Assessing patterns of body contamination after personal protective equipment removal among health care workers: A scoping review

Abstract

It is now widely recognized that health care personnel (HCP) are at risk of contamination with pathogens during personal protective equipment (PPE) doffing. Studies of this phenonemona, have utilized a variety of PPE ensembles, doffing methods, and experimental methods. A scoping review was performed, consistent with PRISMA guidance. The PubMed and sciVerse Scopus databases were searched using an a priori search strategy. Data were extracted for analysis using the matrix method, and then a narrative analysis was performed. Articles were classified based on PPE ensemble. Only 19 of 151 articles were included in the final analysis. All included studies reported some post-doffing contamination, and this contamination was most frequently observed on the hands, wrist, face, and neck. Reviewed studies used a variety of tracer contaminants, PPE ensembles, doffing protocols, tracer assessment locations, and methods, making it difficult to identify patterns across studies. Additional research is needed to improve the study methodology related to the selection and placement of tracers to ensure sensitive detection of post-doffing contamination, compare how specific doffing procedures or pieces of PPE influence post-doffing contamination, and to understand what post-doffing contamination means for patient and HCP infection risk.