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Baseline Evaluation With a Sweating Thermal Manikin of Personal Protective Ensembles Recommended for Use in West Africa

Published online by Cambridge University Press:  28 August 2015

Aitor Coca ,
Travis DiLeo ,
Jung-Hyun Kim ,
Raymond Roberge  and
Ronald Shaffer
Aitor Coca*
Affiliation:
National Personal Protective Technology Laboratory of the National Institute for Occupational Safety and Health, Pittsburgh, Pennsylvania.
Travis DiLeo
Affiliation:
National Personal Protective Technology Laboratory of the National Institute for Occupational Safety and Health, Pittsburgh, Pennsylvania.
Jung-Hyun Kim
Affiliation:
National Personal Protective Technology Laboratory of the National Institute for Occupational Safety and Health, Pittsburgh, Pennsylvania.
Raymond Roberge
Affiliation:
National Personal Protective Technology Laboratory of the National Institute for Occupational Safety and Health, Pittsburgh, Pennsylvania.
Ronald Shaffer
Affiliation:
National Personal Protective Technology Laboratory of the National Institute for Occupational Safety and Health, Pittsburgh, Pennsylvania.
*
Correspondence and reprint requests to Aitor Coca, PhD, NPPTL, 626 Cochrans Mill Road, Pittsburgh, PA 15236 (e-mail: esq6@cdc.gov).
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Abstract

Objective

Experience with the use of personal protective equipment (PPE) ensembles by health care workers responding to the Ebola outbreak in the hot, humid conditions of West Africa has prompted reports of significant issues with heat stress that has resulted in shortened work periods.

Methods

A sweating thermal manikin was used to ascertain the time to achievement of a critical core temperature of 39°C while wearing 4 different PPE ensembles similar to those recommended by the World Health Organization and Médecins Sans Frontières (Doctors Without Borders) at 2 different ambient conditions (32°C/92% relative humidity and 26°C/80% relative humidity) compared with a control ensemble.

Results

PPE ensembles that utilized coveralls with moderate to high degrees of impermeability attained the critical core temperature in significantly shorter times than did other ensembles. Encapsulation of the head and neck region resulted in higher model-predicted subjective impressions of heat sensation.

Conclusions

To maximize work capacity and to protect health care workers in the challenging ambient conditions of West Africa, consideration should be given to adjustment of work and rest schedules, improvement of PPE (e.g., using less impermeable and more breathable fabrics that provide the same protection), and the possible use of cooling devices worn simultaneously with PPE. (Disaster Med Public Health Preparedness. 2015;9:536–542)

Keywords

Ebolapersonal protective equipment ensemblesheat stresscore temperaturesweating thermal manikin
Type
Original Research
Information
Disaster Medicine and Public Health Preparedness , Volume 9 , Issue 5 , October 2015 , pp. 536 - 542
Copyright
Copyright © Society for Disaster Medicine and Public Health, Inc. 2015 

