Use Of Eye Protection Research Articles

Personal Protective Equipment Use by Dairy Farmworkers Exposed to Cows Infected with Highly Pathogenic Avian Influenza A(H5N1) Viruses - Colorado, 2024.

The risk for transmission of highly pathogenic avian influenza A(H5N1) virus from dairy cows to humans is currently low; however, personal protective equipment (PPE) use during work activities on dairy farms has not been well described. PPE use can protect farmworkers when they are working with highly pathogenic avian influenza A(H5N1)-infected cows. The Colorado Department of Public Health and Environment (CDPHE) and the Colorado Department of Agriculture (CDA) offered PPE to all Colorado farms before or during an A(H5N1) outbreak in cows in 2024. CDPHE surveyed 83 dairy workers from three farms with a confirmed bovine A(H5N1) outbreak. Frequently reported farm worker activities included milking cows or working in the milking parlor (51%), cleaning cow manure (49%), and transporting cows (46%). Frequently reported PPE items available to workers before A(H5N1) outbreaks included gloves (88%), eye protection (e.g., safety glasses or goggles) (76%), rubber boots or boot covers (71%), and head covers (69%). N95 respirator use was low among workers who were exposed to ill cows after detection of A(H5N1) virus (26%). PPE use while working with ill cows increased a mean of 28% after detection of A(H5N1) virus on surveyed farms; use of eye protection while milking cows increased the most (40%). Public health PPE distribution, education, and collaboration with CDA might have increased PPE use on dairy farms with A(H5N1) virus-infected cows and mitigated risk for farmworkers acquiring A(H5N1) virus.

Systematic Analysis of the Zoonosis by SARS-CoV-2 in Domestic Cats Under the Concept of One Health

Objective: This study aimed to identify scientific evidence on the zoonotic transmission of SARS-CoV-2 in domestic felines in order to observe the relationship between the susceptibility of cats to SARS-CoV-2, the infection of humans to cats regarding the virus, and the relationship between cat-to-human transmission of SARS-CoV-2. Methods: A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) method. Four scientific databases (Google Scholar, Pub- Med, Scielo, and Web of Science) were used for article search, and the review was limited until July 1, 2023. Results: A total of 2327 articles were identified from the three databases, of which 16 were finally included in the review. Eight articles provided information on the high susceptibility of cats to SARS-CoV-2, 7 articles described the characteristics of clinical signs presented in both humans and cats, and only 1 article discussed the infection from a cat to a human. Conclusion: It is important to consider isolating pets during the latency period of the disease within medical recommendations, reinforce the use of eye protection, and adopt the concept of "One Health" to prevent public health problems.

Dyschromatopsia due to welding arcs: An underestimated occupational injury

Welders are at risk of developing dyschromatopsia, a color vision deficiency, due to occupational exposure, including welding arcs. This visual impairment can impact occupational safety and performance but has received limited attention in research. : This study aimed to investigate the prevalence and characteristics of defective color vision among welders exposed to welding arcs. A cross-sectional study was conducted with 52 male welders working in various industries. Demographic and occupational data were collected through a questionnaire. Color vision assessment was performed using Ishihara and Farnsworth Munsell test. Welding exposure data were collected through self-reporting and workplace observations. Chi-square test was used for data analysis. A p-value of less than 0.05 was considered statistically significant. The prevalence of defective color vision among welders was 15.4%. Age, gender, years of experience, and types of welding performed did not significantly influence the prevalence. Welders in the age group of 31-40 years showed a higher prevalence. Inadequate use of eye protection was identified as a barrier to preventing color vision impairments. Defective color vision is a prevalent occupational injury among welders exposed to welding arcs. The study underscores the importance of preventive measures, including proper eye protection and education programs, to reduce the risk of visual impairments and improve occupational safety. Further research is needed to understand the long-term consequences of welding arc exposure on color vision and its impact on worker performance.

