医护人员长时间佩戴口罩与干眼的关系：一项混合方法研究。
Prolonged facemask wearing among hospital workers and dry eye - a mixed-methods study.
机构信息
Department of Ophthalmology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
Department of Epidemiology, Colorado School of Public Health, Aurora, CO, USA.
出版信息
BMC Ophthalmol. 2023 Oct 19;23(1):420. doi: 10.1186/s12886-023-03153-3.
BACKGROUND
Prolonged facemask wearing may have negatively affected essential workers with dry eye. We conducted a mixed-methods study to examine and understand the associations of the ocular surface, periocular environment, and dry eye-related symptoms among hospital workers across the job spectrum with prolonged facemask use.
METHODS
We recruited clinical and non-clinical hospital workers with self-reported symptoms of dry eye and prolonged facemask use. We measured symptoms using the 5-item Dry Eye Questionnaire and the Ocular Surface Disease Index (OSDI). Objective ocular signs included corneal and conjunctival staining, fluorescein tear break up time (TBUT), meibography, tear film interferometry, and periocular humidity. We compared symptoms and signs across levels of periocular humidity, dry eye severity, facemask type, and job type. Participants with moderate or severe dry eye symptoms (OSDI > = 23) were invited for a semi-structured, one-on-one interview.
RESULTS
We enrolled 20 clinical and 21 non-clinical hospital workers: 27% were 40 years or older, 76% were female, 29% reported a race other than White, and 20% were Hispanic. Seventeen individuals participated in the semi-structured interviews. From the quantitative analyses, we found that 90% of participants reported worsened severity of dry eye at work due to facemasks. Although wearing facemasks resulted in higher periocular humidity levels compared with not wearing facemasks, 66% participants reported increased airflow over their eyes. Findings from the qualitative interviews supported the finding that use of facemasks worsened dry eye symptoms, especially when facemasks were not fitted around the nose. The data did not suggest that non-clinical hospital workers experienced a greater impact of dry eye than clinical workers.
CONCLUSIONS
Healthcare providers and patients with dry eye should be educated about the discomfort and the ocular surface health risks associated with inadequately fitted facemasks. Wearing a fitted facemask with a pliable nose wire appears to mitigate the upward airflow.
背景
长时间佩戴口罩可能会对患有干眼的一线工作人员造成负面影响。我们进行了一项混合方法研究，以检查和了解在整个工作范围内使用口罩的医院工作人员的眼表、眼周环境和干眼相关症状之间的关联。
方法
我们招募了有干眼症状和长时间佩戴口罩的临床和非临床医院工作人员。我们使用干眼症状问卷（5 项）和眼表疾病指数（OSDI）来测量症状。客观的眼部体征包括角膜和结膜染色、泪膜破裂时间（TBUT）、睑板腺照相、泪膜干涉成像和眼周湿度。我们比较了不同眼周湿度、干眼严重程度、口罩类型和工作类型的症状和体征。邀请有中度或重度干眼症状（OSDI≥23）的参与者进行半结构化的一对一访谈。
结果
我们共招募了 20 名临床工作人员和 21 名非临床工作人员：27%的人年龄在 40 岁或以上，76%为女性，29%报告的种族不是白人，20%为西班牙裔。17 人参加了半结构化访谈。从定量分析中，我们发现 90%的参与者报告说由于口罩导致工作时干眼的严重程度恶化。虽然戴口罩会使眼周湿度比不戴口罩时更高，但 66%的参与者报告说眼睛上方的气流增加了。定性访谈的结果支持了这样的发现，即使用口罩会使干眼症状恶化，尤其是当口罩没有贴合鼻子时。数据并未表明非临床医院工作人员比临床工作人员受到干眼的影响更大。
结论
应该向干眼患者和医护人员宣传不适当佩戴口罩会带来不适和眼表健康风险。佩戴贴合鼻梁、有弹性鼻夹的口罩似乎可以减轻向上的气流。
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