Postpandemic Evaluation of the Eco-Efficiency of Personal Protective Equipment Against COVID-19 in Emergency Departments: Proposal for a Mixed Methods Study

Simon Berthelot; Yves Longtin; Manuele Margni; Jason Robert Guertin; Annie LeBlanc; Tania Marx; Khadidiatou Mangou; Ariane Bluteau; Diego Mantovani; Sergey Mikhaylin; Frédéric Bergeron; Valérie Dancause; Anne Desjardins; Nadia Lahrichi; Danielle Martin; Charles Jérôme Sossa; Philippe Lachapelle; Isabelle Genest; Stéphane Schaal; Anne Gignac; Stéphane Tremblay; Éric Hufty; Lynda Bélanger; Erica Beatty

doi:10.2196/50682

Postpandemic Evaluation of the Eco-Efficiency of Personal Protective Equipment Against COVID-19 in Emergency Departments: Proposal for a Mixed Methods Study

JMIR Res Protoc. 2023 Dec 7:12:e50682. doi: 10.2196/50682.

Authors

Simon Berthelot^{1

2}, Yves Longtin³, Manuele Margni⁴, Jason Robert Guertin^{1

5}, Annie LeBlanc², Tania Marx⁶, Khadidiatou Mangou¹, Ariane Bluteau¹, Diego Mantovani⁷, Sergey Mikhaylin⁸, Frédéric Bergeron⁹, Valérie Dancause¹⁰, Anne Desjardins¹⁰, Nadia Lahrichi⁴, Danielle Martin¹¹, Charles Jérôme Sossa¹², Philippe Lachapelle¹⁰, Isabelle Genest¹⁰, Stéphane Schaal¹⁰, Anne Gignac¹⁰, Stéphane Tremblay¹⁰, Éric Hufty¹⁰, Lynda Bélanger¹⁰, Erica Beatty¹³

Affiliations

¹ Axe Santé des populations et pratiques optimales en santé, Centre de recherche, CHU de Québec-Université Laval, Québec, QC, Canada.
² Département de médecine de famille et de médecine d'urgence, Faculté de médecine, Université Laval, Québec, QC, Canada.
³ Jewish General Hospital, Montréal, QC, Canada.
⁴ Ecole Polytechnique, Université de Montréal, Montréal, QC, Canada.
⁵ Département de médecine sociale et préventive, Faculté de médecine, Université Laval, Québec, QC, Canada.
⁶ Services des urgences, Centre hospitalier universitaire de Besançon, Besançon, France.
⁷ Axe Médecine régénératrice, Centre de recherche, CHU de Québec-Université Laval, Québec, QC, Canada.
⁸ EcoFoodLab, Département des sciences de aliments, Institut sur la Nutrition et les Aliments Fonctionnels, Université Laval, Québec, QC, Canada.
⁹ Bibliothèque, Université Laval, Québec, QC, Canada.
¹⁰ CHU de Québec-Université Laval, Québec, QC, Canada.
¹¹ Fashion Design and Creative Direction, Toronto Metropolitan University, Toronto, ON, Canada.
¹² Institut régional de santé publique, Université d'Abomey-Calavi, Ouidah, Benin.
¹³ Département de médecine d'urgence, Hôpital Montfort, Ottawa, ON, Canada.

PMID: 38060296
PMCID: PMC10739239
DOI: 10.2196/50682

Abstract

Background: The COVID-19 pandemic has had a profound impact on emergency department (ED) care in Canada and around the world. To prevent transmission of COVID-19, personal protective equipment (PPE) was required for all ED care providers in contact with suspected cases. With mass vaccination and improvements in several infection prevention components, our hypothesis is that the risks of transmission of COVID-19 will be significantly reduced and that current PPE use will have economic and ecological consequences that exceed its anticipated benefits. Evidence is needed to evaluate PPE use so that recommendations can ensure the clinical, economic, and environmental efficiency (ie, eco-efficiency) of its use.

Objective: To support the development of recommendations for the eco-efficient use of PPE, our research objectives are to (1) estimate the clinical effectiveness (reduced transmission, hospitalizations, mortality, and work absenteeism) of PPE against COVID-19 for health care workers; (2) estimate the financial cost of using PPE in the ED for the management of suspected or confirmed COVID-19 patients; and (3) estimate the ecological footprint of PPE use against COVID-19 in the ED.

Methods: We will conduct a mixed method study to evaluate the eco-efficiency of PPE use in the 5 EDs of the CHU de Québec-Université Laval (Québec, Canada). To achieve our goals, the project will include four phases: systematic review of the literature to assess the clinical effectiveness of PPE (objective 1; phase 1); cost estimation of PPE use in the ED using a time-driven activity-based costing method (objective 2; phase 2); ecological footprint estimation of PPE use using a life cycle assessment approach (objective 3; phase 3); and cost-consequence analysis and focus groups (integration of objectives 1 to 3; phase 4).

Results: The first 3 phases have started. The results of these phases will be available in 2023. Phase 4 will begin in 2023 and results will be available in 2024.

Conclusions: While the benefits of PPE use are likely to diminish as health care workers' immunity increases, it is important to assess its economic and ecological impacts to develop recommendations to guide its eco-efficient use.

Trial registration: PROSPERO CRD42022302598; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=302598.

International registered report identifier (irrid): DERR1-10.2196/50682.

Keywords: COVID-19; SARS-CoV-2; cost-consequence analysis; ecological footprint; emergency department; health care workers; life cycle assessment; personal protective equipment; systematic review; time-driven activity-based costing.

©Simon Berthelot, Yves Longtin, Manuele Margni, Jason Robert Guertin, Annie LeBlanc, Tania Marx, Khadidiatou Mangou, Ariane Bluteau, Diego Mantovani, Sergey Mikhaylin, Frédéric Bergeron, Valérie Dancause, Anne Desjardins, Nadia Lahrichi, Danielle Martin, Charles Jérôme Sossa, Philippe Lachapelle, Isabelle Genest, Stéphane Schaal, Anne Gignac, Stéphane Tremblay, Éric Hufty, Lynda Bélanger, Erica Beatty. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 07.12.2023.