Prospective observational study of gender and ethnicity biases in respiratory protective equipment for healthcare workers in the COVID-19 pandemic. Issue 5 (20th May 2021)

• Record Type: Journal Article
• Authors: Carvalho, Clarissa Y M; Schumacher, Jan; Greig, Paul Robert; Wong, Danny J N; El-Boghdadly, Kariem
• Is Part Of: BMJ open. Volume 11:Issue 5(2021)
• Publication Date: 2021-05-20
• Subjects: COVID-19 -- health & safety -- occupational & industrial medicine -- adult intensive & critical care; Medicine -- Research -- Periodicals; 610.72
• DOI: 10.1136/bmjopen-2020-047716
• Languages: English
• ISSNs: 2044-6055

Abstract

Abstract : Objective: To describe success rates of respiratory protective equipment (RPE) fit testing and factors associated with achieving suitable fit. Design: Prospective observational study of RPE fit testing according to health and safety, and occupational health requirements. Setting: A large tertiary referral UK healthcare facility. Population: 1443 healthcare workers undergoing quantitative fit testing. Main outcome measures: Quantitative fit test success (pass/fail) and the count of tests each participant required before successful fit. Results: Healthcare workers were fit tested a median (IQR) 2 (1–3) times before successful fit was obtained. Males were tested a median 1 (1–2) times, while females were tested a median 2 (1–2) times before a successful fit was found. This difference was statistically significant (p<0.001). Modelling each fit test as its own independent trial (n=2359) using multivariable logistic regression, male healthcare workers were significantly more likely to find a well-fitting respirator and achieve a successful fit on first attempt in comparison to females, after adjusting for other factors (adjusted OR=2.07, 95% CI): 1.66 to 2.60, p<0.001). Staff who described their ethnicity as White were also more likely to achieve a successful fit compared with staff who described their ethnicity as Asian (OR=0.47, 95% CI: 0.38 to 0.58, p<0.001), Black (OR=0.54, 95% CI: 0.41 to 0.71, p<0.001), mixed (OR=0.50 95% CI: 0.31 to 0.80, p=0.004) or other (OR=0.53, 95% CI: 0.29 to 0.99, p=0.043). Conclusions: Male and White ethnicity healthcare workers are more likely to achieve RPE fit test success. This has broad operational implications to healthcare services with a large female and Black, Asian and minority ethnic group population. Fit testing is imperative in ensuring RPE effectiveness in protecting healthcare workers during the COVID-19 pandemic and beyond.