Health workers with religious beards experiencing professional discrimination amid COVID-19, UK study finds

By Angela Betsaida B. Laguipo, BSNNov 8 2020

The coronavirus disease 2019 (COVID-19) pandemic continues to rage across the globe, leaving few lives untouched by its many dramatic effects and its major ramifications on public health, economic vitality, and society's welfare – not least, a recent study suggests, those working in healthcare. Health workers have been on the frontline of the ongoing health crisis, working hard to save lives from the virus. It comes as no surprise, then, that many healthcare workers have been negatively affected by a plethora of both primary and knock-on effects of the pandemic.

A new study conducted by researchers across the UK has looked at how male health workers with religious beards have been affected by workplace practices during the pandemic. The researchers from Stepping Hill Hospital in Stockport, UK, sought to determine some of the effects on male healthcare workers who had been asked to remove their beards in light of personal protective equipment (PPE) policies, particularly strict mask fit-testing stipulations.

Study: The impact of keeping a religious beard in the COVID-19 pandemic: an online cross-sectional survey study exploring experiences of male medical healthcare professionals. Image Credit: Krakenimages.com / Shutterstock

*Important notice: medRxiv publishes preliminary scientific reports that are not peer-reviewed and, therefore, should not be regarded as conclusive, guide clinical practice/health-related behavior, or treated as established information.

The study also aimed to estimate the number of men who kept religious beards or trimmed/shaved them during the pandemic, as well as those who continued to wear their religious beards and faced subsequent problems in the workplace.

In many healthcare facilities in the United Kingdom, there has been a disproportionate effect on individuals from Black, Asian, and minority ethnic (BAME) backgrounds. Subsequently, there has been much debate on the reasons why exactly it is that minority groups have been affected, including the availability of PPE for healthcare workers in general.

Included in a lot of PPE is the filtering facepiece (FFP3) or a powered air-purifying respirator (PAPR) hood. The FFP3 needs fit testing to ensure it can be securely sealed to protect the user during exposure to infected patients.

Yet, the fit testing of the mask poses many challenges. First, it is hard to test the mask's effectiveness on all the healthcare staff, which leads to the potential wastage of vital supplies. Moreover, some people may not pass the fit test due to their facial structure or anatomy, including those with facial hair or beards.

Many men with religious beards have been left with little choice but to trim or shave them off. Many religious men, such as Muslims, Sikhs, and Jews, consider their beads an integral part of their religious identity. Asking these men to shave or remove their beards may negatively impact their spiritual, psychological, and emotional well-being.

The study

In the study, which appeared on the pre-print server medRxiv* in November 2020, the team used online social media tools such as Facebook, Twitter, Linkedin, and Whatsapp between April and May, the peak of the COVID-19 pandemic in the United Kingdom, to gather their data. The researchers distributed the survey to the participants through Google Forms.

Overall, 469 healthcare professionals with beards participated in the study. They were asked questions regarding the challenges they faced with the use of PPEs, mask fit testing, and their employers' and co-workers' attitudes towards their facial hair.

The research team found that the healthcare workers experienced professional discrimination through fit testing rejection, unavailability or inadequate PPR, and subsequent pressure to shave their beards. These are unpleasant outcomes of the COVID-19 pandemic for some of the NHS's staff.

"Discrimination against staff is linked to poorer outcomes for patients, and little progress has been made in the last two decades on this front," the researchers wrote in the paper.

"Our findings are consistent with previous research which demonstrated discrimination faced by Muslim women with respect to dress codes in theatre and hospital ward environments," they added.

The researchers have suggested that insufficient consideration was given to the beard's importance for these health care workers. They argue that accommodating those who have religious facial hair – through to failure to provide alternative PPEs or let the staff perform an alternative type of work – was not adequately provided.

The COVID-19 pandemic

The coronavirus pandemic emerged in Wuhan City in the Hubei Province of China in December 2019. From there, it has rapidly spread to 190 countries across the globe, infecting over 50 million people and claiming at least 1.25 million lives.

Many healthcare workers in Britain have been infected by the virus or have experienced stress and anxiety-related issues resulting from the pressure healthcare systems have been under due to COVID-19.

The present study highlights some of the less apparent ways in which the COVID-19 pandemic has taken its toll on healthcare workers battling to save the lives of those with severe and critical cases of COVID-19 in hospitals. It also underscores a complex and thorny issue healthcare employers face in striking a balance between observing workplace cultural sensitivity while maintaining adequate protective procedures for staff when working with SARS-CoV-2 infected patients.

*Important notice: medRxiv publishes preliminary scientific reports that are not peer-reviewed and, therefore, should not be regarded as conclusive, guide clinical practice/health-related behavior, or treated as established information.