Disposable Coveralls Research Articles

Operating Room Airborne Microbial Load: Nonscrubbed Staff Apparel Matters

BackgroundInfection is a leading cause of total joint arthroplasty failure. In previous studies, we found correlations between the level of contamination, concentrations of airborne particles, and the number of staff present. In this study, we focused on the apparel of nonscrubbed operating room (OR) staff to elucidate their contribution to the airborne microbial load. MethodsWe compared hospital-laundered scrubs to disposable coveralls using 2 methods. (1) Participants entered an isolation chamber with a controlled environment and completed tasks for 1 hour wearing both the approved and alternative OR attire. Settle plates collected viable contaminants that were shed by the participants during testing. (2) Lab members conducted standardized maneuvers in a functional OR that simulated typical movements of the nurse, anesthesiologist, implant representative, and entering/exiting staff. An airborne particle counter and settle plates were positioned throughout the OR. After 1 hour, the staff changed apparel and repeated the test. Each session of both phases consisted of 2 tests by the same individuals on the same day. ResultsThere was approximately a 10-fold difference in the settlement rate of viable particles between groups when employing the isolation chamber. The settle rate for scrubs was 5,519 ± 1,381 colony forming units (CFUs)/m2/h, while the settle rate for coveralls was 505 ± 55 CFUs/m2/h (P = .008). During testing in the OR, 218.7 ± 35 CFUs/m2/h were captured for scrubs, compared with 50.5 ± 13 CFUs/m2/h for the coverall (P < .01). The concentration of airborne particles collected for scrubs was 4,952.1 ± 495 particles/m3 and 1,065 ± 53 particles/m3 for the coveralls (P < .01). This was a 77% and 79% reduction for both measures, respectively. ConclusionsThe open nature of standard scrubs allows contaminated particles to escape into the OR environment, whereas the one-piece design of the coveralls restricts pathways of escape. The results of this study may be helpful when developing hospital infection prevention policies.

Exposure risk management: Personal protective equipment and the risk of accidents occurring during aerosol generating procedures applied to COVID-19 patients.

COVID-19 is considered to be very contagious as it can be spread through multiple ways. Therefore, exposure risk of healthcare workers (HCWs) treating COVID-19 patients is a highly salient topic in exposure risk management. From a managerial perspective, wearing personal protective equipment and the risk of accidents occurring during aerosol generating procedures applied to COVID-19 patients are two interconnected issues encountered in all COVID-19 hospitals. The study was conducted to understand the realistic impact of exposure risk management on HCWs exposed to risks of SARS-CoV-2 virus infection in a healthcare unit. In particular, this study discusses the role of personal protective equipment (PPEs) used in aerosol generating procedures (AGPs) to protect HCWs, and the related risk of accidents occurring when performing AGPs. This is a cross-sectional single-hospital study conducted at the "Sf. Ioan cel Nou" Hospital in Suceava, Romania, that had to ensure safety of healthcare workers (HCWs) getting in contact with COVID-19 cases. Data used in the study were collected between 10.12.2020-19.03.2021 by means of a questionnaire that collected information on risk assessment and healthcare workers' exposure management, and which was translated and adapted from the World Health Organization (WHO) and applied to respondents online. For this purpose, ethical approval was obtained, doctors and nurses from all hospital departments being invited to complete the questionnaire. Data processing, as well as descriptive, correlation and regression analyses have been done by using the 21.0 version of the Statistical Package for Social Sciences software. Most of the 312 HCWs reported having always used disposable gloves (98.13%), medical masks N95 (or equivalent) (92.86%), visors or googles (91.19%), disposable coverall (91.25%) and footwear protection (95.00%) during AGPs. The waterproof apron had always been worn only by 40% of the respondents, and almost 30% of staff had not used it at all during AGPs. Over the last three months, the period when the questionnaire was completed, 28 accidents were reported while performing AGPs: 11 accidents with splashing of biological fluids/ respiratory secretions in the eyes, 11 with splashing of biological fluids/ respiratory secretions on the non-idemn skin, 3 with splashing of biological fluids/ respiratory secretions in the oral/ nasal mucosa and 3 with puncture/ sting with any material contaminated with biological fluids/ respiratory secretions. Also, 84.29% of respondents declared having changed their routine, at least, moderately due to COVID-19. An effective risk exposure management is based on wearing protective equipment. The only protection offered by the disposable coverall, as it results from our analysis, is related to splashing of biological fluids/ respiratory secretions on the non-idemn skin. In addition, the results show that the number of accidents should decrease due to the fact that disposable gloves and footwear protection are used while performing AGPs on patients with COVID-19 and hand hygiene is practised before and after touching a patient with COVID-19 (regardless of glove wearing).

