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与气溶胶个人防护装备相关的热应激及其影响。

Heat stress associated with aerosol PPE and its impact.

机构信息

MSk Lab, Imperial College London, London W12 0BZ, UK.

Theatres and Anaesthesia, Imperial College Healthcare NHS Trust, London W2 1NY, UK.

出版信息

Occup Med (Lond). 2023 Apr 26;73(3):120-127. doi: 10.1093/occmed/kqac114.

Abstract

BACKGROUND

Aerosol personal protective equipment (PPE) is subjectively reported to negatively impact healthcare workers' performance and well-being, but this has not been assessed objectively.

AIMS

This randomized controlled crossover study aimed to quantify the heat stress associated with aerosol PPE and to investigate its impact upon mood, cognitive and motor function, and task performance.

METHODS

Sixteen healthy, young, lean participants (eight males) undertook an exercise protocol, which simulated the metabolic expenditure of hospital work: once wearing aerosol PPE (PPE visit) and once wearing standard surgical attire (control visit). Participants walked on a treadmill for 2 h followed by 30-min rest. Core temperature, heart rate, urine specific gravity, weight, grip strength, mood (Bond-Lader scale) and task performance (Intubation of a Manikin) were recorded. Values are between-visit mean (standard deviation) differences.

RESULTS

On the PPE visit core temperature (+0.2 (0.3)°C; P < 0.01), heart rate (+12 (13) bpm; P < 0.001), urine specific gravity (+0.003 (0.005); P < 0.05) and intubation task time (+50 (81) s; P < 0.01) were greater than on the control visit; and alertness (-14 (21) mm; P < 0.001), contentment (-14 (15) mm; P < 0.001) and grip strength (-4 (4) N; P < 0.01) were less.

CONCLUSIONS

This study demonstrates that wearing aerosol PPE in a simulated hospital environment results in heat exhaustion and has a negative impact upon mood, motor function, and task performance. Whilst wearing PPE is important to prevent disease transmission, strategies should be developed to limit its impact upon healthcare workers' performance and well-being.

摘要

背景

气溶胶个人防护设备(PPE)被主观报告为对医护人员的表现和健康产生负面影响,但这尚未得到客观评估。

目的

本随机对照交叉研究旨在量化气溶胶 PPE 相关的热应激,并研究其对情绪、认知和运动功能以及任务表现的影响。

方法

16 名健康、年轻、瘦的参与者(8 名男性)进行了一项模拟医院工作代谢消耗的运动方案:一次穿着气溶胶 PPE(PPE 访问),一次穿着标准手术服(对照访问)。参与者在跑步机上行走 2 小时,然后休息 30 分钟。记录核心体温、心率、尿比重、体重、握力、情绪(邦德-拉德量表)和任务表现(模拟人插管)。值为访问间平均值(标准差)差异。

结果

在 PPE 访问中,核心体温(+0.2(0.3)°C;P < 0.01)、心率(+12(13)bpm;P < 0.001)、尿比重(+0.003(0.005);P < 0.05)和插管任务时间(+50(81)s;P < 0.01)均大于对照访问;警觉度(-14(21)mm;P < 0.001)、满足感(-14(15)mm;P < 0.001)和握力(-4(4)N;P < 0.01)则更低。

结论

本研究表明,在模拟医院环境中佩戴气溶胶 PPE 会导致热衰竭,并对情绪、运动功能和任务表现产生负面影响。虽然佩戴 PPE 对于防止疾病传播很重要,但应制定策略来限制其对医护人员表现和健康的影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4848/10132207/2646eecc6f9b/kqac114_fig1.jpg

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