الفهرس 
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Abstract
The increased rate of nosocomial transmission of COVID-19 across the world necessitates all health institutions to ensure effective implementation of infection prevention and control precautions .
The CDC recommended that health care professionals stick to infection control guidelines (N95 masks, eye protection (goggles or face shields), gloves, and gowns) to protect against COVID-19. It is especially recommended that N95 masks be worn during aerosol-generating procedures such as intubation, extubation, and related procedures as well as manual ventilation and open suctioning of the respiratory tract.
HCWs have experienced various physical health problems associated with the use of PPE; affecting the skin, respiratory, musculoskeletal, nervous, urinary, and circulatory systems. Skin problems were the most frequent ones. PPE included surgical or medical masks, N95 masks, gowns, gloves, glasses, face shields, visor, filtering face piece, and goggles to prevent COVID19 in the workplace.
The aim of the present study was to explore the adverse physical health problems and skin reactions caused by the use of PPEs among Intensive Care Unit Healthcare Professionals during the COVID-19 Pandemic in a governmental hospital in Alexandria.
This study included hundred health care professionals (physicians & nurses)., from whom data was collected using (questionnaire) through random visits.
In the present study, 100 health care practitioners working in intensive care unit were included. The majority of respondents were females 62%, 38%.were males. The study groups include 15 physicians, out of them: 9 were males and 6 females. The majority of them 60%were in the age group (30-39 yrs.), meanwhile nurses (faculty of nursing) included 54 nurses, out of them; 32 were females and 22 were males.The majority of the studied group 51.9% were in the age group (30-39 yrs.). while, the institute nurses included 31 health care practitioners, out of them:24 were females and 7 were males. The majority of them were in the age group (30-39).
One hundred percent of physician reported that they had their knowledge about covid-19 from hospital training program,46.7% from CDC &WHO,and 20% from internet websites other than CDC&WHO.Meanwhile, nurses(faculty of nursing) reported that : 98.1%of them gathered their knowledge from hospital training program, 40,7% from internet websites other than CDC & WHO, 35.2% from CDC & WHO and 13% from television. On the other hand, institute nurses reported that: 96.8% had their knowledge from hospital training program, 32.3% from internet websites other than CDC & WHO, 16.1% from television and 6.5% from CDC& WHO. There has been a statistically significant difference between the different study groups regarding the source of knowledge only with CDC & WHO (P=0.004).
All of respondents (physicians and nurses) reported that they had the experience of treating & caring of patients with covid-19. Moreover, all of physicians and nurses (faculty of nursing) reported having knowledge about the risks of covid-19 pandemic, only 93.5% of institute nurses reported that they understand and know the risks of covid-19 pandemic.
Ninety eight percent of respondents reported that they understand the risks ofcovid-19 pandemic for the patients and healthcare workers. Meanwhile, All the participants reported that they know the mode of transmission of covid-19 virus, know how to protect themselves & others from gaining covid-19 infection &that the use of PPE will keep healthcare workers from getting covid-19 infection, know the recommended PPE should be used when taking care for patients with covid-19 infection and have correct knowledge about the components of PPE.There was no statistically significant difference between the different study groups regarding the knowledge about the covid-19 pandemic.
Regarding the practice of health care professionals, this study show that 77% of respondents reported that all recommended PPE were readily available in the ICU otherwise 23% reported that it was not readily available all the time. All respondents performed Hand hygiene either washing hands with soap and water, or the use of an alcohol-based hand rub before & after caring for patients with covid-19, the respondents compliance to recommended PPE during treatment and/or care of patients with covid-19 was: 4% for 60% compliance, 51% for 70% compliance, 42% for 80% compliance, 1% for 90% compliance & 2% for 100%. All these practices had shown no statistically significant difference between the studied groups.
In the current study, it was be found that the overall prevalence of physical adverse events among HCWs was very high, as 100% of the respondents had an experience of adverse effects as a result of PPE use. The most common adverse effects reported by the respondents were: from using of masks, nasal bridge scar 89%, breathing difficulty 86%, ear pain 70%, voice disorders 35%, rash 21%, acne 15%, and facial itching 6%. Moreover, the reported adverse effects resulting from using latex gloves were allergy/dermatitis 95%, skin rash 45% followed by itching 24%, device like mark 13%, skin dryness 12%, edema 7% and skin soaked with sweat 3%. On the other hand, the adverse effects of goggles/face shield use were headache 91% followed by blurred vision 61%, device like mark 14%, fogging 3%, redness zygoma/forehead 1% and burning pain 1%. Concurrently, the most common of gowns adverse effects was heat 90%, followed by itching 3%. At the same time, the most common adverse effects of boots using reported by the respondents was heat 91% followed by itching 7%, device like mark 1% and dryness of skin 1%.
