Talc and petroleum jelly among the best lubricants for people wearing
PPE, study finds

Date:
September 24, 2020
Source:
Imperial College London
Summary:
Talcum powder, a coconut oil-cocoa butter beeswax mixture, and
petroleum jelly provide the best skin protection for long-term
PPE use, say scientists.



FULL STORY ==========================================================================
For frontline healthcare workers during the COVID-19 pandemic,
wearing personal protective equipment (PPE) like face visors, googles,
and respiratory protective equipment is an essential part of working
life. More workers are wearing facial PPE now than ever before, often for extended periods of time, to protect them against the SARS-CoV-2 virus.


========================================================================== However, extended PPE use, particularly on the delicate skin of the
face, can cause friction and shear injuries like skin tears, blistering, ulcers, and hives.

The effects of friction and shear can be reduced by lubricants, which
workers are advised to apply every half hour. Half-hourly applications
can be impractical during shift work and may expose workers to the virus,
and many typical moisturisers don't last long as they are designed to
be absorbed into the skin for a 'non-greasy feel'.

Now, researchers from Imperial College London have investigated which
products create the longest-lasting protective layer between PPE and
skin. They hope their findings will help healthcare workers and other
long-term PPE users like those in hospitality to prevent skin injury
and deformity.

They found that the best lubricants to use are those that don't absorb
into the skin, creating a long-lasting layer of protection between skin
and PPE. They say that non-absorptive creams like coconut oil-cocoa
butter beeswax mixtures, and powders like talcum powder, are most likely
to provide PPE wearers with long-lasting skin protection.

The findings are published today in PLOS ONE.



==========================================================================
Lead author Dr Marc Masen, of Imperial's Department of Mechanical
Engineering, said: "We think of moisturisers as good for our skin,
but commercial skin creams are often designed to absorb into the skin
without leaving any residue.

While this is fine for everyday moisturising, our study shows that
a greasy residue is precisely what's needed to protect skin from PPE
friction." To identify the best-performing lubricants, the researchers custom-built a tribometer -- an instrument that assesses friction
between two surfaces -- and used it to test the friction between skin
and polydimethylsiloxane (PDMS), which is a common component of PPE.

They used the tribometer to test commercially available products to
measure how they changed the friction between PDMS and the inner forearm
skin of a healthy 44-year-old male participant. They tested friction
upon application, and then one, two, and four hours after application.

They found that while most products initially reduced friction by 20
per cent, some silicone-based and water-and-glycerin based lubricants
increased friction levels over time by up to 29 per cent compared to
dry skin.

However, two products reduced friction as time went on. Talcum powder
reduced friction by 49 per cent on application and 59 per cent at four
hours, and a commercially available product comprising coconut oil, cocoa butter and beeswax reduced friction by 31 per cent on application and
53 per cent at four hours. A mixture of petrolatum and lanolin reduced
friction by 30 per cent throughout testing.



==========================================================================
When testing commercial moisturisers, they found that friction on
application was low, but increased drastically within ten minutes of application. The researchers say this is because the active ingredients,
known as humectants, attract water like magnets from the lower layers
of skin to the upper ones, leaving it soft, unlubricated, and breakable.

Co-author Dr Zhengchu Tan, also of the Department of Mechanical
Engineering, said: "The products that don't absorb easily into the skin
are the ones that provide a protective layer. In fact, for PPE wearers,
it's best to actively avoid creams and moisturisers which advertise a 'non-greasy feel'." Dr Masen said: "Friction can be incredibly damaging
for the skin, particularly when applied for an extended period. We hope
our study will save healthcare workers and other frontline PPE wearers
from suffering with the painful and damaging effects of skin friction."
The researchers say that while their study signposts PPE wearers to the
best skin-saving products, they are looking to perform further studies
using facial skin and more participants. Due to COVID-19 restrictions
during lockdown, they were only able to test the products on one study participant, and used his inner forearm as a surrogate for facial skin.

This research was funded by the Imperial College COVID-19 response fund.

The authors paid for the products, shipping and handling, and declare
no competing interests.


========================================================================== Story Source: Materials provided by Imperial_College_London. Original
written by Caroline Brogan. Note: Content may be edited for style
and length.


========================================================================== Journal Reference:
1. Marc A. Masen, Aaron Chung, Joanna U. Dawczyk, Zach Dunning, Lydia
Edwards, Christopher Guyott, Thomas A. G. Hall, Rachel
C. Januszewski, Shaoli Jiang, Rikeen D. Jobanputra, Kabelan
J. Karunaseelan, Nikolaos Kalogeropoulos, Maria R. Lima,
C. Sebastian Mancero Castillo, Idris K.

Mohammed, Manoj Murali, Filip P. Paszkiewicz, Magdalena Plotczyk,
Catalin I. Pruncu, Euan Rodgers, Felix Russell, Richard Silversides,
Jennifer C.

Stoddart, Zhengchu Tan, David Uribe, Kian K. Yap, Xue Zhou, Ravi
Vaidyanathan. Evaluating lubricant performance to reduce COVID-19
PPE- related skin injury. PLOS ONE, 2020; 15 (9): e0239363 DOI:
10.1371/ journal.pone.0239363 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2020/09/200924141512.htm

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