A national survey to evaluate the thermal stress associated with personal protective equipment among healthcare workers during the COVID-19 pandemic in Italy.

The humanity is facing the most severe pandemic since the “Spanish flu” back in 1918. The situation is particularly critical especially to the health sectors and all the workers involved. The conditions for healthcare workers are exacerbated by the additional stress imposed on the body due to the personal protective equipment (PPE) worn to keep them safe from COVID-19 which may increase the chances of hyperthermia and amplifying the health risk and work productivity loss. In order to investigate the thermal effects of PPE on healthcare workers during the COVID-19 pandemic, an online survey was carried out in Italy during the warm season (May-October) of 2020 as part of WORKLIMATE project funded by the Italian Institute for Insurance against Accidents at Work. The primary aim of the study was to assess the thermal impact of COVID-19-PPE of healthcare workers engaged in different activities. In addition, information regarding the types of PPE worn, the potential loss of work productivity and the behaviors carried out to reduce heat strain during the work shift, were also collected. A total of 191 questionnaires were collected: hospital doctors (38%), nurses (33%), intensive care doctors and anesthetists (9%), other specialization (20%). About four out of five (78%) of workers declared they perceived heat stress in the areas covered by the PPE and an increase in thirst (58%), sweating (70%), tiredness (46%), headache (43%), general distress (52%), skin reaction (27%) and difficulty concentrating (29%). 54% of workers also stated there is no area to rest in which to remove PPE. Additionally, 81% of workers declared they also perceived productivity loss. The information obtained by this survey could be particularly useful to allow appropriate measures for managing heat stress and therefore protecting the health of these workers and improving their work productivity while maintaining the anti-COVID-19 measures.