Medical Masks’ and Respirators’ pattern of use, adverse effects and errors among Portuguese healthcare professionals during the COVID-19 pandemic: a cross-sectional study

Peres, David; Monteiro, Jorge; Boléo-Tomé, José Pedro

BACKGROUND: During COVID-19 pandemic, a shortage of surgical masks (Mask) and respirators (Resp) was experienced worldwide. We aimed to assess its pattern of use, adverse effects and user errors by Portuguese healthcare professionals (HCP). METHODS: A cross-sectional study was conducted through snowball convenience sample, collected by email/ social media to healthcare organizations. Participants answered an online anonymous survey in March 2021. RESULTS: Mean age of 3052 respondents was 42.1 years old, 83.6% were female and 77.8% provided direct healthcare to COVID-19 patients. Mean time of use per shift was 6-8 hours in 40.8% of the participants. 28.0% reported never changing it during their shift. Resp use (vs. Mask) was more associated with discomfort (58.2% vs. 26.8%), affecting task performance (41.5 vs. 18.9%) and communication (55.0 vs. 40.9%), dyspnea (36.0 vs. 14.4%), skin rash (37.5 vs. 19.4%) and headache (37.5 vs. 19.4%). Frequent user errors included touching the front while in use (70.1% Mask vs. 66.3% Resp) and omitting hand hygiene before (61.8% Mask vs. 55.0% Resp) or after use (61.3% Mask vs. 57.0% Resp). Average number of errors was higher for Mask (4.3), than for Resp (3.2) (all: p<0.001). CONCLUSION: Most HCP admitted an extended use of Mask/ Resp. Resp were more prone to adverse effects and Mask more prone to errors. Strategies to reinforce good practices should be considered.