston Harbor estuary, South Carolina, USA

The COVID-19 pandemic has introduced personal protective equipment (PPE) litter into the environment since early 2020. These items are often made of plastic polymers and can degrade over time. This study quantified PPE litter abundance around Charleston Harbor, South Carolina. Plastic and PPE litter were collected at ten sites in September 2021. Items were weighed and categorized by type and plastic polymer. A total of 286 items of PPE were found, comprising 2.9 % of all plastic litter. Gloves were the most abundant type of PPE (n = 142), and PPE was found at an average density of 0.03 items m−1 and 0.19 g m−1. Compared to other coastal surveys conducted during the pandemic, PPE litter was present at higher proportions in Charleston Harbor. These results establish baseline levels of pandemic-related PPE litter in Charleston Harbor, and future research is necessary to quantify the environmental risks associated with PPE litter exposure.

Personal protective equipment (PPE) pollution associated with the COVID-19 pandemic on beaches in the eastern region of the Gulf of California, Mexico

The COVID-19 pandemic has led to an increase in plastic pollution, including improper disposal of personal protective equipment (PPE). This study focuses on examining the presence and distribution of discarded PPE in three locations in Sonora, Mexico, located within the Gulf of California. Transects were conducted in 2021 and 2022, during which PPE items were visually identified, photographed, and classified. Face masks were found to be the most prevalent PPE type (96% of the total), with polymer-based masks being the most commonly observed (97% of the total). The density of PPE was higher on recreational beaches compared to non-recreational ones. Statistical analysis revealed a significant difference (W = 217.5, p = 0.014) in the PPE density between the sampled recreational beaches in 2021 and 2022, with a higher density recorded in the first year. Improper disposal of PPE poses environmental risks and potential threats to marine organisms. The documented discarded COVID-19-related PPE in this study provides important baseline information for future research and monitoring. This information is valuable to better understand the ecotoxicological effects of PPE and develop effective waste management strategies in the Gulf of California.

Evaluation of disinfection methods for personal protective equipment (PPE) items for reuse during a pandemic.

The COVID-19 pandemic resulted in many supply chain issues, including crippling of essential personal protective equipment (PPE) needed for high-risk occupations such as those in healthcare. As a result of these supply chain issues, unprecedented crisis capacity strategies were implemented to divert PPE items such as filtering facepiece respirators (FFRs, namely N95s) to those who needed them most for protection. Large-scale methods for decontamination were used throughout the world to preserve these items and provided for their extended use. The general public also adopted the use of non-specialized protective equipment such as face coverings. So, the need for cleaning, decontamination, or disinfection of these items in addition to normal clothing items became a necessary reality. Some items could be laundered, but other items were not appropriate for washing/drying. To fill research gaps in small-scale, non-commercial cleaning and disinfection, this bench-scale research was conducted using small coupons (swatches) of multiple PPE/barrier protection materials inoculated with virus (non-pathogenic bacteriophages Phi6 and MS2) and tested against a range of decontamination methods including bleach-, alcohol- and quaternary ammonium compound (QAC)-based liquid sprays, as well as low concentration hydrogen peroxide vapor (LCHPV) and bench-scale laundering. In general, non-porous items were easier to disinfect than porous items, and the enveloped virus Phi6 was overall easier to inactivate than MS2. Multiple disinfection methods were shown to be effective in reducing viral loads from PPE coupons, though only laundering and LCHPV were effective for all materials tested that were inoculated with Phi6. Applications of this and follow-on full-scale research are to provide simple effective cleaning/disinfection methods for use during the current and future pandemics.

Availability and use of personal protective equipment in low- and middle-income countries during the COVID-19 pandemic.

