ArticleCase studies in thermal engineering2022
Thermal discomfort caused by personal protective equipment in healthcare workers during the delta COVID-19 pandemic in Guangzhou, China: A case study.
Article in Case studies in thermal engineering, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Pooled it
- Novel cooling vest with personal protective equipment alleviates heat strain without increasing metabolic demands in the heat.Scandinavian journal of work, environment & health · 2026Trial
- Evaluation of potentially toxic elements and pharmaceutical compounds in leachate and exhaust air from non-incineration medical waste treatment devices.Scientific reports · 2025Article
- The effects of acoustic-light-thermal environment quality parameters on pedestrians' overall comforts in residential districts.Scientific reports · 2024Article
- Effect of the cooling clothing integrating with phase change material on the thermal comfort of healthcare workers with personal protective equipment during the COVID-19.Case studies in thermal engineering · 2023Article
- Influencing factors of quality of life among front-line nurses who collected nucleic acid samples during COVID-19: a path analysis.Frontiers in public health · 2023Article
- Effects of mask wearing duration and relative humidity on thermal perception in the summer outdoor built environment.Building simulation · 2022Article
- Influence of Different Protection States on the Mental Fatigue of Nurses During the COVID-19 Pandemic.Risk management and healthcare policy · 2022Article
Corrections and comments
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Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: In contrast to the previous COVID-19 pandemic, most frontline healthcare workers (HCWs) worked on residents' nucleic acid tests in outdoor environments, instead of taking care of COVID-19 patients in hospitals during the hot summer of 2021. Therefore, it is necessary to investigate the prevalence and characteristics of thermal discomfort caused by personal protective equipment (PPE). Methods: A cross-sectional survey was conducted online at hospitals from 11 administrative regions of Guangzhou for the assessment of thermal discomfort among HCWs from June 12-16, 2021. Univariate and logistic regression analyses were used to explore the risk factors associated with thermal discomfort. Results: A total of 3658 valid responses were collected. The thermal discomfort and humid discomfort levels increased from 2.91 ± 1.19 to 3.61 ± 0.72 and from 0.98 ± 1.36 to 3.06 ± 1.1 after wearing PPE, respectively (p < 0.01). Feelings of being "very hot" and "uncomfortably humid" were the most influenced by wearing PPE, increasing from 31% to 69.1% and from 9.1% to 45.7%, respectively. There were significant increases in the thermal discomfort level (3.75 ± 0.57 vs. 3.33 ± 0.89, p < 0.01) and the humid discomfort level (3.33 ± 0.95 vs. 2.54 ± 1.19, p < 0.01) between the comfortable group and uncomfortable group, accompanied by similar patterns in the feelings of being "very hot" and "uncomfortably humid." For general thermal-related symptoms, the most common new-onset symptom was profuse sweating (80%) followed by labored breathing (55.2%) and excessive dehydration (46.8%), while facial swelling (74%) was associated with local thermal-related symptoms, followed by hand maceration erosion (56.7%) and visual impairment (49.3%). In the multivariate analysis, the apparent temperature of the environment (≥35 °C), working in negative-pressure ambulances and outdoors, continuing to wear PPE for 1-3 days during this period, being aged >40 years, and previous experiences fighting the pandemic were independently associated with thermal discomfort (p < 0.01). Immediately after PPE removal, 32.3% of respondents considered drinking ice water/another drink, followed by 25% shortening the duration of wearing PPE and 19.1% going to the toilet. A large proportion of the participants looked forward to modifications to the material of the suit (72.9%) and mask (53.4%) for heat dissipation and dehumidification, as well as anti-fogging goggles (60.2%), adding hydration equipment to PPE (53.4%), and using soft materials to reduce pressure (40%). Conclusions: Thermal discomfort is common and degrades health physiology related to PPE in summer environments. This suggests that modifications to the current working practices are urgently required to improve the resilience of HCWs and enhance their services during pandemics.
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