No full-text available
To read the full-text of this research,
you can request a copy directly from the authors.
Improving thermal comfort of individual wearing medical protective clothing: Two personal cooling strategies integrated with the polymer water-absorbing resin material
... The equipment that uses PPE must have guaranteed safety and quality, but comfort must still be considered by ensuring that these materials remain comfortable to use on the human body. To achieve thermal comfort and maintain the body temperature at 37°C, the layers of PPE material need to be combined with other adsorbent materials, such as silica gel [3]. This addition plays a crucial role in enhancing the overall user experience. ...
The utilization of RD-type silica gel material as an adsorbent within the Personal Protective Equipment (PPE) layer underwent a comprehensive analysis aimed at elucidating its unique adsorption characteristics through the application of MATLAB programming. This study aims to determine the characteristics of silica gel RD to water vapor in terms of adsorption capacity and rate. A layer modeling approach was employed to simulate the Personal Protective Equipment (PPE), which comprised four distinct layers: the surrounding environment air, the fabric layer, the RD-type silica gel layer, and the air gap separating the silica gel from the skin surface. The simulation encompassed environmental conditions set at 27℃, while the human body's temperature was maintained at 35℃. This study uses a simulation method using GAB (Guggenheim–Anderson–de Boer) modeling calculations to determine isothermal characteristics and LDF (Linear Driving Force) modeling to determine kinetic characteristics with an adsorbent temperature of 26.84℃. The simulation results show that the isothermal characteristics of silica gel RD at a relative humidity of 60% or a relative pressure of 0.6 have an absorption capacity of 0.38 kg/kg. Moreover, the kinetic characteristics of silica gel RD have an absorption rate of 0.38 kg/kg of water vapor with a time of 980 s until a significant reduction in the absorption value occurs.
Purpose
The purpose of this paper is to determine the effect of clothing fabrics, sizes and air ventilation rate on the volume and thickness of the air gap under the air ventilation garments (AVGs).
Design/methodology/approach
The geometric models of the human body and clothing were obtained by using a 3D body scanner. Then the distribution of the volume and thickness of the air gap for four clothing fabrics and three air ventilation rates (0L/S, 12L/S and 20L/S) were calculated by Geomagic software. Finally, a more suitable fabric was selected from the analysis to compare the distribution of the air gap entrapped for four clothing sizes (S, M, L and XL) and the three air ventilation rates.
Findings
The results show that the influence of air ventilation rate on the air gap volume and thickness is more obvious than that of the clothing fabrics and sizes. The higher is the air ventilation rate, the thicker is the air gap entrapped, and more evenly distributed is the air gap. It can be seen that the thickness of the air gap in the chest does not change significantly with the changes of the air ventilation rates, clothing fabrics and sizes, while the air gap in the waist is affected significantly.
Originality/value
This research provides a better understanding of the distribution of the air gap entrapped in ventilated garments, which can help in designing the optimal air gap dimensions and thus provide a basis and a reference for the design of the AVGs.
Previous studies have primarily focused on thermal discomfort-related problems arising from wearing personal protective equipment (PPE) in hot environments. However, PPE is also extensively utilized under comfortable thermal conditions, where health-related problems may become particularly important due to hypoxia and inhalation of self-emitted bio-effluents. To evaluate the impact of wearing PPE on the health outcomes of individuals under comfortable thermal conditions, ten physiological parameters were measured under three conditions (sitting without PPE, sitting with PPE, and walking with PPE). Under light intensity activity, wearing PPE significantly increased end-tidal carbon dioxide pressure (17.9 ± 6.3 mm Hg vs 22.0 ± 5.7 mm Hg, P <0.001) when compared to wearing no PPE, while negligible (although statistically significant) changes were observed for tympanic membrane temperature and blood oxygen saturation. It did not affect significantly respiratory frequency (RF), inspiratory carbon dioxide pressure (PICO2), heart rate (HR), pulse rate (PR), systolic/diastolic blood pressure (SBP/DBP), and potential of ST-segment (ST) in electrocardiogram. It suggests that short-term PPE use is safe under comfortable conditions. The physiological parameters of PPE wearers were more affected by the increase in activity intensity than the presence of PPE. Larger body mass index was associated with decreased RF and increased PICO2. Higher age was associated with increased HR and PR and decreased ST. Males had a lower SpO2 but a higher SBP. The data obtained improves our understanding of the health outcomes associated with wearing PPE and assists in improving PPE, thus contributing to better occupational health.
Skin temperature is a widely used physiological parameter in thermal comfort research. It serves as an indicator
of personnel’s thermal comfort and has the potential to guide the regulation of thermal conditions in future
indoor environment designs. This study reviews relevant publications from 2013 to late 2023, focusing on
population differences in skin temperature (local characteristics, age, gender, etc.), changing characteristics in
different environments (dynamic and non-uniform environment, sleep environment, outdoor environment, etc.),
and the application of skin temperature in thermal sensation prediction and performance evaluation of devices.