TRAUMATIC LENS SUBLUXATION FROM PICKLEBALL INJURY: A CASE SERIES

Purpose: The purpose of this study was to describe two cases of traumatic lens subluxation resulting from pickleball injury. Methods: This is a case series. Results: A 77-year-old man presented with worsening vision and was noted to have subluxation of his intraocular lens 10 days after being struck in the eye with a pickleball. The patient underwent a lens exchange with scleral fixation. A 76-year-old woman presented with blurry vision on the same day as her injury and was noted to have subluxation of her crystalline lens. She also underwent a lens insertion with scleral fixation. However, she experienced additional complications of postoperative cystoid macular edema and traumatic glaucoma. Conclusion: We recommend increased use of eye protection in pickleball.

284 Eye Protection Compliance in the Operating Theatres of a Regional Major Trauma Centre

Abstract Aim Surgical procedures inherently involve risk of blood splatter. Various studies have consistently demonstrated significant (>40%) contamination of face masks worn by surgeons, though this may be macroscopically visible in fewer than half of cases; laparoscopic surgery is similarly not devoid of risk, with a comparable contamination profile. Nevertheless, routine use of eye protection by scrubbed surgical staff is inconsistent. This study audited the use of eye-protection by scrubbed surgical staff in a Major Trauma Centre. Method Local Trust guidelines mandated scrubbed surgical staff to wear eye-protection (namely disposable visor-masks or plastic glasses, not including spectacles). Operations over an initial 6-week cycle were audited to determine the rate of eye-protection use by surgical staff. Following a presentation to theatre staff, a further audit cycle was completed to assess for improvement in guideline compliance. Results 98 operations were recorded in the first cycle, 39 of which were open procedures. Compliance rates were measured for different staff grades. Across all operations, 301 staff were scrubbed (183 surgeons). 52.2% of scrubbed staff (35% of surgeons) wore the requisite eye protection. Re-audit involved 88 operations, including 31 open procedures, with a total of 243 scrubbed staff (146 surgeons). A demonstrable increase in compliance occurred across all staff grades with a total compliance rate of 67.5% (49% of surgeons). Conclusions Conjunctival contamination presents significant risk to surgeons without adequate protection. The results of this study demonstrate the inadequacy of current protective practice; increasing awareness of the necessity for adequate eye protection is thus a clinical priority.

Quantifying the efficacy of protective eyewear in pediatric soccer-induced retinal injury

Ocular injury is common in children playing sports. Sports-related eye injuries, if severe enough, can lead to permanent vision impairment. Soccer, the most popular sport in the world, is a sport in which players rarely use protective eyewear. The purpose of this study was to determine how eye injuries are induced by a soccer ball impact and to evaluate whether eye protection influences the effects of impact. A finite element (FE) computer simulation was used to simulate soccer ball trauma on a model of the eye with and without eye protection. Protective eyewear of different materials (polycarbonate and acrylic) was modeled to investigate the optimal medium for eye protection. Stress and strain experienced by the eyeball was quantified by the FE computer simulation in each model. Protective eyewear was found to be effective in lowering ocular stress and strain by absorbing and redirecting energy from the ball. Compared to the unprotected eye model, polycarbonate eyewear reduced the average stress the retina experienced by 61%, whereas the acrylic model reduced the average stress by 40%. Polycarbonate and acrylic eyewear also reduced the maximum strain experienced by the retina by 69% and 47%, respectively, reducing the severity of deformations of the eye on impact. These findings suggest that wearing protective eyewear, especially when made of polycarbonate, can be an effective means of reducing injury-inducing retinal stress. The use of eye protection is thus recommended for pediatric patients participating in soccer.

