Wear Personal Protective Equipment Research Articles

Knowledge, attitude, and wearing of personal protective equipment among dental hygienists in regions during the COVID-19 era

Objectives: This study aimed to understand the knowledge, attitude, and wearing of four types of personal protective equipment among dental hygienists based on to the COVID-19 infection control guidelines and to provide basic data on the need to wear these equipment by dental hygienists in dental medical institutions. Methods: Between March 31 and April 26, 2022, 285 dental hygienists working at dental institutions in Busan and Gyeongsang Provinces participated in the study. Results: The higher the knowledge on personal protective equipment, the higher the glove-wearing rate; and the higher the attitude toward personal protective equipment, the higher the KF94 mask-wearing rate. Furthermore, the higher the rate of wearing face shields, the higher the rate of wearing gloves and full-body protective suits; and the higher the rate of wearing gloves, the higher the rate of wearing a full-body protective suit. Conclusions: To prevent cross-infection by dental hygienists in dental medical institutions, it is necessary to have the four types of personal protective equipment at all times and to strengthen comprehensive education on these equipment.

IJCM_319A: A Cross-sectional study on prevalence of work-related skin diseases among construction workers in Chengalpattu district

Background: A variety of activities in construction site such as mason, painting, welding, cement mixing, concrete mixing, may eventually lead to exposures that can subject the construction workers as most vulnerable group to develop occupational skin diseases. Objective: To determine the prevalence of occupational skin diseases among construction workers in Chengalpattu district. Methodology: A cross-sectional study was conducted among 301 construction workers in construction sites at Chengalpattu district of Tamil Nadu state over a period of two months (October 2022 to November 2022). Data collection was done using a interviewer administered semi-structured questionnaire and statistical analysis was done using IBM SPSS 21 version and p value of <0.05. Results: Among the respondents 40.9% (123) construction workers found to be suffering from skin diseases like pruritis (14%), dryskin(13%), fissures (6.3%), blisters (5.6%), redness (2%), Among them highest prevalence of occupational skin disease was seen in cement mixing worker (13%) and mason (13%)followed by mason helper (12%) and concrete worker (3%). Work related skin diseases were found to be associated with nature of work (p <0.05). Conclusion: The health problems among construction workers are one of the areas of public health concern in the country which is usually unnoticed as they are being under unorganized sectors. Thus, proper wearing of Personal protective equipment, providing a supportive workplace environment and reinforcement messages will have a favourable impact on the work productivity as well as ensuring a good health for those workers.

Application of Multi-Criteria Decision-Making in Leaf Spring Manufacturing’s Performance

Lean manufacturing is the optimal way of producing goods through the removal of waste and implementing flow, as opposed to batch processing. Many factories have transformed to align with the goal of lean manufacturing by minimising the resources of factories, such as less worker effort, less time and many more to lead to high efficiency towards good product quality and become highly responsive to customer demand. The condition of product and machinery, arrangement of inventory and equipment, the standard operation procedure of work and workers' safety awareness are the dominant elements in the leaf spring manufacturing process. Due to the crucial role that leaf springs play in the performance and safety of vehicles, it is crucial to eradicate any flaws in the designing and manufacturing processes. This study focuses on 5 core criteria, which are workers, time, safety, machines, and products that need to be enhanced. In the subgroup, each pair of sub-criteria will be compared regarding their importance with respect to each criterion. Analytical Hierarchy Process (AHP) is proposed to rank and aggregate the criteria based on their level of importance. The outcome of AHP showed that Safety (0.233) and Time (0.281) were the prominent criteria that need to be prioritised. Wear Personal Protective Equipment (PPE) (0.394), First Aid (0.324), Die and Pin (0.347), and Forklift Deliver (0.368) are the sub-criteria for safety and time. As a result, prompt and precise actions are needed to increase the quality and reliability of the product.

