A mixed methods study on effectiveness and appropriateness of face shield use as COVID-19 PPE in middle income countries - 28/07/22
, Samantha Hall, BSc Hons b, Mike van der Es, MBA a, Adekemi Sekoni, PhD c, Amy Price, DPhil d, Maria Clara Padoveze, PhD e, Folasade T. Ogunsola, PhD c, Lucia Yasuko Izumi Nichiata, PhD e, Emilio Hornsey, BSc f, Brian Crook, PhD b, Ferla Cirino, MSc g, Larry Chu, MD d, Paul R. Hunter, MB ChB, MBA a
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Highlights |
• | Most face shields tested provided some protection against droplet exposure. |
• | No face shield tested gave full protection against droplet exposure. |
• | Prospective users want facial personal protective equipment that is practical, comfortable, and proven protective. |
• | Face shields that offer maximum droplet protection may hinder good communication. |
• | Many health care workers in middle income countries paid for personal protective equipment out of own pocket. |
Abstract |
Background |
Face shields were widely used in 2020-2021 as facial personal protective equipment (PPE). Laboratory evidence about how protective face shields might be and whether real world user priorities and usage habits conflicted with best practice for maximum possible protection was lacking – especially in limited resource settings.
Methods |
Relative protective potential of 13 face shield designs were tested in a controlled laboratory setting. Community and health care workers were surveyed in middle income country cities (Brazil and Nigeria) about their preferences and perspectives on face shields as facial PPE. Priorities about facial PPE held by survey participants were compared with the implications of the laboratory-generated test results.
Results |
No face shield tested totally eliminated exposure. Head orientation and design features influenced the level of protection. Over 600 individuals were interviewed in Brazil and Nigeria (including 240 health care workers) in March-April 2021. Respondents commented on what influenced their preferred forms of facial PPE, how they tended to clean face shields, and their priorities in choosing a face cover product. Surveyed health care workers commonly bought personal protection equipment for use at work.
Conclusions |
All face shields provided some protection but none gave high levels of protection against external droplet contamination. Respondents wanted facial PPE that considered good communication, secure fixture, good visibility, comfort, fashion, and has validated protectiveness.
El texto completo de este artículo está disponible en PDF.Key words : Droplets, Infection control, Brazil, Nigeria, Respiratory pathogen
Esquema
| Funding/support: This project was primarily funded by the World Health Organization based on a grant from the German Federal Ministry of Health (BMG). Dr. Brainard and Professor Hunter Suppressed were also funded by the National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Emergency Preparedness and Response, a partnership between the UK Health Security Agency, King's College London and the University of East Anglia. The views expressed are those of the author(s) and not necessarily those of the NIHR, UK HSA or the Department of Health and Social Care. Open access of this article is sponsored by the World Health Organization. |
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| Conflicts of interest: Forms from all authors are available. Professor Hunter does many media appearances related to the pandemic but neither this nor activities of any co-author appear to present a relevant Conflict of Interest. |
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| Author contributions: Conceptualization: EH, MCP, FO, PRH, AP, MC. Securing funding: PRH and ME led. Laboratory work and summary: BC and SH led. Protocol development: led by JB. Ethics approval: JB, MCP, ME, FO, AS, EH, LN, FC. Survey writing: EH, JB, MCP, AS. Survey deployment: AS, FO, MCP, EH, FC, LN. Translation to Portuguese: led by MCP. Administration: led by ME, JB, PRH. Survey data analysis: JB, MCP, AS, FO. Writing first draft and assembling revisions: JB. All authors have seen and approve of this submission. |
Vol 50 - N° 8
P. 878-884 - août 2022 Regresar al número
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