Hygienic assessment of risks of thermal balance disruption in medical laboratory workers using personal protective equipment for biohazards

Introduction: Specifics of activities of medical personnel in different types of laboratories can potentially create working conditions that violate occupational safety and health regulations.

Objective: The study aimed to assess health risks of thermal balance disruption in PCR laboratory staff wearing personal protective equipment for biohazards in the context of the COVID-19 pandemic.

Materials and methods: The study was conducted in winter 2020–2021 in PCR laboratories of the Volgograd Region. It included measurements of laboratory microclimate parameters, such as relative humidity, air temperature and velocity, used to estimate the heat load index. An observation cohort of 31 female medical laboratory workers aged 32.48 ± 1.45 years with  a three to nine months experience of work in the PCR laboratory was formed to monitor the thermal state at the start and end of the work shift by measuring skin temperature at five points, sublingual temperature, and heat sensation. The results of measurements were used to estimate the mean skin temperature and heart rate while the dynamics of work ability was assessed by the results of contact tremorometry.

Results: We established a significant increase in all measured values. The mean skin temperature at the end of the shift reached 33.85 ± 0.24 °C, thus exceeding the upper limit of the permissible value. The heart rate and heat sensation parameters  approached the upper values of the maximum permissible thermal state of a person. Contact tremorometry results indicated a decrease in the performance by the end of the work shift. The findings gave evidence of tension of thermoregulatory reactions and the risk of thermal balance disruption posed by the use of a specific type of personal protective equipment in the PCR laboratory.

Conclusion: The research results provide strong support for the conclusion that the use of PPE for biohazards poses a risk of thermal balance disruption in medical laboratory personnel. The severity of stress of thermoregulatory reactions depends on technical and design characteristics of the PPE used. The necessity of a physiological and hygienic substantiation of acceptable duration of work of medical workers wearing various types of PPE for biohazards in PCR laboratories justifies the importance of further studies.

1. Badamshina GG, Ziatdinov VB, Fatkhutdinova LM. Topical issues of assessment of working conditions of medical workers on the level of biological factor. Meditsina Truda i Promyshlennaya Ekologiya. 2019;59(9):551–552. (In Russ.) doi: 10.31089/1026-9428-2019-59-9-551-552

2. Bolonkina TA, Dementiev AA, Shatrova NV, Rudakova MN. Influence of work under the conditions of the COVID-19 pandemic on the functional state of the central nervous system of medical workers of the emergency station. Vestnik Novykh Meditsinskikh Tekhnologiy. 2020;(6):81–86. (In Russ.) doi: 10.24411/2075-4094-2020-16744

3. Vazhenina AA, Trankovskaya LV, Anishchenko ЕB. 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: 10.47470/0016-9900-2019-98-4-418-423

4. Mendaliyev NA, Kurakbayev KK, Beisembaeva ShA. Job satisfaction and associated factors among specialists of clinical diagnostic laboratory. Vestnik Kazakhskogo Natsional'nogo Meditsinskogo Universiteta. 2017;(1):519–522. (In Russ.)

5. Nenakhov IG, Stepkin YuI, Mekhanteva LE. Complex evaluation of conditions of labor process of employees of test laboratory centers. Gigiena i Sanitariya. 2018;97(8):721–728. (In Russ.) doi: 10.47470/0016-9900-2018-97-8-721-726

6. Pankov VA, Lakhman OA, Kuleshova MV, Rukavishnikov VS. Emotional burnout in medical workers during the work in extreme conditions. Gigiena i Sanitariya. 2020;99(10):1034–1041. (In Russ.) doi: 10.47470/0016-9900-2020-99-10-1034-1041

7. Tanshina OV, Vechorko VI, Genina EA. Nurses’ work in the capital’s multi-disciplinary hospital in the fight against the COVID-19 pandemic. Profilakticheskaya Meditsina. 2020;23(8):19–23. (In Russ.) doi: 10.17116/profmed20202308119

8. Vechorko VI, Kitsul IS, Zakharova EG, Borovova EV. Morbidity with a temporary disability of employees of medical institutions under a new coronavirus infection. Zdravookhraneniye Rossiyskoy Federatsii. 2021;65(1):5–11. (In Russ.). doi: 10.47470/0044-197X-2021-65-1-5-11