THE RELATIONSHIP BETWEEN DRY EYE SYNDROME AND THE USE OF PERSONAL PROTECTIVE EQUIPMENT (PPE) IN HOSPITAL MEDICAL WORKERS)

Introduction & Objectives : Background: The need to wear personal protective equipment (PPE) during a pandemic can cause dry eye syndrome. It will increase sweating so reduce tear production and the use of masks increase air flow to the eye area so that tear evaporation increases. Objective: To determine the relationship between the incidence of dry eye syndrome and the use of PPE in hospital medical personnel.
 Methods : Methods: This was an analytic observational study with a cross-sectional design using the OSDI (Ocular Surface Disease Index) questionnaire. The research was carried out at the Cilacap Hospital in 2021. There were 49 samples (51% male and 49% female), with an age range of 20-50 years. The data was analyzed by using the Spearmans test.
 Results : Results: The incidence of dry eye syndrome was 69.5% (mild 18.4%, moderate 18.4%, severe 32.7%). As many as 53.1% of the incidence of dry eye syndrome occurred in wearing PPE for more than 4 hours and was more common in the use of PPE level 1 (40.8%), followed by level 3 (36.7%) and level 2 (22.5%). In the Spearman's test, it was found that there was a significant association between the incidence of dry eyes syndrome and the use of PPE (duration and level of PPE) (p<0.05) but had a weak relationship strength (r=0.3).
 Conclusion : Conclusion: There is a significant relationship between the incidence of dry eyes syndrome and the use of PPE (duration and level of PPE use) but has a weak relationship strength.

Intraoperative Radiation Exposure During Midfoot Charcot Reconstruction

While radiation exposure in foot and ankle surgery varies by procedure, attempts to minimize this hazard remain imperative to protect patients and surgeons. Hindfoot deformity correction employs significant radiation through intraoperative fluoroscopy, however, a paucity of data exists concerning Charcot reconstruction. This investigation describes and compares radiation exposure across varying Charcot pathology and fixation constructs. A retrospective chart review of patients undergoing midfoot Charcot reconstruction under large C-arm assistance from 2016-2022 was conducted. Demographics, pathology-specific, and intervention-specific variables were recorded and compared among midfoot reconstructions. The threshold for statistical significance was set at p ≤ .05. Among 40 patients, the average midfoot radiation exposure and fluoroscopy times were 9.5 ± 5.39 mGy and 256.64 ± 130.67 seconds, respectively. There existed no statistically significant difference in radiation exposure (p = .32) or fluoroscopy times (p = .71) among the different midfoot constructs. There existed a statistically significant relationship between radiation exposure with weight (p = .01) body mass index (p = .03) and number of stages (p = .04). Similarly, a relationship existed between fluoroscopy time with weight (p = .02), body mass index (p = .03), and number of beams/screws (p = .003). Due to the complexity of Charcot reconstruction coupled with multiple robust types of fixation, surgeons must remain cognizant of fluoroscopy usage. Moreover, providers who routinely perform Charcot reconstruction should wear personal protective equipment to protect against radiation.

Phytosanitary Practices in the Democratic Republic of Congo: Survey of 500 Market Gardeners in the Kinshasa and Lubumbashi Cities Between 2020-2021

This study involved a survey on phytosanitary practices among 500 market gardeners in the cities of Kinshasa and Lubumbashi in the Democratic Republic of Congo (DRC). Market gardening was practiced by 56.2% of men and 43.8% by women. The average age was 42 ± 8.7 years. Most producers (77.4%) had at least a secondary level of education (Primary School Diploma). Only 9.4% of respondents had been trained in the proper use of plant protection products. Thiodan-Endosulfan, a prohibited and highly toxic substance, was the most widely used product (93%). None of the market gardeners surveyed were using the recommended rates of insecticides. More than half of the respondents did not wear personal protective equipment when preparing and applying pesticides. Empty pesticide packages were most often abandoned in the fields or discarded in the environment (57%). Phytosanitary practices in the DRC are potentially harmful to the environment, the health of farmers and consumers.

The Use Of Personal Protective Equipment (PPE) Masks For Visitors At DR Kariadi Hospital Semarang In The Next Normal Era

Hospitals are complex health care facilities and provide health care services aimed at improving the health of patients or clients and maintaining the health of hospital visitors. Visitors play a role in the transmission of diseases, particularly the Covid-19 virus, if they do not wear PPE masks when in contact with patients. The purpose of the study was to determine and understand the use of PPE masks for visitors at Dr Kariadi Hospital Semarang in the Next Normal Era. The method used is descriptive qualitative research method with data explanation analysis method. This research data collection method uses semi-structured interviews. Participants in this study were selected using purposive technique. The total number of participants was four, the participants were doctors, nurses and visitors. The findings of this study, the four participants said that visitors at Dr Kariadi Hospital Semarang wear PPE masks when someone is supervising and visitors' awareness of wearing PPE masks is influenced by age, knowledge and education factors.

