Poor personal protective equipment practices were associated with heat-related symptoms among Asian healthcare workers: a large-scale multi-national questionnaire survey
Hsiao-Yu Yang,
Hsiu-Ling Chou,
Clarence Hong Wei Leow,
Ching-Chiu Kao,
D. Daniel,
Vena Jaladara,
Levina Chandra Khoe,
P K Latha,
Yodi Mahendradhata,
Phuong Minh Nguyen,
Rujipas Sirijatuphat,
Dewi Sumaryani Soemarko,
Vidhya Venugopal,
Kai Zhang,
Jason Kai Wei Lee
Affiliations
Hsiao-Yu Yang
Institute of Environmental and Occupational Health Sciences, National Taiwan University College of Public Health
Hsiu-Ling Chou
Department of Nursing, Asia Eastern University of Science and Technology
Clarence Hong Wei Leow
Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore
Ching-Chiu Kao
Department of Nursing, Wan Fang Hospital, Taipei Medical University
D. Daniel
Department of Health Behaviour, Environment and Social Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada
Vena Jaladara
Department of Health Behaviour, Environment and Social Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada
Levina Chandra Khoe
Department of Community Medicine, Faculty of Medicine, Universitas Indonesia
P K Latha
Sri Ramachandra Institute of Higher Education & Research
Yodi Mahendradhata
Center for Tropical Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada
Phuong Minh Nguyen
Department of Military Occupational Medicine, Vietnam Military Medical University
Rujipas Sirijatuphat
Division of Infectious Diseases and Tropical Medicine, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University
Dewi Sumaryani Soemarko
Department of Community Medicine, Faculty of Medicine, Universitas Indonesia
Vidhya Venugopal
Sri Ramachandra Institute of Higher Education & Research
Kai Zhang
Department of Environmental Health Sciences, School of Public Health, University at Albany, State University of New York
Jason Kai Wei Lee
Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore
Abstract Background It is pertinent to understand the perceptions of healthcare workers (HCWs) with their associated personal protective equipment (PPE) usage and heat strain symptoms experienced to effectively combat the negative effects of heat stress during treatment and care activities. Methods We evaluated the associated heat stress perceived by HCWs across Asia and validated a questionnaire on perceptions of heat stress, associated PPE usage, and heat strain symptoms experienced. The questionnaire was administered to 3,082 HCWs in six Asian regions. Factor analyses, including Cronbach’s alpha, assessed the questionnaire’s validity and reliability. Structural equation modelling analysed the effects of knowledge, attitudes and practices, and heat strain symptoms. Results The questionnaire was found to be reliable in assessing HCWs’ knowledge, and attitudes and practices towards heat stress and PPE usage (both Cronbach’s alpha = 0.9), but not heat strain symptoms (Cronbach’s alpha = 0.6). Despite knowledge of heat stress, HCWs had negative attitudes and practices regarding PPE usage (β1 = 0.6, p < 0.001). Knowledge (path coefficient = 0.2, p < 0.001), and negative attitudes and practices (path coefficient = 0.2, p < 0.001) of HCWs towards heat stress and PPE usage adversely affected symptoms experienced. Conclusions The questionnaire was not reliable in assessing symptoms. HCWs should, nevertheless, still self-assess their symptoms for early detection of heat strain. To effectively attenuate heat strain, understanding HCWs’ attitudes and practices towards PPE usage should guide policymakers in implementing targeted heat management strategies.
