The COVID-19 pandemic resulted in many supply chain issues, including crippling of essential personal protective equipment (PPE) needed for high-risk occupations such as those in healthcare. As a ...result of these supply chain issues, unprecedented crisis capacity strategies were implemented to divert PPE items such as filtering facepiece respirators (FFRs, namely N95s) to those who needed them most for protection. Large-scale methods for decontamination were used throughout the world to preserve these items and provided for their extended use. The general public also adopted the use of non-specialized protective equipment such as face coverings. So, the need for cleaning, decontamination, or disinfection of these items in addition to normal clothing items became a necessary reality. Some items could be laundered, but other items were not appropriate for washing/drying. To fill research gaps in small-scale, non-commercial cleaning and disinfection, this bench-scale research was conducted using small coupons (swatches) of multiple PPE/barrier protection materials inoculated with virus (non-pathogenic bacteriophages Phi6 and MS2) and tested against a range of decontamination methods including bleach-, alcohol- and quaternary ammonium compound (QAC)-based liquid sprays, as well as low concentration hydrogen peroxide vapor (LCHPV) and bench-scale laundering. In general, non-porous items were easier to disinfect than porous items, and the enveloped virus Phi6 was overall easier to inactivate than MS2. Multiple disinfection methods were shown to be effective in reducing viral loads from PPE coupons, though only laundering and LCHPV were effective for all materials tested that were inoculated with Phi6. Applications of this and follow-on full-scale research are to provide simple effective cleaning/disinfection methods for use during the current and future pandemics.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Face mask usage by the healthy population in the community to reduce risk of transmission of respiratory viruses remains controversial. We assessed the effect of community-wide mask usage to control ...coronavirus disease 2019 (COVID-19) in Hong Kong Special Administrative Region (HKSAR).
Patients presenting with respiratory symptoms at outpatient clinics or hospital wards were screened for COVID-19 per protocol. Epidemiological analysis was performed for confirmed cases, especially persons acquiring COVID-19 during mask-off and mask-on settings. The incidence of COVID-19 per million population in HKSAR with community-wide masking was compared to that of non-mask-wearing countries which are comparable with HKSAR in terms of population density, healthcare system, BCG vaccination and social distancing measures but not community-wide masking. Compliance of face mask usage in the HKSAR community was monitored.
Within first 100 days (31 December 2019 to 8 April 2020), 961 COVID-19 patients were diagnosed in HKSAR. The COVID-19 incidence in HKSAR (129.0 per million population) was significantly lower (p<0.001) than that of Spain (2983.2), Italy (2250.8), Germany (1241.5), France (1151.6), U.S. (1102.8), U.K. (831.5), Singapore (259.8), and South Korea (200.5). The compliance of face mask usage by HKSAR general public was 96.6% (range: 95.7% to 97.2%). We observed 11 COVID-19 clusters in recreational ‘mask-off’ settings compared to only 3 in workplace ‘mask-on’ settings (p = 0.036 by Chi square test of goodness-of-fit).
Community-wide mask wearing may contribute to the control of COVID-19 by reducing the amount of emission of infected saliva and respiratory droplets from individuals with subclinical or mild COVID-19.
Background: The importance of personal protective equipment (PPE) for health-care professionals working in an infective environment has been highlighted again in this COVID pandemic. CDC recommends ...the use of PPE with FFp2/N95 wear in dental health professionals. There are studies revealing the varied physiological as well as psychological impact of long-duration wear of PPE in health professionals. This study aims to evaluate the effects of wearing PPE with N95 mask before donning and after doffing (for 4 h) on the oxygen saturation levels and pulse rate. Materials and Methods: Forty dental surgeons of both sexes with informed consent working at a government dental college, in Kerala, were studied by a standard pulse oximetry test for oxygen saturation and pulse rate before donning and after doffing of PPE with FFP2/N95 respirator over 4 h duration. They were ensured to be hemodynamically stable, breathing room air under standard room temperature, and humidity. Data were entered and evaluated using a standard paired t-test using SPSS version 20. Results: The mean age group of the dental surgeons was 39 ± 9 years, and 60% were male. The mean values of oxygen saturation before donning and after doffing were 97.6 (1.1) and 96.7 (1.2), respectively, and the difference was significant (P < 0.01). The pulse rate before donning and after doffing was found to be 79.7 (6.7) and 81.2 (6.7), respectively, with significance (P < 0.01). However, the difference was not significant according to gender or age groups. Conclusion: The decrease in oxygen saturation and an increase in heart rate among dental surgeons were found to be significant after 4 h wear of PPE with FFP2 respirator. Nevertheless, these data of physiological impact of PPE cannot overshadow the risk-benefit ratio of PPE wear. The cautious use of PPE with improved technology can mitigate the risks involved in its use.
•PCM with bidirectional thermal regulation was designed and fabricated successfully.•Heat transfer in thermal protective clothing containing PCM layer was investigated.•Effects of PCM layer on ...thermal protection and thermal hazard were examined.•PCM showed great potential applications for intelligent thermal protective clothing.
Coating of fabric by organic phase change materials (PCMs) loaded with paraffin wax changed thermal properties of the fabric. The PCM coated fabric with intelligent bidirectional thermal regulation was designed and prepared. The basic and thermal physical properties of the PCM coated fabric were measured. The PCM layer was incorporated into thermal protective clothing, and the thermal protective performance was evaluated under hot contact exposure. High thermal capacity of PCM increased the potential of thermal protective clothing for heat accumulation during the hot contact exposure, but also modified heat release from the thermal protective clothing after the end of exposure. The incorporation of the PCM coated fabric increased greatly the thermal protective performance during the heat exposure, which was influenced by melt temperature, PCM content and enthalphy. The thermal hazardous effect caused by the PCM coated fabric was slightly increased, but presenting no significant correlation with the skin absorbed thermal energy after the exposure. Therefore, the PCM showed great potential applications for developing intelligent thermal protective clothing. The conclusions obtained from this study contributed to development of PCM with high thermal capacity and low heat release suitable for the thermal protective clothing.
