Discussion
critically ill, thirst, cognitive and motor function, impaired short-term memory and motor function
HEAT, CRITICALLY ILL
This study quantified the heat stress associated with wearing aerosol PPE in a simulated hospital environment and examined its impact on mood, cognitive and motor function, and task performance. Wearing aerosol PPE resulted in heat exhaustion and negatively impacted mood, grip strength and task performance.The changes in core temperature demonstrate that wearing aerosol PPE is a heat stress. The increase followed by plateau in core temperature during the control visit is an expected consequence of exercise and is caused by a transient heat imbalance [Both PPE and heat stress negatively impact mood, motor and cognitive function, and task performance. It is important, therefore, to separate the effects of wearing aerosol PPE, which occur immediately after donning PPE (pre-exercise), from the effects of the heat stress, which occur after wearing PPE for a period of time (post-exercise) [Collectively, the results demonstrate that wearing aerosol PPE for 2 h results in heat exhaustion (core temperature >38°C, heart rate >100 bpm, excessive sweating and thirst, impaired short-term memory and motor function) [This study has potential implications for healthcare workers, healthcare organizations and PPE manufacturers. The use of aerosol PPE is likely to remain commonplace for the foreseeable future. Whilst the use of aerosol PPE is essential in many circumstances, this study demonstrates objectively that its use has side-effects which could impact negatively on healthcare workers’ well-being and performance. As many of these negative effects are time-dependent and reversible, healthcare organizations should consider limiting the time healthcare workers spend wearing aerosol PPE without breaks. Additionally, as participants are not always aware of performance decrements, this study supports the usage of ‘buddy’ systems which enable healthcare workers to check on each other when wearing aerosol PPE [A limitation of this study is its generalizability. The study was conducted in a human performance laboratory and the participants were neither healthcare workers nor heat acclimatized. Whilst it is impossible to recreate in a laboratory the emotional strain of caring for critically ill patients, it is possible to recreate the thermal conditions [In conclusion, this study is the first to quantify the heat stress associated with aerosol PPE usage and to objectively evaluate its impact on mood, motor and cognitive function, and task performance. The results demonstrate that wearing aerosol PPE results in heat exhaustion and negatively impacts mood, motor function and task performance. Aerosol PPE usage is likely to remain prevalent in the future; therefore, strategies should be developed to mitigate its impact.