This study clarifies the effectiveness of skin temperature in characterizing the thermal state of the human body
through a review of existing research. It also proposes directions for future work considering research limitations
in personal comfort models and performance evaluation of devices. The study suggests that skin temperature is
likely to play a significant role in the future due to the development of technologies such as big data and the
Internet of Things. In addition to conducting in-depth research in subdivided fields based on existing research, it
is also important to pay attention to standardized data collection and processing.
Objective:
Coronavirus 2019 disease (COVID-19), the cause of the ongoing pandemic, is an acute respiratory tract infection, which has made it necessary for healthcare personnel to use protective equipment such as N95 masks, protective goggles and visors. External compression headaches caused by the compression of the pericranial soft tissues by wearing hats, helmets, or goggles (worn during swimming or diving) have been previously described. In our study, we aimed to evaluate the presence and characteristics of personal protective equipment-associated headaches in healthcare workers during the COVID-19 pandemic period and to determine the effects of such headaches.
Materials and methods:
A face-to-face questionnaire was delivered to 300 male and female healthcare personnel between the ages of 18-56 working in healthcare units where COVID-19 patients were evaluated and treated. The data from 296 completed questionnaires was evaluated.
Results:
We included 296 participants (166 females and 130 males) in our study; the mean age was 33.98 ± 8.52 years (range 18-56). One hundred ninety-six (66.22%) participants indicated that they had new onset personal protective equipment-associated headaches. Percentages of those with newly emergent headaches because of protective equipment were higher in the following participant groups: females (p = 0.045), those with COVID-19 disease history (p < 0.001), and those diagnosed with headaches before the pandemic (p = 0.001).
Conclusion:
Our study showed the presence of new-onset headaches associated with personal protective equipment in healthcare workers during the COVID-19 pandemic. Personal protective equipment-related headaches were associated with the following factors: female sex, a history of COVID-19 disease, and the presence of primary headaches diagnosed before the pandemic.
With the outbreak of COVID-19, a large number of medical staffs have invested in the front line of anti-epidemic. Medical protective clothing (MPC) can provide a safe environment for the wearers to block bacteria and viruses. However, nowadays, the thermal performance of MPC on the market is very poor, resulting in the extremely low comfort of the wearer. Some improved MPCs were made of materials, which were not easy to obtain with high cost. Some improved MPCs were lack of thermal comfort experimental data based on real human body. Therefore, this paper proposed a novel MPC with reusable PCM and ventilation. Through simulation and experiment, human comfort of the novel MPC was compared with the other two kinds of MPCs. Five subjects were invited to carried out the comfort tests under three states of motion with three types of MPCs. The results showed the novel MPC with higher cost performance in the effective period had been proved that PPD decreased by 39.5% than the traditional MPC. Besides, the novel MPC could meet the comfort requirements of medical staffs for one shift. Furthermore, the work can provide theoretical methods and basic experimental data for the continuous improvement of the comfort and safety of MPC.
Medical protective clothing increases the risk of heat stress while protecting healthcare workers from viruses. In this study, the impact of environmental heat stress, insulation of PPE’s in-ner-garment layer, and personal cooling strategy on physiological and perceptual responses of PPE-clad young college students were investigated. Three levels of wet bulb globe temperatures (WBGT = 15, 28 and 32 °C) and two types of inner garments (0.37 clo and 0.75 clo) were chosen for this study. In an uncompensable heat stress environment (WBGT=32 °C), two commercially available personal cooling systems including a ventilation cooling system (VCS) and an ice pack cooling system (ICS) on heat strain mitigation of PPE-clad participants was also investigated. At WBGT = 15 °C with 0.75 clo inner garments, mean skin temperatures were stabled at 31.2 °C, Tskin,RH was 60-65%, and HR was about 75.5 bpm, which denotes that the working scenario was on the cooler side. At WBGT = 28 °C, Tskin was plateaued at around 34.7 °C, and participants reported ‘hot’ thermal sensations. The insulation reduction of inner garments from 0.75 clo to 0.37 clo did not significantly improve the participants' physiological thermal comfort. At WBGT = 32 °C, Tskin was maintained at 35.2~35.7 °C, Tskin,RH was near 90% RH, Tcore was greater than 37.1 °C, and the mean HR was 91.9 bpm. This denotes that such a working scenario is uncompensable and per-sonal cooling to mitigate heat stress is required. When compared to NCS (no cooling), mean skin temperatures in ICS and VCS were reduced by 0.61 °C and 0.22 °C, respectively, and the heart rate was decreased by 10.7 bpm and 8.5 bpm, respectively. Perceptual responses in ICS and VCS improved significantly throughout the entire field trials, with VCS outperforming ICS in terms of individual cooling effect.
