Human Factor Considerations in Using Personal Protective Equipment in the COVID-19 Pandemic Context: Binational Survey Study

• Published in: Journal of medical Internet research 2020-06, Vol.22 (6), p.e19947-e19947
• Main Authors: Parush, Avi, Wacht, Oren, Gomes, Ricardo, Frenkel, Amit
• Format: Article
• Language: English
• Subjects: Betacoronavirus - pathogenicity; Coronavirus Infections - prevention & control; COVID-19; Humans; Infectious Disease Transmission, Patient-to-Professional - prevention & control; Original Paper; Pandemics - prevention & control; Personal Protective Equipment - standards; Pneumonia, Viral - prevention & control; SARS-CoV-2
• ISSN: 1438-8871; 1439-4456; 1438-8871
• DOI: 10.2196/19947

Full level 1 personal protective equipment (PPE) is used in various domains and contexts. Prior research has shown influences of such equipment on performance, comfort, and contamination levels. The coronavirus disease (COVID-19) pandemic forced a pervasive requirement of PPE, with little preparation, rushed deployment, inadequate time for training, and massive use by personnel who are inexperienced or not qualified in its effective use. This study aims to examine the key human factors (physical and ergonomic, perceptual and cognitive) that influence the use of level 1 PPE when attending to patients with suspected or confirmed COVID-19. The research approach consisted of a short survey disseminated to health care professionals in two countries, Israel and Portugal, with similar demographics and health care systems. The survey included 10 items with a 5-point Likert scale regarding the key human factors involved in level 1 PPE, as identified in prior research. A total of 722 respondents from Israel and 301 respondents from Portugal were included in the analysis. All the respondents reported using level 1 PPE with patients with COVID-19 in the range of several hours daily to several hours weekly. The Cronbach α was .73 for Israel and .75 for Portugal. Responses showed high levels of difficulty, with medians of 4 for items related to discomfort (n=539/688, 78% in Israel; n=328/377, 87% in Portugal), hearing (n=236/370, 64% in Portugal; n=321/642, 50% in Israel), seeing (n=697/763, 89% in Israel; n=317/376, 84% in Portugal), and doffing (n=290/374, 77% in Portugal; n=315/713, 44% in Israel). A factor analysis showed a set of strongly related variables consisting of hearing, understanding speech, and understanding the situation. This suggests that degradation in communication was strongly associated with degradation in situational awareness. A subsequent mediation analysis showed a direct effect of PPE discomfort on situational awareness (P