Lesiones cutáneas en el personal sanitario secundarias al uso de equipo de protección personal frente al Covid-19  <span class="so-article-trans-title" dir="auto"> Translated title: Skin lesions in health personnel secondary to the use of personal protective equipment against Covid-19 </span>

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Abstract

Resumen Objetivo principal: Determinar la prevalencia de lesiones cutáneas en el personal sanitario relacionadas al uso del equipo de protección personal (EPP) durante la pandemia por SARS-CoV-2. Metodología: Se realizó un estudio transversal, descriptivo y cuantitativo; se aplicó un cuestionario a personal médico y de enfermería que atendieron pacientes con Covid-19, se cuantificaron las reacciones adversas más frecuentes ocasionadas por: mascarillas, guantes, lentes, ropa protectora y alcohol gel. Resultados principales: Participaron 90 personas, de las cuales 81 (90%) presentaron lesiones cutáneas asociadas al EPP. El accesorio que ocasionó más lesiones fue la mascarilla (87,7%), seguido de lentes (85,5%) y alcohol gel (82,2%). La reacción más frecuente por mascarillas fue úlcera en puente nasal (68,9%); en los lentes fue lesión por presión en frente (76,7%); y por el uso de alcohol gel fue resequedad (75,5%). Conclusión principal: El uso prolongado (>5 horas horas) del EPP puede ocasionar efectos adversos cutáneos en el personal sanitario. La mascarilla fue el aditamento que más generó lesiones cutáneas, siendo la úlcera por presión en puente nasal la más frecuente.

Translated abstract

Abstract Objective: To measure the prevalence of skin lesions in health personnel related to the use of personal protective equipment (PPE) during the SARS-CoV-2 pandemic. Methods: A cross-sectional, descriptive and quantitative study was carried out; A questionnaire was applied to medical and nursing staff who treated patients with COVID-19, the most frequent adverse reactions caused by: masks, gloves, glasses, protective clothing and alcohol gel were quantified. Results: 90 people participated, of which 81 (90%) presented skin lesions associated with PPE. The accessory that caused the most injuries was the mask (87.7%), followed by glasses (85.5%) and alcohol gel (82.2%). The most frequent reaction to masks was nasal bridge ulcer (68.9%); in glasses it was pressure injury to the forehead (76.7%); and due to the use of alcohol gel it was dryness (75.5%). Conclusions: Prolonged use (>5 hours) of PPE can cause adverse skin effects in healthcare personnel. The mask was the accessory that generated the most skin lesions, with pressure ulcers on the nasal bridge being the most frequent.

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An interactive web-based dashboard to track COVID-19 in real time

Ensheng Dong, Hongru Du, Lauren Gardner (2020)

In December, 2019, a local outbreak of pneumonia of initially unknown cause was detected in Wuhan (Hubei, China), and was quickly determined to be caused by a novel coronavirus, 1 namely severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The outbreak has since spread to every province of mainland China as well as 27 other countries and regions, with more than 70 000 confirmed cases as of Feb 17, 2020. 2 In response to this ongoing public health emergency, we developed an online interactive dashboard, hosted by the Center for Systems Science and Engineering (CSSE) at Johns Hopkins University, Baltimore, MD, USA, to visualise and track reported cases of coronavirus disease 2019 (COVID-19) in real time. The dashboard, first shared publicly on Jan 22, illustrates the location and number of confirmed COVID-19 cases, deaths, and recoveries for all affected countries. It was developed to provide researchers, public health authorities, and the general public with a user-friendly tool to track the outbreak as it unfolds. All data collected and displayed are made freely available, initially through Google Sheets and now through a GitHub repository, along with the feature layers of the dashboard, which are now included in the Esri Living Atlas. The dashboard reports cases at the province level in China; at the city level in the USA, Australia, and Canada; and at the country level otherwise. During Jan 22–31, all data collection and processing were done manually, and updates were typically done twice a day, morning and night (US Eastern Time). As the outbreak evolved, the manual reporting process became unsustainable; therefore, on Feb 1, we adopted a semi-automated living data stream strategy. Our primary data source is DXY, an online platform run by members of the Chinese medical community, which aggregates local media and government reports to provide cumulative totals of COVID-19 cases in near real time at the province level in China and at the country level otherwise. Every 15 min, the cumulative case counts are updated from DXY for all provinces in China and for other affected countries and regions. For countries and regions outside mainland China (including Hong Kong, Macau, and Taiwan), we found DXY cumulative case counts to frequently lag behind other sources; we therefore manually update these case numbers throughout the day when new cases are identified. To identify new cases, we monitor various Twitter feeds, online news services, and direct communication sent through the dashboard. Before manually updating the dashboard, we confirm the case numbers with regional and local health departments, including the respective centres for disease control and prevention (CDC) of China, Taiwan, and Europe, the Hong Kong Department of Health, the Macau Government, and WHO, as well as city-level and state-level health authorities. For city-level case reports in the USA, Australia, and Canada, which we began reporting on Feb 1, we rely on the US CDC, the government of Canada, the Australian Government Department of Health, and various state or territory health authorities. All manual updates (for countries and regions outside mainland China) are coordinated by a team at Johns Hopkins University. The case data reported on the dashboard aligns with the daily Chinese CDC 3 and WHO situation reports 2 for within and outside of mainland China, respectively (figure ). Furthermore, the dashboard is particularly effective at capturing the timing of the first reported case of COVID-19 in new countries or regions (appendix). With the exception of Australia, Hong Kong, and Italy, the CSSE at Johns Hopkins University has reported newly infected countries ahead of WHO, with Hong Kong and Italy reported within hours of the corresponding WHO situation report. Figure Comparison of COVID-19 case reporting from different sources Daily cumulative case numbers (starting Jan 22, 2020) reported by the Johns Hopkins University Center for Systems Science and Engineering (CSSE), WHO situation reports, and the Chinese Center for Disease Control and Prevention (Chinese CDC) for within (A) and outside (B) mainland China. Given the popularity and impact of the dashboard to date, we plan to continue hosting and managing the tool throughout the entirety of the COVID-19 outbreak and to build out its capabilities to establish a standing tool to monitor and report on future outbreaks. We believe our efforts are crucial to help inform modelling efforts and control measures during the earliest stages of the outbreak.

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Skin damage among health care workers managing coronavirus disease-2019

Jiajia Lan, Zexing Song, Xiaoping Miao … (2020)

To the Editor: Since the outbreak of coronavirus disease-2019 (COVID-19) in December 2019, more than 200,000 health care workers from all over China have been participating in the fight against this highly contagious disease in Hubei province, which is the center of infection in China. Skin damage caused by enhanced infection-prevention measures among health care workers, which could reduce their enthusiasm for overloaded work and make them anxious, has been reported frequently. Previous studies have revealed that hand eczema is quite common in health care workers, 1 , 2 and the risk factors include frequent hand hygiene and wearing gloves for a long time. 3 , 4 Considering the frequent hand hygiene and long-time wearing of tertiary protective devices (N95 mask, goggles, face shield, and double layers of gloves) among health care workers during the epidemic period of COVID-19, we aimed to estimate the prevalence, clinical features, and risk factors of this skin damage among them. From January to February 2020, self-administered online questionnaires were distributed to 700 individuals, consisting of physicians and nurses who worked in the designated departments of tertiary hospitals in Hubei, China. The questionnaire included questions about the condition of skin damage and the frequency or duration of several infection-prevention measures (Supplemental Material 1, available via Mendeley at https://data.mendeley.com/datasets/zknvry83v5/2). Finally, 542 individuals (Supplemental Material 2) completed the study (response rate, 77.4%), with 71.4% (387 of 542) working in isolation wards and 28.6% (155 of 542) working in fever clinics. The general prevalence rate of skin damage caused by enhanced infection-prevention measures was 97.0% (526 of 542) among first-line health care workers. The affected sites included the nasal bridge, hands, cheek, and forehead, with the nasal bridge the most commonly affected (83.1%). Among a series of symptoms and signs, dryness/tightness and desquamation were the most common symptom (70.3%) and sign (62.2%), respectively (Table I ). The health care workers who wore some medical devices more than 6 hours had higher risks of skin damage in corresponding sites than those who did for less time (N95 masks: odds ratio [OR], 2.02; 95% confidence interval [CI], 1.35-3.01; P 10 times daily) hand hygiene could increase the risk of hand skin damage (OR, 2.17; 95% CI, 1.38-3.43; P 6 h/d 317 (58.5) Cheek: 259 (81.7) 2.02 1.35-3.01 6 h/d 265 (58.8) Nasal bridge: 233 (87.9) 2.32 1.41-3.83 6 h/d 157 (59.2) Forehead: 92 (58.6) 1.52 0.93-2.50 .66 Gloves 113∗ ≤6 h/d 52 (46.0) Hands: 29 (55.8) 1 [Ref] >6 h/d 61 (54.0) Hands: 39 (63.9) 1.41 0.66-3.00 .44 321† ≤6 h/d 131 (40.8) Hands: 100 (76.3) 1 [Ref] >6 h/d 190 (59.2) Hands: 146 (76.8) 1.03 0.61-1.74 >.99 Hand hygiene 434 ≤10 times/d 113 (26.0) Hands: 68 (60.2) 1 [Ref] >10 times/d 321 (74.0) Hands: 246 (76.6) 2.17 1.38-3.43 10 times/d. Our study has some limitations. Firstly, we only studied 1 site with a single exposure factor, but some sites could be related to more than 1 factor. The nasal bridge, for example, could be compressed by the N95 mask and goggles simultaneously, although goggles were the main factor. Secondly, possible risk factors such as participants wearing the N95 mask after work in daily life were not included. In conclusion, our study demonstrated that the prevalence of skin damage of first-line health care workers was very high. Moreover, we found that longer exposure time was a significant risk factor, which highlights that the working time of first-line staff should be arranged reasonably. Besides, prophylactic dressings could be considered to alleviate the device-related pressure injuries, according to a prior study. 5

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The adverse skin reactions of health care workers using personal protective equipment for COVID-19

Kaihui Hu, Jing Fan, Xueqin Li … (2020)

Abstract In December 2019, a new coronavirus was found in Wuhan, Hubei Province, China, and spread rapidly throughout the country, attracting global attention. On February 11, the World Health Organization (WHO) officially named the disease caused by 2019-nCoV coronavirus disease 2019 (COVID-19). With the increasing number of cases, health care workers (HCWs) from all over China volunteered to work in Hubei Province. Because of the strong infectivity of COVID-19, HCWs need to wear personal protective equipment (PPE), such as N95 masks, latex gloves, and protective clothing. Due to the long-term use of PPE, many adverse skin reactions may occur. Therefore, the purpose of this study is to explore the adverse skin reactions among HCWs using PPE. Questionnaires were used for the research; a quantitative study was carried out to determine the incidence of adverse skin reactions among HCWs using PPE. A total of 61 valid questionnaires were collected. The most common adverse skin reactions among HCWs wearing N95 masks were nasal bridge scarring (68.9%) and facial itching (27.9%). The most common adverse skin reactions among HCWs wearing latex gloves were dry skin (55.7%), itching (31.2%), and rash (23.0%). The most common adverse skin reactions among HCWs wearing protective clothing were dry skin (36.1%) and itching (34.4%). When most HCWs wear PPE for a long period of time, they will experience adverse skin reactions. The incidence of adverse skin reactions to the N95 mask was 95.1%, that to latex gloves was 88.5%, and that to protective clothing was 60.7%.

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Author and article information

Journal

Journal ID (publisher-id): index

Title: Index de Enfermería

Abbreviated Title: Index Enferm

Publisher: Fundación Index (Granada, Granada, Spain )

ISSN (Print): 1132-1296

ISSN (Electronic): 1699-5988

Publication date (Print and electronic): December 2022

Volume: 31

Issue: 4

Pages: 270-273

Affiliations

[3] Monterrey orgnameCentro de Investigación Biomédica del Noreste México

[2] Apodaca orgnameConsorcio de Enfermería y Promotores de la Salud México

[1] Apodaca orgnameInstituto Mexicano del Seguro Social orgdiv1Hospital General de Zona No. 67 Mexico

Article

Publisher ID: S1132-12962022000400007 Publisher ID: S1132-1296(22)03100400007

DOI: 10.58807/indexenferm20225171

SO-VID: 0a3bdc17-3106-406e-98de-aac82309f4ea

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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

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Date received : 08 July 2022

Date accepted : 10 August 2022

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Figures: 0, Tables: 0, Equations: 0, References: 14, Pages: 4

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Lesiones cutáneas en el personal sanitario secundarias al uso de equipo de protección personal frente al Covid-19 Translated title: Skin lesions in health personnel secondary to the use of personal protective equipment against Covid-19

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Novel Coronavirus Disease COVID-19

Most cited references 14

An interactive web-based dashboard to track COVID-19 in real time

Skin damage among health care workers managing coronavirus disease-2019

The adverse skin reactions of health care workers using personal protective equipment for COVID-19

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