Prevalence of physical and psychological impacts of wearing personal
protective equipment (PPE) on health care workers during COVID-19; a
systematic review and meta-analysis.
Abstract
Background: The COVID-19 pandemic has necessitated the use of personal
protective equipment (PPE) among the frontline health care workers
(HCWs). Although PPE offers a great deal of help in preventing
infection, it poses significant physical and psychological impacts at
varying levels. Correspondingly, multiple independent studies have
brought out the PPE associated problems. However, there exists a lacuna
on comprehensive information of global prevalence related to the same.
Aims: To estimate the prevalence and risk factors of PPE among HCWs
during COVID-19 across the globe. Design: Systematic review and
Meta-analysis. Method: The review was undertaken as per the protocol
registered in PROSPERO xxxxxx following PRISMA guidelines. Two
independent reviewers have undertaken the search strategy, study
selection and methodological quality assessment. Discrepancies were
addressed by the third reviewer. Heterogeneity was addressed through I2
statistics and forest plots generated by open meta-software. Results: A
total of 16 articles conducted across 6 different countries among 10,182
HCWs were included in the review. The pooled prevalence of skin lesions,
headache, sweating, breathing difficulty, vision difficulty, thirst/dry
mouth, fatigue and communication difficulty, anxiety, fear were
57(47-66%),51(37-64%),75(56-90%),44(23-68%),61(21-94%),54%(30-77%),67(58-76%),74%(47-94%),28(24-33%),14(10-17%)
respectively. Moreover, the various risk factors included; the use of
PPE greater than 6 Hrs. and young females. In addition, the medical
management of new-onset problems created an additional burden on the
frontline HCWs. Conclusion: The front-line HCWs encountered physical and
psychological problems at varying levels as a result of wearing PPE
which needs to be addressed to prevent the inadequate use of PPE leading
to infections. Relevance to clinical practice: The review sheds light on
the need to address the physical and psychological morbidity due to PPE
use for ensuring the working morale and optimum health status of
frontline HCWs to combat ongoing and future pandemics.