9. Briko NI, Kagramanyan IN, Nikiforov VV, SuranoIva TG, Chernyavskaya OP, Polezhaeva NA. Panden - mic COVID-19. Prevention measures in the Russian Federation. Epidemiologiya i Vaktsinoprofilaktika. 2020;19(2):4–12. (In Russ.). doi: 10.31631/2073-3046-2020-19-2-4-12

10. Konyukhov AV, Geregei AM, Lemeshko VI. Features of the thermal state of medical workers when using personal protective equipment against biological factors. Meditsina Truda i Promyshlennaya Ekologiya. 2020;60(11):801–803. (In Russ.) doi: 10.31089/1026-9428-2020-60-11-801-803

11. Losik TK, Ivanov IV, Zibarev EV, Konyukhov AV. Integrated process of determining the level of energy consumption of workers in the workplace. Meditsina Truda i Promyshlennaya Ekologiya. 2020;60(2):123–127. (In Russ.) doi: 10.31089/1026-9428-2020-60-2-123-127

12. Istomin SV, Turchenko VN, Gamayunov SY. The impact of unfavorable temperature working conditions on agricultural workers. Nauchnaya Zhizn'. 2020;15(6(106)):792–808. (In Russ.) doi: 10.35679/1991-9476-2020-15-6-792-808

13. Kozhevnikova NY. The temperature of the air environment of industrial premises as a harmful factor in working conditions. Agrarnoe Obrazovanie i Nauka. 2016;(6):3. (In Russ.)

14. Rudakov ML, Stepanov IS. Assessment of professional risk caused by heating microclimate in the process of underground mining. Zapiski Gornogo Instituta. 2017;225:364–368. (In Russ.) doi: 10.18454/PMI.2017.3.364

15. Witte NK. [Human Heat Exchange and Its Hygienic Value.] Kiev: Gosmedizdat Publ., 1956. (In Russ.)

16. Arens E, Zhang H. The skin’s role in human thermoregulation and comfort. In: Thermal and Moisture Transport in Fibrous Materials. Pan N., Gibson P., eds. Cambridge: Woodhead Publishing Ltd, 2006:560–602. doi: 10.1533/9781845692261.3.560

17. Chudecka M, Szczepanowska E, Kempińska-Podhorodecka A. Changes of thermoemission of upper extremities in female handball players – the preliminary study. Medicina Sportiva. 2008;12(3):99–102. doi: 10.2478/v10036-008-0019-5

18. Vasilieva JA. The level of tremor and strength of nervous processes in individuals with different initial tonus of the autonomic nervous system. Vestnik Kurganskogo Gosudarstvennogo Universiteta. 2016;(2(41)):11–14. (In Russ.)

19. Afanasieva RF, Chebotarev AG, Konstantinov EI. Methodological approaches to the categorization of the working environment by workplace microclimate parameter at mines. Gornaya Promyshlennost'. 2013;(6(112)):72. (In Russ.)

20. 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

21. Latyshevskaya NI, Kvartovkina LK. Evaluation of occupational risk for reproductivity in female workers of food industry. Meditsina Truda i Promyshlennaya Ekologiya. 1999;(3):36–39. (In Russ.)

22. Pavlova TV, Markovskaya VA. Influence of thermal stress on physical and psychic working efficiency in extreme situations. Problemy Pravookhranitel'noy Deyatel'nosti. 2017;(4):34–38. (In Russ.).

23. Morozova TV. Heating microclimate assessment as a risk factor of reproductive health damage in workers in the polymerprocessing industry. Zdorov'e Naseleniya i Sreda Obitaniya. 2018;(11(308)):50–57. (In Russ.) doi: 10.35627/2219-5238/2018-308-11-50-57

24. Sorokin GA. Chronophysiological study of occupationally conditioned fatigue. Fiziologiya Cheloveka. 2008;34(6):70–77. (In Russ.)

25. Sorokin GA, Suslov VL, Yakovlev EV, Frolova NM. Professional burnout in doctors: the value of the intensity and quality of the work. Gigiena i Sanitariya. 2018;97(12):1221–1225. (In Russ.) doi: 10.47470/0016-9900-2018-97-12-1221-1225