Heat stress and thermal perceptions related to personal protective equipment in healthcare workers during the COVID-19 pandemic in Indonesia.

BackgroundThe COVID-19 pandemic necessitates the use of personal protective equipment (PPE) by healthcare workers (HCWs), elevating heat stress risks and potentially reducing work productivity. However, limited information exists on HCWs' experiences with PPE-related heat stress in Indonesia.ObjectivesThis study examines HCWs' experiences with PPE, their perceived knowledge and attitudes, and anticipatory practices using a case study in the Covid emergency hospital (Rumah Sakit Darurat Covid (RSDC) in Bahasa) in Jakarta, Indonesia.MethodsNinety-two HCWs completed self-reported surveys and 12 people participated in qualitative interviews between February and March 2022.ResultsCommon heat stress symptoms were thirst, excessive sweating, and fatigue. While HCWs frequently took breaks in designated rest areas, they rarely removed PPE or hydrated regularly. Reasons included avoiding urinating, strict policies on drinking and eating, reducing the risk of disease transmission, and conserving PPE. Notably, HCWs with more positive attitudes were less likely to remove PPE during breaks. Moreover, no specific policies or infrastructure exist to assist HCWs in managing heat stress risks.ConclusionTo mitigate or minimize heat stress, HCWs should wear comfortable, thin shirts inside PPE and receive training on how to keep hydrated when using PPE. PPE manufacturers should develop and design PPE that reduces excessive heat, since the need for comfortable PPE may increase in the future to avoid reducing HCWs' work productivity. Finally, dedicated guidelines and supportive facilities are needed to enable healthcare workers to cope with heat stress associated with PPE usage.