Adverse Effects of Personal Protective Equipment Used on Healthcare Workers' Skin during COVID-19 Outbreak
Keywords:
COVID-19, Face Masks, Healthcare Workers, Personal Protective Equipment, Skin DamageAbstract
Objective: To investigate the adverse events on skin with continuous practice of personal protective equipment (PPE) in COVID-19 management among healthcare workers (HCWs).
Methods: This cross-sectional multicenter study was conducted at hospitals operating in Karachi, Pakistan from November 2020 to January 2021. The target population was HCWs including doctors, paramedical staff, postgraduate, and undergraduate students involved in the care of patients during COVID-19; and continuously wearing level 3 barrier protection personal protective equipment (L3PPE), such as masks, gloves, and protective clothing. Adverse effect was defined as presence of new onset obvious skin damages with continuous PPE used during used COVID-19 management.
Results: Of 383 HCWs, adverse effect was observed in 168 (43.9%) HCWs. The most common adverse effects because of facial mask were indentation and ear pin 200 (52.2%), by gloves was dry skin 186 (48.8%), by gown was wheals 19 (7.0%), and by goggles was pressure injury 40 (43.0%). A significantly higher association of adverse effect of using L3PPE was found with age >27 years (p-value <0.031), eczema and asthma as preexisting diseases (p-value <0.001), ≤10 times daily standard hand hygiene procedure (p-value 0.002), >6 hours of PPE worn per day (p-value <0.001), N-95 mask use (p-value 0.029), both OPD and isolation ward work setting (p-value <0.001), and systematic features like, headache (p-value 0.019), sneezing (p-value <0.001), feeling of intense heat (p-value <0.001), claustrophobia (p-value <0.001), and facial suffusion (p-value <0.001).
Conclusion: A higher number of HCWs reported adverse effects of L3PPE continuously usage during COVID-19 management.
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