Healthcare worker

医护人员
  • 文章类型: Journal Article
    COVID-19大流行使医护人员(HCWs)面临严重的感染风险。我们的研究目的是调查SARS-CoV-2感染的流行病学特征和危险因素,并评估上海Omicron大流行期间的疫苗有效性(VE),中国。
    2022年12月至2023年1月在上海市总医院工作的医护人员中对COVID-19进行了主动监测。采用问卷调查法进行病例对照研究,分析感染相关危险因素。进行了一项回顾性队列研究,以评估VE对原发感染的影响。
    在Omicron爆发期间,2,460例(81.6%)HCWs中有2,008例感染了SARS-CoV-2。女性感染率较高,年轻的年龄组,护士和医疗技术人员。在问卷的1742名参与者中,1,463(84.0%)检测呈阳性,其中95.1%出现症状。大多数感染(53.0%)是在医院外获得的。与较高感染几率相关的危险因素在急诊科(aOR3.77,95%CI1.69-8.38)和医学检查领域(aOR2.47,95%CI1.10-5.51)。与较低感染几率相关的保护因素是既往感染SARS-CoV-2(aOR0.01,95%CI0-0.07)和接受四剂疫苗(aOR0.40,95%CI0.17-0.97)。对于前线HCW,经口鼻接触同事的患者更有可能受到感染(aOR1.74,95%CI1.21~2.51).在VE分析中,在流行期间接受紧急异源加强剂(第四剂)的HCWs的原发感染风险较低(aHR0.25,95%CI0.15-0.40),导致调整后的VE为75.1%。
    为了应对未来的大流行,对于公共卫生政策而言,重要的是通过风险区分感染控制措施来保护HWs,加强个人保护,并在Omicron波到来之前向易受伤害的个人推荐疫苗接种。
    UNASSIGNED: The COVID-19 pandemic has exposed healthcare workers (HCWs) to serious risk of infection. The aims of our study were to investigate the epidemiological characteristics and risk factors of SARS-CoV-2 infection among HCWs, and evaluate the vaccine effectiveness (VE) during the Omicron pandemic in Shanghai, China.
    UNASSIGNED: Active surveillance of COVID-19 was performed among HCWs who worked in Shanghai General Hospital from December 2022 to January 2023. A case-control study was conducted by questionnaire survey to analyse the infection-related risk factors. A retrospective cohort study was explored to evaluate VE against primary infection.
    UNASSIGNED: During the Omicron outbreak, 2,008 of 2,460 (81.6%) HCWs were infected with SARS-CoV-2. The infection rate was higher in women, younger age groups, nurses and medical technicians. Among the 1,742 participants in the questionnaire, 1,463 (84.0%) were tested positive, and 95.1% of them developed symptoms. Most of the infections (53.0%) were acquired outside the hospital. The risk factors associated with higher odds of infection were working in the emergency department (aOR 3.77, 95% CI 1.69-8.38) and medical examination area (aOR 2.47, 95% CI 1.10-5.51). The protective factors associated with lower odds of infection were previous infection with SARS-CoV-2 (aOR 0.01, 95% CI 0-0.07) and receiving four doses of vaccines (aOR 0.40, 95% CI 0.17-0.97). For frontline HCWs, those who had oral-nasal exposure to coworkers were more likely to be infected (aOR 1.74, 95% CI 1.21-2.51). In VE analysis, the risk of primary infection was lower in HCWs who received the emergency heterologous booster (the fourth dose) during the epidemic (aHR 0.25, 95% CI 0.15-0.40), resulting in an adjusted-VE of 75.1%.
    UNASSIGNED: In response to future pandemic, it is important for public health policies to aim at protecting HCWs through risk-differentiated infection control measures, strengthening personal protection and recommending vaccination to vulnerable individuals before the arrival of Omicron wave.
