A Web Survey to Evaluate the Thermal Stress Associated with Personal Protective Equipment among Healthcare Workers during the COVID-19 Pandemic in Italy

Abstract

The pandemic has been afflicting the planet for over a year and from the occupational point of view, healthcare workers have recorded a substantial increase in working hours. The use of personal protective equipment (PPE), necessary to keep safe from COVID-19 increases the chances of overheating, especially during the summer seasons which, due to climate change, are becoming increasingly warm and prolonged. A web survey was carried out in Italy within the WORKLIMATE project during the summer and early autumn 2020. Analysis of variance (ANOVA) was used to evaluate differences between groups. 191 questionnaires were collected (hospital doctor 38.2%, nurses 33.5%, other healthcare professionals 28.3%). The impact of PPE on the thermal stress perception declared by the interviewees was very high on the body areas directly covered by these devices (78% of workers). Workers who used masks for more than 4 h per day perceived PPE as more uncomfortable (p < 0.001) compared to the others and reported a greater productivity loss (p < 0.001). Furthermore, the study highlighted a high perception of thermal stress among healthcare workers that worn COVID-19-PPE and this enhances the need for appropriate heat health warning systems and response measures addressed to the occupational sector.

Keywords: PPE; adaptation strategy; global warming; heat stress; occupational safety and health.

Figure 1

Air temperatures anomalies in Italy during the period May–October 2020 (A) and during the period July-August 2020 (B) compared to the climatology 1981–2010. Data obtained from https://psl.noaa.gov/cgi-bin/data/composites/printpage.pl, accessed on 6 April 2021.

Figure 2

Thermal sensations declared by healthcare workers for each parts of the body covered by PPE during working time. Dark blue: Very cold; Blue: Cold; Light blue: Slightly cold; Green: Neutral; Yellow: Slightly hot; Orange: Hot; Red: Very hot.

Figure 3

ANOVA to evaluate the effect of the use of the masks on the answers related to items 34, 35, 37 and 46 (A) and items 39, 41, 42 and 43 (B). Different kind of masks (from 1 up to 3 kind) and different time of use (<4 h or >4 h) was considered. A 5-point Likert scale (1 for strongly disagree and 5 for strongly agree) was used for questions. (Sig): *** p < 0.001; ** p < 0.01; * p < 0.05.

Figure 4

ANOVA to evaluate the effect of the use of the gloves on the answers related to items 38, 39, 41 (A) and items 42, 43, 46 (B). One or two pairs of overlapping gloves and dif-ferent time of use (<4 h or >4 h) was considered. A 5-point Likert scale (1 for strongly disagree and 5 for strongly agree) was used for questions. (Sig): *** p < 0.001; ** p < 0.01; * p < 0.05.