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Biomechanical and physiological evaluation of respiratory protective equipment application

Biomechanical and physiological evaluation of respiratory protective equipment application
Biomechanical and physiological evaluation of respiratory protective equipment application

Purpose: Respiratory protective equipment is widely used in healthcare settings to protect clinicians whilst treating patients with COVID-19. However, their generic designs do not accommodate the variability in face shape across genders and ethnicities. Accordingly, they are regularly overtightened to compensate for a poor fit. The present study aims at investigating the biomechanical and thermal loads during respirator application and the associated changes in local skin physiology at the skin-device interface.

Materials and Methods: Sixteen healthy volunteers were recruited and reflected a range of gender, ethnicities and facial anthropometrics. Four single-use respirators were evaluated representing different geometries, size and material interfaces. Participants were asked to wear each respirator in a random order while a series of measurements were recorded, including interface pressure, temperature and relative humidity. Measures of transepidermal water loss and skin hydration were assessed pre- and post-respirator application, and after 20 minutes of recovery. Statistical analysis assessed differences between respirator designs and associations between demographics, interface conditions and parameters of skin health.

Results: Results showed a statistically significant negative correlation (p < 0.05) between the alar width and interface pressures at the nasal bridge, for three of the respirator designs. The nasal bridge site also corresponded to the highest pressures for all respirator designs. Temperature and humidity significantly increased (p < 0.05) during each respirator application. Significant increases in transepidermal water loss values (p < 0.05) were observed after the application of the respirators in females, which were most apparent at the nasal bridge.

Conclusion: The results revealed that specific facial features affected the distribution of interface pressures and depending on the respirator design and material, changes in skin barrier function were evident. The development of respirator designs that accommodate a diverse range of face shapes and protect the end users from skin damage are required to support the long-term use of these devices.

goodness of fit, interface pressure, physiological response, respiratory protective equipment, skin health
241-252
Caggiari, Silvia
58f49054-6ca6-429b-b499-49b93357e5ba
Bader, Dan L.
06079726-5aa3-49cd-ad71-402ab4cd3255
Foxell, Finn
bcbdb42d-5ae8-4dc5-9389-6f49ef7dee12
Pipe, Nicholas
c9e66d48-a82e-4987-82c4-1f4f7a65c1bc
Couch, Seana
0a3bd379-029f-4b9b-b54d-9e3bd3d17719
Turner, Abbie
3c77ae81-a951-4392-805f-b5fae50f7287
Worsley, Peter R
6d33aee3-ef43-468d-aef6-86d190de6756
Caggiari, Silvia
58f49054-6ca6-429b-b499-49b93357e5ba
Bader, Dan L.
06079726-5aa3-49cd-ad71-402ab4cd3255
Foxell, Finn
bcbdb42d-5ae8-4dc5-9389-6f49ef7dee12
Pipe, Nicholas
c9e66d48-a82e-4987-82c4-1f4f7a65c1bc
Couch, Seana
0a3bd379-029f-4b9b-b54d-9e3bd3d17719
Turner, Abbie
3c77ae81-a951-4392-805f-b5fae50f7287
Worsley, Peter R
6d33aee3-ef43-468d-aef6-86d190de6756

Caggiari, Silvia, Bader, Dan L., Foxell, Finn, Pipe, Nicholas, Couch, Seana, Turner, Abbie and Worsley, Peter R (2022) Biomechanical and physiological evaluation of respiratory protective equipment application. Medical Devices: Evidence and Research, 15, 241-252. (doi:10.2147/MDER.S370142).

Record type: Article

Abstract

Purpose: Respiratory protective equipment is widely used in healthcare settings to protect clinicians whilst treating patients with COVID-19. However, their generic designs do not accommodate the variability in face shape across genders and ethnicities. Accordingly, they are regularly overtightened to compensate for a poor fit. The present study aims at investigating the biomechanical and thermal loads during respirator application and the associated changes in local skin physiology at the skin-device interface.

Materials and Methods: Sixteen healthy volunteers were recruited and reflected a range of gender, ethnicities and facial anthropometrics. Four single-use respirators were evaluated representing different geometries, size and material interfaces. Participants were asked to wear each respirator in a random order while a series of measurements were recorded, including interface pressure, temperature and relative humidity. Measures of transepidermal water loss and skin hydration were assessed pre- and post-respirator application, and after 20 minutes of recovery. Statistical analysis assessed differences between respirator designs and associations between demographics, interface conditions and parameters of skin health.

Results: Results showed a statistically significant negative correlation (p < 0.05) between the alar width and interface pressures at the nasal bridge, for three of the respirator designs. The nasal bridge site also corresponded to the highest pressures for all respirator designs. Temperature and humidity significantly increased (p < 0.05) during each respirator application. Significant increases in transepidermal water loss values (p < 0.05) were observed after the application of the respirators in females, which were most apparent at the nasal bridge.

Conclusion: The results revealed that specific facial features affected the distribution of interface pressures and depending on the respirator design and material, changes in skin barrier function were evident. The development of respirator designs that accommodate a diverse range of face shapes and protect the end users from skin damage are required to support the long-term use of these devices.

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More information

Accepted/In Press date: 15 June 2022
Published date: 26 July 2022
Additional Information: © 2022 Caggiari et al.
Keywords: goodness of fit, interface pressure, physiological response, respiratory protective equipment, skin health

Identifiers

Local EPrints ID: 468879
URI: http://eprints.soton.ac.uk/id/eprint/468879
PURE UUID: ad204441-5f5e-4f0d-a0b3-a0099521f25d
ORCID for Silvia Caggiari: ORCID iD orcid.org/0000-0002-8928-2141
ORCID for Peter R Worsley: ORCID iD orcid.org/0000-0003-0145-5042

Catalogue record

Date deposited: 31 Aug 2022 16:43
Last modified: 30 Sep 2022 02:02

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Contributors

Author: Silvia Caggiari ORCID iD
Author: Dan L. Bader
Author: Finn Foxell
Author: Nicholas Pipe
Author: Seana Couch
Author: Abbie Turner
Author: Peter R Worsley ORCID iD

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