Heat Stress and Thermal Perception amongst Healthcare Workers during the COVID-19 Pandemic in India and Singapore

• Published in: International journal of environmental research and public health 2020-11, Vol.17 (21), p.8100
• Main Authors: Lee, Jimmy, Venugopal, Vidhya, Latha, P K, Alhadad, Sharifah Badriyah, Leow, Clarence Hong Wei, Goh, Nicholas Yong De, Tan, Esther, Kjellstrom, Tord, Morabito, Marco, Lee, Jason Kai Wei
• Format: Article
• Language: English
• Subjects: Adult; Air conditioning; Best practice; Betacoronavirus; Coronavirus Infections; Coronaviruses; COVID-19; Disease transmission; Female; Fever; Health care; Health Knowledge, Attitudes, Practice; Health Personnel; Heat; Heat stress; Heat tolerance; Hospitals; Hot Temperature; Humans; India - epidemiology; Ingestion; Male; Median (statistics); Medical personnel; Medical schools; Medical supplies; Pain perception; Pandemics; Personal Protective Equipment; Pneumonia, Viral; Printed materials; Protective equipment; Questionnaires; SARS-CoV-2; Singapore - epidemiology; Slurries; Stress, Physiological; Surveys and Questionnaires; Sweating; Temperature effects; Thermal stress; Thirst; Variables
• ISSN: 1660-4601; 1661-7827; 1660-4601
• DOI: 10.3390/ijerph17218100

The need for healthcare workers (HCWs) to wear personal protective equipment (PPE) during the coronavirus disease 2019 (COVID-19) pandemic heightens their risk of thermal stress. We assessed the knowledge, attitudes, and practices of HCWs from India and Singapore regarding PPE usage and heat stress when performing treatment and care activities. One hundred sixty-five HCWs from India ( = 110) and Singapore ( = 55) participated in a survey. Thirty-seven HCWs from Singapore provided thermal comfort ratings before and after ice slurry ingestion. Differences in responses between India and Singapore HCWs were compared. A -value cut-off of 0.05 depicted statistical significance. Median wet-bulb globe temperature was higher in India (30.2 °C (interquartile range [IQR] 29.1-31.8 °C)) than in Singapore (22.0 °C (IQR 18.8-24.8 °C)) ( < 0.001). Respondents from both countries reported thirst ( = 144, 87%), excessive sweating ( = 145, 88%), exhaustion ( = 128, 78%), and desire to go to comfort zones ( = 136, 84%). In Singapore, reports of air-conditioning at worksites ( = 34, 62%), dedicated rest area availability ( = 55, 100%), and PPE removal during breaks ( = 54, 98.2%) were higher than in India ( = 27, 25%; = 46, 42%; and = 66, 60%, respectively) ( < 0.001). Median thermal comfort rating improved from 2 (IQR 1-2) to 0 (IQR 0-1) after ice slurry ingestion in Singapore ( < 0.001). HCWs are cognizant of the effects of heat stress but might not adopt best practices due to various constraints. Thermal stress management is better in Singapore than in India. Ice slurry ingestion is shown to be practical and effective in promoting thermal comfort. Adverse effects of heat stress on productivity and judgment of HCWs warrant further investigation.