In order to prevent the nosocomial transmission of the SARS-CoV-2 virus, it has become necessary for health workers to increase their use of personal protective equipment (PPE). The aim of the study was to investigate the prevalence and influencing factors for adverse skin reactions (ASR) due to occupational PPE use among nursing staff in Germany during the COVID-19 pandemic. The study uses a mixed methods design. A focus group was created with experts from the field of healthcare, and an online survey was then carried out among nursing staff. Influencing factors were identified using multivariate logistic regression via odds ratios (ORs) with 95% confidence intervals (CIs). A total of 2274 nursing staff took part in the survey, with 1967 included in the analysis. The prevalence of ASR was 61%, with 94% affecting at least one area of the face. Statistically significant factors of influence were Filtering Face Peace (FFP) mask wearing duration of ≥4 h, a history of contact allergies, and being female and young. A pre-existing skin disease had a protective effect. The prevalence of PPE-related ASR underlines the necessity for targeted preventive measures for nursing staff during pandemic situation.
Citation: Aparicio Betancourt, M.; Duarte-Díaz, A.; Vall-Roqué, H.; Seils, L.; Orrego, C.; Perestelo-Pérez, L.; Barrio-Cortes, J.; Beca-Martínez, M.T.; Molina Serrano, A.; Bermejo-Caja, C.J.; et al. Global Healthcare Needs Abstract: The COVID-19 pandemic has exposed gaps and areas of need in health systems worldwide. This work aims to map the evidence on COVID-19-related healthcare needs of adult patients, their family members, and the professionals involved in their care during the first year of the pandemic. We searched the databases MEDLINE, Embase, and Web of Science. Two reviewers independently screened titles and abstracts and assessed full texts for eligibility. Disagreements were resolved by consensus. Descriptive data were extracted and inductive qualitative content analysis was used to generate codes and derive overarching themes. Thirty-six studies met inclusion criteria, with the majority reporting needs from the perspective of professionals (35/36). Professionals' needs were grouped into three main clusters (basic, occupational, and psycho-socio-emotional needs); patients' needs into four (basic, healthcare, psycho-socio-emotional, and other support needs); and family members' needs into two (psycho-socio-emotional and communication needs). Transversal needs across subgroups were also identified and grouped into three main clusters (public safety, information and communication, and coordination and support needs). This evidence map provides valuable insight on COVID-19-related healthcare needs. More research is needed to assess first-person perspectives of patients and their families, examine whether needs differ by country or region, and evaluate how needs have evolved over time.
We report the response process of the Laboratory Analysis Task Force (LATF) for Unknown Disease Outbreaks (UDOs) at the Korea Disease Control and Prevention Agency (KDCA) during January 2020 to coronavirus disease 2019 (COVID-19), which developed as a UDO in Korea. The advanced preparedness offered by the laboratory diagnostic algorithm for UDOs related to respiratory syndromes was critical for the rapid identification of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and enabled us to establish and expand the diagnostic capacity for COVID-19 on a national scale in a timely manner.
Background:
In the event of coronavirus disease-2019 (COVID-19) spread worldwide, frontline healthcare workers play a key role in the containment of this devastating pandemic, and to prevent the cross-transmission and gain confidence in battle with the pandemic, they are wearing personal protective equipment (PPE).
Aim and objective:
To explore the adverse health problems and skin reactions caused by the use of PPEs among the frontline nurses in the ICUs of COVID hospital.
Materials and methods:
A cross-sectional study was conducted using an online-based questionnaire assessing the physical problems, and adverse skin reactions of PPEs were sent among the 150 frontline nurses in ICUs of COVID hospital. The collected data were analyzed using descriptive statistics.
Results:
We got 137 valid responses from frontline nurses, and the most common adverse health effects expressed by them were headache (73.4%), extreme sweating (59.6%), and difficulty in breathing (36.7%); 91.7% complained about the fogging of the goggle. Majority of frontline nurses expressed nasal bridge scarring (76.64%) and indentation and pain on the back of the ears (66.42%) as the adverse skin reactions after wearing N95 masks. The common skin problems identified due to double gloving of latex gloves were excessive skin soakage with sweat (70.07%) and skin chapping (19%). The protective clothing caused minimal adverse reactions, and excessive sweating (71.53%) was the most reported.
Conclusion:
The healthcare workers wearing PPE for a prolonged period show significant adverse effects, so appropriate strategies should be taken to prevent the adverse effects by designing effective PPEs and education of preventive measures among healthcare workers.
How to cite this article:
Jose S, Cyriac MC, Dhandapani M. Health Problems and Skin Damages Caused by Personal Protective Equipment: Experience of Frontline Nurses Caring for Critical COVID-19 Patients in Intensive Care Units. Health Problems and Skin Damages Caused by Personal Protective Equipment: Experience of Frontline Nurses Caring for Critical COVID-19 Patients in Intensive Care Units. Indian J Crit Care Med 2021;25(2):134-139.