Availability and appropriate use of personal protective equipment (PPE) is of particular importance in Low and Middle-Income countries (LMICs) where disease outbreaks other than COVID-19 are frequent and health workers are scarce. This study assesses the availability of necessary PPE items during the COVID-19 pandemic at health facilities in seven LMICs. Data were collected using a rapid-cycle survey among 1554 health facilities in seven LMICs via phone-based surveys between August 2020 and December 2021. We gathered data on the availability of World Health Organization (WHO)-recommended PPE items and the use of items when examining patients suspected to be infected with COVID-19. We further investigated the implementation of service adaptation measures in a severe shortage of PPE. There were major deficiencies in PPE availability at health facilities. Almost 3 out of 10 health facilities reported a stock-out of medical masks on the survey day. Forty-six percent of facilities did not have respirator masks, and 16% did not have any gloves. We show that only 43% of health facilities had sufficient PPE to comply with WHO guidelines. Even when all items were available, healthcare workers treating COVID-19 suspected patients were reported to wear all the recommended equipment in only 61% of health facilities. We did not find a statistically significant difference in implementing service adaptation measures between facilities experiencing a severe shortage or not. After more than a year into the COVID-19 pandemic, the overall availability of PPE remained low in our sample of low and middle-income countries. Although essential, the availability of PPE did not guarantee the proper use of the equipment. The lack of PPE availability and improper use of available PPE enable preventable COVID-19 transmission in health facilities, leading to greater morbidity and mortality and risking the continuity of service delivery by healthcare workers.

Unfamiliar personal protective equipment: The role of routine practice and other factors affecting healthcare personnel doffing strategies.

Healthcare personnel (HCP) may encounter unfamiliar personal protective equipment (PPE) during clinical duties, yet we know little about their doffing strategies in such situations. To better understand how HCP navigate encounters with unfamiliar PPE and the factors that influence their doffing strategies. The study was conducted at 2 Midwestern academic hospitals. The study included 70 HCP: 24 physicians and resident physicians, 31 nurses, 5 medical or nursing students, and 10 other staff. Among them, 20 had special isolation unit training. Participants completed 1 of 4 doffing simulation scenarios involving 3 mask designs, 2 gown designs, 2 glove designs, and a full PPE ensemble. Doffing simulations were video-recorded and reviewed with participants during think-aloud interviews. Interviews were audio-recorded and analyzed using thematic analysis. Participants identified familiarity with PPE items and designs as an important factor in doffing. When encountering unfamiliar PPE, participants cited aspects of their routine practices such as designs typically used, donning and doffing frequency, and design cues, and their training as impacting their doffing strategies. Furthermore, they identified nonintuitive design and lack of training as barriers to doffing unfamiliar PPE appropriately. PPE designs may not be interchangeable, and their use may not be intuitive. HCP drew on routine practices, experiences with familiar PPE, and training to adapt doffing strategies for unfamiliar PPE. In doing so, HCP sometimes deviated from best practices meant to prevent self-contamination. Hospital policies and procedures should include ongoing and/or just-in-time training to ensure HCP are equipped to doff different PPE designs encountered during clinical care.

Personal protective equipment usage among Iranian police officers during COVID-19 pandemic; a cross-sectional study

Objective: Due to the important role of police during COVID-19 pandemics and lack of previous studies on the impact of personal protective equipment (PPE) in reduction of COVID-19 infection among police officers, we aimed to investigate the role of using PPE in prevention of COVID-19 infection among Iranian police personnel.
 Methods: This cross-sectional survey was conducted in Tehran, Iran during January 2021 to November 2022. The study sample consisted of police personnel who were active in field operations. Demographics (age, height, weight, gender, marital status, number of children and underlying diseases) and job characteristics such as frequency and type of operations, involvement of colleagues with COVID-19, and COVID-19 infection history, using PPE, types of used PPE (mask, face shield, gloves, etc), protective strategies (such as social distancing) and COVID-19 vaccination were recorded. Statistical analysis was performed with IBM SPSS Statistics for Windows, version 25.
 Results: Totally, 340 participants were analyzed (33.54±9.74 years old, 91.2% males), of whom, 150 participants (44.1%) reported at least one episode of confirmed COVID-19 infection. The most common component of PPE used both during operations and daily life was face mask (44.7% and 75%, respectively). The most popular measure with higher adherence compared to others was social distancing with 70% popularity and an adherence score of 5.85±3.74. Three hundred subjects (88.2%) had received at least one dose of COVID-19 vaccine. Among PPE items, using face mask, washing hands with soap, social distancing and vaccination were significantly different between patients with and without prior COVID-19 infection (p>0.05).
 Conclusion: The findings showed that use of PPE is significantly efficacious in reduction of COVID-19 infection among police officers. Therefore, despite difficulties of using PPE among police forces, it is strongly recommended for virus spread control in this population.

