{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,11]],"date-time":"2025-09-11T17:01:29Z","timestamp":1757610089460,"version":"3.44.0"},"reference-count":43,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,9,3]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n<jats:p>Several health care workers (HCWs) succumbed to infection during the recent coronavirus disease 2019 (COVID-19) pandemic. In some cases, HCWs were even blamed for ignorance of standard operating procedures while using personal protective equipment (PPE). This case-control study evaluated the effectiveness of PPE in prevention of transmission by comparing attitudes toward use of PPE. In a retrospective 1:1 case-control design, HCWs who contracted COVID-19 infection were identified as cases and telephonically contacted. Those HCWs who were working in the same patient care area but were not COVID-19 positive before nor at that point in time when the paired case had tested positive were included as controls. Responses around the use of PPE were collected on an indigenously developed questionnaire on a Likert scale using a mix of questions. Those infected with COVID-19 (cases) were younger, felt that single gloves were sufficient, believed that full PPE was not as effective in preventing infection, and did not prefer using a face shield when in comparison with the controls who believed otherwise. The cases reported greater discomfort while using PPE and were more likely to remove protective equipment because of discomfort. The controls were more likely to be vaccinated and be following the WHO protocol for hand hygiene, although these differences were not statistically significant. The differences in attitudes and practices between cases and controls revealed characteristics that could be associated with transmission. Vaccination, improved hand-hygiene practices, and an emphasis on eye protection with face shields might ensure a healthier frontline workforce.<\/jats:p>","DOI":"10.4269\/ajtmh.23-0270","type":"journal-article","created":{"date-parts":[[2025,6,17]],"date-time":"2025-06-17T14:25:33Z","timestamp":1750170333000},"page":"529-536","source":"Crossref","is-referenced-by-count":0,"title":["Effectiveness of Personal Protective Equipment against Coronavirus Disease 2019 Transmission: A Case-Control Study"],"prefix":"10.4269","volume":"113","author":[{"given":"Vikash","family":"Mahla","sequence":"first","affiliation":[{"name":"University College of Medical Sciences, New Delhi, India;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alpana","family":"Raizada","sequence":"additional","affiliation":[{"name":"University College of Medical Sciences, New Delhi, India;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vrinda","family":"Goel","sequence":"additional","affiliation":[{"name":"University College of Medical Sciences, New Delhi, India;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rahul","family":"Sharma","sequence":"additional","affiliation":[{"name":"University College of Medical Sciences, New Delhi, India;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Monica","family":"Lobo","sequence":"additional","affiliation":[{"name":"Father Muller Medical College Hospital, Mangalore, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dhawani","family":"Julka","sequence":"additional","affiliation":[{"name":"University College of Medical Sciences, New Delhi, India;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ashish","family":"Goel","sequence":"additional","affiliation":[{"name":"University College of Medical Sciences, New Delhi, India;"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2795","reference":[{"key":"b1","series-title":"Diabetes Metab Syndr","first-page":"1743","article-title":"COVID-19 and mortality in doctors","volume":"14","author":"Iyengar","year":"2020"},{"key":"b2","series-title":"Clin Infect Dis","first-page":"257","article-title":"Comparing dynamics and determinants of severe acute respiratory syndrome coronavirus 2 transmissions among healthcare workers of adult and pediatric settings in central Paris","volume":"72","author":"Contejean","year":"2021"},{"article-title":"At Least 500 Covid Doctors Have Lost Their Lives, Says IMA","year":"2020","author":"Kaul","key":"b3"},{"key":"b4","series-title":"Postgrad Med J","first-page":"753","article-title":"Origin, transmission, diagnosis and management of coronavirus disease 2019 (COVID-19)","volume":"96","author":"Umakanthan","year":"2020"},{"key":"b5","series-title":"Infez Med","first-page":"20","article-title":"COVID-19 pandemic: From origins to outcomes. A comprehensive review of viral pathogenesis, clinical manifestations, diagnostic evaluation, and management","volume":"29","author":"Ochani","year":"2021"},{"key":"b6","series-title":"Antimicrob Resist Infect Control","first-page":"100","article-title":"Risk of SARS-CoV-2 transmission by aerosols, the rational use of masks, and protection of healthcare workers from COVID-19","volume":"9","author":"Sommerstein","year":"2020"},{"key":"b7","series-title":"J