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  • 文章类型: Journal Article
    该研究旨在使用测听法评估职业噪声对医护人员听力损失的影响。在21名参与者的医院进行了为期6个月的随访期的纵向研究。分为高噪声暴露(HNE)和低噪声暴露(LNE)组。HNE组的平均噪声水平较高(70.4±4.5dBA),在基线和随访时使用纯音测听法测量听力损失。HNE组在0.25kHz的频率下具有显著较高的平均阈值水平,0.5kHz,4.0kHz,随访期后,平均0.5、1、2和4kHz(所有p值<0.05)。在调整混杂因素后,HNE组在0.25kHz时的听力损失水平明显更高,0.5kHz,与第二次测量时的LNE组相比,平均频率为0.5、1、2和4kHz。在超过6个月的65dBA以上的职业噪声水平被发现在0.25kHz的频率引起显著的阈值变化,0.5kHz,和0.5-4.0kHz的平均值。这项研究强调了医护人员中噪声引起的听力损失的风险,并强调了在工作场所实施有效的听力保护计划的重要性。定期监测和评估噪声水平和听觉能力,以及正确使用个人防护设备,是减轻职业噪声暴露对医护人员听力健康影响的关键步骤。
    The study aimed to evaluate the impact of occupational noise on hearing loss among healthcare workers using audiometry. A longitudinal study was conducted with a six-month follow-up period in a hospital with 21 participants, divided into high-noise-exposure (HNE) and low-noise-exposure (LNE) groups. Mean noise levels were higher in the HNE group (70.4 ± 4.5 dBA), and hearing loss was measured using pure-tone audiometry at baseline and follow-up. The HNE group had significantly higher mean threshold levels at frequencies of 0.25 kHz, 0.5 kHz, 4.0 kHz, and an average of 0.5, 1, 2, and 4 kHz (all p-values < 0.05) after the follow-up period. After adjusting for confounding factors, the HNE group had significantly higher hearing loss levels at 0.25 kHz, 0.5 kHz, and average frequencies of 0.5, 1, 2, and 4 kHz compared to the LNE group at the second measurement. Occupational noise levels above 65 dBA over six months were found to cause significant threshold changes at frequencies of 0.25 kHz, 0.5 kHz, and an average of 0.5-4.0 kHz. This study highlights the risk of noise-induced hearing loss among healthcare workers and emphasizes the importance of implementing effective hearing conservation programs in the workplace. Regular monitoring and assessment of noise levels and hearing ability, along with proper use of personal protective equipment, are crucial steps in mitigating the impact of occupational noise exposure on the hearing health of healthcare workers.
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  • 文章类型: Journal Article
    目的:在标准的COVID-19疫情防控措施范围内,明确计算机断层扫描(CT)检查过程中的关键感染过程和危险因素。旨在减轻医院交叉感染的发生。
    方法:病例医院组建了一个由30名CT检查专家组成的团队。根据CT检查过程,从严重性(S)的角度评估潜在的故障模式,发生概率(O),和可检测性(D);然后结合相应的风险预防措施。最后,根据风险优先数(RPN)和专家分析确定关键感染过程和危险因素。
    结果:通过RPN的应用和进一步分析,确定了四个关键的潜在感染过程,包括“CT申请表(A1),在CT患者(B2)的扫描过程中,\“\”CT室和物体处置(C2),“和”医疗废物(垃圾)处理(C3)“。此外,还确定了八个关键风险因素,包括\“清洁人员不正常佩戴口罩(C32),“\”护士没有选择静脉井,导致外周静脉外渗以增强CT(B25),\"\"病人找不到CT室(A13),“\”患者已获得CT申请表,但不知道程序(A12),患者身体不适,无法继续进行CT扫描(B24),\"\"辅助人员(或技术人员)对灭菌和消毒标准(C21)没有很好的掌握,\"\"辅助人员(或技术人员)不彻底消毒CT机(C22),“和”清洁人员缺乏COVID-19预防和控制(C33)的知识。”
    结论:医院可以通过各种渠道宣传CT检查的注意事项,降低CT检查失败的发生率。医院的清洁服务通常是外包的,从事这些服务的员工的教育背景普遍不高。因此,在培训和沟通过程中,更有必要提供一系列与其理解水平相一致的范围和培训计划。本研究开发的模型有效地识别了关键的感染预防过程和关键的风险因素,加强医务人员和患者的安全。这对重大传染病的潜在流行具有重要的研究意义。
    OBJECTIVE: To identify the key infection processes and risk factors in Computed Tomography (CT) examination process within the standard prevention and control measures for the COVID-19 epidemic, aiming to mitigate cross-infection occurrences in the hospital.