GLOVES: DOS AND DON’TS

Standard infection-prevention and control procedures must be in place during all healthcare contacts, regardless of whether a patient is known to be contagious or not, to stop the transmission of infection. As with all the items of personal protective equipment, the need for gloves must be subject to careful risk assessment of the task to be carried. Having decided that gloves should be used, a choice between sterile and non-sterile gloves must be made depending on the tasks undertaken.
 Sterile gloves are worn to prevent the transmission of microorganisms from healthcare workers (HCWs) to patients. In addition, they also protect against blood and body fluids during surgical and aseptic procedures. The recommendation to wear sterile gloves includes all surgical interventions, vaginal delivery, Insertion of indwelling devices (IV line, urinary catheter, etc.), performing lumber punctures, giving epidurals, etc., invasive radiological procedures, preparing total parenteral nutrition and chemotherapeutic agents (1). 
 Non-sterile gloves are used to protect the HCWs from acquiring microorganisms from patients and contaminated environments, coming in direct contact with blood and body fluids by contact with non-intact skin or mucous membranes, e.g., vaginal examination, oral/dental care, emptying urine bags, suctioning of endotracheal tubes and by contact with the potential presence of infectious agents, e.g., MRSA both on intact and non-intact skin. Non-sterile gloves are also to be worn by contacting blood and body fluids indirectly by handling and cleaning contaminated items and equipment, handling clinical waste, and cleaning up spills of blood and body fluids (1).
 However, misuse and carelessness while wearing gloves can lead to cross-contamination, and infection spread rather than infection prevention and control. Possible microbial transmission has been documented where used gloves were not removed or changed before performing care activities requiring asepsis, not changing gloves while moving from one patient to the other, taking care of multiple patients with the same pair of gloves, wearing layers of gloves and then removing the outer layer as they move from room to room (2).
 Failure to change or remove contaminated gloves is also a significant cause of poor compliance with hand hygiene, creating a high risk of microbial transmission. Gloves are never meant to be worn in lieu of hand hygiene. Healthcare workers should wash their bare hands according to the World Health Organization's five moments of hand hygiene (3) Hand hygiene has to be followed strictly before donning and after the doffing of gloves. Gloves should only be worn in cases of the indications listed above. In some areas, HCWs are usually seen wearing gloves when there is no need. Besides contact precautions, gloves are not recommended while taking vitals, injecting intramuscularly and subcutaneously, giving oral medicines, vascular line manipulation in the absence of blood leakage, using the telephone, writing in patients’ charts, and moving patients’ furniture. Gloves should never be worn in the hallways or elevators, moving from one place to another within the hospital premises, or serving multiple patients. Gloves are not meant to be worn over and over or washed in between usage (4).
 Adhering to hand hygiene and rationalizing the use and type of gloves in any healthcare setting can help prevent microbial contamination of the environment and for the safety of patients and HCWs from microorganisms.

