Filtering half-masks, also called filtering facepieces respirators, are widely used in health care to prevent from risks of infection by biohazards. Since the spread of Sars CoV-2 pandemia, these devices have become the daily protective tool employed in hospital practice, necessary and suitable for all intents and purposes. However, to be effective, they have to meet applicable standards and, inter alia, need to fit properly on the face of the operator; as well as be properly worn before performing activities in direct contact with infected patients (in vivo) or biological samples (in vitro). The pandemic context of the past two years, however, has not allowed neither the material nor the time for filtering half-masks’ quantitative fit tests for healthcare workers. Since the emergency phase is temporarily over, it was decided to perform, in collaboration with the “Fondazione I.R.C.C.S. Policlinico San Matteo” in Pavia, a study (first in Italy) on the effective compliance concerning adaptability to the face of FFP2 - FFP3 - KN95 type masks, in addition to the regulatory compliance checks and seal control using dyes already carried out in the last two years in the above-mentioned polyclinic. Thirteen different models of respirators were tested with quantitative fit test protocols (QNFT) on a sample of 25 people, for a total of 309 trials performed. In parallel, Foundation workers were asked to fill in a highly structured questionnaire concerning work-related stress, perception of safety levels during the four pandemic phases, including a section relevant to perceived adequacy of personal protective equipment. The results of the QNFT tests showed serious deficiencies in terms of ergonomics and fit for most of the facepieces tested; moreover these observations did not match with the widespread opinion of the interviewed health workers. Biased perceptions of the effectiveness of filter faces can create a false sense of security, which in hospital is a dangerous source of additional risk. In conclusion, regulatory compliance and filtering half-mask checks - together with health workers training and QNFT programs - are essential to ensure effective levels of biosecurity in hospital. These evaluation procedures help minimize exposure to the risk of infection from biohazards such as Sars CoV-2, protecting health and safety of workers during the provision of diagnostic therapeutic assistance pathways (PDTA) aimed at patients.
Le semimaschere filtranti, anche chiamate facciali filtranti, sono ampiamente utilizzate in ambito sanitario per prevenire il rischio di infezione da alcuni agenti biologici. Dalla diffusione di Sars CoV-2 e la conseguente pandemia, questi dispositivi sono diventati uno strumento di protezione quotidiano impiegato nella pratica ospedaliera. Tuttavia, per essere efficaci, devono rispondere ai requisiti normativi e adattarsi adeguatamente al viso dell’operatore; inoltre, devono essere indossati correttamente prima di svolgere attività a diretto contatto con pazienti infetti (in vivo) o con campioni biologici (in vitro). Il contesto pandemico degli ultimi due anni, però, non ha consentito né il materiale né il tempo per test quantitativi di vestibilità delle semimaschere agli operatori sanitari. Essendo temporaneamente superata la fase emergenziale si è deciso di realizzare, in collaborazione con la "Fondazione I.R.C.C.S. Policlinico San Matteo" di Pavia, uno studio (primo in Italia) sull'effettiva rispondenza in merito all'adattabilità al viso delle maschere di tipo FFP2 - FFP3 - KN95, in aggiunta alle verifiche di conformità normativa e al controllo della tenuta mediante coloranti già effettuate negli ultimi due anni nel suddetto policlinico. Sono stati testati con protocolli di fit test quantitativo (QNFT) tredici modelli diversi di respiratori su un campione di 25 persone, per un totale di 309 prove effettuate. Parallelamente, ai lavoratori della Fondazione è stato chiesto di compilare un questionario altamente strutturato riguardante lo stress lavoro-correlato e la percezione dei livelli di sicurezza durante le quattro fasi della pandemia, compresa una sezione relativa all'adeguatezza percepita dei dispositivi di protezione individuale. I risultati delle prove di QNFT hanno evidenziato gravi carenze in termini di ergonomia e vestibilità per la maggior parte dei facciali testati; in più, queste osservazioni in larga parte non hanno trovato corrispondenza con l'opinione degli operatori sanitari intervistati. Una percezione distorta dell'efficacia dei facciali filtranti può creare un falso senso di sicurezza che è una pericolosa fonte di rischio aggiuntivo in ospedale. In conclusione, la conformità normativa e i controlli delle semimaschere filtranti, insieme alla formazione degli operatori sanitari e ai programmi QNFT, sono essenziali per garantire livelli efficaci di biosicurezza in ospedale. Queste procedure di valutazione aiutano a minimizzare l'esposizione al rischio di infezione da agenti biologici come Sars CoV-2, proteggendo la salute e la sicurezza degli operatori durante l'erogazione dei percorsi diagnostico-terapeutici assistenziali (PDTA) rivolti ai pazienti.
LA TUTELA OCCUPAZIONALE IN FASE PANDEMICA SARS-COV-2 IN POLICLINICO: VERIFICHE QUANTITATIVE DI TENUTA DEI DISPOSITIVI DI PROTEZIONE INDIVIDUALE PER LE VIE RESPIRATORIE E INDAGINI SULLA SICUREZZA PERCEPITA DAGLI OPERATORI NELL’AMBITO DELLA VALUTAZIONE DELLO STRESS LAVORO-CORRELATO
DE TOGNI, CHIARA
2021/2022
Abstract
Filtering half-masks, also called filtering facepieces respirators, are widely used in health care to prevent from risks of infection by biohazards. Since the spread of Sars CoV-2 pandemia, these devices have become the daily protective tool employed in hospital practice, necessary and suitable for all intents and purposes. However, to be effective, they have to meet applicable standards and, inter alia, need to fit properly on the face of the operator; as well as be properly worn before performing activities in direct contact with infected patients (in vivo) or biological samples (in vitro). The pandemic context of the past two years, however, has not allowed neither the material nor the time for filtering half-masks’ quantitative fit tests for healthcare workers. Since the emergency phase is temporarily over, it was decided to perform, in collaboration with the “Fondazione I.R.C.C.S. Policlinico San Matteo” in Pavia, a study (first in Italy) on the effective compliance concerning adaptability to the face of FFP2 - FFP3 - KN95 type masks, in addition to the regulatory compliance checks and seal control using dyes already carried out in the last two years in the above-mentioned polyclinic. Thirteen different models of respirators were tested with quantitative fit test protocols (QNFT) on a sample of 25 people, for a total of 309 trials performed. In parallel, Foundation workers were asked to fill in a highly structured questionnaire concerning work-related stress, perception of safety levels during the four pandemic phases, including a section relevant to perceived adequacy of personal protective equipment. The results of the QNFT tests showed serious deficiencies in terms of ergonomics and fit for most of the facepieces tested; moreover these observations did not match with the widespread opinion of the interviewed health workers. Biased perceptions of the effectiveness of filter faces can create a false sense of security, which in hospital is a dangerous source of additional risk. In conclusion, regulatory compliance and filtering half-mask checks - together with health workers training and QNFT programs - are essential to ensure effective levels of biosecurity in hospital. These evaluation procedures help minimize exposure to the risk of infection from biohazards such as Sars CoV-2, protecting health and safety of workers during the provision of diagnostic therapeutic assistance pathways (PDTA) aimed at patients.È consentito all'utente scaricare e condividere i documenti disponibili a testo pieno in UNITESI UNIPV nel rispetto della licenza Creative Commons del tipo CC BY NC ND.
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https://hdl.handle.net/20.500.14239/15742