Effectiveness of Personal Protective Equipment in Reducing Skin Exposure to Soluble Platinum

Various forms of personal protective equipment (PPE), including disposable coveralls and gloves, are used to help reduce skin exposure to soluble platinum in precious metals refineries. We aimed to investigate the effectiveness of PPE in reducing workers' skin exposure to soluble platinum. Thirty precious metals refinery workers were divided into two groups according to their use of PPE and related procedures. Group A (n = 13) used disposable coveralls worn over standard overalls along with long-sleeved rubber gloves, while Group B (n = 17) used standard overalls only and surgical nitrile gloves. The skin (palm, wrist, neck, and forehead) and respiratory exposure of these groups to soluble platinum were concurrently measured (using Ghostwipes™ and MDHS 46/2, respectively) along with their urinary platinum excretion. Both groups of workers experienced comparable geometric mean (GM) respiratory exposure to soluble platinum (Group A = 0.744 µg m-3 versus Group B = 0.711 µg m-3) (P = 0.789), but significantly lower skin exposure (average of all measured anatomical areas) was found for Group A (Group A = 0.005 µg cm-2 versus Group B = 0.033 µg cm-2) (P = 0.018). Significantly lower skin exposure was measured on the palm (P = 0.017), wrist (P = 0.017), forehead (P = 0.027) of Group A workers compared with Group B. No significant difference was found for the urinary platinum excretion of the two groups (Group A GM = 0.208 µg g-1 creatinine versus Group B GM = 0.361 µg g-1 creatinine) (P = 0.273). The use of disposable coveralls and long-sleeved rubber gloves, along with strict usage procedures, proved effective in reducing precious metals refinery workers' skin exposure to soluble platinum.

Black Water Protection Bundle for First Responders and the Healthcare Environment

<h3>Background</h3> Black water flooding and other biological spills occur not too infrequently in the healthcare setting. Our first responders from engineering and environmental services teams often do not have immediate access to personal protective equipment (PPE) and other environmental supplies to prevent bodily exposures and contain the spread of contamination to the rest of the facility. <h3>Methods</h3> The Infection Prevention, Engineering, and Environmental Services Teams met to create a GRAB-AND-GO SPILL KIT BUNDLE. The team looked at existing resources at the Supply Chain Department that will meet PPE needs, namely: masks with eye protection, long nitrile gloves, long boot covers, waterproof and disposable coveralls, and tubs of bleach wipes. To contain the fluid spill, the following were purchased: three wet high efficiency particulate air (HEPA) filter vacuums, capable of trapping 99.7 percent of airborne particles larger than 0.3 microns when suctioning contaminated fluid, marine-grade fluid containment booms, and large absorbent pads. The last two replaced towels and linens for containing the spread of contaminated fluid. A cleanable rubber walk-off mat was added to serve as a neutral zone between the clean and contaminated areas of the flood or spill site. A list of supply inventory was included to the kit to establish maintenance par levels. <h3>Results</h3> Three units of the GRAB-AND-GO SPILL KIT were created to address the following: speedy and efficient response to the black water flooding or spills, protection of first responders from biological contamination and exposures, and containment of contaminated fluid and wastes from spreading to the rest of the facility. <h3>Conclusions</h3> First responders need immediate access to supplies to contain black water flooding and spills in the healthcare setting. This was achieved through a bundled approach, the handy GRAB-AND-GO KITS made it possible to protect both the first responders and the healthcare environment from biological exposures and contamination, respectively.

Modeling airborne nanoparticle filtration through a complete structure of non-woven material used in protective apparel

Airborne nanoparticles represent a new danger in occupational health. Numerous theoretical and experimental studies have been conducted on the efficiency of filtering media used for respiratory protection, but few have focused on media used for skin protective equipment. Indeed, a significant proportion of airborne nanoparticles can end up on the skin, causing local effects and eventually penetrating the human body. Following experimental data obtained with sodium chloride nanoparticles, the authors propose an empirical model to evaluate the penetration of airborne nanoparticles through medium used in disposable coveralls. This study presents an adaptation of the conventional filtration theory used for filtering media used in respirators. The authors' model is compared with Wang et al.'s and Brochot's models and demonstrates improvements in their descriptive ability. Moreover, a domain of validity of the proposed model was determined that will enable the evaluation of the efficiency of similar protective apparel material structures against airborne nanoparticles.

Life Cycle Assessment of Reusable and Disposable Cleanroom Coveralls.

