Physiological Impacts of Surgical Mask Coverage of Elastomeric Half-mask Respirator Exhalation Valves in Healthcare Workers
| Autor: | Paul Thurman, Stella E. Hines, Eileen Zhuang, Hegang H Chen, Melissa A. McDiarmid |
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| Rok vydání: | 2021 |
| Předmět: |
business.product_category
Coronavirus disease 2019 (COVID-19) Health Personnel medicine.medical_treatment Occupational Exposure Heart rate heart rate elastomeric respirators Humans Medicine AcademicSubjects/MED00640 Cardiopulmonary resuscitation Respirator Pandemics Oxygen saturation (medicine) Ventilators Mechanical healthcare workers SARS-CoV-2 business.industry Masks Public Health Environmental and Occupational Health carbon dioxide COVID-19 Exhalation oxygen saturation Surgical mask Anesthesia PPE Original Article business Body mass index |
| Zdroj: | Annals of Work Exposures and Health |
| ISSN: | 2398-7316 2398-7308 |
| Popis: | Objectives Elastomeric half-mask respirator (EHMR) use in healthcare increased significantly during the COVID-19 pandemic. Concern for potential release of infectious aerosols from EHMR exhalation valves prompted recommendations to cover them with surgical masks (SMs), thereby improving source control. The physiological and subjective effects of wearing a SM over the exhalation valve of an EHMR, however, are unknown. Methods Twelve healthy healthcare worker volunteers completed a 30-min series of simulated healthcare-related tasks, including resting, talking, walking, and bending, proning and supinating a weighted manikin, and performing cardiopulmonary resuscitation. This series recurred three times with different mask configurations—SM only, EHMR only, or EHMR with SM covering the exhalation valve. A transcutaneous sensor continuously measured carbon dioxide (tcPCO2), oxygen saturation (SpO2), and heart rate (HR) from each subject. Subjects scored their rates of perceived exertion (RPE) and levels of discomfort after each round. Physiological parameters and subjective scores were analyzed using mixed linear models with a fixed effect for mask type, activity, age, body mass index (BMI), and gender. Analysis also tested for interaction between mask type and activity. Results Physiological parameters remained within normal ranges for all mask configurations but varied by task. Statistically significant but small decreases in mean tcPCO2 (37.17 versus 37.88 mmHg, P < 0.001) and SpO2 (97.74 versus 97.94%, P < 0.001) were associated with wearing EHMR with SM over the exhalation valve compared with EHMR alone. Mean HR did not differ between these mask configurations. Wearing SM only was associated with lower RPE and level of discomfort compared with EHMR, but these subjective scores did not differ when comparing EHMR with SM to EHMR only. Age, BMI, and gender had no significant effect on any outcomes. Conclusions Wearing a SM over an EHMR did not produce clinically significant changes in tcPCO2, SpO2, or HR compared with uncovered EHMR during healthcare-related tasks. Covered EHMR use also did not affect perceived exertion or discomfort compared with uncovered EHMR use. Covering the exhalation valve of an EHMR with a SM for source control purposes can be done safely. |
| Databáze: | OpenAIRE |
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