The need for healthcare workers (HCWs) to wear personal protective equipment (PPE) during the coronavirus disease 2019 (COVID-19) pandemic heightens their risk of thermal stress. We assessed the knowledge, attitudes, and practices of HCWs from India and Singapore regarding PPE usage and heat stress when performing treatment and care activities. One hundred sixty-five HCWs from India (n = 110) and Singapore (n = 55) participated in a survey. Thirty-seven HCWs from Singapore provided thermal comfort ratings before and after ice slurry ingestion. Differences in responses between India and Singapore HCWs were compared. A p-value cutoff of 0.05 depicted statistical significance. Median wet-bulb globe temperature was higher in India (30.2 • C (interquartile range [IQR] 29.1-31.8 • C)) than in Singapore (22.0 • C (IQR 18.8-24.8 • C)) (p < 0.001). Respondents from both countries reported thirst (n = 144, 87%), excessive sweating (n = 145, 88%), exhaustion (n = 128, 78%), and desire to go to comfort zones (n = 136, 84%). In Singapore, reports of airconditioning at worksites (n = 34, 62%), dedicated rest area availability (n = 55, 100%), and PPE removal during breaks (n = 54, 98.2%) were higher than in India (n = 27, 25%; n = 46, 42%; and n = 66, 60%, respectively) (p < 0.001). Median thermal comfort rating improved from 2 (IQR 1-2) to 0 (IQR 0-1) after ice slurry ingestion in Singapore (p < 0.001). HCWs are cognizant of the effects of heat stress but might not adopt best practices due to various constraints. Thermal stress management is better in Singapore than in India. Ice slurry ingestion is shown to be practical and effective in promoting thermal comfort. Adverse effects of heat stress on productivity and judgment of HCWs warrant further investigation.
Thermoregulation has substantial implications for energy consumption and human comfort and health. However, cooling technology has remained largely unchanged for more than a century and still relies on cooling the entire space regardless of the number of occupants. Personalized thermoregulation by thermoelectric devices (TEDs) can markedly reduce the cooling volume and meet individual cooling needs but has yet to be realized because of the lack of flexible TEDs with sustainable high cooling performance. Here, we demonstrate a wearable TED that can deliver more than 10°C cooling effect with a high coefficient of performance (COP > 1.5). Our TED is the first to achieve long-term active cooling with high flexibility, due to a novel design of double elastomer layers and high-ZT rigid TE pillars. Thermoregulation based on these devices may enable a shift from centralized cooling toward personalized cooling with the benefits of substantially lower energy consumption and improved human comfort.
Workers exposed to hot and humid conditions suffer from heat stress that affects their concentration and can potentially lead to an increase in workplace accidents. To minimize heat stress, protective equipment may be worn, such as personal cooling garments. This paper presents and discusses the performances, advantages and disadvantages of existing personal cooling garments, namely air-cooled, liquid-cooled, phase change, hybrid, gas expansion and vacuum desiccant cooling garments, and a thermoelectric cooling technology. The main objective is to identify the cooling technique that would be most suitable for deep mining workers. It appears that no cooling technology currently on the market is perfectly compatible with this type of mining environment.
However, combining two or more cooling technologies into a single hybrid system could be the solution to an optimized cooling garment for deep mines.
A method was established to evaluate calculation methods of mean skin temperature, in order to find appropriate ones for use in human thermal comfort study. In this method three indexes, including reliability, sensitivity and number of measurement sites, were proposed. Under air temperatures of 21 °C, 24 °C, 26 °C, and 29 °C, 22 subjects’ local skin temperatures (21 sites) and electrocardiograms were measured, and their thermal sensation and thermal comfort were inquired. Human heart rate variability indicated the physiological relation between mean skin temperature and ambient temperature for the sensitivity evaluation. Adopting the evaluation method, 26 types of mean skin temperature calculation methods were evaluated based on the experimental data. The results indicate that a calculation method of mean skin temperature with 10 sites is the most appropriate one, due to its high reliability, excellent sensitivity and fewer measuring sites. When it was applied to reflect thermal comfort, the performance was good.