Cleanroom garments serve a critical role in such industries as pharmaceuticals, life sciences, and semiconductor manufacturing. These textiles are available in reusable and disposable alternatives. In this report, the environmental sustainability of cleanroom coveralls is examined using life cycle assessment technology. The complete supply chain, manufacture, use, and end-of-life phases for reusable and disposable cleanroom coveralls are compared on a cradle-to-end-of-life cycle basis. Three industry representative coveralls are examined: a reusable woven polyethylene terephthalate (PET) coverall, a disposable flash spunbonded high-density polyethylene (HDPE) coverall, and a disposable spunbond-meltblown-spunbond polypropylene (SMS PP) coverall. The reusable cleanroom coverall system shows substantial improvements over both disposable cleanroom coverall systems in all environmental impact categories. The improvements over the disposable HDPE coverall were 34% lower process energy (PE), 23% lower natural resource energy (NRE), 27% lower greenhouse gas (GHG) emissions, and 73% lower blue water consumption. The improvements over the disposable SMS PP coverall were 59% lower PE, 56% lower NRE, 57% lower GHG emissions, and 77% lower blue water consumption. In addition, the reusable system shows a 94-96% reduction in solid waste to the landfill from the cleanroom facility. Between the two disposable cleanroom coveralls, the flash spunbonded HDPE coverall shows a measurable environmental improvement over the SMS PP coverall.LAY ABSTRACT: Pharmaceutical drugs are manufactured and handled in controlled environments called cleanrooms to ensure the safety and quality of products. In order to maintain strict levels of cleanliness, cleanroom personnel are required to wear garments such as coveralls, hoods, and gloves that restrict the transfer of particles from the person to the environment. These garments are available in reusable and disposable types. Cleanroom operators consider a number of factors when selecting between reusable and disposable garments, including price, comfort, and environmental sustainability.In this report, the environmental sustainability of reusable and disposable cleanroom coveralls is examined using a technique called life cycle assessment. With this technique, environmental parameters such as energy use and greenhouse gas emissions are quantified and compared for three market representative cleanroom coveralls, from raw material extraction through manufacturing, use, and final disposal. Reusable coveralls were found to substantially outperform disposable coveralls in all environmental parameters examined. This is an important conclusion that supports cleanroom companies that select reusable coveralls to be more sustainable.

Efficiency of five chemical protective clothing materials against nano and submicron aerosols when submitted to mechanical deformations

ABSTRACTDue to their potential toxicity, the use of nanoparticles in the workplace is a growing concern. Some studies indicate that nanoparticles can penetrate the skin and lead to adverse health effects. Since chemical protective clothing is the last barrier to protect the skin, this study aims to better understand nanoparticle penetration behaviour in dermal protective clothing under mechanical deformation. For this purpose, five of the most common types of fabrics used in protective clothing, one woven and four nonwoven, were chosen and submitted to different simulated exposure conditions. They were tested against polydispersed NaCl aerosols having an electrical-mobility diameter between 14 and 400 nm. A bench-scale exposure setup and a sampling protocol was developed to measure the level of penetration of the aerosols through the material samples of disposable coveralls and lab coat, while subjecting them to mechanical deformations to simulate the conditions of usage in the workplace. Particle size distribution of the aerosol was determined upstream and downstream using a scanning mobility particle sizer (SMPS). The measured efficiencies demonstrated that the performances of nonwoven materials were similar. Three nonwovens had efficiencies above 99%, while the woven fabric was by far, the least effective. Moreover, the results established that mechanical deformations, as simulated for this study, did not have a significant effect on the fabrics' efficiencies.

Health and the Environment after Hurricane Katrina

Health and the Environment after Hurricane Katrina

Effect of Abrasion on Penetration of Tri-allate Through Selected Disposable Coverall Fabrics

Many agricultural workers wear disposable nonwoven coveralls while applying pesticides in the field. The degree of protection these garments offer after abrasive wear has not been studied. The purpose of this study was to examine the effects of abrasion on the penetration of a liquid pesticide, tri-allate, through selected disposable garment fabrics: Kleenguard® EP and Tyvek®. The relationship between the initial thickness and the initial mass of the fabric specimens and pesticide penetration also was examined to determine the effect of initial fabric variability on penetration. Penetration of tri-allate through the two fabrics differed statistically although total penetration was less than 1 % for both fabrics. Abrasion simulating one day's wearing resulted in a statistically significant increase in penetration through Kleenguard® EP but had no effect on penetration through Tyvek®. Initial mean thickness correlated with the penetration of tri-allate for Tyvek® at all three levels of abrasion and for unabraded Kleenguard® EP, but there was no correlation between initial mean thickness and pesticide penetration on abraded Kleenguard® EP specimens. Abrasion was a greater determinant of the rate of pesticide penetration than initial variability in thickness for Kleenguard® EP; initial variability in thickness remained a significant factor in pesticide penetration even after abrasion for Tyvek®. Initial mass did not correlate with pesticide penetration for either fabric.