1214. The Effects of Modified Personal Protective Equipment (PPE) Protocols on Healthcare Personnel Providing Patient Care During the COVID-19 Pandemic: A Qualitative Assessment

Abstract Background Healthcare personnel (HCP) faced personal protective equipment (PPE)-related challenges during the COVID-19 pandemic including supply shortages, additional PPE items, different designs, and modified protocols (PR)/guidelines. We used a human factors engineering- and ethnography-informed approach to qualitatively assess the effects of these challenges on HCP and their PPE use during the pandemic. Methods We observed PPE use (e.g., donning/doffing) by HCP caring for patients with COVID-19, those under investigation (PUI), and those with other conditions in 1 acute, 1 intermediate, and 1 intensive care unit at a large Midwestern academic hospital. We conducted mini-interviews with a subset of HCP to clarify observed behavior and identify PPE-related concerns. We captured observation, interview, and additional data (e.g., unit layouts, signage) in structured and unstructured notes. We transcribed and imported notes into MAXQDA and applied a deductive-inductive analytical approach. Results From April-July 2021, we observed 188 patient care episodes and conducted 47 mini-interviews. Observations included COVID-19 (n=102), PUI (n=4), and non-COVID-19 (n=82) rooms on varying isolation precautions. PRs related to masks and eye protection changed during the study period and particularly affected donning practices. Other barriers included time-intensive PRs, unclear PR communication, unfamiliar designs, lack of surfaces on which to set supplies while donning/doffing, and inconvenient PPE storage/cleaning locations. We observed recommendation/PR deviations related to PPE use (e.g., exposed wrists, unapproved/no eye protection), cleaning, and signage/storage (e.g., designated “clean” surfaces). HCP reported PPE extended use/reuse, provision of design options, and their own adaptations (e.g., “batching” tasks, modifying PPE) facilitated donning/doffing. New PPE requirements highlighted tensions between HCP comfort and safety; despite this, some wanted to include modified PRs in their routine infection prevention practices permanently. Conclusion PPE use barriers and facilitators related to modified COVID-19 PRs have implications for the ongoing pandemic and future respiratory pathogen outbreaks. Disclosures Loreen Herwaldt, MD, 3M: • 3M is providing products for one of Dr. Herwaldt’s research studies unrelated to the work reported here.|PDI Healthcare: PDI Healthcare has provided research funding to Dr. Herwaldt unrelated to the work reported in this abstract.

Personal protective equipment (PPE) pollution driven by COVID-19 pandemic in Marina Beach, the longest urban beach in Asia: Abundance, distribution, and analytical characterization

COVID-19 pandemic has enforced the use of personal protective equipment (PPE, masks and gloves). However, the mismanagement of litter are exacerbating the increasing plastic issue worldwide. In the present study, we sampled discarded PPE in 10 sites along Marina Beach, India. We characterized the litter types by chemical analysis techniques. A total of 1154 COVID-19-associated PPE items were found on Marina beach. The highest number of items were face masks (97.9 %) and the mean PPE density in the sites studied was 4 × 10−3 PPE m−2. The results demonstrate that poor solid waste management and lack of awareness are the main causes of pollution at Marina beach. FTIR spectroscopy revealed that face masks and gloves were principally made of polypropylene and latex, respectively. The FTIR spectra also showed signs of chemical degradation. Our results suggest that plastic pollution is increasing, possibly becoming more impactful to marine biota. Beach management measures were discussed.

Viral contamination on the surfaces of the personal protective equipment among health care professionals working in COVID-19 wards: A single-center prospective, observational study

To evaluate potential viral contamination on the surfaces of personal protective equipment (PPE) in COVID-19 wards. Face shields, gloves, the chest area of PPE and shoe soles were sampled at different time points. The samples were tested for the presence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by PCR, and the cycle threshold (CT) values were recorded. The positive rate was 74.7% (239/320) for all PPE specimens. The CT values of the samples were ranked in the following order: face shields > chests > gloves > shoe soles (37.08±1.38, 35.48±2.02, 34.17±1.91 and 33.52±3.16, respectively; P for trend < .001). After disinfection, the CT values of shoe soles decreased compared with before disinfection (32.78±3.47 vs. 34.3±2.61, P=.037), whereas no significant effect of disinfection on the CT values of face shields, chests and gloves was observed. After disinfection, the CT values of specimens collected from shoe soles gradually increased; before disinfection, the CT values of shoe sole specimens were all less than 35. SARS-CoV-2 can attach to the surfaces of the PPE of healthcare professionals in COVID-19 wards, especially the shoe soles and undisinfected gloves. Shoe soles had the highest SARS-CoV-2 loads among all tested PPE items.