Exposure Analysis of Noise Intensity in the Manufacturing Area at The Job Training and Development Center Serang

Machines in manufacturing areas often cause noise. The noise comes from machine tools such as lathes, milling machines, grinder machines, and other tools that cause sound and vibration so they are prone to causing physical and psychological disorders. This study was to determine and analyze the noise level in three areas and ten points in the manufacturing room of The Job Training and Development Center Serang by the Regulation of the Minister of Manpower and Transmigration of the Republic of Indonesia Number PER.13/MEN/X/2011 with the maximum noise limit that has been set is 85 dBA. As for the results of the ten points, there is a point that exceeds the threshold value, namely at point 6 (85.8) dBA in the lathe area. Every operator in the manufacturing room that has a noise level that exceeds the threshold value must wear personal protective equipment in the form of earplugs or ear muffs that have been provided by the workshop to reduce the noise level.

Being an older hospitalized patient during the COVID-19 pandemic - A qualitative interview study

BackgroundOlder people hospitalized for COVID-19 are a vulnerable group due to the disease itself, aging and often loss of hearing and vision. Person-centered care, where patients have opportunities to communicate and participate in their own care, is important. However, because healthcare staff needed to wear personal protective equipment during the pandemic, to protect the patients and themselves, providing person-centered care was often difficult. This study aims to describe older hospitalized patients’ experiences both of being cared for, while having COVID-19, and of the care provided by healthcare staff wearing PPE.MethodsFourteen older patients, over 65 years of age, were interviewed, and the data were analyzed using qualitative content analysis. The study adhered to Consolidated criteria for reporting qualitative research guidelines.ResultsThree subthemes and one overall theme, “The desire for survival overshadows difficulties”, emerged in the analysis. The main findings revealed that the older hospitalized patients experienced the care they received from the healthcare staff as satisfactory. The older patients reported understanding and accepting that the pandemic situation meant that their ability to participate in their own care and communicate with healthcare staff were given lower priority.ConclusionsOlder hospitalized patients need to be provided person-centered care, and situations such as a pandemic are no exception. Care tasks that are not acute in nature, e.g., planning for patients’ return home, could be conducted by healthcare staff not required to wear PPE.

ACStalk: Design and Implementation of An Access/Entry Control System using an Internet of Things (IoT) Platform

<p>An access/entry control system usually consists of many subsystems. These subsystems have different Application Programming Interfaces (APIs), but they need to be integrated and interacted well. Without a good integrated platform, the communications between subsystems will be very complicated. In addition, except user name and password, Radio Frequency Identification (RFID), and the human’s biometrics (e.g., fingerprint and face) are used to identify users. Wireless Local Area Network (WLAN), mobile communications (e.g. 4G/5G) and Bluetooth are adopted as the remote access technologies. In addition, with the COVID-19 pandemic, public health and personal safety are getting more concerns. People are required to wear personal protective equipment (PPE) in some special areas (e.g., barns and factories) to ensure the personal healthy and food’s safety. To identify the user and detect whether the PPE is correctly worn, this paper proposes an access/entry control system by using an Internet of Things (IoT) platform. Through the proposed IoT system architecture, different identification mechanisms and communication technologies can be adopted, and the messages can be exchanged between two mechanisms. This paper elaborates the architecture design of the IoT platform and discusses the implementation/deployment issues of the PPE detection by using machine learning mechanisms.</p> <p> </p>

Pengaruh Masa Kerja dan Tingkat Pengetahuan dengan Ketaatan Penggunaan Alat Pelindung Diri (APD) pada Pekerja di PT.X

Occupational Safety and Health (K3) is very important to note for all workers and company owners. Occupational Safety and Health (K3) is a system created for workers and business owners to prevent work accidents and occupational diseases (PAK). This type of research is an observational descriptive which aims to determine the relationship between tenure and level of knowledge regarding the use of personal protective equipment (PPE). The research design used was cross-sectional. Based on data analysis, the relationship between knowledge and years of service with adherence to the use of personal protective equipment (PPE) in PT. X workers is very influential. many respondents from PT.X workers are reluctant to wear personal protective equipment (PPE) because there are several factors, namely lack of knowledge, lack of years of service and other factors. For PT.X workers who have not used personal protective equipment (PPE) it is expected to be more raise awareness about the importance of using personal protective equipment (PPE) so as to avoid work accidents or occupational diseases (PAK).

