Hostname: page-component-848d4c4894-x5gtn Total loading time: 0 Render date: 2024-06-10T16:56:04.939Z Has data issue: false hasContentIssue false
  • English
  • Français

Safety and Efficacy of CarbonCool Half-Body Vest for HAZMAT Decontamination Crews Wearing Personal Protective Equipment: A Pilot Study

Published online by Cambridge University Press:  15 September 2020

Pamela Jia Min Tay Open the ORCID record for Pamela Jia Min Tay [Opens in a new window] ,
Zhi Xiong Koh ,
Ying Hao  and
Mark Kwok Fai Leong
Pamela Jia Min Tay*
Affiliation:
Duke-NUS Medical School, Singapore
Zhi Xiong Koh
Affiliation:
Department of Emergency Medicine, Singapore General Hospital, Singapore
Ying Hao
Affiliation:
Health Services Research Centre, Singapore Health Services, Singapore
Mark Kwok Fai Leong
Affiliation:
Department of Emergency Medicine, Singapore General Hospital, Singapore SingHealth Duke-NUS Emergency Medicine Academic Clinical Programme, Singapore
*
Correspondence: Pamela JM Tay, BSc Duke-NUS Medical School, Singapore E-mail: pamelatay93@gmail.com
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

Personal protective equipment (PPE) are essential for medical personnel responding to hazardous materials (HAZMAT) incidents. However, their impermeable design causes increased physiological strain and reduced thermoregulation, limiting work times and causing heat-related illnesses (HRI). Use of wearable cooling devices slow heat accumulation and have been shown to reduce thermal and cardiovascular strain in such situations.

Methods:

This was a prospective clinical evaluation to determine the tolerability and effectiveness of the CarbonCool cooling system – a half-body cooling vest – in participants undergoing a HAZMAT decontamination recertification. Physiological measurements (heart rate [HR], weight, temperature, and blood pressure) and participant feedback were obtained. The main outcome of interest was participants’ tolerability of the cooling vest.

Results:

A total of 23 healthy participants were recruited, with 10 randomized to the intervention group and 13 in the control group. Mean age in the control and intervention group was 35.5 years old (SD = 7.8) and 30.0 years old (SD = 6.2), respectively. Qualitative feedback obtained from participants regarding safety, mobility, and cooling efficacy was largely positive. Difference of before-after temperature and HR was 0.3°C (SD = 0.8) and 11.5bpm (SD = 13.6) in the control group compared to 0.0°C (SD = 0.5) and 0.0bpm (SD = 6.4) for the intervention group.

Conclusion:

This clinical evaluation showed that the CarbonCool cooling vest is safe and tolerable in participants wearing PPE. Further trials with sample size powered to detect physiological outcomes are needed to assess the effect of the cooling vest on a subject’s endurance to heat stress.

Keywords

cooling vestPPEreusable vest
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 35 , Issue 6 , December 2020 , pp. 645 - 650
Check for updates
Copyright
© The Author(s), 2020. Published by Cambridge University Press on behalf of the World Association for Disaster and Emergency Medicine