Medical Waste during COVID-19 Pandemic: Its Types, Abundance, Impacts and Implications

COVID-19 has resulted in an abrupt and significant increase in medical waste, albeit with improving air and water quality in certain regions. This paper aims to review the types, abundance, and impacts of COVID-19-related medical waste through examining the contents of 54 peer-reviewed scholarly papers. COVID-19-related medical waste compositions vary over time, with COVID-19 screening, diagnostic, and treatment wastes, as well as used personal protective equipment (PPE), constituting the majority of medical waste at the start, followed by vaccination waste during the peak of vaccination. COVID-19-related medical waste is expected to decrease and steady as more and more countries relax restrictions in an attempt to live with COVID-19. Geographically, the amount of COVID-19-related medical waste depends on population size, with highly-populated countries and cities such as China, Manila, Jakarta, and Bangkok seeing or expected to see a hike in the waste of between 210 tonnes/day and 280 tonnes/day during COVID-19. Packaging of the medical and PPE items forming the medical waste stream also contributes to a substantial amount of waste. As plastics are a major component of medical waste, the increase in COVID-19-related medical waste and its mismanagement have worsened environmental pollution caused by plastics. The surge of medical waste during COVID-19 strained the existing medical waste disposal systems, and incineration of the waste contributed to air pollution, which was often localized. Mismanagement of the waste could also raise public health concerns and cause visual repercussions.

Hydrothermal deconstruction of single-use personal protective equipment during the COVID-19 pandemic

To minimise the transmission of the SARS-CoV-2 virus, there has been a substantial increase in the production and usage of synthetic personal protective equipment (PPE) globally. Consequently, single-use PPE have been widely adopted without appropriate regulations for their disposal, leading to extensive environmental contamination worldwide. This study investigates the non-catalytic hydrothermal deconstruction of different PPE items, including isolation gowns, gloves, goggles, face shields, surgical masks, and filtering-facepiece respirators. The selected PPE items were subjected to hydrothermal deconstruction for 90 min in the presence of 30-bar initial oxygen pressure, at temperatures ranging between 250 °C and 350 °C. The solid content in form of total suspended solids (TSS) was reduced up to 97.6%. The total chemical oxygen demand (tCOD) and soluble chemical oxygen demand (sCOD) decreased with increasing deconstruction temperature, and at 350 °C the lowest tCOD and sCOD content of 546.6 mg/L and 470 mg/L, respectively, was achieved. Short-chained volatile fatty acids were produced after 90 min of deconstruction, predominantly acetic acid at concentrations up to 8974 mg/L. Ammonia nitrogen content (NH3–N) of up to 542.6 mg/L was also detected. Carbon dioxide (CO2) and unreacted oxygen (O2) were the main gaseous by-products at up to 15.6% (w/w) and 88.7% (w/w), respectively. The findings suggest that non-catalytic hydrothermal deconstruction is a viable option to process and manage PPE waste.

The planetary health effects of COVID-19 in dental care: a life cycle assessment approach.