Association between First-pass Intubation Success and Enhanced PPE Use during the COVID-19 Pandemic

Objectives We evaluated first-pass endotracheal intubation (ETI) success within the critical care transport (CCT) environment using a natural experiment created by the COVID-19 pandemic. Our primary objective was to evaluate if the use of personal protective equipment (PPE) or the COVID-19 time period was associated with differences in first-pass success rates of ETI within a large CCT system with a high baseline ETI first-pass success rate. We hypothesized that pandemic-related challenges would be associated with decreased first-pass success rates. Methods We performed a retrospective before-after cohort study of airway management by CCT personnel relative to the COVID-19 pandemic. We used a mixed effects logistic regression to evaluate the association between enhanced PPE (N95 mask, eye protection) use and the pandemic time period on first-pass intubation success, while controlling for other factors potentially associated with intubation success. Variables in the final model included patient demographics (age, sex, and race), body mass index, medical category (trauma versus non-trauma), interfacility or scene response, blade size (Macintosh 3 versus 4), use of face mask, use of eye protection, and crew member length of service. Results We identified 1279 cases involving intubation attempts on adult patients during the study period. A total of 1133 cases were included in the final analysis, with an overall first-pass success rate of 95.7% (96.4% pre-COVID-19 and 94.8% during COVID-19). In our final mixed effects logistic regression model, enhanced PPE use and the COVID-19 time period were not associated with first-pass intubation success rate. Conclusion In a large regional CCT system with a high ETI first-pass success rate, neither PPE use nor the COVID-19 time period were associated with differences in ETI first-pass success while controlling for relevant patient and operational factors. Other emergency medical services (EMS) systems may have encountered different effects of pandemic-related PPE use on intubation success rates. Further studies are needed to evaluate the influence of sustained use of enhanced PPE or changes in training or procedural experience on post-pandemic ETI first-pass success rates for non-CCT EMS clinicians.

A 5-Year Retrospective Analysis of the Risk Factors, Treatment, and Prognosis of Patients With Fungal Keratitis in Heilongjiang, China

To report the epidemiologic features, laboratory findings, and treatment outcomes of patients with fungal keratitis (FK) during a busy farming period (May, June, and September to November) in Heilongjiang Province, China. Retrospective, observational case series. In total, 251 patients diagnosed with FK at the Eye Hospital, First Affiliated Hospital of Harbin Medical University, from 2017 to 2021 were identified. Medical records were retrospectively analyzed, and demographic features, risk factors, monthly distributions, clinical characteristics, laboratory findings, treatment strategies, and prognostic data were collected. The number of FK cases in the busy farming period accounted for 74.1% (186/251) of the total. The mean patient age was 58.2±9.5 years. Males (66.7%) were more likely to develop FK than females (33.3%), and plant-related trauma was the main cause in 80.1% (149/186) of the cases. The most common causative fungal species was Fusarium (34.9%). In vivo confocal microscopy had the highest positivity rate for FK diagnosis (94.6%). The depth of hypopyon, depth of hyphae or spores, and infiltrate width were significantly positively correlated with delayed presentation. Patients with a longer time of presentation to the hospital were more likely to undergo surgery because of topical medical therapy failure. The most important measures for FK prevention are the use of eye protection during outdoor work and visiting the hospital for treatment as soon as possible after eye injury.

Dorsally placed commercially available subpalpebral lavage systems have low complication rates in horses.

To retrospectively evaluate the complication rate following dorsal placement of a commercially available 1-hole subpalpebral lavage system (SPL) at a veterinary teaching hospital. 102 client-owned horses with ophthalmic disease. Medical records of horses (2010 to 2020) with ophthalmic disease were reviewed to determine whether a commercially available SPL system was dorsally placed. Data collected from the medical record included signalment, presenting complaint(s), diagnosis, ophthalmic procedures performed, SPL laterality, hospital service that placed the SPL, anesthetic technique for placement (general anesthesia or sedation with local nerve blocks), duration of SPL management while hospitalized or at home, type of enclosure for the horse, use of eye protection, duration of time the SPL was in place, location of SPL management (home vs hospital), types and numbers of medications administered, recorded complications, and outcome of the globe. Complications experienced during treatment were categorized as either ocular or nonocular. The χ2 test for independence test and Fisher exact test were performed to examine the relationship between the department that placed the SPL, method of anesthesia, antimicrobial administration, type of facial protection used, and complication type and rate. Overall complication rate for SPL systems was 29.1% (37/127), with 21.2% (27/127) being ocular complications and 7.9% (10/127) being nonocular complications. SPL complication rate was not affected by any variable that was examined. Commercially available SPL systems placed dorsally have a low ocular complication rate. These SPL systems may be placed by veterinarians with varied training backgrounds and managed at home without significantly increasing complication rate.