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References

1. Unprecedented number of medical staff infected with Ebola. World Health Organization website. http://www.who.int/mediacentre/news/ebola/25-august-2014/en/. Published August 15, 2014. Accessed November 30, 2014.Google Scholar
2. Ebola situation report – 4 March 2015. World Health Organization website. http://apps.who.int/ebola/current-situation/ebola-situation-report-4-march-2015. Published March 6, 2015. Accessed August 10, 2015.Google Scholar
3. Pshenichnaya, NY, Nenadskaya, SA. Probable Crimean-Congo hemorrhagic fever virus transmission occurred after aerosol-generating medical procedures in Russia: nosocomial cluster. Int J Infect Dis. 2015;33:120-122. http://dx.doi.org/10.1016/j.ijid.2014.12.047.CrossRefGoogle ScholarPubMed
4. Macintyre, CR, Seale, H, Yang, P, et al. Quantifying the risk of respiratory infection in healthcare workers performing high-risk procedures. Epidemiol Infect. 2014;142(9):1802-1808. http://dx.doi.org/10.1017/S095026881300304X. PMID:24308554.CrossRefGoogle ScholarPubMed
5. Wolz, A. Face to face with Ebola--an emergency care center in Sierra Leone. N Engl J Med. 2014;371(12):1081-1083. PMID:25162580.CrossRefGoogle ScholarPubMed
6. Chertow, DS, Kleine, C, Edwards, JK, et al. Ebola virus disease in West Africa--clinical manifestations and management. N Engl J Med. 2014;371(22):2054-2057. PMID:25372854.CrossRefGoogle Scholar
7. Interim Guidance for Healthcare Workers Providing Care in West African Countries Affected by the Ebola Outbreak: Limiting Heat Burden While Wearing Personal Protective Equipment (PPE). Centers for Disease Control and Prevention website. http://www.cdc.gov/vhf/ebola/hcp/limiting-heat-burden.html. Last updated January 29, 2015. Accessed August 10, 2015.Google Scholar
8. Bernard, TE, Caravello, V, Schwartz, SW, Ashley, CD. WBGT clothing adjustment factors for four clothing ensembles and the effects of metabolic demands. J Occup Environ Hyg. 2008;5(1):1-5. PMID:17999329.CrossRefGoogle ScholarPubMed
9. Holmér, I. Thermal manikin history and applications. Eur J Appl Physiol. 2004;92(6):614-618. PMID:15185083.CrossRefGoogle ScholarPubMed
10. Meinander, H, Hellsten, M. The influence of sweating on the heat transmission properties of cold protective clothing studied with a sweating thermal manikin. Int J Occup Saf Ergon. 2004;10(3):263-269. PMID:15377411.CrossRefGoogle ScholarPubMed
11. Holmér, I. Protective clothing in hot environments. Ind Health. 2006;44(3):404-413. PMID:16922184.CrossRefGoogle ScholarPubMed
12. Fiala, D, Lomas, KJ, Stohrer, M. A computer model of human thermoregulation for a wide range of environmental conditions: the passive system. J Appl Physiol (1985). 1999;87(5):1957-1972. PMID:10562642.CrossRefGoogle ScholarPubMed
13. Fiala, D, Lomas, KJ, Stohrer, M. Computer prediction of human thermoregulatory and temperature responses to a wide range of environmental conditions. Int J Biometeorol. 2001;45(3):143-159. PMID:11594634.CrossRefGoogle ScholarPubMed
14. Rugh, JP, Lustbader, J. Application of a sweating manikin controlled by a human physiological model and lessons learned. Presented at: 6th International Thermal Manikin and Modeling Meeting; October 16-18, 2006; Hong Kong, China.Google Scholar
15. Zhang, H, Arens, E, Huizenga, C, Han, T. Thermal sensation and comfort models for non-uniform and transient environments: Part I: local sensation of individual body parts. eScholarship website. http://escholarship.org/uc/item/3sw061xh. Published July 1, 2009. Accessed August 10, 2015.Google Scholar
16. Zhang, H, Arens, E, Huizenga, C, Han, T. Thermal sensation and comfort models for non-uniform and transient environments: Part II: local comfort of individual body parts. http://escholarship.org/uc/item/1pz9j3j2. Published July 1, 2009. Accessed August 10, 2015.Google Scholar
17. Zhang, H, Arens, E, Huizenga, C, Han, T. Thermal sensation and comfort models for non-uniform and transient environments: Part III: whole-body sensation and comfort. Retrieved from: http://escholarship.org/uc/item/2tm289vb. Published July 1, 2009. Accessed August 10, 2015.Google Scholar
18. Sawka, MN, Montain, SJ. Fluid and electrolyte supplementation for exercise heat stress. Am J Clin Nutr . 2000;72(2)(suppl):564S-572S. PMID:10919961.CrossRefGoogle ScholarPubMed
19. Ainsworth, BE, Haskell, WL, Herrmann, SD, et al. 2011 Compendium of Physical Activities: a second update of codes and MET values. Med Sci Sports Exerc. 2011;43(8):1575-1581. PMID:21681120.CrossRefGoogle ScholarPubMed
20. Hancock, PA, Vasmatzidis, I. Effects of heat stress on cognitive performance: the current state of knowledge. Int J Hyperthermia. 2003;19(3):355-372. PMID:12745975.CrossRefGoogle ScholarPubMed
21. DuPont personal protection protective clothing and bloodborne pathogens. DuPont website. http://safespec.dupont.com/safespec/media/documents/bloodborne_pathogens.pdf. Accessed August 10, 2015.Google Scholar
22. Kim, JH, Coca, A, Williams, WJ, Roberge, RJ. Subjective perceptions and ergonomics evaluation of a liquid cooled garment worn under protective ensemble during an intermittent treadmill exercise. Ergonomics. 2011;54(7):626-635. PMID:21770750.CrossRefGoogle ScholarPubMed
23. ASTM F1671/F1671M-13 Standard Test Method for Resistance of Materials Used in Protective Clothing to Penetration by Blood-Borne Pathogens Using Phi-X174 Bacteriophage Penetration as a Test System. West Conshohocken, PA: ASTM International; 2013. www.astm.org.Google Scholar
24. World Health Organization. Interim Infection Prevention and Control Guidance for Care of Patients with Suspected or Confirmed Filovirus Haemorrhagic Fever in Health-Care Settings, with Focus on Ebola. WHO/HIS/SDS/2014.4. Geneva, Switzerland: World Health Organization (WHO); 2014.Google Scholar
25. Sterk, E, ed. Filovirus Haemorrhagic Fever Guideline. Barcelona, Spain: Medecins Sans Frontieres; 2008:39-48.Google Scholar
26. Personal protective equipment in the context of filovirus disease outbreak response. World Health Organization website. http://apps.who.int/iris/bitstream/10665/137410/1/WHO_EVD_Guidance_PPE_14.1_eng.pdf. Published October 2014. Accessed August 10, 2015.Google Scholar