Personal protective equipment use by health‐care workers in intensive care units during the COVID‐19 pandemic in Japan: comparative analysis with the PPE‐SAFE survey

Comparison of shortages and reuse of single‐use personal protective equipment between Japan and an international survey during the COVID‐19 pandemic in 2020. Aim We investigated personal protective equipment (PPE) use and supply shortage, training, and adverse events among health‐care workers (HCWs)...

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Published inAcute medicine & surgery Vol. 7; no. 1; pp. e584 - n/a
Main Authors Unoki, Takeshi, Tamoto, Mitsuhiro, Ouchi, Akira, Sakuramoto, Hideaki, Nakayama, Asami, Katayama, Yukiko, Miyazaki, Satoko, Yamada, Toru, Fujitani, Shigeki, Nishida, Osamu, Tabah, Alexis
Format Journal Article
LanguageEnglish
Published United States John Wiley & Sons, Inc 01.01.2020
John Wiley and Sons Inc
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ISSN2052-8817
2052-8817
DOI10.1002/ams2.584

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Abstract Comparison of shortages and reuse of single‐use personal protective equipment between Japan and an international survey during the COVID‐19 pandemic in 2020. Aim We investigated personal protective equipment (PPE) use and supply shortage, training, and adverse events among health‐care workers (HCWs) in the intensive care unit (ICU) during the coronavirus disease (COVID‐19) pandemic in Japan and compared the results with an international survey that used the same methodology. Methods This Web‐based survey was carried out from 14 April to 6 May, 2020, in Japan and included HCWs directly involved in ICU management of COVID‐19 patients. A survey invitation was emailed using the Japanese Society of Intensive Care Medicine’s mailing list. Results We analyzed 460 valid responses from among 976 responses. The N95/FFP2 mask (77%) was the most frequently used, although half of our respondents reported reuse of single‐use N95/FFP2 masks. The median duration (1 h) of uninterrupted PPE use per shift was less than that in the international study. The most common PPE‐related adverse event was experiencing intense heat (75%). Logistic regression analysis revealed that being a nurse was independently associated with experiencing intense heat. Conclusion Shortage of PPE and frequent mask reuse were prevalent during the COVID‐19 pandemic in Japan. Intense heat is the most significant symptom, especially for nurses, even with short‐duration PPE use. Strategies to protect HCWs from dehydration and intense heatstroke are needed.
AbstractList We investigated personal protective equipment (PPE) use and supply shortage, training, and adverse events among health-care workers (HCWs) in the intensive care unit (ICU) during the coronavirus disease (COVID-19) pandemic in Japan and compared the results with an international survey that used the same methodology.AimWe investigated personal protective equipment (PPE) use and supply shortage, training, and adverse events among health-care workers (HCWs) in the intensive care unit (ICU) during the coronavirus disease (COVID-19) pandemic in Japan and compared the results with an international survey that used the same methodology.This Web-based survey was carried out from 14 April to 6 May, 2020, in Japan and included HCWs directly involved in ICU management of COVID-19 patients. A survey invitation was emailed using the Japanese Society of Intensive Care Medicine's mailing list.MethodsThis Web-based survey was carried out from 14 April to 6 May, 2020, in Japan and included HCWs directly involved in ICU management of COVID-19 patients. A survey invitation was emailed using the Japanese Society of Intensive Care Medicine's mailing list.We analyzed 460 valid responses from among 976 responses. The N95/FFP2 mask (77%) was the most frequently used, although half of our respondents reported reuse of single-use N95/FFP2 masks. The median duration (1 h) of uninterrupted PPE use per shift was less than that in the international study. The most common PPE-related adverse event was experiencing intense heat (75%). Logistic regression analysis revealed that being a nurse was independently associated with experiencing intense heat.ResultsWe analyzed 460 valid responses from among 976 responses. The N95/FFP2 mask (77%) was the most frequently used, although half of our respondents reported reuse of single-use N95/FFP2 masks. The median duration (1 h) of uninterrupted PPE use per shift was less than that in the international study. The most common PPE-related adverse event was experiencing intense heat (75%). Logistic regression analysis revealed that being a nurse was independently associated with experiencing intense heat.Shortage of PPE and frequent mask reuse were prevalent during the COVID-19 pandemic in Japan. Intense heat is the most significant symptom, especially for nurses, even with short-duration PPE use. Strategies to protect HCWs from dehydration and intense heatstroke are needed.ConclusionShortage of PPE and frequent mask reuse were prevalent during the COVID-19 pandemic in Japan. Intense heat is the most significant symptom, especially for nurses, even with short-duration PPE use. Strategies to protect HCWs from dehydration and intense heatstroke are needed.
Comparison of shortages and reuse of single‐use personal protective equipment between Japan and an international survey during the COVID‐19 pandemic in 2020.