Pharmacy practitioners' adherence to safe-handling practices of chemotherapeutic drugs: A cross-sectional study in Saudi Arabia.

Chemotherapy drug handling and occupational exposure are topics of concern for a variety of oncology health care professionals. Inappropriate handling can pose health risks to practitioners particularly, those who handle them on a daily basis. Therefore, this study aimed to assess chemotherapy handling practices among oncology pharmacists and pharmacy technicians in Saudi Arabia. A cross-sectional study was conducted using an online survey with a structured pre-validated questionnaire. Data was collected from pharmacists and pharmacy technicians who handle chemotherapeutic agents in Saudi Arabia, and analyzed using descriptive and inferential statistics. A total of 79 oncology pharmacy practitioners responded to the survey. The majority (92.4%) had written chemotherapy guidelines at their workplaces. Almost all participants (98.7%) reported the availability of protective gloves and gowns, however, the availability of eye protection was only 57%. Most used chemotherapy-designated gloves (83.6%), and gowns (86.1%). However, 54.4% have reused disposable gowns. The extent of utilization of most protective equipment ranged from 70% (always using closed system transfer device) to 98% (always using shoe cover); while the practice of always using eye protection and face shield was only 30.4% and 38%, respectively. With regard to cleaning practice, the work area was cleaned at least once a day by 35%; monthly decontamination (77%); certification by the biomedical department every 6 months (67%) and at least yearly (95%). Accidental exposure was reported by 28%, and the most common adverse effect was skin irritation (82%). There was no workplace medical surveillance available for 50%. The majority (88.6%) received relevant training, but not periodic updates on their training (38%). The main barriers against the use of personal protective equipment were: that some personal protective equipments were not always available (38%), and personal protective equipments were too uncomfortable to use (30.4%). The demographic variables did not have a statistically significant effect (p > 0.05) on the responses except for type of institution (workplace) on some of the cleaning practices that showed significant differences namely, the monthly decontamination and certification by the biomedical department. Most protective equipment and chemotherapy guidelines were available, and the majority of pharmacy practitioners adhered to many aspects of chemotherapy safe-handling practices. Nevertheless, some areas such as medical surveillance programs, use of eye protection and face shields, the practice of re-using disposable gowns, some of the barriers against personal protective equipment use, and the provision of periodic training need improvement for better protection of the health care professionals.

Ten-year analysis of traumatic open-globe injuries in Edmonton, Canada, from 2009–2018

ObjectifIdentifier et décrire l'incidence et les corrélats des blessures à globe ouvert consignées à l'Eye Institute of Alberta (EIA) du Royal Alexandra Hospital, à Edmonton. NatureRevue de rétrospective des dossiers médicaux réalisée dans un seul centre sur une période de 10 ans. MéthodesTous les patients traités à l'EIA entre janvier 2009 et décembre 2018 en raison d'une blessure traumatique à globe ouvert ont été recensés dans le cadre d'une recherche par mots clés. On a extrait des dossiers les données démographiques clés, notamment le type de blessure et sa localisation. On a eu recours à une régression de Poisson afin de mettre au jour les tendances en ce qui a trait à l'incidence de blessures à globe ouvert sur les 10 ans de l’étude et dans l'ensemble des statistiques démographiques. On a en outre analysé les associations entre les variables démographiques clés. RésultatsAu total, 551 blessures traumatiques à globe ouvert ont été traitées à l'EIA entre janvier 2009 et décembre 2018, d'où une moyenne mensuelle de 4,63 blessures pendant les 10 années de l’étude. L’âge moyen des patients était de 42 ± 21,56 ans; on compte 3,9 fois plus d'hommes (n = 442) qui ont eu besoin d'un traitement en raison d'une blessure à globe ouvert que de femmes (n = 114). Parmi les patients pour lesquels une forme de protection oculaire avait été notée (n = 186), seulement 11 % ont affirmé porter leur protection oculaire au moment du traumatisme. Le taux d'incidence de plaies de zone 3 était significativement plus élevé chez les hommes (41,4 %) que chez les femmes (29,8 %). ConclusionLes blessures à globe ouvert demeurent une source importante de morbidité oculaire à l'EIA, qui traite en moyenne un peu plus de 1 cas urgent par semaine. Compte tenu de la forte association avec le sexe et l'utilisation peu fréquente de modalités de protection oculaire, des stratégies ciblées de sensibilisation du public sont nécessaires pour réduire le risque de survenue de ces blessures qui menacent la vision.