    METHODS: The case hospital has assembled a team of 30 experts specialized in CT examination. Based on the CT examination process, the potential failure modes were assessed from the perspective of severity (S), occurrence probability (O), and detectability (D); they were then combined with corresponding risk prevention measures. Finally, key infection processes and risk factors were identified according to the risk priority number (RPN) and expert analysis.
    RESULTS: Through the application of RPN and further analysis, four key potential infection processes were identified, including \"CT request form (A1),\" \"during the scan of CT patient (B2),\" \"CT room and objects disposal (C2),\" and \"medical waste (garbage) disposal (C3)\". In addition, eight key risk factors were also identified, including \"cleaning personnel does not wear masks normatively (C32),\" \"nurse does not select the vein well, resulting in extravasation of the peripheral vein for enhanced CT (B25),\" \"patient cannot find the CT room (A13),\" \"patient has obtained a CT request form but does not know the procedure (A12),\" \"patient is too unwell to continue with the CT scan (B24),\" \"auxiliary staff (or technician) does not have a good grasp of the sterilization and disinfection standards (C21),\" \"auxiliary staff (or technician) does not sterilize the CT machine thoroughly (C22),\" and \"cleaning personnel lacks of knowledge of COVID-19 prevention and control (C33)\".
    CONCLUSIONS: Hospitals can publicize the precautions regarding CT examination through various channels, reducing the incidence of CT examination failure. Hospitals\' cleaning services are usually outsourced, and the educational background of the staff employed in these services is generally not high. Therefore, during training and communication, it is more necessary to provide a series of scope and training programs that are aligned with their understanding level. The model developed in this study effectively identifies the key infection prevention process and critical risk factors, enhancing the safety of medical staff and patients. This has significant research implications for the potential epidemic of major infectious diseases.
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  • 文章类型: Journal Article
    肺癌的患病率,一种主要的恶性肿瘤,多年来一直在增加,极大地影响了中国居民的健康。本研究调查了湖南省医务人员肺癌的流行病学特征,以及职业危险因素。
    本研究分析的数据来自全省最大的肿瘤医院:中南大学附属湖南省肿瘤医院,医学院。收集的数据包括2004年至2013年期间因肺癌治疗而住院的医护人员的输入。信息是通过统计分析和电话访谈获得的。
    医护人员中肺癌的患病率远高于普通人群,从2004年至2013年的十年中,每1,000个病例中的医护人员数量与每1,000个人口中的医护人员数量之间的差异揭示了这一点。对数据的分析进一步表明,医疗保健工作者中的肺癌患病率随年龄呈指数增长。虽然吸烟在一定程度上增加了肺癌的发病率,它很可能不是肺癌的主要原因。此外,肺癌发病率最高的似乎主要发生在初级全科医生中,医学放射科医生,和护士。缺乏个人安全措施的意识可能会使医护人员患肺癌的风险更大。
    The prevalence of lung cancer, a major type of malignant tumor, has been increasing over the years greatly impacting the health of Chinese residents. This study investigates the epidemiological characteristics of lung cancer among healthcare workers in the Hunan Province, as well as the occupational risk factors.
    The data analyzed in this study was collected from the largest tumor hospital in the province: the Hunan Provincial Tumor Hospital affiliated with Central South University, School of Medicine. The data collected encompasses input collected between the years of 2004 to 2013 of the population of healthcare workers who were hospitalized for lung cancer treatments. Information was obtained through statistical analysis and telephonic interviews.
    The prevalence of lung cancer among healthcare workers was much higher than that of the general population, as revealed by the difference between number of healthcare worker cases per 1,000 cases and number of healthcare workers per 1,000 population in the decade from 2004 to 2013. Analysis of the data further demonstrates that lung cancer prevalence among healthcare workers increases exponentially with age. Although smoking has been shown to increase the incidence of lung cancer to some extent, it is most likely not the main cause of lung cancer. In addition, it appears that the highest rates of lung cancer incidence occurs in mainly in primary general practitioners, medical radiologists, and nurses. The lack of awareness of personal safety measures may place healthcare workers at a greater risk of lung cancer.