Community Health","first-page":"1242","article-title":"Assessment of knowledge, attitudes, and perception of health care workers regarding COVID-19, a cross-sectional study from Egypt","volume":"45","author":"Abdel Wahed","year":"2020"},{"key":"b8","series-title":"Med Leg J","first-page":"47","article-title":"Problems arising from PPE when worn for long periods","volume":"88","author":"Vidua","year":"2020"},{"key":"b9","series-title":"J Crit Care","first-page":"70","article-title":"Personal protective equipment and intensive care unit healthcare worker safety in the COVID-19 era (PPE-SAFE): An international survey","volume":"59","author":"Tabah","year":"2020"},{"key":"b10","series-title":"Mayo Clin Proc","first-page":"S11","article-title":"Precautions, utilization of personal protective equipment, and conservation strategies during the COVID-19 pandemic","volume":"95","author":"Sampathkumar","year":"2020"},{"year":"2020","series-title":"Rational Use of Personal Protective Equipment (PPE) for Coronavirus Disease (COVID-19): Interim Guidance","key":"b11"},{"key":"b12","series-title":"Niger J Clin Pract","first-page":"1846","article-title":"Knowledge, attitudes and practices towards Covid-19 among Nigerian healthcare workers during the Covid-19 pandemic: A single centre survey","volume":"24","author":"Abene","year":"2021"},{"key":"b13","series-title":"J Prev Med Hyg","first-page":"E830","article-title":"Knowledge and practice of protective personal equipment (PPE) among healthcare providers in Saudi Arabia during the early stages of COVID-19 pandemic in 2020","volume":"62","author":"Ashoor","year":"2021"},{"key":"b14","series-title":"BMC Public Health","first-page":"1424","article-title":"Knowledge and attitude on prevention of COVID-19 among community health workers in Nepal\u2014A cross-sectional study","volume":"21","author":"Shrestha","year":"2021"},{"key":"b15","series-title":"Am J Infect Control","first-page":"1225","article-title":"Specific risk factors for SARS-CoV-2 transmission among health care workers in a university hospital","volume":"48","author":"\u00c7elebi","year":"2020"},{"key":"b16","series-title":"Indian J Med Res","first-page":"459","article-title":"Healthcare workers & SARS-CoV-2 infection in India: A case-control investigation in the time of COVID-19","volume":"151","author":"Chatterjee","year":"2020"},{"key":"b17","series-title":"Trans R Soc Trop Med Hyg","first-page":"551","article-title":"Risk factors and frequency of COVID-19 among healthcare workers at a tertiary care centre in India: A case-control study","volume":"115","author":"Dev","year":"2021"},{"key":"b18","series-title":"J Bone Joint Surg Am","first-page":"847","article-title":"Survey of COVID-19 disease among orthopaedic surgeons in Wuhan, People\u2019s Republic of China","volume":"102","author":"Guo","year":"2020"},{"key":"b19","series-title":"Cureus","first-page":"e52475","article-title":"The factors associated with COVID-19 infection among healthcare workers at a tertiary care institution in north India: A case-control study","volume":"16","author":"Kaur","year":"2024"},{"key":"b20","series-title":"BMC Infect Dis","first-page":"878","article-title":"A case-control study of factors associated with SARS-CoV-2 infection among healthcare workers in Colombia","volume":"21","author":"Rodriguez-Lopez","year":"2021"},{"key":"b21","series-title":"J Occup Environ Med","first-page":"e580","article-title":"Psychological impacts of the COVID-19 pandemic on Canadian healthcare workers: A case control comparison from three cross sectional surveys","volume":"65","author":"Turner","year":"2023"},{"key":"b22","series-title":"Adv Biomed Res","first-page":"36","article-title":"Effectiveness of using face masks and personal protective equipment to reducing the spread of COVID-19: A systematic review and meta-analysis of case-control studies","volume":"12","author":"Hajmohammadi","year":"2023"},{"key":"b23","series-title":"Cureus","first-page":"e10125","article-title":"Profile of patients suspected to be COVID-19: A retrospective analysis of early pandemic data","volume":"12","author":"Goel","year":"2020"},{"key":"b24","series-title":"Disaster Med Public Health Prep","first-page":"1889","article-title":"Correlates of in-hospital COVID-19 deaths: A competing risks survival time analysis of retrospective mortality data","volume":"16","author":"Goel","year":"2022"},{"key":"b25","series-title":"J Paediatr Child Health","first-page":"1486","article-title":"COVID-19 and the personal protection debate: An exposition on transmission","volume":"56","year":"2020"},{"key":"b26","series-title":"Antimicrob Resist Infect Control","first-page":"156","article-title":"The effect of eye protection on SARS-CoV-2 transmission: A systematic review","volume":"10","author":"Byambasuren","year":"2021"},{"key":"b27","series-title":"Int J Environ Res Public Health","first-page":"1942","article-title":"Experimental efficacy of the face shield