W.Y.B.HO1, L.Y.C.TAN2, X.ZHAO1, D.WANG1, H.L.J LIM1
National Skin Centre1, National Healthcare Group2
Personal protective equipment (PPE)-related occupational dermatosis (PROD) represents a significant burden to frontline healthcare workers(HCW).We aim to understand the epidemiology of PROD in order to formulate mitigation strategies to safeguard our workforce.
A multi-centre cross-sectional study using a self-administered online questionnaire was conducted from July-September 2020. Frontline HCW who had physical interface with COVID-19 patients for a minimum cumulative duration of 2 weeks were invited to participate.
Of 416 valid respondents, majority were female (77.2%, n=321), Chinese (65.9%, n=274) nurses (52.4%, n=218) with a mean age of 32.8 years (SD: 8.0). Prevalence of PROD was 73.8% (n=307), with face masks being the commonest cause (93.8%, n=288). The most frequent PROD associated with face masks, protective eyewear, hair nets, gowns and gloves were acne (71.5%, n=206), pressure-related injuries (70.7%, n=99), scalp itch (53.3%, n=16), itch or rash (78.8%, n=26) and hand xerosis (75.0%, n=27) respectively. Exposure time to PPE beyond an hour increased the odds of developing PROD by 4.8 times (76.6% vs. 40.6%; OR = 4.8 [95% CI: 2.3 to 10.0]; p< 0.001). Majority of HCW made behavioural adaptations to mitigate sequelae from mask wear (63.2%, n=182), eyewear (67.1%, n=94), gloves (69.4%, n=25), gowns (54.5%, n=18), and hair nets (43.3%, n=13).
Based on our study’s findings, we recommend hourly breaks for frontline HCW where possible and for HCW to be (1) fitted to various models of face mask and protective eyewear, (2) screened for pre-existing dermatoses and briefed on mitigation strategies and available support channels prior to deployment.