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  • 文章类型: Journal Article
    有人认为,在COVID-19大流行期间,医护人员(HCWs)正经历着巨大的压力源,威胁着他们的心理健康,但是对他们寻求专业心理帮助的态度和意图知之甚少。本研究旨在调查中国医务人员在COVID-19大流行期间寻求专业心理帮助的态度和意图以及相关因素。
    2022年11月,从中国湖南省的12家医院在线招募了1,224名在医院工作的中国医护人员。分别使用中文版寻求专业心理帮助的态度量表(ATSPPH-SF)和一般寻求帮助问卷(GHSQ)来评估受访者寻求专业心理帮助的态度和意图。人口统计和社会心理数据是使用自行开发的问卷收集的,感知社会支持量表,寻求帮助量表的自我污名,和患者健康问卷-9量表。
    最终分析中的1,208名HCWs在COVID-19大流行期间表现出相对消极的态度和寻求专业心理帮助的低意图。多元线性回归分析结果显示,女性性别(p=0.031),心理学习体验(p<0.001),和社会支持(p<0.001)对这些HCWs寻求专业心理帮助的态度有积极的预测作用,而寻求帮助的自我污名(p<0.001)和抑郁症状(p<0.001)产生了负面影响。此外,心理学习经验(p=0.004)和社会支持(p<0.001)对这些HCWs寻求专业心理帮助的意图有积极的预测作用,而离婚的婚姻状况(p=0.011)和寻求帮助的自我污名(p<0.001)产生了负面影响。
    医护人员寻求专业心理帮助的总体态度和意图并不乐观。应针对影响因素制定有效的干预措施,以促进有发生心理健康问题风险的医护人员的专业心理求助态度和意图。
    UNASSIGNED: It has been suggested that healthcare workers (HCWs) are experiencing massive stressors that threaten their mental health during the COVID-19 pandemic, but little is known about their attitudes and intentions toward seeking professional psychological help. This study aimed to investigate the attitudes and intentions of Chinese HCWs toward seeking professional psychological help during the COVID-19 pandemic and the associated factors.
    UNASSIGNED: A total of 1,224 Chinese HCWs working in hospitals were recruited online from 12 hospitals in Hunan province in China for a survey conducted in November 2022. The Chinese version of the attitudes toward seeking professional psychological help scale-short form (ATSPPH-SF) and the general help-seeking questionnaire (GHSQ) were separately used to assess the attitudes and intentions of the respondents toward seeking professional psychological help. Demographic and socio-psychological data were collected using a self-developed questionnaire, the perceived social support scale, the self-stigma of seeking help scale, and the patient health questionnaire-9 scale.
    UNASSIGNED: The 1,208 HCWs in the final analysis showed relatively negative attitudes and low intentions toward seeking professional psychological help during the COVID-19 pandemic. Results of the multiple linear regression analysis showed that female sex (p = 0.031), experience of psychological learning (p < 0.001), and social support (p < 0.001) had a positive predictive effect on the attitudes of these HCWs toward seeking professional psychological help, whereas self-stigma of seeking help (p < 0.001) and depressive symptoms (p < 0.001) exerted negative effects. Moreover, experience of psychological learning (p = 0.004) and social support (p < 0.001) had a positive predictive effect on the intentions of these HCWs toward seeking professional psychological help, whereas divorced marital status (p = 0.011) and self-stigma of seeking help (p < 0.001) exerted negative effects.
    UNASSIGNED: The overall attitudes and intentions of HCWs toward seeking professional psychological help were not optimistic. Effective interventions targeted at influencing factors should be formulated to promote the professional psychological help-seeking attitudes and intentions of HCWs who are at risk of developing mental health problems.
