Literature review of physiological strain of personal protective equipment on personnel in the high-consequence infectious disease isolation environment

Claire E Figi; Jocelyn J Herstein; Elizabeth L Beam; Aurora B Le; Angela L Hewlett; James V Lawler; John J Lowe; Shawn G Gibbs

doi:10.1016/j.ajic.2023.05.005

Literature review of physiological strain of personal protective equipment on personnel in the high-consequence infectious disease isolation environment

Am J Infect Control. 2023 Dec;51(12):1384-1391. doi: 10.1016/j.ajic.2023.05.005. Epub 2023 May 12.

Authors

Claire E Figi¹, Jocelyn J Herstein², Elizabeth L Beam³, Aurora B Le⁴, Angela L Hewlett⁵, James V Lawler⁶, John J Lowe⁷, Shawn G Gibbs⁸

Affiliations

¹ Department of Epidemiology and Biostatistics, School of Public Health, Texas A&M University, College Station, TX. Electronic address: claire.figi@gmail.com.
² Department of Environmental, Agricultural, and Occupational Health, University of Nebraska Medical Center, College of Public Health, 985110 Nebraska Medical Center, Omaha, NE. Electronic address: jocelyn.herstein@unmc.edu.
³ College of Nursing, University of Nebraska Medical Center, 985330 Nebraska Medical Center, Omaha, NE. Electronic address: ebeam@unmc.edu.
⁴ Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Arbor, MI. Electronic address: aurorale@umich.edu.
⁵ Global Center for Health Security, University of Nebraska Medical Center, 986161 Nebraska Medical Center, Omaha, NE; Department of Internal Medicine, Division of Infectious Diseases, University of Nebraska Medical Center, 983332 Nebraska Medical Center, Omaha, NE. Electronic address: alhewlett@unmc.edu.
⁶ Global Center for Health Security, University of Nebraska Medical Center, 986161 Nebraska Medical Center, Omaha, NE. Electronic address: james.lawler@unmc.edu.
⁷ Department of Environmental, Agricultural, and Occupational Health, University of Nebraska Medical Center, College of Public Health, 985110 Nebraska Medical Center, Omaha, NE; Global Center for Health Security, University of Nebraska Medical Center, 986161 Nebraska Medical Center, Omaha, NE. Electronic address: jjlowe@unmc.edu.
⁸ Department of Environmental and Occupational Health, School of Public Health, Texas A&M University, College Station, TX. Electronic address: sgibbs@tamu.edu.

PMID: 37182761
DOI: 10.1016/j.ajic.2023.05.005

Abstract

Background: Heat strain and dehydration can affect an individual's physical and mental performance. The purpose of this review was to examine the literature for the impact of heat strain on health care workers (HCWs) who care for patients with high-consequence infectious diseases (HCIDs) while wearing personal protective equipment (PPE), discuss the risks of impaired safety caused by heat strain and dehydration in HCID environments, identify attempts to combat PPE-related heat strain, recognize limitations, and provide suggestions for further research.

Methods: A literature search was performed in PubMed or MEDLINE and Google Scholar. Authors screened abstracts for inclusion criteria and reviewed articles if the abstracts were considered to include information relevant to the aim.

Results: The search terms yielded 30 articles that were sorted based on environment setting, physiological impact, and interventions.

Discussion: The safety of the HCWs and patients can be enhanced through the development and usage of cooler, more comfortable PPE materials and ensembles to help slow the rate of dehydration and support the regulation of core body temperature.

Conclusions: Heat strain caused by wearing PPE is an occupational health concern for HCWs in the high-risk environment, that is, HCID care. Future studies are needed to develop innovative PPE ensembles that can reduce heat strain and improve well-being.

Keywords: Heat stress; Isolation.

Publication types

Review

MeSH terms

Communicable Diseases*
Dehydration*
Health Personnel
Hot Temperature
Humans
Personal Protective Equipment