Personal protective clothing (PPC) is a prerequisite for the health safety of individuals exposed to various health hazards, including infectious pathogens. Typically, protective clothing is designed to withstand hazards in a particular work environment. Growing concerns of biothreats and the emergence of recent pandemics underscore the need for PPC with a higher degree of protection and comfortability. Lightweight, high mobility, low physical and thermal stress, improved heat dissipation, and breathability are essential requirements for a comfortable PPC. Unfortunately, conventional protective clothing is less comfortable and provides limited protection against many hazards. However, imparting desired properties to protective clothing may require modifying and tuning the clothing materials/fabrics by incorporating suitable materials/additives. In this aspect, graphene draws researchers’ attention for its unique properties and flexible bonding capabilities. Fabrics modified with graphene or graphene-modified nanostructures could effectively overcome these limitations of conventional protective clothing. Additionally, the unique properties of graphene/graphene derivatives, such as antimicrobial activity, flame resistance, electrothermal conductivity, ultraviolet resistance, breathability, and so on could potentially be shifted to the fabrics modified by graphene. This chapter shed light on the importance of PPC, the limitations of conventional PPC, followed by measures that could be taken to improve PPC, the unique properties of graphene and graphene-modified nanostructures related to PPC, techniques of incorporating graphene/graphene-nanostructures in fabrics, and the modern research in this context and prospects of graphene-modified textiles associated with PPC.
A variety of public health events seriously threaten human life and health, especially the outbreak of COVID-19 at the end of 2019 has caused a serious impact on human production and life. Wearing personal protective equipment (PPE) is one of the most effective ways to prevent infection and stop the spread of the virus. Medical protective fiber materials have become the first choice for PPE because of their excellent barrier properties and breathability. In this article, we systematically review the latest progress in preparation technologies, properties, and applications of medical protective fiber materials. We first summarize the technological characteristics of different fiber preparation methods and compare their advantages and disadvantages. Then the barrier properties, comfort, and mechanical properties of the medical protective fiber materials used in PPE are discussed. After that, the applications of medical protective fibers in PPE are introduced, and protective clothing and masks are discussed in detail. Finally, the current status, future development trend, and existing challenges of medical protective fiber materials are summarized.
Wearing Personal Protective Equipment (PPE) is essential to protect healthcare workers during the COVID-19, but the traditional cooling methods do not meet the requirements of epidemic prevention during the COVID-19. Therefore, the cooling clothing integrated with phase change material (PCM-CC) was proposed for healthcare workers performing nucleic acid sample collection outdoors. Human experiments and subjective questionnaires were used to test the effect of wearing PCM-CC on the thermal sensations of healthcare workers and to analyze the effectiveness of PCM-CC in relieving thermal stress and thereby, improving the thermal comfort of healthcare workers. Results showed that wearing PCM-CC was effective in alleviating various heat symptoms associated with wearing PPE in a hot-temperature environment. Wearing PCM-CC reduced head and facial discomfort by 25% and 41% under the 26 °C thermal environment, while it improved the mean thermal sensation vote (TSV) values by 0.71 and 1.85 under the 26 °C and 32 °C thermal environments, respectively, and made the mean TSV value close to the neutral value. Meanwhile, wearing PCM-CC reduced mean skin temperatures by 0.65 °C, and the pronounced cooling effect was found in the chest. Wearing PCM-CC could be an effective thermoregulation measure to refine the thermal comfort of healthcare workers during the COVID-19 pandemic.
With the outbreak of infectious diseases such as Corona Virus Disease 2019, medical staff work intensively in isolated plots, medical disposable protective clothing (MDPC) has poor air condition and humidity permeability, which seriously reduces the thermal comfort of medical staff. In this paper, the effect of indoor thermal environment and activity levels on thermal comfort inside MDPC was studied by experiment. Five parts of the body were measured inside MDPC and the appropriate movements were chosen to simulate different levels of labor intensity. Meanwhile, physiological parameters and subjective thermal sensation were statistically analyzed. The results showed the influence range of different indoor temperatures on the temperature and humidity inside MDPC was about 1 °C and 10%, respectively; it indicated that the environment inside MDPC could be improved by reducing indoor temperature, that is, a cross intelligent adjustment mode was proposed. The effect of labor intensity on the temperature inside MDPC was significantly less than that of humidity. Within 20 minutes, the humidity changes under moderate and heavy labor intensity were even more than 10%, and the subjective discomfort threshold of the subjects increased by nearly 50%. Furthermore, the maximum benefit could be obtained by concentrating cooling on back, forehead, chest and upper arm. Theoretical models of working time, labor intensity, and temperature and humidity inside MDPC under different indoor temperatures and different parts were given. In addition, acceptable regions inside MDPC which were approximately parallelogram in the enthalpy-humidity chart. These conclusions could be a reference for future thermal comfort inside MDPC research.
