| Methods |
Retrospective cohort survey carried out in Singapore to assess the harm associated with the use of the personal protective equipment in healthcare staff working in a “SARS‐designated hospital” from March 2003 to middle 2004. Three departments from the hospital were surveyed the National Skin Centre (NSC), Department of Emergency (A&E) and the intensive care unit (ICU)
Control group: unclear
Control group: none |
| Participants |
340 healthcare staff were surveyed, 322 responded (60 from the NSC, 77 from the TTSH A&E, and 185 from the TTSH ICU) |
| Interventions |
Use of personal protective equipment (PPE), namely, masks, gloves and gowns. Adverse skin reactions to PPE |
| Outcomes |
Laboratory: none
Effectiveness: not applicable
Safety: adverse skin reactions (ASR) from the use of 3 types of PPE (masks (respirator, surgical or paper masks), plastic gloves and disposable gowns) developed with prolonged use (8.4, 9.4 and 8.8 months, respectively) |
| Notes |
The authors conclude that prolonged use of PPEs (N95 respirators, rubber gloves) is associated with high frequency of ASR. The authors reported that there were no significant differences in adverse skin reactions to masks and gloves due to sex, race or profession. Some differences were reported by age as follows:
• Those who developed acne with masks were younger (mean of 29.5 years) compared with those who did not (mean of 33.2; P < 0.001)
• Those who developed dry skin with gloves were younger (mean of 28.7 years) compared with those who did not (mean of 33.2; P < 0.002)
• Those who developed itch with gloves were younger (mean of 29.5 years) compared with those who did not (mean of 33.2; P < 0.001)
Survey results show that acne, itch and rash are the most common harms reported after wearing a N95 respirator (59.6%, 51.4% and 35.8%) and that dry skin, itch and rash were reported by (73.4%, 56.3% and 37.5%, respectively) glove users. Other harms were reported by very small numbers of users (4 or below). This study, although a retrospective survey is important as it suggests that barrier intervention‐using carries harms and such harms may affect compliance with the intervention |
| Risk of bias |
| Bias |
Authors' judgement |
Support for judgement |
| Random sequence generation (selection bias) |
Unclear risk |
N/A |
| Allocation concealment (selection bias) |
Unclear risk |
N/A |
| Blinding (performance bias and detection bias)
All outcomes |
Unclear risk |
N/A |
| Incomplete outcome data (attrition bias)
All outcomes |
Unclear risk |
N/A |
| Selective reporting (reporting bias) |
Unclear risk |
N/A |