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  • 文章类型: Journal Article
    关于工作压力与心理健康之间的关系的中介机制知之甚少,尤其是初级公共卫生工作者(PHW)。我们旨在评估PHW中工作压力与心理健康之间的关系,并探讨社会支持与自我效能感的中介作用。
    对上海16个行政区的249个社区卫生服务中心的3,809名PHW进行了大规模横断面调查,中国。采用皮尔逊相关和分层线性回归来探讨工作压力之间的关联,社会支持,自我效能感和心理健康。进行了结构方程模型(SEM)来检验中介效应。
    原发性PHWs中抑郁和焦虑症状的患病率分别为67.3和55.5%,分别。工作压力对心理健康有显著的正向影响(β=0.325,p<0.001)。社会支持和自我效能感部分介导了工作压力与心理健康的关系,分别。同时,社会支持和自我效能感的连锁中介效应也缓冲了工作压力对焦虑和抑郁症状的预测作用(β=0.372,p<0.001)。
    工作压力对初级PHW的心理健康有显著的直接和间接影响。增强社会支持和自我效能感可能是减轻工作压力对心理健康影响的有效心理干预措施。这些发现强调了初级公共卫生工作者心理健康问题的严重性,并为早期预防和有效干预策略提供了新的证据。
    Little is known about the mediating mechanisms underlying the association between work stress and mental health, especially among primary public health workers (PHWs). We aimed to evaluated the association between work stress and mental health among PHWs, and explore the mediating roles of social support and self-efficacy.
    A large-scale cross-sectional survey was conducted among 3,809 PHWs from all 249 community health centers in 16 administrative districts throughout Shanghai, China. Pearson correlation and hierarchical linear regression were used to explore the associations among work stress, social support, self-efficacy and mental health. Structural equation modeling (SEM) was conducted to examine the mediation effects.
    The prevalence of depression and anxiety symptoms among primary PHWs was 67.3 and 55.5%, respectively. There is a significant positive direct effect of work stress on mental health (β = 0.325, p < 0.001). Social support and self-efficacy partially mediated the relationship between work stress and mental health, respectively. Meanwhile, the chained mediating effects of social support and self-efficacy also buffered the predictive effects of work stress on anxiety and depression symptoms (β = 0.372, p < 0.001).
    Work stress has significant direct and indirect effects on mental health among primary PHWs. Enhancing social support and self-efficacy may be effective psychological interventions to mitigate the effects of work-related stress on mental health. These findings highlight the severity of mental health problems among primary public health workers and provide new evidence for early prevention and effective intervention strategies.
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  • 文章类型: Journal Article
    目的:本研究旨在探讨中国医护人员工作场所暴力与离职意向之间的关系,并探讨性别在这种关系中的调节作用。
    方法:一项横断面调查从中国一个省份的一个中心招募了692名医护人员。内容包括一份关于工作场所暴力的问卷,专制领导,和离职意向。使用SPSS中的PROCESS工具分析了调节的中介效应,并使用Bootstrap方法提取了5000个样本,以估计每种效应的95%置信区间。
    结果:结果表明,工作场所暴力对离职意向的影响是由专制领导介导的。此外,性别调节了专制领导与离职意向之间的关系。
    结论:医护人员管理者应建立工作场所暴力干预制度,改变直接领导的领导方式,降低医护人员的离职倾向。
    OBJECTIVE: This study aimed to explore the association between workplace violence and turnover intention among Chinese healthcare workers and explore the role of gender as a moderator in this relation.
    METHODS: A cross-sectional survey recruited 692 healthcare workers from a single center in a Chinese province. The content included a questionnaire regarding workplace violence, authoritarian leadership, and turnover intention. The moderated mediation effects were analyzed using the PROCESS tool in SPSS and bootstrap method was used to extract 5000 samples to estimate the 95% confidence interval of each effect.
    RESULTS: The results indicated that the effect of workplace violence on turnover intention was mediated by authoritarian leadership. In addition, gender moderated the association between authoritarian leadership and turnover intention.
    CONCLUSIONS: Healthcare worker managers should establish a workplace violence intervention system and change the leadership style of direct leaders to reduce healthcare workers\' turnover intention.