964. Impact of the COVID-19 Pandemic on Bedside Medical Education: A Mixed-Methods Study

BackgroundThe COVID-19 pandemic obligated academic medical programs to substantially alter the traditional Internal Medicine (IM) rounding model to decrease risk of inpatient nosocomial viral transmission. Our study aimed to describe how IM rounding practices changed during the COVID-19 pandemic and to understand the impacts of these changes on medical education. MethodsWe conducted a two-phase, mixed-methods study of inpatient IM rounding team practices at a large academic hospital in Houston, TX. In the first phase (January-February 2021), we organized and audio-recorded 4 virtual (Zoom) focus groups. Each included 5-6 rounding team members, divided by: attendings; senior residents; interns; and medical and physician assistant students. In the second phase (March-May 2021), we performed 6 direct observations of IM teams during rounds. Two observers systematically recorded variables such as time spent on non-bedside versus bedside rounds, number of each team member type entering patient rooms for bedside teaching, and types of personal protective equipment (PPE) worn. ResultsTopics discussed during focus groups included comparisons of rounding team size, rounding duration, physical distancing and PPE use, bedside education, communication methods, and patient safety before and after March 2020. Perceptions of changes in each topic were generally consistent across groups (Table 1). Direct observation data showed that team rounding styles remained diverse in the proportion of rounding time spent in an office versus on the wards, and in the number and types of team members entering patient rooms. IM team members uniformly wore respiratory PPE when entering all patient rooms; use of eye protection varied. Teams spent more total time discussing patients with or suspected to have COVID-19 compared to patients without COVID-19 (median 24 min versus 13 min, p< 0.0001). ConclusionOur results suggest that the COVID-19 pandemic adversely impacted bedside medical education, even into Spring of 2021. Conclusions from this study can be used to 1) address educational gaps related to COVID-19 pandemic-associated rounding changes and 2) create innovative methods of providing high-quality clinical education that will be minimally impacted by future respiratory virus pandemics.Disclosures Prathit A. Kulkarni, M.D., Vessel Health, Inc. (Grant/Research Support)

400. Impact of SARS-CoV-2 Test-based Strategy to Reduce Quarantine Days Among Asymptomatic Healthcare Workers After Household Exposure