and the mask against emitted and potentially received particles","volume":"18","author":"Wendling","year":"2021"},{"key":"b28","series-title":"Am J Infect Control","first-page":"878","article-title":"A mixed methods study on effectiveness and appropriateness of face shield use as COVID-19 PPE in middle income countries","volume":"50","author":"Brainard","year":"2022"},{"key":"b29","series-title":"Am J Infect Control","first-page":"240","article-title":"Are health care workers protected? An observational study of selection and removal of personal protective equipment in Canadian acute care hospitals","volume":"41","author":"Mitchell","year":"2013"},{"key":"b30","series-title":"PLoS One","first-page":"e0268582","article-title":"A retrospective observational insight into COVID-19 exposures resulting from personal protective equipment (PPE) breaches","volume":"17","author":"Gaikwad","year":"2022"},{"key":"b31","series-title":"Med Arch","first-page":"361","article-title":"The effect of personal protective equipment (PPE) and disinfectants on skin health during Covid 19 pandemia","volume":"75","author":"Cebeci","year":"2021"},{"key":"b32","series-title":"Int J Environ Res Public Health","first-page":"8065","article-title":"Prevalence and factors associated with the reuse of mask during the COVID-19 pandemic: A nationwide survey in Taiwan","volume":"18","author":"Cheng","year":"2021"},{"key":"b33","series-title":"J Hosp Infect","first-page":"277","article-title":"N95 mask reuse in a major urban hospital: COVID-19 response process and procedure","volume":"106","author":"Czubryt","year":"2020"},{"key":"b34","series-title":"Infect Control Hosp Epidemiol","first-page":"1364","article-title":"Extended use or reuse of N95 respirators during COVID-19 pandemic: An overview of national regulatory authority recommendations","volume":"41","author":"Kobayashi","year":"2020"},{"key":"b35","series-title":"Medicine (Baltimore)","first-page":"e25924","article-title":"Survey and enlightenment on the wearing of protective equipment of nurses working on the front line against COVID-19","volume":"100","author":"Wu","year":"2021"},{"key":"b36","series-title":"BMC Public Health","first-page":"1791","article-title":"The trajectory of COVID-19 pandemic and handwashing adherence: Findings from 14 countries","volume":"21","author":"Szczuka","year":"2021"},{"key":"b37","series-title":"J Hosp Infect","first-page":"185","article-title":"Heat stress and PPE during COVID-19: Impact on healthcare workers\u2019 performance, safety and well-being in NHS settings","volume":"108","author":"Davey","year":"2021"},{"key":"b38","series-title":"Postgrad Med J","first-page":"351","article-title":"Investigation of adverse reactions in healthcare personnel working in level 3 barrier protection PPE to treat COVID-19","volume":"97","author":"Yuan","year":"2021"},{"key":"b39","series-title":"Tex Med","first-page":"4","article-title":"Can you hear me now? Communicating across the COVID-19 PPE chasm","volume":"116","author":"Fuller","year":"2020"},{"key":"b40","series-title":"Adv Respir Med","first-page":"636","article-title":"Fogging of goggles in PPE during COVID-19 pandemic. A practical problem with multiple possible solutions","volume":"88","author":"Madan","year":"2020"},{"key":"b41","series-title":"Wound Manag Prev","first-page":"12","article-title":"Problems encountered by nurses due to the use of personal protective equipment during the coronavirus pandemic: Results of a survey","volume":"66","author":"Atay","year":"2020"},{"key":"b42","series-title":"Indian J Community Med","first-page":"207","article-title":"Impact of steam inhalation, saline gargling, and povidone-iodine gargling on clinical outcome of COVID-19 patients in Bengaluru, Karnataka: A randomized control trial","volume":"47","author":"Chalageri","year":"2022"},{"key":"b43","series-title":"Complement Ther Clin Pract","first-page":"101601","article-title":"Efficacy of add-on Ayurveda and yoga intervention in health care workers of tertiary care hospital during COVID-19: Randomized controlled trial","volume":"48","author":"Sharma","year":"2022"}],"container-title":["The American Journal of Tropical Medicine and Hygiene"],"original-title":[],"link":[{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/113\/3\/article-p529.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/113\/3\/article-p529.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/113\/3\/article-p529.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,3]],"date-time":"2025-09-03T13:13:21Z","timestamp":1756905201000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/113\/3\/article-p529.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,3]]},"references-count":43,"journal-issue":{"issue":"3"},"URL":"https:\/\/doi.org\/10.4269\/ajtmh.23-0270","relation":{},"ISSN":["0002-9637","1476-1645"],"issn-type":[{"type":"print","value":"0002-9637"},{"type":"electronic","value":"1476-1645"}],"subject":[],"published":{"date-parts":[[2025,9,3]]}}}