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Ten Hoeve, JE, Jacobson, MZ. Worldwide health effects of the Fukushima Daiichi nuclear accident. Energy Environ Sci. 2012;5(9):8743–8757.10.1039/c2ee22019aCrossRefGoogle Scholar
Okumura, T, Takasu, N, Ishimatsu, S, et al. Report on 640 victims of the Tokyo subway sarin attack. Ann Emerg Med. 1996;28(2):129–135.CrossRefGoogle ScholarPubMed
Okumura, S, Okumura, T, Ishimatsu, S, Miura, K, Maekawa, H, Naito, T. Clinical review: Tokyo - protecting the health care worker during a chemical mass casualty event: an important issue of continuing relevance. Crit Care. 2005;9(4):397–400.10.1186/cc3062CrossRefGoogle ScholarPubMed
Buller, MJ, Tharion, WJ, Duhamel, CM, Yokota, M. Real-time core body temperature estimation from heart rate for first responders wearing different levels of personal protective equipment. Ergonomics. 2015;58(11):1830–1841.10.1080/00140139.2015.1036792CrossRefGoogle ScholarPubMed
Cheung, SS, Petersen, SR, McLellan, TM. Physiological strain and countermeasures with firefighting. Scand J Med Sci Sports. 2010;20(Suppl 3):103–116.10.1111/j.1600-0838.2010.01215.xCrossRefGoogle ScholarPubMed
Muza, SR, Banderet, LE, Cadarette, B. Protective uniforms for nuclear, biological, and chemical warfare: metabolic, thermal, respiratory, and psychological issues. In: Medical Aspects of Harsh Environments. Volume 2. Falls Church, Virginia USA: United States Army; 2001:1084–1187. https://pdfs.semanticscholar.org/5852/63a0a4625bb84995bfff402653428fed4226.pdf?_ga=2.93384733.1651878136.1540042796-310072538.1540042796. Accessed October 20, 2018.Google Scholar
Levine, L, Quigley, MD, Cadarette, BS, Sawka, MN, Pandolf, KB. Physiologic Strain Associated with Wearing Toxic-Environment Protective Systems during Exercise in the Heat. Vol II. London: Taylor & Francis; 1990.Google Scholar
Kim, S, Kim, D-H, Lee, H-H, Lee, J-Y. Frequency of firefighters’ heat-related illness and its association with removing personal protective equipment and working hours. Ind Health. 2019;57(3):370–380.10.2486/indhealth.2018-0063CrossRefGoogle ScholarPubMed
Grahn, D, Makam, M, Craig Heller, H. A method to reduce heat strain while clad in encapsulating outerwear. J Occup Environ Hyg. 2018;15(8):573–579.CrossRefGoogle ScholarPubMed
Lucas, RAI, Epstein, Y, Kjellstrom, T. Excessive occupational heat exposure: a significant ergonomic challenge and health risk for current and future workers. Extrem Physiol Med. 2014;3:14.10.1186/2046-7648-3-14CrossRefGoogle ScholarPubMed
Kerslake, DM. The stress of hot environments. Monogr Physiol Soc. 1972;(29):1–312.Google ScholarPubMed
Kjellstrom, T, Holmer, I, Lemke, B. Workplace heat stress, health and productivity-an increasing challenge for low and middle-income countries during climate change. Glob Health Action. 2009.10.3402/gha.v2i0.2047CrossRefGoogle Scholar
Ramsey, JD. Task performance in heat: a review. Ergonomics. 1995;38(1):154–165.CrossRefGoogle ScholarPubMed
Hancock, PA, Vasmatzidis, I. Effects of heat stress on cognitive performance: the current state of knowledge. Int J Hyperthermia. 2003;19(3):355–372.10.1080/0265673021000054630CrossRefGoogle ScholarPubMed
Parsons, KC. Human Thermal Environments. Second. UK: Taylor & Francis; 2003.Google Scholar
Ramsey, JD, Burford, CL, Beshir, MY, Jensen, RC. Effects of workplace thermal conditions on safe work behavior. J Safety Res. 1983;14(3):105–114.CrossRefGoogle Scholar
Chan, APC, Guo, YP, Wong, FKW, Li, Y, Sun, S, Han, X. The development of anti-heat stress clothing for construction workers in hot and humid weather. Ergonomics. 2016;59(4):479–495.10.1080/00140139.2015.1098733CrossRefGoogle ScholarPubMed
