Hostname: page-component-cd9895bd7-8ctnn Total loading time: 0 Render date: 2024-12-28T06:18:05.767Z Has data issue: false hasContentIssue false
  • English
  • Français

Physiological Evaluation of Personal Protective Ensembles Recommended for Use in West Africa

Published online by Cambridge University Press:  20 March 2017

Aitor Coca ,
Tyler Quinn ,
Jung-Hyun Kim ,
Tianzhou Wu ,
Jeff Powell ,
Raymond Roberge  and
Ronald Shaffer
Aitor Coca*
Affiliation:
National Personal Protective Technology Laboratory of the National Institute for Occupational Safety and Health, Pittsburgh, Pennsylvania
Tyler Quinn
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
Tianzhou Wu
Affiliation:
National Personal Protective Technology Laboratory of the National Institute for Occupational Safety and Health, Pittsburgh, Pennsylvania
Jeff Powell
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).
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective

Personal protective equipment (PPE) provides health care workers with a barrier to prevent human contact with viruses like Ebola and potential transmission of the disease. However, PPE can also introduce an additional physiological burden from potentially increased heat stress. This study evaluated the human physiological and subjective responses to continuous light exercise within environmental conditions similar to those in West Africa while wearing 3 different, commonly used PPE ensembles (E1, E2, and E3).

Methods

Six healthy individuals were tested in an environmental chamber (32°C, 92% relative humidity) while walking (3 METs, 2.5 mph, 0% incline) on a treadmill for 60 minutes. All subjects wore medical scrubs and PPE items. E1 also had a face shield and fluid-resistant surgical gown; E2 additionally included goggles, coverall, and separate hood; and E3 also contained a highly impermeable coverall, separate hood, and surgical mask cover over the N95 respirator.

Results

Heart rate and core temperature at the end of the exercise were significantly higher for E2 and E3 than for E1. Subjective perceptions of heat and exertion were significantly higher for E2 and E3 than for E1.

Conclusions

Heat stress and PPE training, as well as the implementation of a work-to-rest ratio that avoids dehydration and possible heat stress issues, are recommended. (Disaster Med Public Health Preparedness. 2017;11:580–586)

Keywords

Ebolapersonal protective equipment ensemblesheat stresscore temperature
Type
Original Research
Information
Disaster Medicine and Public Health Preparedness , Volume 11 , Issue 5 , October 2017 , pp. 580 - 586
Copyright
Copyright © Society for Disaster Medicine and Public Health, Inc. 2017 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

1. World Health Organization Media Centre. Unprecedented number of medical staff infected with Ebola. WHO website. http://www.who.int/mediacentre/news/ebola/25-august-2014/en/. Published August 25, 2014. Accessed November 30, 2014.Google Scholar
2. Fischer, WA II, Hynes, NA, Perl, TM. Protecting health care workers from Ebola: personal protective equipment is critical but is not enough. Ann Intern Med. 2014;161(10):753-754. https://doi.org/10.7326/M14-1953.Google Scholar
3. Wolz, A. Face to face with Ebola—an emergency care center in Sierra Leone. N Engl J Med. 2014;371(12):1081-1083. https://doi.org/10.1056/NEJMp1410179.Google Scholar
4. 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. https://doi.org/10.1056/NEJMp1413084.CrossRefGoogle ScholarPubMed
5. Applebaum, KM, Graham, J, Gray, GM, et al. An overview of occupational risks from climate change. Curr Environ Health Rep. 2016;3(1):13-22. https://doi.org/10.1007/s40572-016-0081-4.CrossRefGoogle ScholarPubMed
6. Cheuvront, SN, Kenefick, RW, Montain, SJ, et al. Mechanisms of aerobic performance impairment with heat stress and dehydration. J Appl Physiol. 2010;109(6):1989-1995. https://doi.org/10.1152/japplphysiol.00367.2010.Google Scholar
7. Coca, A, DiLeo, T, Kim, J-H, et al. Baseline evaluation with a sweating thermal manikin of personal protective ensembles recommended for use in West Africa. Disaster Med Public Health Prep. 2015;9(05):536-542. https://doi.org/10.1017/dmp.2015.97.Google Scholar
8. Potter, AW, Gonzalez, JA, Xu, X. Ebola response: modeling the risk of heat stress from personal protective clothing. PLoS One. 2015;10(11):e0143461. https://doi.org/10.1371/journal.pone.0143461.CrossRefGoogle ScholarPubMed
9. Ainsworth, BE, Haskell, WL, Herrmann, SD, et al. Compendium of physical activities: a second update of codes and MET values. Med Sci Sports Exerc. 2011;43:1575-1581. https://doi.org/10.1249/MSS.0b013e31821ece12.Google Scholar
10. Borg, GA. Psychophysical bases of perceived exertion. Med Sci Sports Exerc. 1982;14(5):377-381. https://doi.org/10.1249/00005768-198205000-00012.CrossRefGoogle ScholarPubMed
11. Ramanathan, N. A new weighting system for mean surface temperature of the human body. J Appl Physiol. 1964;19(3):531-533.Google Scholar
12. International Organization for Standardization. 10551, Ergonomics of the thermal environment-Assessment of the influence of the thermal environment using subjective judgment scales. Geneva, Switzerland: International Organization for Standardization; 1995.Google Scholar
13. International Organization for Standardisation. 7730, Ergonomics of the thermal environment–Analytical determination and interpretation of thermal comfort using calculation of the PMV and PPD indices and local thermal comfort criteria. Geneva, Switzerland: International Organization for Standardization; 2005.Google Scholar
14. Morley, J, Beauchamp, G, Suyama, J, et al. Cognitive function following treadmill exercise in thermal protective clothing. Eur J Appl Physiol. 2012;112(5):1733-1740. https://doi.org/10.1007/s00421-011-2144-4.CrossRefGoogle ScholarPubMed
15. Schlader, ZJ, Temple, JL, Hostler, D. Exercise in personal protective equipment in a hot, humid environment does not affect risk propensity. Temperature (Austin). 2016;3(2):262-270.CrossRefGoogle Scholar
16. Hancock, PA, Vasmatzidis, I. Effects of heat stress on cognitive performance: the current state of knowledge. Int J Hyperthermia. 2003;19(3):355-372. https://doi.org/10.1080/0265673021000054630.CrossRefGoogle ScholarPubMed
17. Grélot, L, Koulibaly, F, Maugey, N, et al. Moderate thermal strain in healthcare workers wearing personal protective equipment during treatment and care activities in the context of the 2014 Ebola virus disease outbreak. J Infect Dis. 2016;213(9):1462-1465.Google Scholar
18. Maynard, SL, Kao, R, Craig, DG. Impact of personal protective equipment on clinical output and perceived exertion. J R Army Med Corps. 2016;162(3):180-183. doi: 10.1136/jramc-2015-000541.Google Scholar
19. Quinn, T, Kim, JH, Strauch, A, et al, Physiological evaluation of cooling devices for use in conjunction with personal protective ensembles recommended for use in West Africa. Disaster Med Public Health Prep. 2017; https://doi.org/10.1017/dmp.2016.209.CrossRefGoogle Scholar