Real-time monitoring and evaluation of cognitive performance based on physiological indicators is a potentially new measure to ensure high air temperature safety. Heart rate might be an appropriate physiological indicator, yet it still needs several direct shreds of evidence. This study analyzed the relation between heart rate and cognitive performance at high air temperatures, based on the experimental data obtained from three phases of climate-controlled experiments. The climate-controlled experiments include five temperature levels of 26, 30, 33, 37, and 39 °C, and two relative humidity levels of 50% and 70%. During the experiments, eight cognitive tests were conducted to assess the basial cognitive performance, heart rate was continuously monitored, and the ratings of alertness and thermal sensation, comfort, and acceptability were documented. A total of 104 healthy subjects took part in the three phases of experiments, and 1478 valid samples were obtained. By analyzing the experimental data comprehensively, the results show that when the heart rate went up to 90bpm, the speed and accuracy of Stroop and d2 test would decline significantly(p < 0.05). The accuracy of Visual learning, Addition, Multiplication, and Typing only dropped significantly when the heart rate reach a level of 100bpm(p < 0.05). There was an inverted U-shaped relation between the relative accuracy of cognitive tests and heart rate. Based on the quadratic regression equation with a downward opening, the Heart Rate-Cognitive performance (HR-CP) model was built up. The R² value of all regression equations is close to or greater than 0.8. These results suggest that heart rate might be a potential physiological indicator to evaluate the effects of high air temperature on cognitive performance.
Since the outbreak of COVID-19, wearing personal protective equipment (PPE) has become increasingly common, especially for healthcare workers performing nucleic acid sample collection. A field experiment and questionnaire survey were conducted in a semi-open transition space of a university building in Guangzhou, southern China. Thirty-two subjects wore PPE to simulate nucleic acid sample collection, during which thermal parameters were recorded and subjective questionnaires were completed. The relationship between thermal sensation and thermal index was analyzed to determine the neutral temperature and comfort temperature zones. Subjects had higher requirements for thermal environment parameters when wearing PPE than when not wearing PPE, and were found to have statistically significant differences in thermal perception when wearing and not wearing PPE. Wearing PPE significantly raised the subjects' thermal and humidity sensations and restricted their airflow. Wearing PPE resulted in thermal discomfort for the subjects and a high unacceptability rate for environmental thermal parameters. The subjects wore PPE for an acceptable duration of approximately 1.5 hours. The neutral operative temperatures were significantly lower when wearing PPE than when not wearing PPE, and the deviation from the neutral temperature was 9.7 °C. The neutral operative temperature was 19.5 °C and the comfort temperature zone was 17.4–21.5 °C when subjects wore PPE, demonstrating that subjects who wore PPE preferred lower temperatures. These results suggest that people who wear PPE for work, especially outdoors, should receive more attention to ensure thermal comfort and safety.
Aim
This study aims to investigate the problems experienced by perioperative nurses due to the use of personal protective equipment and their attitudes towards caregiving roles.
Methods
This cross-sectional study was conducted with 175 volunteer nurses working in surgical clinics across Turkey between March–June 2021. Data were collected online with a personal information form, an information form regarding the personal protective equipment usage times of nurses and the problems experienced, and the Attitude Scale for Nurses in Caregiving Roles.
Results
It was found that 98.3% of nurses had problems with personal protective equipment (excluding gloves); 97.7% of them had problems with sterile or non-sterile gloves, and 65.7% of them stated that pressure injuries developed due to personal protective equipment. It was determined that the rate of nurses considering leaving the profession today is higher than before the outbreak. The Attitude Scale for Nurses in Caregiving Roles obtained a mean score of 65.83 ± 9.41. Those who did not intend to leave the nursing profession had higher scale mean scores than those who thought to leave.
Conclusion
It was determined that perioperative nurses experienced skin problems due to the use of personal protective equipment and most of them developed pressure injuries, nearly half of them considered leaving the profession during the COVID-19 pandemic, and considering leaving the profession adversely affected their caregiver roles. According to the results of this study, it is recommended that attempts should be made to develop strategies to prevent skin problems and pressure injuries in perioperative nurses.
Liquid cooling garments (LCGs), which are considered to be a very effective way to reduce thermal erosion since the 1950s. But at present, the design and test of the liquid cooling garments system is not perfect, so it needs further research. In this study, the heat transfer model between the LCG and the environment and human body was established, and we analyzed the influence of voltage and flow rate on the cooling performance of LCG. We designed and produced a LCG prototype. Series of experiments were carried out based on the system to verify the accuracy of the heat transfer model. The experimental results show that the working voltage of the Thermo Electric Cooler (TEC) has more significant influence on the cooling effect than the flow velocity of the liquid in the pipe. Furthermore, the effective cooling power of the LCG increases first and then decreases with the increase of the working voltage, in other word, there is an optimal working voltage. In addition, the fitting relation between the working voltage and the effective cooling power is given. Besides, the experimental results also show that the cooling effect of the LCG increases with the increase of flow rate under the optimal operating voltage, and the average maximum cooling temperature difference of the cooling garment is 5.4-5.5°C when the ambient temperature is 39.2 °C. A specific cooling temperature was proposed to assess practicality and the value is 5.5 °C/kg.