Heat stress mitigation with ice cooling vests in PPE-clad medical workers: Effects of cooling area and gender differences

During the COVID-19 pandemic, many health care workers (HCWs) were required to perform medical tasks in outdoor settings while wearing medical protective clothing. Although personal protective equipment (PPE) is virus-resistant, it can impair the heat dissipation of HCWs. Hence, HCWs face significant heat stress risks while working outdoors. There is an urgent need to find effective ways to reduce heat stress in order to protect the health and safety of HCWs who wear personal protective equipment. In this study, the applicability of two ice-bag cooling vests (ICVs) with varying cooling areas for HCWs wearing PPE was evaluated. Based on the effects of the two ICVs on the thermal comfort of HCWs working outdoors, a cooling strategy for HCWs wearing PPE in outdoor environments was demonstrated. In addition, the gender difference in cooling demand was examined. Eighteen participants took part in the outdoor field study. The results indicated that using ice-bag cooling vests could reduce sweat loss by 27.3–39.4 % (0.09–0.13 kg) and the mean skin temperature by 0.25–0.95 °C. Cooling the back is more effective than cooling the abdomen in reducing overall thermal sensation. The area of discomfort corresponds to the area of sweating. Sweating is an important factor influencing the comfort of HCWs. ICVs could provide some comfort relief for 15–30 min. Gender differences in thermal sensation disappear after 30 min of exposure. The ICVs are recommended for use in future emergency situations. The findings of this study are beneficial to the health and safety of outdoor-working HCWs wearing personal protective equipment.

YOLOv5s-gnConv: detecting personal protective equipment for workers at height.

Falls from height (FFH) accidents can devastate families and individuals. Currently, the best way to prevent falls from heights is to wear personal protective equipment (PPE). However, traditional manual checking methods for safety hazards are inefficient and difficult to detect and eliminate potential risks. To better detect whether a person working at height is wearing PPE or not, this paper first applies field research and Python crawling techniques to create a dataset of people working at height, extends the dataset to 10,000 images through data enhancement (brightness, rotation, blurring, and Moica), and categorizes the dataset into a training set, a validation set, and a test set according to the ratio of 7:2:1. In this study, three improved YOLOv5s models are proposed for detecting PPE in construction sites with many open-air operations, complex construction scenarios, and frequent personnel changes. Among them, YOLOv5s-gnconv is wholly based on the convolutional structure, which achieves effective modeling of higher-order spatial interactions through gated convolution (gnConv) and cyclic design, improves the performance of the algorithm, and increases the expressiveness of the model while reducing the network parameters. Experimental results show that YOLOv5s-gnconv outperforms the official model YOLOv5s by 5.01%, 4.72%, and 4.26% in precision, recall, and mAP_0.5, respectively. It better ensures the safety of workers working at height. To deploy the YOLOv5s-gnConv model in a construction site environment and to effectively monitor and manage the safety of workers at height, we also discuss the impacts and potential limitations of lighting conditions, camera angles, and worker movement patterns.

Comparison of acetylcholinesterase among employees based on job positions and personal protective equipment in fuel station.

The purpose of this study was to compare the levels of acetylcholinesterase (AChE) among employees based on job positions and the wearing of personal protective equipment (PPE) in fuel station areas. The sample group consisted of 200 people sorted into various groups, including (i) Inside fuel dispenser area (I-FDA) group consisting of 100 employees for refueling, cashier, and loading fuel into storage tanks, and (ii) Outside fuel dispenser area (O-FDA) group, consisting of 100 employees working in convenience stores, food stores, coffee shops, and offices, as well as general staff and car washers. Data were collected using interview questionnaires and blood samples were analyzed for AChE activity. The results showed that the I-FDA group had a significantly lower mean of serum AChE (7.38±1.73 U/ml) than the O-FDA group (7.85±1.49 U/ml) (p<0.05). The I-FDA group had a 2.43 times higher risk of abnormal serum AChE than the O-FDA group (OR=2.43, 95%CI=1.05-5.60). When considering the risk factors for job positions, it was found that refueling and cashier positions had lower AChE activity levels than those who did not (p<0.05). In the part, employees for food sales in a closed building and those wearing PPE masks had significantly higher AChE activity levels than those who did not or who wore them (p<0.05). Based on the aforementioned, employers at fuel stations should strictly determine the appropriate measures for wearing a PPE mask. Further, employees should be provided accommodation away from oil supply or enclosed buildings during breaks to reduce the effects on the neurotransmitter.

Is Personal Protective Equipment Worth the Hassle? Annual Risk of Cryptosporidiosis to Dairy Farmers and How Personal Protective Equipment and Handwashing Can Mitigate It.

