11/04/2020
PERSONAL PROTECTIVE EQUIPMENTS AND THEIR ROLE:
for communicable disease exposure, PPE is specialized clothing or equipment used to prevent contact with hazardous substances. Its use is an integral part of infection control and prevention measures that protect workers from exposure to blood, body fluids, and other potentially infectious materials. PPE such as gowns, gloves, masks, and goggles provide physical barriers that prevent the hands, skin, clothing, eyes, nose, and mouth from coming in contact with infectious agents. PPE is used to reduce transmission of communicable diseases when other measures such as engineering controls and work practices cannot completely eliminate exposure.
Employers are required by OSHA standard 29 CFR Part 1910.132 to assess the workplace for hazards that necessitate the use of PPE and document that such an assessment has been done. They must also provide appropriate PPE in the workplace, store and maintain PPE in good working order, train employees on proper use of PPE, and ensure that employees use PPE appropriately. The following PPE affords protection of mucous membranes, skin, and clothing from infectious agents. Local public health agencies must have these items readily available at all times for use by employees with exposure to communicable diseases. Items such as uniforms, pants, blouses, and eyewear not intended to protect against communicable diseases are not considered PPE.
Gloves
Clean, disposable gloves are worn during direct contact with blood/body fluids, mucous membranes, non-intact skin, or any other potentially infectious material. They are also worn as a part of contact precautions (for persons infected with pathogens transmitted by the contact route, such as MRSA, VRE, and RSV) while directly touching the patient or when in the immediate patient environment.
Disposable gloves are available in latex, vinyl, and nitrile materials. Since many individuals are allergic to latex, vinyl, or nitrile gloves are recommended alternatives. Vinyl gloves can be used for brief patient contact but nitrile gloves provide greater barrier protection for extended patient care activities or those requiring more manual dexterity. Local health agencies can select either vinyl or nitrile products for their clinical functions.
Discard gloves at point of use and wash hands immediately after removing gloves.
Gowns
Isolation gowns are used as part of standard and contact precautions to protect clothing and arms of health care workers. When used for standard precautions, gowns are worn only if contact with blood/body fluids is expected. Fluid resistant gowns should be used when splashes or sprays of blood/body fluids are expected. For contact precautions, gowns are worn during all patient contact and when in the patient’s environment. Gowns are always worn in combination with gloves, and with other PPE when indicated. Remove at point of use and discard disposable gowns or place cloth gowns in laundry container. Wash hands immediately after removing all PPE.
Surgical masks
Surgical masks are used to protect the mouth and nose from splashes or sprays of blood/body fluids, or respiratory secretions, and to place on coughing patients to reduce dissemination of respiratory secretions. They may have either ear loops or ties, and can be either pleated or made of molded material.
Surgical masks are cleared by the FDA as having fluid-resistant properties.
Procedure masks
Procedure or isolation masks may also be used to protect the mouth and nose, but are not cleared by the FDA for fluid resistant properties. There is no evidence to show that surgical masks are more protective than procedure masks, but there may be more variation in quality and performance among procedure masks. Many procedure masks have built-in eye protection, and are available in pleated or molded styles.
Local health agencies may select either surgical or procedure masks, depending on employees’ preference.
Eye protection
Goggles or face shields are used to protect eyes from splashes or sprays of blood/body fluids. Personal eye glasses or contact lenses are not considered adequate eye protection. Goggles and face shields should wrap around the sides of the face to protect splashes from all angles.
Respiratory protection
PAPRs are battery operated respirators that filter the air before it enters a hood worn over the head. Loose fitting PAPRs do not require fit-testing but users must undergo a medical evaluation prior to wearing. Many users prefer PAPRs over an N-95 FFP as a more comfortable option for respiratory protection. Unlike N-95 FFPs, PAPRs require battery maintenance and cleaning procedures between uses.
Filtering face pieces (FFP) and respirators such as powered air-purifyin respirators (PAPR) are used to filter the air of small infectious particles such as TB bacteria or the SARS virus before entering the respiratory tract. The type of FFP used to protect against infectious diseases is a NIOSH approved N-95 filtering face piece, which is available in many styles, including pleated, molded, and duck-billed. Wearers must be fit-tested and receive a medical evaluation before they can use a FFP or a respirator.
Employees who share the same air space with suspect or known TB patients, Avian influenza patients, or who will be in direct contact with pandemic influenza patients need to wear a NIOSH approved fit-tested N-95 FFP or a PAPR until they are no longer in the air space shared by the infectious person.