Human metabolic rate is a fundamental and essential aspect of thermal comfort, and gender differences in metabolic rate may underlie gender differences in comfort. This study explores gender differences in physiological and subjective responses to a wide range of cold to hot temperatures. Forty healthy college students (20 females and 20 males) participated in the experiments. Subjects were sedentary, wearing 0.6 clo, staying at 26 °C for 30 min, then exposed to either at cool (14, 16, 18, 20 °C), neutral (24, 26°C), or warm (28, 30, 32, and 34 °C) temperatures for 90 minutes. Both subjective questionnaires (thermal sensation, thermal comfort, thermal acceptability) and physiological measurements (metabolic rate, skin temperature, skin blood flow, and skin wettedness) were collected during the exposures. Females tend to have lower metabolic rates than males at all temperatures, although significant differences were only found at 14, 16, and 18 °C. Females tend to be cooler and less comfortable than males at cool temperatures, which could be explained by the lower metabolic rates and lower skin temperatures in females. Males tend to be warmer and less comfortable at warm temperatures, which could be explained by higher metabolic rates and higher skin wettedness in males. No significant gender differences in subjective or physiological responses were found at neutral conditions.
This study investigates the varies in human physiological response, subjective sensation and acute subclinical health symptoms with increasing activity levels at different high temperatures. Thirty-two healthy subjects were recruited to walk on a treadmill in a climate chamber at a speed of 4 km/h. They experienced four temperature conditions (26 °C, 30 °C, 33 °C and 37 °C), each exposure lasting 85 min. Eardrum temperature, heart rate, skin temperature, systolic blood pressure, respiratory flow, and respiration rate changed significantly with increasing temperatures. At temperature of 37 °C, the SpO2 decreased significantly compared with at 33 °C. Subjects perceived the environment unacceptable at 37 °C. The perceived air quality and air freshness correlated linearly with the enthalpy of air. The intensity of headache, dizzy, fatigue and sleepiness increased with increasing temperatures, while only aggravated significantly at 37 °C. Additionally, compared with the results at light activity level, heart rate and other key physiological parameters increased significantly with increasing activity levels. The subjects felt “very hot” at 37 °C, and the change trend in symptoms reported by subjects increased significantly at 37 °C with the increased exposure time, while no significant change was observed in 26-33 °C. It indicates that exposure to 37 °C impairs the health and safety of heat acclimatized subjects. Using linear fitting curve to predict human physiological tolerance time suggested by ISO 9986. The result shows that eardrum temperature exceeded 38.5 °C for 97min continuously walk at 37 °C. This provides valuable information involved physiological and psychological responses when human exposed to high temperatures in daily life or industrial production.
Well-designed Environmental Epidemiological Studies (EES) play a crucial role in quantifying the influence of environmental exposures and their associated risks on health in the wider population. They provide critical research evidence for identifying and developing interventions to avert adverse health consequences from those exposures. However, uncertainty and variability inherent to any field based EES could hinder the nature and magnitude of association between an exposure and health outcome. This is particularly pronounced in resource limited settings and resource-tight research projects. The present study evaluated the association between occupational heat stress and renal health among informal work sectors in India had some significant challenges. Informal workers exposed to chronic occupational heat stress had significantly higher adverse renal health outcomes than the unexposed workers. Our field challenges included gaining access and permissions to conduct the study, participant recalls bias and attrition, accurately estimating exposures, confounding from causes of both exposure and disease, and to a large extent tight-funding. Though opportunities are abundant, we must ensure field conditions are optimized to attain study objectives. A keen understanding and sensitivity towards the cultural and work settings is essential for successful project completion. Based on our experiences, we provide strategies we adopted to improve fieldwork and the outcomes of the EES of occupational heat exposures and its health impacts. We provide recommendations to help overcome the field challenges and achieve better results for future studies in developing country settings.
COVID-19 has caused a huge impact on people’s daily life and has made great damage on national economy. All the epidemic situation not only require the improvement of medical science, but also the corresponding auxiliary research field, e.g. the improve of protective clothing for medical use (MUPC). Developing a new kind of MUPC with portable cooling devices to improve medical workers’ thermal comfort and protection performance of MUPC is imminent. In this paper, an integrated MUPC with a portable vortex tube cooling device was studied with experimental method. In a phytotron, a manikin wearing the MUPC was experimentally studied in terms of the influence of environment temperature and cool air supply conditions. On the basis of experiments, the MUPC inside air temperature and relative humidity, skin temperature of human body was studied with simulation method. Overall thermal sensation vote (TSV) and local TSV of human body were calculated, based on simulation results, to evaluate human thermal sensation. The results showed that, first, 50L/min cool air flowrate with 18∼20℃ supply temperature can create a good MUPC inside thermal sensation environment, for both head supply and body supply conditions. Both body supply condition and head supply condition cannot create a uniform MUPC inside thermal sensation environment. Second, MUPC inside air relative humidity is around or lower than 60% for most body parts, except for air supply position and body parts that air is difficult to reach. Thirdly, with cool air supplied into MUPC, a micro-positive pressure environment can be obtained, and the protection performance of MUPC can be improved.
