COVID-19 pandemisi sırasında 4 ve 8 saatlik vardiyalarda cerrahi yüz maskesi ile çalışan sağlık personelinde fizyolojik değişiklikler ve maskeye bağlı rahatsızlıklar.

Yıl 2023, Cilt: 9 Sayı: 1, 1 - 6, 01.01.2023

Hulya Dirol , Turbat Amiraslanov Ege Alkan

https://doi.org/10.53394/akd.956415

Öz

Amaç: Yüz maskelerinin rahatsız edici etkileri psikolojik etkinin ötesinde olabilir ve sağlık personelinin sağlığını tehlikeye atabilir. Bu çalışmada, 4 ve 8 saatlik vardiyalı cerrahi yüz maskesi ile çalışan sağlık personelinde maskeye bağlı psikolojik ve fizyolojik değişiklikleri saptamaktır.
Yöntem: Çalışma, Ocak-Mart 2021 tarihleri arasında 102 sağlık çalışanı ile üçüncü basamak bir hastanede gerçekleştirildi. Kalp/akciğer hastalığı olan veya halen sigara içen kişiler çalışma dışı bırakıldı. Katılımcıların vücut ısısı, solunum/kalp hızı, kan basıncı, parmak ucu oksijen doygunluğu (SpO2) ölçümleri ve maske-rahatsızlık anketi vardiya başında, ortasında ve sonunda yapıldı.
Bulgular: Araştırmaya katılan 102 gönüllünün 63'ü (%61,8) kadın olup, yaş ortalaması 30,92 ± 6,38'dir. En rahatsız edici maske rahatsızlığı, vardiya ortasında direnç ve vardiya sonunda yorgunluktu. Anketteki tüm parametrelerin puanları hem vardiya ortasında hem de vardiya sonunda başlangıca göre anlamlı olarak daha yüksekti (tüm parametreler için p=0,000). Vardiya sonunda nem, direnç, sıcaklık, tuzluluk, koku ve yorgunluk puanlarında vardiya ortasına göre anlamlı artışlar vardı (p=0,001, p=0,023, p=0,024, p=0,022, p=0,013 ve p <0,000, sırasıyla). Sıcaklık, kan basıncı, kalp ve solunum hızı, vardiyanın ortasında, başlangıca kıyasla önemli ölçüde artarken (tümü için p<0,001) SpO2 önemli ölçüde azaldı (p=0,003). Diyastolik kan basıncı dışındaki tüm parametreler, vardiya sonunda başlangıca göre önemli değişiklikler gösterdi. Ancak, orta vardiyada ve son vardiyada parametrelerde anlamlı bir fark yoktu.
Sonuç: Çalışmamız cerrahi yüz maskeleri ile çalışan sağlık personelinde önemli fizyolojik etkiler ve maskeye bağlı rahatsızlıkları ortaya çıkarmıştır.

Anahtar Kelimeler

Cerrahi maskeler, Fizyoloji, Sağlık Personeli, Psikolojik yan etkiler

Physiological changes and mask-related discomforts in healthcare personnel working with surgical face masks at 4-hour and 8-hour shifts during the COVID-19 pandemic.

Öz

Objective: Disturbing effects of face masks may be beyond the psychological effect and may endanger healthcare personnel's health. Based on this theory, here, we investigated the mask-related psychological and physiological changes in healthcare personnel working with a surgical face mask for a 4 and 8-hour shift.
Method: The study was conducted in a tertiary hospital with 102 healthcare-worker between January-March 2021. Individuals with heart/lung disease or current smokers were excluded. Body temperature, respiratory/heart rate, blood pressure, fingertip oxygen-saturation (SpO2) measurements of participants, and the mask-discomfort questionnaire were performed at the beginning, mid and end-shift.
Results: Of the 102 volunteers participating in the study, 63 (61,8%) were women and the mean age was 30,92 ± 6,38. The most disturbing mask discomfort was resistance at mid-shift and fatigue at end-shift. The scores of all parameters in the questionnaire were significantly higher at both mid-shift and end-shift compared to the beginning (p=0,000, for all parameters). There were significant increases in scores of humidity, resistance, temperature, salinity, smell, and fatigue at end-shift compared to mid-shift (p=0,001, p=0,023, p=0,024, p=0,022, p=0,013 and p<0,000, respectively). Temperature, blood pressure, heart, and respiratory rate increased significantly (p<0.001, for all) at mid-shift compared to the beginning, while SpO2 decreased significantly (p=0.003). All parameters except diastolic blood pressure showed significant changes at end-shift compared to the beginning. However, there was no significant difference in parameters at mid-shift and at end-shift.
Conclusion: Our study revealed significant physiological effects and mask-related discomforts in healthcare personnel working with surgical face masks.