The most frequent adverse effects due to mask use were nasal bridge scar 89%in the study group: 93.3% of physicians, 88.9% of nurses (faculty of nursing) and 87.1% of institute nurses, followed by difficulty of breathing 86%; 86.7% of physicians, 85.2% of nurses (faculty of nursing) and 87.1 of institute nurses.. Seventy percent of respondents reported ear pain;:66.7% of physicians,66.7% of nurses (faculty of nursing) and 87.1% of institute nurses. Meanwhile, the incidence of voice disorders was 35%: 40% of physicians, 35.2% of nurses (faculty of nursing) and 32.3% of nurses in institute, skin rash was reported in 21% of respondents: 26.7% of physicians, 20.4% of nurses (faculty of nursing) and 19.4% of institute nurses. Acne was reported in 15% of the study group: 13,3% of physicians, 14,8% of nurses (faculty of nursing) and 16.1% of institute nurses & facial itching was reported in 6% of the respondents : 9.3% of nurses (faculty of nursing) and 3.2% of institute nurses. Otherwise, none of the physicians reported facial itching due to using masks.None of the studied groups reported the experience of having dry skin or skin desquamation due to the use of mask (surgical mask and N 95). There was no statistically significant difference between the different study groups regarding the adverse effects of mask using.
The most common adverse reactions to wearing latex gloves in this study were allergy/ dermatitis 95% followed by rash of the hand 45%,, itching 24%,device like mark 13%,skin dryness 12%,edema 7% and skin soaked with sweat 3%., 93.3% of physicians had allergy / dermatitis when using latex gloves meanwhile, 96.3% of nurses (faculty of nursing) and 93.5% of institute nurses had allergy/dermatitis that was the most frequent side effects reported by the studied groups.in the same time, 33.3% of physicians reported rash while, 42.6% of nurses (faculty of nursing) and 54.8% of institute nurses had rash resulting from using of latex gloves. None of the studied groups reported wheals or injury/skin breakdown regarding the use of latex gloves. These side effects had shown no statistically significant difference among studied groups regarding the side effects due to use of latex gloves.
In this study, it was be found that 94% of respondents reported that they had adverse effects with goggles /face shield: 100% of physicians, 90.7% of nurses (faculty of nursing) and 96.8% of institute nurses. The most common symptoms associated with the use of goggles/face shield were headache 91%: 100% of physicians, 88.9% of nurses (faculty of nursing) and 90.3% of institute nurses, blurred vision 61% : 66.7% of physicians, 59.3% of nurses (faculty of nursing) and 61.3% of institute nurses. followed by device like mark 14%: 13.3% of physicians, 14.8% of nurses (faculty of nursing) and 12.9% of nurses in institute, fogging 3%: 6.7% of physicians, 1.9% of nurses (faculty of nursing) and 3.2% of institute nurses, redness zygoma/forehead 1%: 1.9% of nurses (faculty of nursing) and burning pain 1% only: 1.9% of nurses (faculty of nursing). Neither physicians nor institute nurses had an experience of redness zygoma/forehead and burning pain. There was no statistically significant difference between the different study groups regarding the adverse effects of goggles/face shield use.
In this study, it was be found that 90% 0f the studied groups had side effects due to the use of Gowns 86.7% of physicians, 88.9% of nurses (faculty of nursing) and 93.5% of institute nurses, as body heat 90% was that most frequently side effect and 3% only reported itching.88.7% of physicians, 88.9% of nurses (faculty of nursing) and 93.5% of institute nurses reported body heat as a main side effect of using gowns during patient care. On the other hand, only 1.9% of nurses (faculty of nursing) and 6.5% of institute nurses had itching when using gown. None of the studied groups reported dryness of skin or rash. These results show no statistically significant difference among the studied groups regarding the side effects when using gowns..
In the current study, it was be found that, 91% of the studied groups had adverse effects due to use of boots: 100% of physicians, 88.9% of nurses (faculty of nursing) and 90.3% of institute nurses. The most common side effect is heat in 91%, followed by itching 7%, device like mark 1% and dryness of skin 1%. These results show no statistically significant difference between the different study groups.