Skin Lesions and Personal Protective Equipment in Health Care Workers From Lima, Peru, During the COVID-19 Pandemic: A Cross-sectional Study - Report - MDSpire
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Skin Lesions and Personal Protective Equipment in Health Care Workers From Lima, Peru, During the COVID-19 Pandemic: A Cross-sectional Study
Skin Lesions from PPE Use Among Healthcare Workers in Lima During COVID-19
Overview
A cross-sectional study of 190 healthcare workers in Lima, Peru, found a high prevalence (77%) of skin lesions associated with prolonged PPE use during the COVID-19 pandemic. Erythema, comedones, and erosions were the most common lesions, primarily affecting the nasal bridge and cheeks. Factors such as ICU work, shifts longer than 12 hours, and symptoms like burning or dryness increased lesion risk.
Background
During the COVID-19 pandemic, healthcare workers (HCWs) relied heavily on personal protective equipment (PPE) to prevent infection. Prolonged PPE use, especially under extended shifts and limited breaks, can cause skin irritation, pressure-related lesions, and secondary infections. Commonly affected areas include the nasal bridge and cheeks due to pressure from masks and goggles. In resource-limited settings like Peru, data on PPE-related skin lesions are scarce despite high HCW morbidity and mortality.
Data Highlights
Parameter
Value
Sample size
190 HCWs
Prevalence of skin lesions
77%
Most frequent lesions
Erythema (44%), Comedones (18%), Erosions (15%)
Common lesion locations
Nasal bridge (62%), Cheeks (28%)
Use of prevention methods
39% of HCWs; adhesive tape/bandages used by 58% of those
Risk factors (adjusted prevalence ratio)
ICU work: 1.60 (95% CI 1.11–2.29); >12 hr shifts: 1.64 (95% CI 1.11–2.41); burning sensation: 1.27 (95% CI 1.05–1.55); dryness: 1.39 (95% CI 1.02–1.90)
Key Findings
77% of surveyed HCWs experienced skin lesions related to PPE use during the COVID-19 pandemic.
Erythema was the most common lesion (44%), followed by comedones (18%) and erosions (15%).
The nasal bridge (62%) and cheeks (28%) were the most frequently affected anatomical sites.
Working in the ICU and shifts longer than 12 hours significantly increased the likelihood of developing skin lesions.
Burning sensations and skin dryness were associated symptoms that correlated with higher lesion prevalence.
Only 39% of HCWs used preventive measures, with adhesive tape or bandages being the most common method.
Clinical Implications
Healthcare workers using PPE for prolonged periods, especially in intensive care settings or during extended shifts, are at high risk for developing skin lesions. Regular monitoring and implementation of preventive strategies, such as protective dressings and skin care protocols, are essential to maintain skin integrity and occupational well-being. Addressing skin symptoms early may improve PPE compliance and reduce discomfort that could compromise infection control.
Conclusion
This study highlights the high burden of PPE-related skin lesions among healthcare workers in Lima during the COVID-19 pandemic and identifies key risk factors. Enhanced biosafety monitoring and targeted preventive measures are critical to protect HCWs’ skin health and ensure sustained PPE use in ongoing and future public health emergencies.
References
Peruvian Ministry of Health Guidelines 2020 -- PPE Use During COVID-19
Cross-Sectional Study Lima HCWs 2020-2021 -- Skin Lesions and PPE Use
