Cooling Strategies Can Prevent Overheating While Wearing PPE

By Will Boggs MD

June 22, 2020

NEW YORK (Reuters Health) - The use of personal protective equipment (PPE) can increase the risk of overheating, but several strategies can reduce this risk, researchers in the Netherlands report.

"Cooling strategies can be used prior to, during, or after working activities and could reduce thermal strain, improve thermal discomfort, reduce the cardiovascular strain, and reduce dehydration (i.e. rehydration effect of ice slurry ingestion)," said Dr. Coen C. W. G. Bongers of Radboud University Medical Center, in Nijmegen.

"As a result, healthcare providers (HCP) will be better able to cope with the negative consequences of wearing PPE and work-tolerance times might be extended," he told Reuters Health by email.

Dr. Bongers and colleagues describe thermal regulatory challenges associated with PPE use, along with cooling strategies and their effects, in an infographic in the British Journal of Sports Medicine.

PPE creates a microclimate around the skin that reduces its capacity for heat loss. That, combined with longer shifts, can result in increased core temperature, increased sweat rates and dehydration.

Cooling devices worn under PPE have been shown to decrease the physiological and subjective strain in a simulated hot and humid laboratory environment.

Any cooling strategy must be safe and hygienic, rapidly scalable and accessible for every hospital, and easy to implement in clinical settings.

Two examples of cooling strategies that could be used in clinical settings are cold water/ice slurry ingestion and cooling vests. The type, frequency, and extent of cooling interventions can be optimized depending on the setting, PPE wear time, physical duties and personal preferences.

These cooling strategies can be applied prior to, during and after working activities with PPE, but there is less evidence for the benefits of postcooling compared with precooling and cooling during activities.

"Wearing PPE during COVID-19 medical duties leads to an additional thermal burden for HCP, which could decrease their physical and cognitive performance, but can be easily counteracted by implementing cooling strategies prior to, during, or after working activities," Dr. Bongers said. "The infographic that we developed can help healthcare personnel to implement these strategies into daily practice."

As temperatures rise in the northern hemisphere during summer, he added, "the need to counteract this heat stress proactively using cooling strategies is very important."

SOURCE: British Journal of Sports Medicine, online June 10, 2020.


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