Limiting factors for wearing personal protective equipment (PPE) in a health care environment evaluated in a randomised study

PLoS One. 2019 Jan 22;14(1):e0210775. doi: 10.1371/journal.pone.0210775. eCollection 2019.

Abstract

Pandemics and re-emerging diseases put pressure on the health care system to prepare for patient care and sample logistics requiring enhanced personnel protective equipment (PPE) for health care workers. We generated quantifiable data on ergonomics of PPE applicable in a health care setting by defining error rates and physically limiting factors due to PPE-induced restrictions. Nineteen study volunteers tested randomly allocated head- or full body-ventilated PPE suits equipped with powered-air-purifying-respirators and performed four different tasks (two laboratory tutorials, a timed test of selective attention and a test investigating reaction time, mobility, speed and physical exercise) during 6 working hours at 22°C on one day and 4 working hours at 28°C on another day. Error rates and physical parameters (fluid loss, body temperature, heart rate) were determined and ergonomic-related parameters were assessed hourly using assessment sheets. Depending on the PPE system the most restrictive factors, which however had no negative impact on performance (speed and error rate), were: reduced dexterity due to multiple glove layers, impaired visibility by flexible face shields and back pain related to the respirator of the fully ventilated suit. Heat stress and liquid loss were perceived as restrictive at a working temperature of 28°C but not 22°C.

Trial registration: ClinicalTrials.gov NCT03004690.

Publication types

  • Comparative Study
  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Body Temperature
  • Ergonomics
  • Female
  • Gloves, Protective
  • Health Personnel*
  • Heart Rate
  • Heat Stress Disorders / etiology
  • Humans
  • Male
  • Outcome Assessment, Health Care
  • Personal Protective Equipment* / adverse effects
  • Pilot Projects
  • Practice Guidelines as Topic
  • Protective Clothing
  • Protective Devices
  • Random Allocation
  • Respiratory Protective Devices
  • Task Performance and Analysis
  • Young Adult

Associated data

  • ClinicalTrials.gov/NCT03004690

Grants and funding

We would like to acknowledge the Christian Doppler Research Fund (Austrian Federal Ministry of Science, Research and Economy, the National Foundation for Research, Technology and Development) and ERINHA (European Research Infrastructure on Highly Pathogenic Agents, FP7-INFRA-2010-2-2.8) for financial support of our research project to KZ. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.