The Physiological Burden of Prolonged PPE Use on Healthcare Workers During Long Shifts
June 10, 2020 by Jon Williams, PhD, [et al.]
"Healthcare workers (HCW) and first responders often work long, physically and mentally exhausting shifts.... These long hours can result in fewer adequate breaks for personal care, nutrition, and hydration.... [M]any HCWs are... required to wear personal protective equipment (PPE), which may include N95 filtering facepiece respirators (FFRs).... Particular features of PPE can impose a physiological (how the body normally functions) burden on the HCW.... [E]very HCW should be medically cleared before wearing respiratory protection.... [T]here are still many factors that can exacerbate the PPE burden.... [U]sing an FFR for an extended period... could compromise... worker, workplace, and patient safety....
Filtering Facepiece Respirators
An N95 FFR user is always going to experience some level of difficulty breathing, or breathing resistance.... Enough breathing resistance could result in a reduction in the frequency and depth of breathing, known as hypoventilation (the opposite of hyperventilation).
Hypoventilation is a primary [but not the sole -.ed] cause of significant discomfort while wearing an N95 FFR (Williams 2010). [S]tudies done by Roberge et al. (2010) indicated that this hypoventilation did not pose a significant risk to healthcare workers over the course of less than one hour of continuous N95 use. When HCWs are working longer hours without a break while continuously wearing an N95 FFR, blood CO2 levels may increase past the 1-hour mark, which could have a significant physiological effect on the wearer (Lim et al., 2006)*. Some of the known physiological effects of increased concentrations of CO2 include:
1. Headache;
2. Increased pressure inside the skull;
3. Nervous system changes (e.g., increased pain threshold, reduction in cognition – altered judgement, decreased situational awareness, difficulty coordinating sensory or cognitive, abilities and motor activity, decreased visual acuity, widespread activation of the sympathetic nervous system that can oppose the direct effects of CO2 on the heart and blood vessels);
4. Increased breathing frequency;
5. Increased “work of breathing”, which is result of breathing through a filter medium;
I wore 3M N95s and all manner of respirator protection starting in the 1970's and through decades of work in the trades. As a professional painter I relied on machine sanding to properly prepare the surface, I made a lot of dust. I wore a lot of N95's. Often throughout the day, often day after day. I never experienced any ill effects from masking, I never knew of anyone who did.
Just now I tested my pulse and Oxygen levels. pulse 60's low 70's oxygen steady at 98 -brief "blip" to 97 back to 98. I put on the 3M 9205+ N95 I bought at home depot, shown in a real world, broadcast in real time mask test on the Aaron Collins youtube channel, real person Aaron Collins puts on the 3M 9205+ N95, he simply adjusts the mask for fit then tests and shows a 99.68% reduction in salt test particles the size of a single cov2 virus.
No change in pulse rate range or oxygen blood levels while wearing the N95 while sitting.
THE EVIL, salting the battlefield for this cov2 and a future high lethality virus, has worked to denigrate and discredit the True Protection that the 3M "quality grade" N95 and better disposable (or reusable), easily sized and fitted, respirator grade mask does provide. Especially when combined with basic eye protection (glasses with side shielding and? prescription or homemade antiviral eye drops) and before masking use of homemade antiviral nose, mouth and throat sprays and subsequent use of homemade antiviral eye wash, nasal flush, mouthwash and gargle and continuing preemptive use of homemade antiviral sprays and nebulization and hygiene. Not hard to do once a routine has been established.
test # 644 8/8/22 3M 9205+ Aura[Lot A220769] N95, Boat, As Worn, White, Headband, 21,820 particles per cc outside the mask at the start of the test 21,720 particles per cc outside the mask at the end of the test, 70 particles per cc inside the mask for a 99.68% reduction. Aaron Collins youtube channel https://www.youtube.com/@coll0412 Data can be found here: https://docs.google.com/spreadsheets/ "
https://blogs.cdc.gov/niosh-science-blog/2020/06/10/ppe-burden/
The Physiological Burden of Prolonged PPE Use on Healthcare Workers During Long Shifts
June 10, 2020 by Jon Williams, PhD, [et al.]