Aims COVID-19 has significantly impacted the safety guidelines for personal protective equipment (PPE) within dental services. We quantified and compared the environmental impact of different forms of PPE.Methods The PPE items were divided into three categories: 1) the body protection category, which included disposable and reusable gowns; 2) the eye protection category, which included a visor with a disposable face shield and a reusable visor; and 3) the respiratory protection category, which included respirator FP2SLw, respirator FFP2 and surgical masks. The OpenLCA software was used for analysing and comparing the environmental impact of all PPE products in the three categories.Results The life cycle assessment results of this study showed that damage to human health was more significant for the reusable gown than the disposable gown for the body-protection-category PPE. A visor with a disposable face shield had a higher environmental footprint than the reusable visor across all impact categories for the eye protection category. In addition, a visor with a disposable face shield released five times more carbon dioxide equivalent emissions and used four times more dissipated water and three times more fossil fuels than the reusable visor. A disposable gown used four times more dissipated water and three times more fossil fuels than reusable gowns. For respiratory PPE, the FP2SLw respirator had the highest burden in all 16 categories, followed by the FFP2 respirator and then the surgical mask.Conclusion The environmental impact of PPE is notable and could be reduced through using less damaging domestic products and increased usage of reusables. In addition, the selection of PPE that are reusable and made of recyclable materials can help to minimise the environmental impact and reduce environmental resource depletion.

Tracking the impacts of COVID-19 pandemic-related debris on wildlife using digital platforms

Since the start of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2; COVID-19) pandemic in December 2019, there have been global surges of single-use plastic use. Due to the importance of personal protective equipment (PPE) and sanitation items in protecting against virus transmission and from testing, facemasks, respirators, disposable gloves and disposable wet wipes have become global staples in households and institutions. Widespread use and insufficient infrastructure, combined with improper waste management have resulted in an emerging category of litter. With widespread presence in the environment, such items pose a direct threat to wildlife as animals can interact with them in a series of ways. We examined the scope of COVID-19 pandemic-related debris, including PPE and sanitation items, on wildlife from April 2020 to December 2021. We document the geographic occurrence of incidents, debris types, and consequences of incidents that were obtained from social media searches, unpublished reports from colleagues, and reports available from the citizen science database “Birds and Debris”. There were 114 unique sightings of wildlife interactions with pandemic-related debris (38 from 2020 and 76 from 2021). Within the context of this dataset, most incidents involved birds (83.3 %), while fewer affected mammals (10.5 %), invertebrates (3.5 %), fish (1.8 %), and sea turtles (0.9 %). Sightings originated in 23 countries, and consisted mostly of entanglements (42.1 %) and nest incorporations (40.4 %). We verified sightings by contacting the original observers and were able to identify replicated sightings and increase the resolution of the data collected compared with previously published results. Due to the complexities associated with global use and accessibility of digital platforms, we likely underestimate the number of animals harmed by debris. Overall, the global scope of this study demonstrates that online and social media platforms are a valuable way to collect biologically relevant citizen science data and track rapidly emerging environmental challenges.

Occurrence of COVID-19 personal protective equipment (PPE) litters along the eastern coast of Palawan Island, Philippines

The emergence of the COVID-19 pandemic has caused worldwide health constraints. This study was conducted to establish a baseline monitoring survey to describe the distribution of PPE litters during the COVID-19 pandemic in the province of Palawan, Philippines. A total of 386 COVID-19-related PPE items were present in 83 % of coastal sampling sites with over a cumulative area of 48,200 m2, with a density of 8 × 10−3 items m−2. The facemask (98 %; n = 377) was the primary type of PPE, followed by face shield (2 %; n = 9). Meanwhile, the daily density of PPE litters in San Manuel, Puerto Princesa ranged from 0 to 9.9 × 10−2 items m−2, with a mean density of 8 × 10−3 items m−2. The accumulation rates of PPE items ranged from 3.27 × 10−1 items to 1.143 items d−1, with an average rate of 7.29 × 10−1 items d−1.

Determining Viral Disinfection Efficacy of Hot Water Laundering.

