Adverse skin reactions among health care workers using face personal protective equipment during the coronavirus disease 2019 pandemic: A cross-sectional survey of six hospitals in Denmark

Background Health care workers (HCWs) report frequent adverse skin reactions (ASRs) due to face personal protective equipment (F-PPE) use during the coronavirus disease 2019 (COVID-19) pandemic. Objectives To describe self-reported ASRs among HCWs using F-PPE; investigate background factors, such as chronic skin diseases and skin types (dry, oily, combination, sensitive), and determine whether HCWs took preventive methods against ASRs. Methods An online questionnaire was distributed to 22 993 HCWs at hospitals. Results The prevalence of ASRs was 61.9% based on 10 287 responders. Different types of F-PPE caused different reactions. The most common ASRs from surgical masks were spots and pimples (37.2%) and from FFP3 masks was red and irritated skin (27.3%). A significantly higher proportion of HCWs with chronic skin diseases had ASRs (71.6%) than those without chronic skin diseases (59.7%) (P < .001). Some skin types were more prone to ASRs (sensitive skin [78.8%] vs dry skin [54.3%]; P = .001). HCWs using F-PPE for >6 hours versus <3 hours per day had a four times higher ASR risk (P = <.001). Nearly all HCWs used preventive and/or counteractive methods (94.2%). Conclusions It is important to consider background factors, such as chronic skin diseases and skin types, to prevent and counteract ASRs due to F-PPE use. Highlights Daily long-term use of face protective equipment increased the risk of adverse skin reaction by four times. Health care workers (HCWs) with chronic skin diseases had significantly more skin reactions than those without. Sensitive skin types were more prone to skin reactions. The skin reactions were higher in HCWs in intensive care units than HCWs in in-patient clinics.

Automated summary

Healthcare workers reported frequent adverse skin reactions while using face personal protective equipment during the COVID-19 pandemic. Factors such as chronic skin diseases and skin types influenced the occurrence of these reactions, with sensitive skin types being more prone. Daily long-term use of face protective equipment increased the risk of adverse skin reactions by four times.