PONE-D-20-14972

Online survey on healthcare skin reactions and urinary symptoms for wearing medical protective equipment in Hubei Province, China

PLOS ONE

Dear Dr. Meng,

Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process.

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The reviewers have raised a number of concerns that need attention. They request additional information on methodological aspects of the study, revisions and additions to the statistical analyses, and they have raised concerns regarding the potential for response bias.

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PLOS ONE

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Partly

Reviewer #2: Partly

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2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: No

Reviewer #2: No

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Reviewer #1: Yes

Reviewer #2: No

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Reviewer #1: Yes

Reviewer #2: No

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5. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: Important text regarding the occurrence of adverse skin and urinary events due to the use of PPE.

The authors describe the problem with theoretical support.

I make considerations about the method:

1) Cross-sectional studies suggest prevalence information.

2) It´s interesting to carry out descriptive statistical tests (simple and absolute frequencies, mean, standard deviation) and to calculate the point prevalence.

3) It´s important calculating the association between explanatory variables.

4) Describe the Delph technique in detail and the number of rounds to validate the instrument.

5) The strategy for recruiting participants must be detailed in the text. How was the invitation forwarded?

6) Is it possible to describe which dressings were used for prevention? What types of moisturizing creams?

7) I suggest reading this article that deals with the same subject with similar methodology: https://www.scielo.br/scielo.php?script=sci_arttext&pid=S0034-71672020001400159&lng=pt&nrm=iso&tlng=en&ORIGINALLANG=en

Reviewer #2: The paper reports data on skin symptoms due to use of personal protective equipment in a small number of health care workers. In general, the paper reports high percentage of irritant symptoms with a very limited statistical analysis. Moreover, also the discussion is quite poor on skin symptoms due to PPE that are reported in many papers, not in relation to COVID-19 diseases.

I suggest some improvement

1. Title: Urinary symptoms. I think that put together skin symptoms with urinary symptoms can lead to misunderstanding of the reactions to personal protective equipment. I suggest to describe only skin symptoms

2. Abstract

Please delete urinary symptoms: there are not reason to put all together

3. Text The number of subjects investigated is low and positive answers for skin symptoms (more than 70%) suggests that there were a selection bias (only workers with symptoms answered the questionnaire?. Please specify the response rate of the population investigated)

4. Line 56 and urinary tract symptoms (UTS) like frequent urination due to consistent heat or prolonged voiding

Please delete

Line 134 The A. reports incidence of skin symptoms, please note that incidence are new cases on considered time, while the table reported data on prevalence of symptoms

5. Consider to do a better statistical analysis to verify factors related to skin symptoms

6. Improve discussion with data on skin symptoms in relation to masks and gloves

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Reviewer #1: Yes: JULIANO TEIXEIRA MORAES

Reviewer #2: No

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Online survey on healthcare skin reactions for wearing medical-grade protective equipment against COVID-19 in Hubei Province, China

PONE-D-20-14972R1

Dear Dr. Meng,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication.

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Kind regards,

Juliano Teixeira Moraes

Guest Editor

PLOS ONE

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Reviewers' comments: