Hygienic Assessment of Personal Protective Equipment against Biological Hazards

Introduction: The professional use of personal protective equipment (PPE) eliminates occupational exposure of personnel to pathogens that cause infectious diseases, including COVID-19. Apart from the risk of exposure to biological hazards, healthcare workers are at risk of impaired work performance and work-related diseases posed by adverse health effects of PPE itself.

Objective: To make a physiological and hygienic assessment of personal protective equipment against biological hazards used by healthcare professionals.

Materials and methods: We evaluated the thermal state of the body in 13 volunteers under simulated conditions of the Tabai temperature and humidity chamber (Japan). The study design included a physiological and hygienic assessment of four variants of protective suits, all compliant with recommendations of the Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing (Rospotrebnadzor) for use when working with microorganisms of risk groups I and II. We studied the physiological response of the thermoregulatory system to heat exposures in terms of indicators characterizing the temperature of the “core”, the temperature of the “shell”, and their integral indicators (weighted mean skin and body temperatures). Changes in the fluid and electrolyte metabolism and the functional state of the cardiorespiratory system were assessed based on objective (sweat and heart rates) and subjective (heat sensation) indicators.

Results: At the air temperatures of 25 and 30 °C, the maximum thermal exposure was registered in the volunteers wearing coveralls made of nonwoven material of the Tyvek type (China). A suit made of polyester fabric with a polyurethane membrane coating (Russia) had a less pronounced effect on the thermal state of the body. The minimum core and shell temperatures were noted for the suits made of polymer-viscose dustproof, water-repellent twill weave fabric (Russia) and Barrier 2X fabric (Russia).

Conclusion: The excess of established values of the thermal state of the body during medium work was observed for all types of the studied suits both in permissible (25 °C) and harmful (30 °C) microclimate conditions. To prevent ill-being of medical personnel, it is necessary to schedule work taking into account the type of PPE used, the intensity of physical activity, and indoor microclimate parameters. 

1. Atkov OYu, Gorokhova SG, Pfaf VF. COVID-19 in health care workers. A new problem in occupational medicine. Meditsina Truda i Promyshlennaya Ekologiya. 2021;61(1):40–48. (In Russ.) doi: 10.31089/1026-9428-2021-61-1-40-48

2. Gorblyansky YuYu, Kontorovich EP, Ponamareva OP, Volynskaya EI. Professional aspects of the new coronavirus infection (COVID-19). Meditsina Truda i Promyshlennaya Ekologiya. 2021;61(2):103–114. (In Russ.) doi: 10.31089/1026-9428-2021-61-2-103-114

3. Denisov EI, Prokopenko LV, Pfaf VF. Issues of occupational health of healthcare workers and pandemic COVID-19. Meditsina Truda i Promyshlennaya Ekologiya. 2021;61(1):49–61. (In Russ.) doi: 10.31089/1026-9428-2021-61-1-49-61

4. Kryukov EV, Trishkin DV, Ivanov AM, et al. Comparative cohort epidemiological study of collective immunity against new coronavirus infection among different groups of military personnel. Vestnik Rossiyskoy Akademii Meditsinskikh Nauk. 2021;76(6):661–668. (In Russ.) doi: 10.15690/vramn1583

5. Garipova RV, Strizhakov LA, Umbetova KT, Safina KR. Occupational diseases of health care workers from exposure to infectious agents: The current state of the problem. Meditsina Truda i Promyshlennaya Ekologiya. 2021;61(1):13–17. (In Russ.) doi: 10.31089/1026-9428- 2021-61-1-13-17

6. Lan F-Y, Fernandez-Montero A, Kales SN. COVID-19 and healthcare workers: emerging patterns in Pamplona, Asia and Boston. Occup Med (Lond). 2020;70(5):340-341. doi: 10.1093/occmed/kqaa089

7. Hignett S, Welsh R, Banerjee J. Human factors issues of working in personal protective equipment during the COVID-19 pandemic. Anaesthesia. 2021;76(1):134-135. doi: 10.1111/anae.15198

8. Saran S, Gurjar M, Baronia A, et al. Personal protective equipment during COVID-19 pandemic: a narrative review on technical aspects. Expert Rev Med Devices. 2020;17(12):1265-1276. doi: 10.1080/17434440.2020.1852079

9. Kuzin AA, Yumanov AP, Degtyarev AA, Eremin GG. Features of the use of personal protective equipment in the foci of a new coronavirus infection. Epidemiologiya i Vaktsinoprofilaktika. 2020;19(6):4–7. (In Russ.) doi: 10.31631/2073-3046-2020-19-6-4-7

10. Zhao Y, Liang W, Luo Y, et al. Personal protective equipment protecting healthcare workers in the Chinese epicentre of COVID-19. Clin Microbiol Infect. 2020;26(12):1716-1718. doi: 10.1016/j.cmi.2020.07.029

11. Park SH. Personal protective equipment for healthcare workers during the COVID-19 pandemic. Infect Chemother. 2020;52(2):165-182. doi: 10.3947/ic.2020.52.2.165

12. Verbeek JH, Rajamaki B, Ijaz S, et al. Personal protective equipment for preventing highly infectious diseases due to exposure to contaminated body fluids in healthcare staff. Cochrane Database Syst Rev. 2019;7(7):CD011621. doi: 10.1002/14651858.CD011621.pub3

13. Loibner M, Hagauer S, Schwantzer G, Berghold A, Zatloukal K. Limiting factors for wearing personal protective equipment (PPE) in a health care environment evaluated in a randomised study. PLoS One. 2019;14(1):e0210775. doi: 10.1371/journal.pone.0210775

14. Losik TK, Afanas'yeva RF, Konstantinova EI. Physiologic and hygienic evaluation of heat state in military men performing continuous physical work in heating microclimate. Meditsina Truda i Promyshlennaya Ekologiya. 2015;(10):41–45. (In Russ.)

15. Agarwal A, Agarwal S, Motiani P. Difficulties encountered while using PPE kits and how to overcome them: An Indian perspective. Cureus. 2020;12(11):e11652. doi: 10.7759/cureus.11652

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. doi: 10.1080/0265673021000054630

17. Vidua RK, Chouksey VK, Bhargava DC, Kumar J. Problems arising from PPE when worn for long periods. Med Leg J. 2020;88(1_suppl):47-49. doi: 10.1177/0025817220935880

18. Marchenkov AP, Filippov IV. Working environment, heat and thermoregulation human body. Vestnik NTsBZhD. 2011;(4(10)):19–22. (In Russ.)

19. Losik TK, Ivanov IV, Konyukhov AV. Physiological – hygienic substantiation of preventive measures for medical personnel working in personal protective equipment against COVID-19 and other biological factors. Voenno-Meditsinskiy Zhurnal. 2021;342(11):58–66. (In Russ.) doi: 10.52424/00269050_2021_342_11_58

20. Coca A, Quinn T, Kim JH, et al. Physiological evaluation of personal protective ensembles recommended for use in West Africa. Disaster Med Public Health Prep. 2017;11(5):580-586. doi: 10.1017/dmp.2017.13

21. Afanasyeva RF, Losik TK, Bessonova NA, Konstantinov EI, Burmistrova OV. Forecasting the effect of workwear materials hygienic propertis on a humans functional state in hot environment. Meditsina Truda i Promyshlennaya Ekologiya. 2015;(9):27. (In Russ.)

22. Burmistrova OV, Losik TK, Shuporin ES. Physiological and hygienic substantiation of development of a technique of an estimation of overalls for protection working in the heating environment on indicators of a thermal condition. Meditsina Truda i Promyshlennaya Ekologiya. 2019;59(12):1013–1019. (In Russ.) doi: 10.31089/1026-9428-2019-59-12-1013-1019

23. Afanasyeva RF, Prokopenko LV, Bessonova NA, et al. The effects some thermal-physical properties of workwear materials on the heat state of workers in hot environment. Meditsina Truda i Promyshlennaya Ekologiya. 2015;(9):27-28. (In Russ.)

24. Dubel EV, Unguryanu TN. Hygienic assessment of working conditions for medical personnel in clinical and paraclinical departments of the hospital. Gigiena i Sanitariya. 2016;95(1):53–57. (In Russ.) doi: 10.18821/0016-99002016-95-1-53-57

25. Bukhtiyarov IV. Epidemiological, clinical, and expert problems of occupational infectious diseases of workers during medical care in the COVID-19 pandemic. Meditsina Truda i Promyshlennaya Ekologiya. 2021;61(1):4–12. (In Russ.) doi: 10.31089/1026-9428-2021-61-1-4-12

26. Bektasova MV, Kiku PF, Sheparev AA. Identification of risk factors in assessment of the working conditions of medical personnel. Dal'nevostochnyy Meditsinskiy Zhurnal. 2019;(2):73–78. (In Russ.) doi: 10.35177/1994- 5191-2019-2-73-78

27. Vazhenina AA, Trankovskaya LV, Anishchenko EB. Hygienic assessment of working conditions of employees in the test laboratory center of the Office of Federal Service for Supervision of Consumer Rights Protection and Human Well-Being. Gigiena i Sanitariya. 2019;98(4):418-423. (In Russ.) doi: 10.18821/0016-9900-2019-98-4-418-423