Clinicians who care for patients infected with coronavirus disease 2019 (COVID-19) must wear a full suite of personal protective equipment, including an N95 mask or powered air purifying respirator, eye protection, a fluid-impermeable gown, and gloves. This combination of personal protective equipment may cause increased work of breathing, reduced field of vision, muffled speech, difficulty hearing, and heat stress. These effects are not caused by individual weakness; they are normal and expected reactions that any person will have when exposed to an unusual environment. The physiologic and psychologic challenges imposed by personal protective equipment may have multiple causes, but immediate countermeasures and long-term mitigation strategies can help to improve a clinician’s ability to provide care. Ultimately, a systematic approach to the design and integration of personal protective equipment is needed to improve the safety of patients and clinicians.
Studies are probing how heat threatens health—and how to lower the risks.
Super-absorbent polymers (SAPs) are a family of functional polymer material, with a high water absorption function. It absorbs water hundreds to thousands of times heavier than itself and has excellent water retention performance. Once the water absorption expands into a hydrogel, it is difficult to separate the water even under pressure. This article describes the water absorption and retention capacity of polymer water-absorbent resin, a compound that can solve the problem of water shortages in agriculture, which is very important for the development of modern agriculture.
Disposable medical protective clothing for 2019-nCoV mainly consists of stacked layers with nanopore films, polymer coated nonwoven fabrics and melt-blown nonwoven fabrics against anti-microbial and anti-liquid penetration. However, such structures lack moisture permeability and breathability leading to an uncomfortable, stuffy wearing experience. Here, we propose a novel medical protective clothing material with a superabsorbent layer to enhance moisture absorption. Poly(acrylic acid-co-acrylamide)/polyvinyl alcohol superabsorbent fibers (PAAAM/PVA fibers) were prepared via wet spinning. And the superabsorbent composite layer was stacked from PAAAM/PVA fibers, bamboo pulp fibers (BPF) and ethylene-propylene side by side fibers (ESF). The novel disposable medical protective composite fabric was obtained through gluing the superabsorbent layer to the inner surface of strong antistatic polypropylene nonwoven fabric. The resultant composite fabric possesses excellent absorption and retention capacity for sweat, up to 12.3 g/g and 63.8%, and a maximum hygroscopic rate of 1.04 g/h, higher than that of the conventional material (only 0.53 g/h). The moisture permeability of the novel material reached 12,638.5 g/(m2 d), which was 307.6% of the conventional material. The novel material can effectively reduce the humidity inside the protective clothing and significantly improve the comfort of medical staff.
Air conditioning systems are used to control the air dry-bulb temperature and humidity level for human thermal comfort. In order to control the humidity level, air dry-bulb temperature needs to be brought down below its dew point temperature to condense out the moisture from the air. This eventually consumes a significant amount of total building energy in terms of electricity. Therefore, to minimize the energy consumption, researchers are stimulating their study towards an alternative latent heat load control system. In this regard, desiccant based sorption technologies are more effective compared to the conventional vapor compression system. Therefore, it is necessary to analyze the different desiccants' individual properties and their physical behavior in material perspective. In this study, an effort is devoted to explore the thermo-kinetic properties of pure LiBr, CaCl2, as well as their mixtures (LiBr:CaCl2 of 90:10; 85:15; 80:20 and 75:25) by X-ray diffraction (XRD), thermo-gravimetric (TG) and absorption rate, analyzes through numerous control experiments. The XRD study confirmed that peaks of CaCl2 and LiBr were shifted slightly for LiBr and CaCl2 mixtures due to interaction effects. The results of present investigation elucidated that mixtures of LiBr and CaCl2 showed less moisture regeneration cost than pure CaCl2 and all the mixtures revealed more rate of moisture absorption than pure LiBr and CaCl2. Further, 85:15 mixture of LiBr:CaCl2 showed higher rate of moisture absorption when compared to other prepared samples.
Personal cooling garments have been developed to reduce the risk of heat stress and heat-related injuries in hot environments. The human body can suffer from a kind of heat stress resulting in reduced working endurance and performance and an increased risk of heat illness when exposed to hot climates. This gets worse when combined with physical work, such as firefighting, military drills, special work situations, and sports. The use of protective clothing which limits the sweat evaporation of the body can also make the situation worse. This review includes a brief look at the human thermoregulation and its relation with the cooling garments, classification of the personal cooling garments, testing procedures, and parameters affecting the efficiency of the cooling garments.
Relationship between thermal-moist comfort of medical protective clothing and human fatigue
- Niu
Study on the structure of internal-using hygroscopic workwear in medical protective clothing
- Sang
Product research on reducing the internal environmental humidity of medical protective clothing
- Jia