We investigated personal protective equipment (PPE) use and supply shortage, training, and adverse events among health-care workers (HCWs) in the intensive care unit (ICU) during the coronavirus disease (COVID-19) pandemic in Japan and compared the results with an international survey that used the same methodology. This Web-based survey was carried out from 14 April to 6 May, 2020, in Japan and included HCWs directly involved in ICU management of COVID-19 patients. A survey invitation was emailed using the Japanese Society of Intensive Care Medicine's mailing list. We analyzed 460 valid responses from among 976 responses. The N95/FFP2 mask (77%) was the most frequently used, although half of our respondents reported reuse of single-use N95/FFP2 masks. The median duration (1 h) of uninterrupted PPE use per shift was less than that in the international study. The most common PPE-related adverse event was experiencing intense heat (75%). Logistic regression analysis revealed that being a nurse was independently associated with experiencing intense heat. Shortage of PPE and frequent mask reuse were prevalent during the COVID-19 pandemic in Japan. Intense heat is the most significant symptom, especially for nurses, even with short-duration PPE use. Strategies to protect HCWs from dehydration and intense heatstroke are needed.
Comparison of shortages and reuse of single‐use personal protective equipment between Japan and an international survey during the COVID‐19 pandemic in 2020. Aim We investigated personal protective equipment (PPE) use and supply shortage, training, and adverse events among health‐care workers (HCWs) in the intensive care unit (ICU) during the coronavirus disease (COVID‐19) pandemic in Japan and compared the results with an international survey that used the same methodology. Methods This Web‐based survey was carried out from 14 April to 6 May, 2020, in Japan and included HCWs directly involved in ICU management of COVID‐19 patients. A survey invitation was emailed using the Japanese Society of Intensive Care Medicine’s mailing list. Results We analyzed 460 valid responses from among 976 responses. The N95/FFP2 mask (77%) was the most frequently used, although half of our respondents reported reuse of single‐use N95/FFP2 masks. The median duration (1 h) of uninterrupted PPE use per shift was less than that in the international study. The most common PPE‐related adverse event was experiencing intense heat (75%). Logistic regression analysis revealed that being a nurse was independently associated with experiencing intense heat. Conclusion Shortage of PPE and frequent mask reuse were prevalent during the COVID‐19 pandemic in Japan. Intense heat is the most significant symptom, especially for nurses, even with short‐duration PPE use. Strategies to protect HCWs from dehydration and intense heatstroke are needed.
Introduction The global disease outbreak caused coronavirus disease (COVID‐19) to emerge as a major public health issue. 1 By 14 July, 2020, 570,288 COVID‐19‐related deaths were reported worldwide. 2 Health‐care workers (HCWs) are at high risk for infection, and need personal protective equipment (PPE) to reduce the risk of disease transmission. 3 Worldwide, the problems associated with PPE use include PPE shortage, 4 inappropriate use, 5 and adverse effects (AEs). Results We obtained 976 responses, of which 516 were excluded for the following reasons: not involved in COVID‐19 management (n = 345), incomplete questionnaires (n = 170), and working outside Japan (n = 1). [...]the final analysis dataset included information from 460 responses. 1 TableComparison of characteristics and workplace attributes among respondents working in intensive care units (ICUs) in this survey as compared to PPE‐SAFE survey Variable This survey PPE‐SAFE n 460 2711 Age, years; median (IQR) 40 (34, 46) 41 (34, 49) Female respondent, n (%) 210 (45.7) 1254 (46.3) ICU experience, years; median (IQR) 10 (6, 15) 10 (4, 18) COVID‐19 dedicated or repurposed ICU, n (%) * 92 (20) 1585 (58) Position, n (%) * Registered nurse 236 (51.3) 744 (27.4) Physician 179 (38.9) 1797 (66.3) Allied HCW 45 (9.8) 170 (6.3) Specialty, n (%) * Emergency 103 (22.4) 72 (2.7) Intensive care 289 (62.8) 2019 (74.5) Anesthesia 35 (7.2) 430 (15.9) Other 33 (7.2) 190 (7.0) Hospital type, n (%) * Remote/regional 29 (6.3) 186 (6.9) Private 25 (5.4) 237 (8.7) Tertiary 247 (53.7) 1548 (57.1) Community/urban 159 (34.6) 741 (27.3) Running capacity, n (%) * Well above 11 (2.4) 690 (25.5) Above 44 (9.6) 586 (21.6) Below 227 (49.4) 663 (24.5) Usual 173 (37.6) 699 (25.8) Unsure 5 (1.1) 57 (2.1) Type of ICU where the responded worked the day of the survey HCW, health‐care worker; IQR, interquartile range. *P < 0.05. Only 16.5% of respondents reported that they were very confident or confident that the available PPE could protect them against SARS‐CoV‐2 exposure. 