"Healthcare workers (HCW) and first responders often work long, physically and mentally exhausting shifts.... These long hours can result in fewer adequate breaks for personal care, nutrition, and hydration.... [M]any HCWs are... required to wear personal protective equipment (PPE), which may include N95 filtering facepiece respirators (FFRs).... Particular features of PPE can impose a physiological (how the body normally functions) burden on the HCW.... [E]very HCW should be medically cleared before wearing respiratory protection.... [T]here are still many factors that can exacerbate the PPE burden.... [U]sing an FFR for an extended period... could compromise... worker, workplace, and patient safety....
Filtering Facepiece Respirators
An N95 FFR user is always going to experience some level of difficulty breathing, or breathing resistance.... Enough breathing resistance could result in a reduction in the frequency and depth of breathing, known as hypoventilation (the opposite of hyperventilation).
Hypoventilation is a primary [but not the sole -.ed] cause of significant discomfort while wearing an N95 FFR (Williams 2010). [S]tudies done by Roberge et al. (2010) indicated that this hypoventilation did not pose a significant risk to healthcare workers over the course of less than one hour of continuous N95 use. When HCWs are working longer hours without a break while continuously wearing an N95 FFR, blood CO2 levels may increase past the 1-hour mark, which could have a significant physiological effect on the wearer (Lim et al., 2006)*. Some of the known physiological effects of increased concentrations of CO2 include:
1. Headache;
2. Increased pressure inside the skull;
3. Nervous system changes (e.g., increased pain threshold, reduction in cognition – altered judgement, decreased situational awareness, difficulty coordinating sensory or cognitive, abilities and motor activity, decreased visual acuity, widespread activation of the sympathetic nervous system that can oppose the direct effects of CO2 on the heart and blood vessels);
4. Increased breathing frequency;
5. Increased “work of breathing”, which is result of breathing through a filter medium;
6. Cardiovascular effects (e.g., diminished cardiac contractility, vasodilation of peripheral blood vessels);
7. Reduced tolerance to lighter workloads.
I wore 3M N95s and all manner of respirator protection starting in the 1970's and through decades of work in the trades. As a professional painter I relied on machine sanding to properly prepare the surface, I made a lot of dust. I wore a lot of N95's. Often throughout the day, often day after day. I never experienced any ill effects from masking, I never knew of anyone who did.
Just now I tested my pulse and Oxygen levels. pulse 60's low 70's oxygen steady at 98 -brief "blip" to 97 back to 98. I put on the 3M 9205+ N95 I bought at home depot, shown in a real world, broadcast in real time mask test on the Aaron Collins youtube channel, real person Aaron Collins puts on the 3M 9205+ N95, he simply adjusts the mask for fit then tests and shows a 99.68% reduction in salt test particles the size of a single cov2 virus.
No change in pulse rate range or oxygen blood levels while wearing the N95 while sitting.
THE EVIL, salting the battlefield for this cov2 and a future high lethality virus, has worked to denigrate and discredit the True Protection that the 3M "quality grade" N95 and better disposable (or reusable), easily sized and fitted, respirator grade mask does provide. Especially when combined with basic eye protection (glasses with side shielding and? prescription or homemade antiviral eye drops) and before masking use of homemade antiviral nose, mouth and throat sprays and subsequent use of homemade antiviral eye wash, nasal flush, mouthwash and gargle and continuing preemptive use of homemade antiviral sprays and nebulization and hygiene. Not hard to do once a routine has been established.
test # 644 8/8/22 3M 9205+ Aura[Lot A220769] N95, Boat, As Worn, White, Headband, 21,820 particles per cc outside the mask at the start of the test 21,720 particles per cc outside the mask at the end of the test, 70 particles per cc inside the mask for a 99.68% reduction. Aaron Collins youtube channel https://www.youtube.com/@coll0412 Data can be found here: https://docs.google.com/spreadsheets/ "