Anahtar Kelimeler

Surgical masks, Physiology, Health Personnel, Psychological Side Effects

Kaynakça

• References: 1. Pal M, Berhanu G, Desalegn C, Kandi V. Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2): An Update. Cureus. 2020;12(3): e7423.
• 2. Dhand R, Li J. Coughs and Sneezes: Their Role in Transmission of Respiratory Viral Infections, Including SARS-CoV-2. 2020;202(5):651-9.
• 3. Lee HP, Wang de Y. Objective assessment of increase in breathing resistance of N95 respirators on human subjects. Ann Occup Hyg. 2011;55(8):917-21.
• 4. Zhu JH, Lee SJ, Wang D, Lee HPJJol, pulmonary, research r. Effects of Long-Duration Wearing of N95 Respirator and Surgical Facemask: A Pilot Study. 2014;1.
• 5. Fikenzer S, Uhe T, Lavall D, Rudolph U, Falz R, Busse M, et al. Effects of surgical and FFP2/N95 face masks on cardiopulmonary exercise capacity. Clinical Research in Cardiology. 2020;109(12):1522-30.
• 6. Ciocan C, Clari M, Fabbro D, De Piano ML, Garzaro G, Godono A, et al. Impact of wearing a surgical mask on respiratory function in view of a widespread use during COVID-19 outbreak. A case-series study. La Medicina del lavoro. 2020;111(5):354-64.
• 7. Nadel ER, Mitchell JW, Stolwijk JA. Differential thermal sensitivity in the human skin. Pflugers Archiv: European journal of physiology. 1973;340(1):71-6.
• 8. Nakamura M, Yoda T, Crawshaw LI, Kasuga M, Uchida Y, Tokizawa K, et al. Relative importance of different surface regions for thermal comfort in humans. European journal of applied physiology. 2013;113(1):63-76.
• 9. Stevens JC, Choo KK. Temperature sensitivity of the body surface over the life span. Somatosensory & motor research. 1998;15(1):13-28.
• 10. Enerson DM, Eisenfeld LI, Kajikuri H. Heat and moisture trapping beneath surgical face masks: a consideration of factors affecting the surgeon's discomfort and performance. Surgery. 1967;62(6):1007-16.
• 11. Scarano A, Inchingolo F, Lorusso F. Facial Skin Temperature and Discomfort When Wearing Protective Face Masks: Thermal Infrared Imaging Evaluation and Hands Moving the Mask. International journal of environmental research and public health. 2020;17(13).
• 12. Lässing J, Falz R, Pökel C, Fikenzer S, Laufs U, Schulze A, et al. Effects of surgical face masks on cardiopulmonary parameters during steady state exercise. Scientific Reports. 2020;10(1):22363.
• 13. Harms CA, Wetter TJ, McClaran SR, Pegelow DF, Nickele GA, Nelson WB, et al. Effects of respiratory muscle work on cardiac output and its distribution during maximal exercise. Journal of applied physiology (Bethesda, Md: 1985). 1998;85(2):609-18.
• 14. Laird IS, Goldsmith R, Pack RJ, Vitalis A. The effect on heart rate and facial skin temperature of wearing respiratory protection at work. Ann Occup Hyg. 2002;46(2):143-8.
• 15. Cheyne WS, Harper MI, Gelinas JC, Sasso JP, Eves ND. Mechanical cardiopulmonary interactions during exercise in health and disease. Journal of applied physiology (Bethesda, Md: 1985). 2020;128(5):1271-9.
• 16. Convertino VA, Cooke WH, Lurie KG. Inspiratory resistance as a potential treatment for orthostatic intolerance and hemorrhagic shock. Aviation, space, and environmental medicine. 2005;76(4):319-25.
• 17. Ryan KL, Cooke WH, Rickards CA, Lurie KG, Convertino VA. Breathing through an inspiratory threshold device improves stroke volume during central hypovolemia in humans. Journal of applied physiology (Bethesda, Md: 1985). 2008;104(5):1402-9.
• 18. Beder A, Büyükkoçak U, Sabuncuoğlu H, Keskil ZA, Keskil S. Preliminary report on surgical mask induced deoxygenation during major surgery. Neurocirugia (Asturias, Spain). 2008;19(2):121-6.
• 19. Melnikov VN, Divert VE, Komlyagina TG, Consedine NS, Krivoschekov SG. Baseline values of cardiovascular and respiratory parameters predict response to acute hypoxia in young healthy men. Physiological research. 2017;66(3):467-79.