Review of Coveralls, Gowns, and their Use as Part of Personal Protective Equipment (PPE KIT) for Effective Protection of Healthcare Workers in India in COVID-19

Raag Setia,Anita Kamra Verma

doi:10.15342/ijms.2021.329

Abstract

Healthcare Workers (HCWs) and public health professionals are playing a pivotal role in containing COVID-19. Personal Protective Equipment (PPEs) are a critical component in the hierarchy of primary infection controls to ‘break the chain of infection’ to protect patients, HCW’s, and public. As SARS-CoV-2 is highly contagious, and vaccine and prophylactics not yet available, understanding correct PPE usage is imperative. This study aims to: understand purpose, use, and quality standards of body-coveralls and gowns and how to use PPE’s for effective protection in COVID 19 in India. Types of PPE’s in healthcare, their purposes, materials used, and properties were reviewed. Gowns and Body-coveralls classification and standards in Europe, USA and India were studied. While current stipulated test standards for coveralls in India are lower, as routine use of reusable gowns made of woven fabrics is more common in India, one could hypothesize that these coveralls provide a higher level of protection. As per current understanding of mode(s) of transmission of SARS-CoV-2 a properly fitted N95 respirator; goggles and splash resistant face shield; gloves; and single-use full body-coverall/gown preferably resistant to Synthetic Blood Penetration under pressure and made of non-woven Laminated SMS (Spunbond-Meltblown-Spunbond)_or Non Laminated SSMMS fabrics are advisable depending upon anticipated level of exposure. HCW’s should educated about transmission risks, correct principles of infection control, functional purpose of PPE’s and must be conscious that PPE’s alone will not protect them. They must follow good practices of how to wear (don) and how to remove (doff) and ensure that they do not inadvertently contaminate their clothing/skin and self-inoculate.

Highlights

Personal Protective Equipment (PPEs) have become important during COVID-19 pandemic due to the highly contagious nature and virulence of the virus and insufficient treatment modalities
Prevention of spread of infection in healthcare is focused on preventing infection of the patients from the Healthcare Workers (HCWs)’s and environment, starting with practice of washing hands in chlorinated water in 1846, introduced by Ignaz Semmelweis, a Hungarian physician who focused on antiseptic procedures [11]; introduction of asepsis by Joseph Lister in 1880’s; masks first used in surgery by Johann Mikulicz, (University of Breslau) who worked with bacteriologist Carl Flügge [12]
In 1976 technology developed to merge/ bond spunbond with meltblown leading to development of a triple-layered fabric of meltblown sandwiched between layers of spunbond with good strength, breathability, and filtration properties against pathogenic bacteria to some extent

Summary

Introduction

Personal Protective Equipment (PPEs) have become important during COVID-19 pandemic due to the highly contagious nature and virulence of the virus and insufficient treatment modalities. PPEs have been used time and again during epidemics and pandemics, and are in routine use as a critical component in the hierarchy of controls as part of infection control to protect healthcare workers (HCW’s), patients and others from health-related risks, and exposure to infections. HCW’s are in the combat zone when treating communicable diseases and risk getting infections [1][2]. The rapid spread of COVID-19, and reports of many HCW’s including doctors and nurses getting infected while treating patients, led to the realization that the routine PPE’s and practices are not sufficient. As countless HCW’s were affected there developed need for suitable PPEs in large quantities. This research is important as need for suitable PPE’s in large numbers continues and though

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