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  • 文章类型: Meta-Analysis
    工作场所暴力(WPV)是一种普遍存在的现象,尤其是在医疗保健方面。在COVID-19流行期间,针对医护人员(HCWs)的WPV有所增加。这项荟萃分析确定了WPV的患病率和危险因素。2022年5月对六个数据库进行了数据库搜索,并于2022年10月进行了更新。HCW中WPV的患病率是主要结果。数据按WPV/HCW类型分层,大流行期(早期,mid,late),和医学专业。WPV危险因素是次要结果。所有分析均通过STATA进行。纽卡斯尔渥太华量表评价质量。敏感性分析确定了影响估计的变化。共分析了38项研究(63,672HCWs)。任何类型的WPV的患病率(43%),物理(9%),口头(48%),和情感(26%)高。从大流行中期到大流行后期,WPV(40-47%),身体暴力(12-23%)言语暴力(45-58%)增加。护士的身体暴力发生率是前者的两倍多(13%vs.5%)比医生,而WPV和言语暴力是平等的。性别,职业,COVID-19的时机没有影响WPV,物理,或言语暴力风险。COVID-19医护人员更有可能受到身体攻击(logOR=0.54;95%CI:0.10:0.97)。大多数医护人员遭受言语暴力,其次是情感,欺凌,性骚扰,和人身攻击。与大流行有关的工作场所暴力增加。护士的暴力程度是医生的两倍。COVID-19医护人员遭受身体和工作场所暴力的风险更高。
    Workplace violence (WPV) is a prevalent phenomenon, especially in the healthcare setting. WPV against healthcare workers (HCWs) has increased during the COVID-19 epidemic. This meta-analysis determined the prevalence and risk factors of WPV. A database search was conducted across six databases in May 2022, which was updated in October 2022. WPV prevalence among HCWs was the main outcome. Data were stratified by WPV/HCW type, pandemic period (early, mid, late), and medical specialty. WPV risk factors were the secondary outcome. All analyses were conducted through STATA. Newcastle Ottawa Scale evaluated the quality. Sensitivity analysis identified effect estimate changes. A total of 38 studies (63,672 HCWs) were analyzed. The prevalence of WPV of any kind (43%), physical (9%), verbal (48%), and emotional (26%) was high. From mid-pandemic to late-pandemic, WPV (40-47%), physical violence (12-23%), and verbal violence (45-58%) increased. Nurses had more than double the rate of physical violence (13% vs. 5%) than physicians, while WPV and verbal violence were equal. Gender, profession, and COVID-19 timing did not affect WPV, physical, or verbal violence risk. COVID-19 HCWs were more likely to be physically assaulted (logOR = 0.54; 95% CI: 0.10: 0.97). Most healthcare employees suffer verbal violence, followed by emotional, bullying, sexual harassment, and physical assault. Pandemic-related workplace violence increased. Nurses were twice as violent as doctors. COVID-19 healthcare employees had a higher risk of physical and workplace violence.
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  • 文章类型: Editorial
    暂无摘要。
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  • 文章类型: Journal Article
    未经批准:在2019年冠状病毒病(COVID-19)大流行期间,N95口罩是医护人员必不可少的防护设备。然而,N95面罩可以抑制空气交换和气味渗透。我们的研究旨在确定使用N95口罩是否会影响医护人员的气味辨别能力。
    未经批准:在我们的研究中,所有参与者被要求完成三项嗅觉测试.每个测试涉及12种不同的气味。参与者戴着N95口罩完成了测试,一个外科口罩,没有面具。记录每个嗅觉测试的分数。
    UNASSIGNED:参与者戴N95口罩时的嗅觉测试得分明显低于不戴口罩时(7vs.10,p<0.01)。当参与者佩戴N95口罩时,得分也低于手术口罩(7vs.8,p<0.01)。
    UNASSIGNED:佩戴N95口罩会降低医护人员的气味辨别能力。因此,我们建议医护人员在诊断具有特征性气味的疾病时寻求其他线索。
    UNASSIGNED: During the coronavirus disease 2019 (COVID-19) pandemic, the N95 mask is an essential piece of protective equipment for healthcare workers. However, the N95 mask may inhibit air exchange and odor penetration. Our study aimed to determine whether the use of N95 masks affects the odor discrimination ability of healthcare workers.
    UNASSIGNED: In our study, all the participants were asked to complete three olfactory tests. Each test involved 12 different odors. The participants completed the test while wearing an N95 mask, a surgical mask, and no mask. The score for each olfactory test was documented.
    UNASSIGNED: The olfactory test score was significantly lower when the participants wore N95 masks than when they did not wear a mask (7 vs. 10, p < 0.01). The score was also lower when the participants wore N95 masks than surgical masks (7 vs. 8, p < 0.01).
    UNASSIGNED: Wearing N95 masks decreases the odor discrimination ability of healthcare workers. Therefore, we suggest that healthcare workers seek other clues when diagnosing disease with a characteristic odor.
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