Next up, this study
, published in the journal Anaesthesia
, which found that female medics who have intubated covid patients are at higher risk than male medics of going on to contract covid themselves. Now, although this is not proven to be causal, if it is, this really matters. We know that the severity of a covid case is affected by the viral load to which the infected person is exposed to at the time of infection. And given intubation generates aerosolised particles, it is a particularly risky procedure from that perspective. So if you’re doing it, you really want to be sure that your mask fits your face. Could ill-fitting PPE be the reason behind this sex-discrepancy? The authors of this study are a bit 🤷♀️ on that point, but the question was taken up
by some other researchers in the next issue of Anaesthesia
Female sex was identified in the study by El‐Boghdadly et al. as an independent factor for proven or suspected COVID‐19 infection of healthcare workers following intubation [1
]. As one of the significant findings outlined in the paper, it was surprising to us that this was not given more prominence in the discussion or the infographic associated with the article.
El‐Boghdadly et al. propose that ‘biological differences’ may be a factor in this disparity, without elaborating further. We postulate that one biologically relevant difference could be body habitus and the gendered design of personal protective equipment (PPE). Personal protective equipment has been noted in other sectors, such as mining and engineering, to be designed for the male body shape [3
]. It stands to reason that this may also be the case in the health sector, and studies by the Royal College of Nursing and ergonomists are underway to investigate.
The COVID‐19 outbreak has brought these issues to the attention of the UK media, where anecdotes of sex disparity in the appropriate fit of PPE have been proffered from various NHS sources [4
]. Stories abound within healthcare about ‘unisex’ (for which read: inadequately sized) PPE – gowns so large that they drag on the floor and trip up the wearer, gloves that are not available in small enough sizes, visors that are dislodged by breasts when the intubator looks down, and ill‐fitting facemasks and goggles that fail to seal when applied to smaller female faces. Such PPE, whereas not being fit for purpose when worn, may also prove more difficult (and therefore more dangerous) to doff.
Women comprise over three‐quarters of healthcare workers in the UK and many other countries. Failure to adequately protect a large sector of the workforce is ethically unsound, a health and safety issue, and a looming potential class action lawsuit. Urgent research is needed to ascertain the extent of the problem, and immediate action is required to ensure sex equity in PPE provision.
Obviously by this point I am whooping and cheering. Still though, “the industry” has said there is no problem so probably it’s fine.