BackgroundAppropriate staffing is essential to provide safe patient care. During the COVID-19 pandemic, healthcare workers (HCWs) are missing work days due to illness or high-risk exposure (HRE) to an infected person. To avoid staffing shortages, we implemented a SARS-CoV-2 test-based strategy among asymptomatic HCWs after HRE to facilitate early return to work.MethodsIn July 2020, our institution implemented a SARS-CoV-2 RT-PCR test-based strategy among HCWs within 7 days of HRE. HCWs were defined as any paid or unpaid persons directly or indirectly involved in patient care. HRE was defined as close contact < 6 feet with an infected household member without use of mask and lasting for ≥ 15 minutes. Contact with a patient or coworker was not considered high-risk due to universal masking and eye protection use. HCWs underwent SARS-CoV-2 RT PCR testing of a nasopharyngeal swab at least once (1-2 days post-exposure) or twice (5-7 days post-exposure). HCWs with symptoms at baseline were excluded. HCWs who were asymptomatic during evaluation were considered as truly asymptomatic (TA). Saved work-days (SWD) were calculated based on number of days saved due to testing strategy compared to the Centers for Disease Control and Prevention’s recommended 14-day quarantine. HCWs were allowed to return to work within 7 days of HRE if they tested negative, or after completing 10-day isolation period ± improvement in symptoms from symptom onset if they tested positive.ResultsBetween 07/01/2020 to 12/31/2020, 450 unique asymptomatic HCWs underwent SARS-CoV-2 testing. Of those, 84% were women and median age was 36 years, 347 tested negative and 103 tested positive. Of those positives, 33% of HCWs tested positive on day 2 after HRE with 141 SWDs (average 2 days/person). Only 37% were TA positives. Of those negatives, 94% were TA SARS-CoV-2 negative with 2620 SWDs (average 7.5 days/person). There were no healthcare outbreaks related to HCWs allowed to return to work following this strategy. Asymptomatic healthcare workers commonly tested positive for SARS-CoV-2 on day 2 from household exposure compared to other daysConclusionTest-based strategy among asymptomatic HCWs with HRE reduced loss of workdays and helped limit staffing shortages. Majority of positive HCWs developed symptoms after positive SARS-CoV-2 testing, which may support allowing most fully vaccinated HCWs with no COVID-like symptoms to continue to work unless symptomatic.Disclosures All Authors: No reported disclosures

Mechanisms and Prevention of Open Globe Eye Injuries

Purpose: Open globe injuries are a frequent cause of unilateral vision loss. The purpose of our study was to determine the epidemiological data of open globe injuries during a 15-year period in Central East Slovenia.&#x0D; Methods: A retrospective analysis of 219 patients (219 eyes) with open globe injuries admitted to the Department of Ophthalmology in the University Clinical Centre Maribor, Slovenia, from January 1999 to January 2014 was performed. We analyzed the following parameters: sex, age, month of injury, place of injury, type of injury, and mechanism of injury, grouped according to sex.&#x0D; Results: The majority of patients were male (186 patients, 85%). The mean age of male patients was 38 years with almost 45% of injuries occurring in the age interval between 30 and 50 years. Most injuries occurred during the colder part of the year from October to January. The most common place of injuries was the home (126 eyes, 66.5%). The most common open globe injuries were penetrating injuries (126 eyes, 57.6%) and rupture of the globe (49 eyes, 22.4%). Males most frequently experienced open globe injuries as a result of sharp objects (86 eyes, 46%), while in females, the most common causes of injuries were falls (10 eyes, 31%) and blunt objects (10 eyes, 31%).&#x0D; Conclusions: The vast majority of eye injuries are preventable. Studying the causes of injuries for a determined region is important to provide for preventable measures, like the use of eye protection, and to provide health education, to prevent severe vision loss or blindness.

Eye injuries from fireworks used during celebrations and associated vision loss: the international globe and adnexal trauma epidemiology study (IGATES).

To report on the factors associated with severe vision loss from fireworks-related ocular trauma during celebrations, including festivals. Tertiary eye care hospitals in 5 countries and private ophthalmology practices in the Netherlands. Patients included received treatment for fireworks-related ocular trauma during celebrations. Demographic and clinical data for patients affected were analyzed and associations with severe vision loss reported. Of 388 patients, 71 (18.3 %) had severe vision loss (worse than 6/60) at 4-week follow-up due to fireworks-related ocular trauma. Mean age overall was 20.6 years (range 2 to 83 years), and there was a male predominance of 4:1. Clinical factors associated with severe vision loss included penetrating injury (OR 4.874 [95% CI 1.298-18.304; p = 0.02]) and lens injury (OR 7.023 [95% CI 2.378-20.736; p = 0.0004]). More patients with closed-globe injuries (CGIs) had improved vision after 4 weeks (OR 3.667, 1.096-12.27) compared to those with open-globe injuries (OGI) (p = 0.035). Eye protection use was reported by 7 patients, and 39.4% patients < 18 years were unsupervised by an adult at the time of injury. Severe vision loss from fireworks-related ocular trauma occurred during celebrations in a variety of countries and was associated with penetrating and/or lens injury and poor presenting vision. New initiatives are needed to prevent severe vision loss associated with these injuries.