2 TableShortages and reuse of single‐use personal protective equipment in intensive care units during COVID‐19 pandemic: comparison between this study and the PPE‐SAFE survey This study PPE‐SAFE survey Used for routine care Reported as missing Washed or reused Used for routine care Reported as missing Washed or reused Mask (n = 460) Mask (n = 2,679) Surgical mask, n (%) 85 (18.5) * 7 (8.2) 16 (18.8) * 289 (10.5) 11 (3.8) 13 (4.5) N95/FFP2 mask, n (%) 353 (76.7) * 41 (11.6) 185 (52.4) * 1557 (57.5) 127 (8.2) 267 (17.1) FFP3 mask, n (%) 9 (2.0) * 2 (22.2) 0 (0.0) 649 (24.0) 78 (12.0) 107 (16.5) PAPR, n (%) 12 (2.6) * 0 (0.0) n/a 184 (6.8) 16 (8.7) n/a None, n (%) 1 (0.2) 32 (1.1) Gown (n = 460) Gown (n = 2,432) Sleeveless apron, n (%) 20 (4.3) 1 (5.0) 0 (0.0) 193 (7.1) 3 (1.6) 5 (2.6) Full sleeve waterproof gown, n (%) 389 (84.6) * 34 (8.7) 14 (3.6) * 1623 (60.0) 115 (7.1) 183 (11.3) Hazmat suits, n (%) 28 (6.1) * 6(21.4) 3 (10.7) 616 (22.7) 73 (11.9) 66 (10.7) None, n (%) 23 (5.0) * 279 (10.3) Eye protection (n = 460) Eye protection (n = 2,519) Goggles, n (%) 122 (26.5) * 7 (5.7) 58 (47.5) * 945 (34.9) 28 (3.0) 326 (34.4) Face shield or visor, n (%) 311 (67.6) * 25 (8.0) 67 (21.5) * 1574 (58.0) 131 (8.3) 820 (52.2) None, n (%) 27 (5.9) 192 (7.1) Head protection (n = 460) Head protection (n = 2,075) Hair cover, n (%) 350 (76.1) 6 (1.7) 8 (2.3) 1,636 (64.7) 43 (2.6) 41 (2.5) Balaclava, n (%) 24 (5.2) * 1 (4.2) 0 (0.0) 317 (12.5) 26 (8.2) 8 (2.5) Impervious hood, n (%) 3 (0.7) * 0 (0.0) 0 (0.0) 122 (4.8) 5 (4.1) 11 (9.0) None, n (%) 83 (18.0) 452 (17.9) n/a, not applicable; PAPR, powered air purification respirator. *P < 0.05 compared with PPE‐SAFE survey data.
Author Katayama, Yukiko
Yamada, Toru
Ouchi, Akira
Tamoto, Mitsuhiro
Sakuramoto, Hideaki
Fujitani, Shigeki
Tabah, Alexis
Nishida, Osamu
Nakayama, Asami
Miyazaki, Satoko
Unoki, Takeshi
AuthorAffiliation 3 Department of Adult Health Nursing College of Nursing Ibaraki Christian University Hitachi Ibaraki Japan
5 Department of Nursing Nihonkai General Hospital Sakata Yamagata Japan
7 Department of Nursing Toho University Omori Medical Center Tokyo Japan
6 Department of Nursing Tokai University Hospital Isehara Kanagawa Japan
10 Intensive Care Unit Faculty of Medicine Redcliffe Hospital University of Queensland Brisbane Australia
4 Department of Nursing Dokkyo Medical University Hospital Mibu Tochigi Japan
1 Department of Acute and Critical Care Nursing School of Nursing Sapporo City University Sapporo Japan
8 Department of Emergency and Critical Care Medicine St. Marianna University School of Medicine Miyamae Kanagawa Japan
9 Department of Anesthesiology and Critical Care Medicine Fujita Health University School of Medicine Toyoake Aichi Japan
2 Department of Nursing Kyoto University Hospital Kyoto Kyoto Japan
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BackLink https://www.ncbi.nlm.nih.gov/pubmed/33042559$$D View this record in MEDLINE/PubMed
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Copyright 2020 The Authors. published by John Wiley & Sons Australia, Ltd on behalf of Japanese Association for Acute Medicine
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CorporateAuthor PPE‐SAFE in Japan Project, International Exchange Committee, the Japan Society of Intensive Care Medicine
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Keywords heat
Health‐care worker
intensive care unit
personal protective equipment
safety
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Snippet Comparison of shortages and reuse of single‐use personal protective equipment between Japan and an international survey during the COVID‐19 pandemic in 2020....
We investigated personal protective equipment (PPE) use and supply shortage, training, and adverse events among health-care workers (HCWs) in the intensive...
Introduction The global disease outbreak caused coronavirus disease (COVID‐19) to emerge as a major public health issue. 1 By 14 July, 2020, 570,288...
Comparison of shortages and reuse of single‐use personal protective equipment between Japan and an international survey during the COVID‐19 pandemic in 2020.
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StartPage e584
SubjectTerms Confidence
Coronaviruses
COVID-19
Disease transmission
Eye protection
Health‐care worker
heat
Hospitals
Infections
Intensive care
intensive care unit
Masks
Original
Pandemics
Personal protective equipment
Questionnaires
safety
Severe acute respiratory syndrome coronavirus 2
Workers
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Title Personal protective equipment use by health‐care workers in intensive care units during the COVID‐19 pandemic in Japan: comparative analysis with the PPE‐SAFE survey
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