Marszałek, A, Bartkowiak, G, Dąbrowska, A, et al. Mine rescuers’ heat load during the expenditure of physical effort in a hot environment, using ventilated underwear and selected breathing apparatus. Int J Occup Saf Ergon. 2018;24(1):1–13.CrossRefGoogle Scholar
Fire Administration U. Firefighter Fatalities in the United States in 2012. www.firehero.org. Accessed October 20, 2018.Google Scholar
Bouchama, A, Knochel, JP. Heat stroke. N Engl J Med. 2002;346(25):1978–1988.10.1056/NEJMra011089CrossRefGoogle ScholarPubMed
Hunt, AP, Billing, DC, Patterson, MJ, Caldwell, JN. Heat strain during military training activities: the dilemma of balancing force protection and operational capability. Temperature (Austin). 2016;3(2):307–317.CrossRefGoogle ScholarPubMed
Smolander, J, Kuklane, K, Gavhed, D, Nilsson, H, Holmér, I. Effectiveness of a light-weight ice-vest for body cooling while wearing fire fighter’s protective clothing in the heat. Int J Occup Saf Ergon. 2004;10(2):111–117.10.1080/10803548.2004.11076599CrossRefGoogle ScholarPubMed
Cadarette, BS, Levine, L, Staab, JE, et al. Upper body cooling during exercise-heat stress wearing the improved toxicological agent protective system for HAZMAT operations. AIHA J. 2003;64(4):510–515.CrossRefGoogle ScholarPubMed
Ho, AFW, Chew, D, Wong, TH, et al. Prehospital trauma care in Singapore. Prehosp Emerg Care. 2015;19(3):409–415.10.3109/10903127.2014.980477CrossRefGoogle ScholarPubMed
Ling Hii, Y, Rocklöv, J, Ng, N. Climate variability and increase in intensity and magnitude of dengue incidence in Singapore. Glob Health Action. 2009;2(1):2036.Google Scholar
Yeung, R, Chan, J, Lee, L, Chan, YL. The use of personal protective equipment in hazmat incidents. Hong Kong J Emerg Med. 2002;9(3).CrossRefGoogle Scholar
Shapiro, Y, Pandolf, KB, Sawka, MN, Toner, MM, Winsmann, FR, Goldman, RF. Auxiliary cooling: comparison of air-cooled vs. water-cooled vests in hot-dry and hot-wet environments. Aviat Space Environ Med. 1982;53(8):785–789.Google ScholarPubMed
White, MK, Glenn, SP, Hudnall, J, Rice, C, Clark, S. The effectiveness of ice- and Freon-based personal cooling systems during work in fully encapsulating suits in the heat. Am Ind Hyg Assoc J. 1991;52(3):127–135.10.1080/15298669191364460CrossRefGoogle ScholarPubMed
Bennett, BL, Hagan, RD, Huey, KA, Minson, C, Cain, D. Comparison of two cool vests on heat-strain reduction while wearing a firefighting ensemble. Eur J Appl Physiol Occup Physiol. 1995;70(4):322–328.CrossRefGoogle Scholar
Cheuvront, SN, Kolka, MA, Cadarette, BS, Montain, SJ, Sawka, MN. Efficacy of intermittent, regional microclimate cooling. J Appl Physiol. 2003;94(5):1841–1848.10.1152/japplphysiol.00912.2002CrossRefGoogle ScholarPubMed
Vallerand, AL, Michas, RD, Frim, J, Ackles, KN. Heat balance of subjects wearing protective clothing with a liquid- or air-cooled vest. Aviat Sp Environ Med. 1991;62(5):383–391.Google ScholarPubMed
Chan, APC, Zhang, Y, Wang, F, Wong, FFK, Chan, DWM. A field study of the effectiveness and practicality of a novel hybrid personal cooling vest worn during rest in Hong Kong construction industry. J Therm Biol. 2017;70(Pt A):21–27.10.1016/j.jtherbio.2017.07.012CrossRefGoogle ScholarPubMed
Lopez, RM, Eberman, LE, Cleary, MA. Superficial cooling does not decrease core body temperature before, during, or after exercise in an American football uniform. J Strength Cond Res. 2012;26(12):3432–3440.CrossRefGoogle Scholar
Hasegawa, H, Takatori, T, Komura, T, Yamasaki, M. Wearing a cooling jacket during exercise reduces thermal strain and improves endurance exercise performance in a warm environment. J Strength Cond Res. 2005;19(1):122.Google Scholar