Plastic rain in protected areas of the United States Brahney, Janice; Hallerud, Margaret; Heim, Eric ...
Science (American Association for the Advancement of Science),
06/2020, Letnik:
368, Številka:
6496
Journal Article
Recenzirano
Odprti dostop
Here, there, and everywhere
No place is safe from plastic pollution. Brahney
et al.
show that even the most isolated areas in the United States—national parks and national wilderness areas—accumulate ...microplastic particles after they are transported there by wind and rain (see the Perspective by Rochman and Hoellein). They estimate that more than 1000 metric tons per year fall within south and central western U.S. protected areas. Most of these plastic particles are synthetic microfibers used for making clothing. These findings should underline the importance of reducing pollution from such materials.
Science
, this issue p.
1257
; see also p.
1184
More than 1000 metric tons of plastic per year are deposited on U.S. protected lands through atmospheric transport.
Eleven billion metric tons of plastic are projected to accumulate in the environment by 2025. Because plastics are persistent, they fragment into pieces that are susceptible to wind entrainment. Using high-resolution spatial and temporal data, we tested whether plastics deposited in wet versus dry conditions have distinct atmospheric life histories. Further, we report on the rates and sources of deposition to remote U.S. conservation areas. We show that urban centers and resuspension from soils or water are principal sources for wet-deposited plastics. By contrast, plastics deposited under dry conditions were smaller in size, and the rates of deposition were related to indices that suggest longer-range or global transport. Deposition rates averaged 132 plastics per square meter per day, which amounts to >1000 metric tons of plastic deposition to western U.S. protected lands annually.
Healthcare workers exposed to coronavirus (COVID-19) may not have adequate access to personal protective equipment (PPE), safety procedures, and diagnostic protocols. Our objective was to evaluate ...the reality and perceptions about personal safety among healthcare workers in Latin America. This is a cross-sectional, online survey-based study administered to 936 healthcare professionals in Latin America from 31 March 2020 to 4 April 2020. A 12-item structured questionnaire was developed. A total of 936 healthcare workers completed the online survey. Of them, 899 (95.1%) were physicians, 28 (2.9%) were nurses, and 18 (1.9%) were allied health professionals. Access to protective equipment was as follows: gel hand sanitizer (
= 889; 95%), disposable gloves (
= 853; 91.1%), disposable gowns (
= 630; 67.3%), disposable surgical masks (785; 83.9%), N95 masks (
= 516; 56.1%), and facial protective shields (
= 305; 32.6%). The vast majority (
= 707; 75.5%) had access to personal safety policies and procedures, and 699 (74.7%) participants had access to diagnostic algorithms. On a 1-to-10 Likert scale, the participants expressed limited human resources support (4.92 ± 0.2; mean ± SD), physical integrity protection in the workplace (5.5 ± 0.1; mean ± SD), and support from public health authorities (5.01 ± 0.12; mean ± SD). Healthcare workers in Latin America had limited access to essential PPE and support from healthcare authorities during the COVID-19 pandemic.
IMPORTANCE: The human and financial costs of treating surgical site infections (SSIs) are increasing. The number of surgical procedures performed in the United States continues to rise, and surgical ...patients are initially seen with increasingly complex comorbidities. It is estimated that approximately half of SSIs are deemed preventable using evidence-based strategies. OBJECTIVE: To provide new and updated evidence-based recommendations for the prevention of SSI. EVIDENCE REVIEW: A targeted systematic review of the literature was conducted in MEDLINE, EMBASE, CINAHL, and the Cochrane Library from 1998 through April 2014. A modified Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach was used to assess the quality of evidence and the strength of the resulting recommendation and to provide explicit links between them. Of 5487 potentially relevant studies identified in literature searches, 5759 titles and abstracts were screened, and 896 underwent full-text review by 2 independent reviewers. After exclusions, 170 studies were extracted into evidence, evaluated, and categorized. FINDINGS: Before surgery, patients should shower or bathe (full body) with soap (antimicrobial or nonantimicrobial) or an antiseptic agent on at least the night before the operative day. Antimicrobial prophylaxis should be administered only when indicated based on published clinical practice guidelines and timed such that a bactericidal concentration of the agents is established in the serum and tissues when the incision is made. In cesarean section procedures, antimicrobial prophylaxis should be administered before skin incision. Skin preparation in the operating room should be performed using an alcohol-based agent unless contraindicated. For clean and clean-contaminated procedures, additional prophylactic antimicrobial agent doses should not be administered after the surgical incision is closed in the operating room, even in the presence of a drain. Topical antimicrobial agents should not be applied to the surgical incision. During surgery, glycemic control should be implemented using blood glucose target levels less than 200 mg/dL, and normothermia should be maintained in all patients. Increased fraction of inspired oxygen should be administered during surgery and after extubation in the immediate postoperative period for patients with normal pulmonary function undergoing general anesthesia with endotracheal intubation. Transfusion of blood products should not be withheld from surgical patients as a means to prevent SSI. CONCLUSIONS AND RELEVANCE: This guideline is intended to provide new and updated evidence-based recommendations for the prevention of SSI and should be incorporated into comprehensive surgical quality improvement programs to improve patient safety.
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