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Heat Stress and Thermal Perception amongst Healthcare Workers during the COVID-19 Pandemic in India and Singapore

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Ng Teng Fong General Hospital, Singapore 609606, Singapore
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Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu 600116, India
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AMET University, Chennai, Tamil Nadu 603112, India
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NUS Graduate School for Integrative Sciences and Engineering, National University of Singapore, Singapore 119077, Singapore
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Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117593, Singapore
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Saw Swee Hock School of Public Health, National University of Singapore, Singapore 117549, Singapore
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Human Potential Translational Research Programme, National University of Singapore, Singapore 119228, Singapore
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Health and Environment International Trust, Nelson 7005, New Zealand
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National Centre for Epidemiology and Population Health, Australian National University, Canberra 2601, Australia
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Institute of BioEconomy, National Research Council, 50019 Florence, Italy
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Centre of Bioclimatology, University of Florence, 50144 Florence, Italy
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N.1 Institute for Health, National University of Singapore, Singapore 117456, Singapore
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Global Asia Institute, National University of Singapore, Singapore 119076, Singapore
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Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2020, 17(21), 8100; https://doi.org/10.3390/ijerph17218100
Received: 29 September 2020 / Revised: 20 October 2020 / Accepted: 31 October 2020 / Published: 3 November 2020
The need for healthcare workers (HCWs) to wear personal protective equipment (PPE) during the coronavirus disease 2019 (COVID-19) pandemic heightens their risk of thermal stress. We assessed the knowledge, attitudes, and practices of HCWs from India and Singapore regarding PPE usage and heat stress when performing treatment and care activities. One hundred sixty-five HCWs from India (n = 110) and Singapore (n = 55) participated in a survey. Thirty-seven HCWs from Singapore provided thermal comfort ratings before and after ice slurry ingestion. Differences in responses between India and Singapore HCWs were compared. A p-value cut-off of 0.05 depicted statistical significance. Median wet-bulb globe temperature was higher in India (30.2 °C (interquartile range [IQR] 29.1–31.8 °C)) than in Singapore (22.0 °C (IQR 18.8–24.8 °C)) (p < 0.001). Respondents from both countries reported thirst (n = 144, 87%), excessive sweating (n = 145, 88%), exhaustion (n = 128, 78%), and desire to go to comfort zones (n = 136, 84%). In Singapore, reports of air-conditioning at worksites (n = 34, 62%), dedicated rest area availability (n = 55, 100%), and PPE removal during breaks (n = 54, 98.2%) were higher than in India (n = 27, 25%; n = 46, 42%; and n = 66, 60%, respectively) (p < 0.001). Median thermal comfort rating improved from 2 (IQR 1–2) to 0 (IQR 0–1) after ice slurry ingestion in Singapore (p < 0.001). HCWs are cognizant of the effects of heat stress but might not adopt best practices due to various constraints. Thermal stress management is better in Singapore than in India. Ice slurry ingestion is shown to be practical and effective in promoting thermal comfort. Adverse effects of heat stress on productivity and judgment of HCWs warrant further investigation. View Full-Text
Keywords: PPE; climate change; worker protection; KAP survey; mitigation strategies PPE; climate change; worker protection; KAP survey; mitigation strategies
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MDPI and ACS Style

Lee, J.; Venugopal, V.; Latha, P.K.; Alhadad, S.B.; Leow, C.H.W.; Goh, N.Y.D.; Tan, E.; Kjellstrom, T.; Morabito, M.; Lee, J.K.W. Heat Stress and Thermal Perception amongst Healthcare Workers during the COVID-19 Pandemic in India and Singapore. Int. J. Environ. Res. Public Health 2020, 17, 8100. https://doi.org/10.3390/ijerph17218100

AMA Style

Lee J, Venugopal V, Latha PK, Alhadad SB, Leow CHW, Goh NYD, Tan E, Kjellstrom T, Morabito M, Lee JKW. Heat Stress and Thermal Perception amongst Healthcare Workers during the COVID-19 Pandemic in India and Singapore. International Journal of Environmental Research and Public Health. 2020; 17(21):8100. https://doi.org/10.3390/ijerph17218100

Chicago/Turabian Style

Lee, Jimmy, Vidhya Venugopal, P K. Latha, Sharifah B. Alhadad, Clarence H.W. Leow, Nicholas Y.D. Goh, Esther Tan, Tord Kjellstrom, Marco Morabito, and Jason K.W. Lee 2020. "Heat Stress and Thermal Perception amongst Healthcare Workers during the COVID-19 Pandemic in India and Singapore" International Journal of Environmental Research and Public Health 17, no. 21: 8100. https://doi.org/10.3390/ijerph17218100

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