Update Alert 8: Epidemiology of and Risk Factors for Coronavirus Infection in Health Care Workers.

Update Alert 8: Epidemiology of and Risk Factors for Coronavirus Infection in Health Care Workers.

COVID-19 and public transport: an overview and recommendations applicable to Latin America

The article presents a general overview on COVID-19 transmission in the context of public transport, particularly applicable to decision making in Latin America. Based on recent findings on COVID-19 transmission and the relative importance of each factor (droplets, fomites, and aerosol routes) in such transmission, we seek to update the discussion on the topic that has generally been based on social distance as the only parameter for reducing the risk of transmission and broadens the vision to integrate ventilation, users’ behavior (mask and eye protection use, silence while in the transport system) and travel distance. Recommendations to improve mobility conditions reducing the risk of COVID-19 contagion are provided.

Relationship between the use and type of eye protection and work-related corneal and conjunctival foreign body injuries

ObjectiveThis study was designed to reveal the relationship between the use and type of eye protection and the occurrence of work-related corneal and conjunctival foreign body injuries.MethodsThis is a retrospective...

Non-pharmaceutical Interventions for Pandemic COVID-19: A Cross-Sectional Investigation of US General Public Beliefs, Attitudes, and Actions.

Non-pharmaceutical interventions (NPIs) represent the primary mitigation strategy for the COVID-19 pandemic. Despite this, many government agencies and members of the general public may be resistant to NPI adoption. We sought to understand public attitudes and beliefs regarding various NPIs and self-reported adoption of NPIs, and to explore associations between NPI performance and the baseline characteristics of respondents. We performed a cross-sectional age-, sex-, and race- stratified survey of the general US population. Of the 1,005 respondents, 37% (95% CI 34.0, 39.9) felt that NPIs were inconvenient, while only 0.9% (95% CI 0.3, 1.5) of respondents believed that NPIs would not reduce their personal risk of illness. Respondents were most uncertain regarding the efficacy of mask and eye protection use, with 30.6 and 22.1%, respectively, unsure whether their use would slow disease spread. On univariate logistic regression analyses, NPI adherence was associated with a belief that NPIs would reduce personal risk of developing COVID-19 [OR 3.06, 95% CI [1.25, 7.48], p = 0.014] and with a belief that NPIs were not difficult to perform [OR 1.79, 95% CI [1.38, 2.31], p < 0.0001]. Respondents were compliant with straightforward, familiar, and heavily-encouraged NPI recommendations such as hand-washing; more onerous approaches, such as avoiding face touching, disinfecting surfaces, and wearing masks or goggles, were performed less frequently. NPI non-adherence is associated with both outcome expectations (belief that NPIs are effective) and process expectations (belief that NPIs are not overly inconvenient); these findings have important implications for designing public health outreach efforts, where the feasibility, as well as the effectiveness, of NPIs should be stressed.

Maintaining skin health and integrity for staff wearing personal protective equipment for prolonged periods: a practical tip sheet

Patient skin injuries associated with medical or therapeutic devices are increasingly reported in the literature. With the coronavirus (COVID-19) pandemic, healthcare staff are wearing personal protective equipment (PPE) for prolonged periods. Anecdotally, cases of healthcare workers' self report of injuries to their face, particularly the bridge of the nose, upper cheek, forehead and above the ears, as a result of extended use of eye protection and masks is increasing. Protecting the skin of frontline healthcare staff is as important as protecting patients' skin. The tip sheet presented in this paper provides staff with a guide in the form of written and visual assistance in order to reduce the risk of device-related pressure injuries (DRPIs) in healthcare staff caused by PPE.