Cows are known carriers of Cryptosporidium parvum (C. parvum), a protozoa that can cause the gastrointestinal illness cryptosporidiosis in humans. Despite this potential exposure, dairy farmers tend to wear personal protective equipment (PPE) to protect the milk from contamination, rather than to protect themselves from zoonotic diseases, such as cryptosporidiosis. In this study, cow feces were collected from individual cattle on dairy farms and analyzed for C. parvum using qPCR. Quantitative microbial risk assessment (QMRA) was used to determine the risk of cryptosporidiosis to the dairy farmer with and without the use of handwashing and PPE (gloves and masks). The annualized risk of cryptosporidiosis to dairy farmers was 29.08% but was reduced significantly in each of the three interventions. Among the individual interventions, glove use provided the greatest reduction in risk, bringing the annual risk of cryptosporidiosis to 4.82%. Implementing regular handwashing, the use of gloves and a mask brought the annual risk of cryptosporidiosis to 1.29%. This study provides evidence that handwashing and PPE use can significantly reduce the risk of cryptosporidiosis to farmers and is worth implementing despite potential barriers such as discomfort and cost.

Tele-monitoring system for intensive care ventilators in isolation rooms

The COVID-19 pandemic and discovery of new mutant strains have a devastating impact worldwide. Patients with severe COVID-19 require various equipment, such as ventilators, infusion pumps, and patient monitors, and a dedicated medical team to operate and monitor the equipment in isolated intensive care units (ICUs). Medical staff must wear personal protective equipment to reduce the risk of infection. This study proposes a tele-monitoring system for isolation ICUs to assist in the monitoring of COVID-19 patients. The tele-monitoring system consists of three parts: medical-device panel image processing, transmission, and tele-monitoring. This system can monitor the ventilator screen with obstacles, receive and store data, and provide real-time monitoring and data analysis. The proposed tele-monitoring system is compared with previous studies, and the image combination algorithm for reconstruction is evaluated using structural similarity index (SSIM) and peak signal-to-noise ratio (PSNR). The system achieves an SSIM score of 0.948 in the left side and a PSNR of 23.414 dB in the right side with no obstacles. It also reduces blind spots, with an SSIM score of 0.901 and a PSNR score of 18.13 dB. The proposed tele-monitoring system is compatible with both wired and wireless communication, making it accessible in various situations. It uses camera and performs live data monitoring, and the two monitoring systems complement each other. The system also includes a comprehensive database and an analysis tool, allowing medical staff to collect and analyze data on ventilator use, providing them a quick, at-a-glance view of the patient's condition. With the implementation of this system, patient outcomes may be improved and the burden on medical professionals may be reduced during the COVID-19 pandemic-like situations.

Comparison of Prevalence and Associated Factors of Multisystem Health Symptoms Among Workers in the Gas Station Area, Thailand

This cross-sectional study aimed to compare the prevalence of multisystem health symptoms (MHS) of workers in gas station areas before and after their employment and examine the factors affecting the MHS of workers. Data were collected by an interview questionnaire from 200 workers inside and outside refueling areas at eight gas stations in Rayong Province, Thailand. This study found that employees had a statistically significant increase in the prevalence of current MHS in comparison to before starting work (p-value&lt;0.05), with 31.5%. Working overtime for more than 6 hours per week led to respiratory symptoms (OR = 2.63, 95% CI = 1.14–6.07) and psychological symptoms (OR = 2.69, 95% CI = 1.12–6.49). Wearing respiratory protective equipment for less than three hours affected ear/throat/nose systems (OR = 4.26, 95% CI = 1.43–12.65). Petrol refueling resulted in liver (OR = 2.32, 95% CI = 1.4–12.65) and eye symptoms (OR = 2.57, 95% CI = 1.10–5.39). Therefore, gas station owners should set up enclosed rooms to reduce the duration of fuel exposure, and workers should wear personal protective equipment when refueling or near the dispenser.

Comparison of virus aerosol concentrations across a face shield worn on a healthcare personnel during a simulated patient cough.