This protocol provides an example of a laboratory process for conducting laundering studies that generate data on viral disinfection. While the protocol was developed for research during the coronavirus disease 2019 (COVID-19) pandemic, it is intended to be a framework, adaptable to other virus disinfection studies; it demonstrates the steps for preparing the test virus, inoculating the test material, assessing visual and integrity changes to the washed items due to the laundering process, and quantifying the reduction in viral load. Additionally, the protocol outlines the necessary quality control samples for ensuring the experiments are not biased by contamination and measurements/observations that should be recorded to track the material integrity of the personal protective equipment (PPE) items after multiple laundering cycles. The representative results presented with the protocol use the Phi6 bacteriophage inoculated onto cotton scrub, denim, and cotton face-covering materials and indicate that the hot water laundering and drying process achieved over a 3-log (99.9%) reduction in viral load for all samples (a 3-log reduction is the disinfectant performance metric in U.S. Environmental Protection Agency's Product Performance Test Guideline 810.2200). The reduction in viral load was uniform across different locations on the PPE items. The results of this viral disinfection efficacy testing protocol should help the scientific community explore the effectiveness of home laundering for other types of test viruses and laundering procedures.

The impact of COVID-19 on Western Australian medical imaging clinical practice and workplace.

IntroductionMedical imaging plays a key role in the management of patients with coronavirus disease‐2019 (COVID‐19). This field is at risk from the impacts of the pandemic on the practice and workplace of medical imaging professionals (MIPs). Recent research has explored this impact internationally and in various states of Australia; however, the impact of the pandemic on Western Australian (WA) MIPs is yet to be examined.MethodsThis cross‐sectional study aimed to address this issue by surveying clinically practicing WA MIPs on their experience of the impact of COVID‐19. The survey was conducted online between the 1st and the 31st of May 2021 and encompassed 101 clinical sites.ResultsFifty‐one valid (17.1%) responses were recorded, and a majority (66.7%) of the participants were employed in public hospitals. The results showed that most participants (94.1%) perceived an impact on their clinical practice, with expressions of insufficient access to personal protective equipment (PPE). The use of all the appropriate PPE items were dependent on whether the participants were employed in a public hospital, private hospital, or a private practice (P = 0.001). Perceived imaging volume decrease across modalities did not differ significantly among the workplaces, except for interventional radiology (P = 0.006). The participants also expressed concerns about inadequate psychological support.ConclusionsCOVID‐19 has enhanced infection control procedures and modified the routine imaging patterns. Specifically, WA medical imaging centres have altered their PPE and cleaning procedures based on updated health advice. Efforts should be taken to strengthen the support provided to the staff members and to ensure adequate access to PPE supplies.

Knowledge of undergraduate students of the course in dentistry about the transmission of covid-19 in dental offices / Conhecimento dos estudantes de graduação do curso de odontologia sobre a transmissão da covid-19 em consultórios odontológicos

The aim of this study was to evaluate the knowledge of dental students about the transmission of coronavirus in dental offices, and the biosafety measures that must be adopted to prevent its dissemination. An online questionnaire with 18 questions was applied to the students to collect the information. The sample was composed of 126 students of the dentistry course of public and private universities who had previous contact with clinical practice. The results revealed that 68.3% of the undergraduates were aware that dentists were among the health professionals who were at most risk for contamination, and 93.7% of them said that the procedures that generated aerosol in the dental office were those that led to the highest chances of transmission of COVID-19. The responses also showed the awareness of students relative to the need to use all the items of personal protective equipment (PPE), in which 90% of the participants considered masks, caps, gloves, facial protectors, aprons, and protective goggles to be essential for preventing propagation of the virus. When asked about hand hygiene, 92.1% of the students considered soap and water the best option. Based on assessment of patients’ history (recent travels, chronic diseases and present health status), 87% reported that it was also important to obtain these items of before attending a patient. It was concluded that the undergraduates had knowledge about the transmission and biosafety methods in the dental office, related to COVID-19, which would contribute to the safety of clinical attendance in the universities.