Nasreen Naz, Shabnum Abbas, Javerya Sattar, Ummey Aymen, Ghulam Abbas, Areej Fatima


Objective: Personal protective equipment (PPE) is requisite for all health professionals including Radiology related health care workers(R-HCW) to protect against Severe Acute Respiratory Syndrome Coronavirus 2. Despite imparting protection, these PPEs may affect both technical and non technical performance on its wearer due to their prolong use. The rationale of this study is to evaluate the impact of using PPE on the performance of R-HCW during the radiological/imaging procedures.

Methods: A pre designed online survey/questionnaire  was forwarded to R-HCW via whatsapp/email.Through this survey,both  demographic data  and  effect of PPE i.e (i)effect on  technical skills/performance, (ii)impairment of vision during procedure and film reporting, (iii) effect on communication skills/decision making  and (iv)increase in the level of fatigue/discomfort by using PPE was recorded.

Results:  There were 288 participants in this survey comprising 57 % male and 43 % female. Around 57 % R-HCW experienced technical limitations in radiological performance, 62 % reported visual impairments during procedures and film reporting and 85 % experienced increase in discomfort and level of fatigue. However communication skills and decision making was hampered in less than half of respondents i.e 44%.

Conclusion: R-HCW experienced impediment in the performance of both technical and non technical skills due to PPEs while performing emergency procedures as well as elective procedures. The impact on the level of fatigue, discomfort and visual impairment was significant. Special attention is needed in this regard to avoid suboptimal performance among R-HCW.


COVID-19, PPEs, SARS-CoV-2.                                                                                                           

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https://www.worldometers.info/coronavirus. Accessed May,16 2020.

Lu H, Stratton CW, Tang Y. Outbreak of pneumonia of unknown etiology in Wuhan China: the mystery and the miracle. J Med Virol 92(4):401–402

World Health Organization. Statement on the second meeting of the International Health Regulations (2005) Emergency Committee regarding the outbreak of novel coronavirus (2019-nCoV). 30 January 2020. https://www.who.int/news-room/detail/30-01- 2020-statement-on-the-second-meeting-of-the-internationalhealth-regulations-(2005)-emergency-committee-regarding-theoutbreak-of-novel-coronavirus-(2019-ncov)

Ong JJY, Bharatendu C, GohY, Tang JZY, Sooi KWX, Tan YL,et al. Headaches associated with personal protective equipment-A cross-sectional study among frontline healthcare workers during COVID-19. Headache. 2020 May;60(5):864-877. DOI: 10.1111/head.13811.

Ontario Agency for Health Protection and Promotion (Public Health Ontario). COVID-19 – What We Know So Far About Routes of Transmission. Toronto, ON: Queen's Printer for Ontario; 2020. Available from: https://www.publichealthontario.ca/-/media/documents/ncov/wwksf-routes transmission-mar-06-2020.pdf?la=en

Wong S, Kwong R, Wu TC et al. Risk of nosocomial transmission of coronavirus disease 2019:an experience in a general ward setting in Hong Kong. J Hosp Infect 2020; https://doi.org/10.1016/j.jhin.2020.03.036

COVID-19: Guidance for maintaining services within health and care settings Infection prevention and control recommendations. Version 1.0 published 20 August 2020; Revised Version 1.1 published 21 January 2021. NHS.

radiology_ppe_poster_a3.pdf. The RCR (Royal College of Radiologists) statement on personal protective equipment(PPE).

IPAC Recommendations for Use of Personal Protective Equipment for Care of Individuals with Suspect or Confirmed COVID 19. Toronto, ON: Queen’s Printer for Ontario; 2020. ©Queen’s Printer for Ontario, 2020.

Liu M, Cheng SZ, Xu KW, Yang Y, Zhu QT, Zhang H et al . Use of personal protective equipment against coronavirus disease 2019 by healthcare professionals in Wuhan, China: cross sectional study. BMJ 2020;369:m2195

Galanis P, Vraka I, Fragkou D, Bilali A, Kaitelidou D. Impact of personal protective equipment use on health care workers’ physical health during the COVID-19 pandemic: a systematic review and meta-analysis. American Journal of Infection Control. 2021 May 7.

Davey S L , Lee BJ , Robbins T , et al . Heat Stress and PPE during COVID-19: Impact on health care workers' performance, safety and well-being in NHS settings. J Hosp Infect. 2021 Feb;108:185-188.

Benítez CY, Güemes A, Aranda J,Ribeiro M, Ottolino P, Saverio SD, et al. Impact of Personal Protective Equipment on Surgical Performance During the COVID-19 Pandemic. World J Surg. 2020;44(9):2842-2847. doi:10.1007/s00268-020-05648-2.

Swaminathan R, Mukundadura BP, Prasad S. Impact of enhanced personal protective equipment on the physical and mental well-being of healthcare workers during COVID-19.Postgrad Med J. Published Online First: 03 December 2020. doi: 10.1136/postgradmedj-2020-139150

Morris NB, Piil JF, Christiansen L, Flouris AD, Nybo L. Prolonged facemask use in the heat worsens dyspnea without compromising motor-cognitive performance. Temperature.2020;1-6. https://doi.org/ 10.1080/23328940.2020.1826840.

Agarwal A, Agarwal S, Motiani P .Difficulties encountered while using PPE kits and how to overcome them: an Indian perspective. Cureus 2020 Nov;12(11): e11652. doi:10.7759/cureus.11652.

Lim ECH, Seet RCS, Lee KH, Wilder-Smith EPV, Chuah BYS, Ong BKC. Headaches and the N95 face-mask amongst healthcare providers. Acta Neurologica Scandinavica. 2006;113(3):199–202

Psycho-physiological effects. Technical Specification Part 6: Respiratory Protective Devices – Human Factors (1st Edition 2014). Reference number: ISO/TS 16976-6:2014 (E).

Lockhart SL, Duggan LV, Wax RS, Saad S, Grocott HP. Personal protective equipment (PPE) for both anesthesiologists and other airway managers: principles and practice during the COVID-19 pandemic. Can J Anesth.2020 Aug;67(8): 1005–1015 (2020).https://doi.org/10.1007/s12630-020-01673-w

Scheid JL, Lupien SP, Ford GS, West SL. Commentary: physiological and psychological impact of face mask usage during the COVID-19 pandemic. Int J Environ Res Public Health. 2020 Sep 12;17(18):6655. doi: 10.3390/ijerph17186655.


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