Patients diagnosed with coronavirus disease 2019 (COVID-19) aerosolize severe acute respiratory coronavirus virus 2 (SARS-CoV-2) via respiratory efforts, expose, and possibly infect healthcare personnel (HCP). To prevent transmission of SARS-CoV-2 HCP have been required to wear personal protective equipment (PPE) during patient care. Early in the COVID-19 pandemic, face shields were used as an approach to control HCP exposure to SARS-CoV-2, including eye protection. An MS2 bacteriophage was used as a surrogate for SARS-CoV-2 and was aerosolized using a coughing machine. A simulated HCP wearing a disposable plastic face shield was placed 0.41 m (16 inches) away from the coughing machine. The aerosolized virus was sampled using SKC biosamplers on the inside (near the mouth of the simulated HCP) and the outside of the face shield. The aerosolized virus collected by the SKC Biosampler was analyzed using a viability assay. Optical particle counters (OPCs) were placed next to the biosamplers to measure the particle concentration. There was a statistically significant reduction (P < .0006) in viable virus concentration on the inside of the face shield compared to the outside of the face shield. The particle concentration was significantly lower on the inside of the face shield compared to the outside of the face shield for 12 of the 16 particle sizes measured (P < .05). Reductions in virus and particle concentrations were observed on the inside of the face shield; however, viable virus was measured on the inside of the face shield, in the breathing zone of the HCP. Therefore, other exposure control methods need to be used to prevent transmission from virus aerosol.

Thermal comfort of personal protective equipment (PPE) wearers in different temperatures and activity conditions

To avoid virus infections, healthcare workers have to wear personal protective equipment (PPE) during work. However, the high temperature and humidity in PPE threaten their physical and mental health. In this study, thermal physiological and psychosocial responses of PPE wearers at different temperatures (26 °C, 30 °C) and different combinations of alternating activity intensities (transcribing/sitting, walking/standing) were observed by experiments. The results show the increase in ambient temperature has a greater influence than the activity intensity on the increase in average skin temperature, whereas the opposite is true for heart rate and tympanic temperature. The thermal physiological state of the participants is mostly affected under ThAh condition. The average weight change can reach 586.8 g, and the participants' heart rate, average skin temperature, and tympanic temperature can reach 133bpm, 36 °C, 37.8 °C, respectively. Due to significant heat accumulation, the average heart rate during 100–120 min (standing), exceeding 120 bpm, was even higher than that during 40–60 min (walking) and the tolerance time for thermal discomfort for PPE wearers may not exceed 100 min under ThAh condition. And the discomfort caused by wearing masks and high humidity are the two most frequently reported occurrences. Furthermore, forehead, chest, and back are suggested to be primarily considered for maximum effectiveness if designing improvement measures to optimize thermal comfort for PPE wearers. This study adopted an experimental condition design that alternated between different activity intensities to reflect the working states of healthcare workers, providing a better understanding of the thermal physiological state of healthcare workers wearing PPE and could serve as a reference for future research in developing PPE cooling strategies.

Determinants of fatigue in emergency department clinicians who wear personal protective equipment.

To determine the independent predictors for clinician fatigue and decline in cognitive function following a shift in the ED during early stages of the COVID-19 pandemic. This was a prospective, quasi-experimental study conducted in a metropolitan adult tertiary-referral hospital ED over 20 weeks in 2021. The participants were ED doctors and nurses working clinical shifts in an ED isolation area or high-risk zone (HRZ) with stringent personal protective equipment (PPE). The participants' objective and subjective fatigue was measured by the Samn-Perelli fatigue score and a psychomotor vigilance 'smart game' score, respectively. Postural signs/symptoms and urine specific gravity (SG) were measured as markers of dehydration. Sixty-three participants provided data for 263 shifts. Median (interquartile range) age was 33 (28-38) years, 73% were female. Worsening fatigue score was associated with working afternoon shifts (afternoon vs day, adjusted odds ratio [aOR] 5.16 [95% confidence interval (CI) 1.32-20.02]) and in non-HRZ locations (HRZ vs non-HRZ, aOR 0.23 [95% CI 0.06-0.87]). Worsening cognitive function (game score) was associated with new onset postural symptoms (new vs no symptoms, aOR 4.14 [95% CI 1.34-12.51]) and afternoon shifts (afternoon vs day, aOR 3.13 [95% CI 1.16-8.44]). Working in the HRZ was not associated with declining cognitive function. Thirty-four (37%) of the 92 participants had an end of shift urine SG >1.030. Working afternoon shifts was associated with fatigue. There was no association between HRZ allocation and fatigue, but our study was limited by a low COVID workload and fluctuating PPE requirements in the non-HRZs. Workplace interventions that target the prevention of fatigue in ED clinicians working afternoon shifts should be prioritised.