A survey on physiological strains of asbestos abatement work wearing protective clothing in summer

Since the health hazard of asbestos fibers has been widely recognized, the number of asbestos abatement projects in schools has increased rapidly. Most of these projects were planned during summer vacation from school. However, in Japan, it is hot and humid in summer. Moreover, the workers have to wear impermeable protective clothing because of the asbestos exposure risk. The purpose of this survey is to study the workload of asbestos abatement work by measuring physiological reactions. Physiological strains of 12 male workers and working conditions during asbestos abatements work in two schools were measured in August in 1988 and in 1989. Body weight loss by the work of all workers was measured, and heart rate, rectal temperature and skin temperatures at five sites of some of them were measured every minute. In both workplaces, the workers wore disposable coveralls with hoods and shoes covers and protective masks. Air temperature in the workplaces was between 24.6 degrees C and 28.8 degrees C, and air humidity was between 85% and 96%. The high humidity was result of covering the floor, ceiling and wall of the workplaces were covered with vinyl seats, and sprinkling the asbestos fibers with water to lower the amount of asbestos in the air. Working hours of asbestos abatement were between 46 minutes and 95 minutes. Sweat rates were between 217 g/h and 605 g/h. These values were greater compared to the estimate values when work was done wearing commonly used light clothing. Heart rates during asbestos abatement work did not exceed 150 beats/min in one school where the temperature was 25 degrees C-27 degrees C.(ABSTRACT TRUNCATED AT 250 WORDS)

Attitudes and Behavioral Intentions of Agricultural Workers Toward Disposable Protective Coveralls

The purpose of this study was to understand better the behavior of grain farmers toward the use of disposable protective coveralls by measuring beliefs, attitudes, and other components of the Fishbein-Ajzen theory of reasoned action and determining relationships among these components. The results indicate that most of the farmers believe that wearing disposable coveralls would provide the best method of protection and a more secure feeling about pesticide use. Respondents believe important referents such as their spouses will likely suggest that disposable coveralls should be worn while applying pesticides. Overall, farmers have positive attitudes and behavioral intentions. Pearson correlations and regression analyses indicate significant relationships among all components of the model. Attitude and subjective norm together provide considerable influence on behavioral intention with attitude being the stronger component. Thus the Fishbein-Ajzen model was applied effectively to the behavior of wearing disposable protective coveralls.

Air contamination in open heart surgery with disposable coveralls, gowns, and drapes

The effect of a polypropylene coverall, replacing shirt and trousers, combined with sterile laminated gowns and drapes compared with an all-cotton system was studied in regard to the dispersion of bacteria and particles in a conventionally ventilated operating theater. The operations carried out were open heart procedures in 30 adult patients. Blood agar sedimentation plates were placed in the operative, anesthesia, and perfusion areas. The mean sedimentation values during 1 hour after the start of operation were as follows in the laminate group: 63 colony-forming units (cfu)/m 2 in the operative area; 77 cfu/m 2 in the anesthesia area; and 143 cfu/m 2 in the perfusion area. The corresponding figures in the cotton group were 350 cfu/m 2, 364 cfu/m 2, and 437 cfu/m 2, respectively ( p < 0.0002). At the beginning of the operation, the mean values noted for colony-forming units in the air at the operative site were 8.0 cfu/m 3 in the lamiaate group and 31 cfu/m 3 in the cotton group. One hour later, the values were 10 cfu/m 3 and 22 cfu/m 3, respectively ( p < 0.0002). At the end of the operation, the number of particles 5 μm or larger in the air at the operative site was 278/m 3 in the laminate group and 592/m 3 in the cotton group. It is concluded that the use of a polypropylene coverall and laminated gowns and drapes significantly reduces the particle and bacterial contamination of the air and the bacterial sedimentation during cardiac operations.

Physiological and Subjective Responses to Working in Disposable Protective Coveralls and Respirators Commonly Used by the Asbestos Abatement Industry

The physiological and subjective effects of working with different respirators while wearing lightweight disposable (Tyvek 1412 polyolefin) coveralls commonly used by the asbestos abatement industry were studied. Nine healthy men (mean age = 27.3 yr, weight = 76.9 kg) each performed a series of four exercise tests with four different respirator ensembles in counterbalanced order. Treadmill work was performed at a set walking speed of 4 kph (2.5 mph), 0 percent elevation (220 kcal/hr), a controlled environmental temperature of 33.9 degrees C, and 50% relative humidity. Each test continued up to 120 min, with repeated work/rest intervals of 26 min of work and 4 min of rest. Tyvek disposable coveralls and hoods were worn with each of these four different respirator ensembles: (1) control--a lightweight, low resistance mask; (2) HEPA--an air purifying, full facepiece respirator with dual high efficiency filters; (3) SAR--a supplied-air, pressure-demand respirator with escape filter; (4) SCBA--an open circuit, pressure-demand, self-contained breathing apparatus. Physiological measurements obtained every minute during each test included heart rate and skin and rectal temperatures. Subjective evaluations of clothing, respirator, and facepiece comfort, ease of breathing, temperature and perspiration in the mask and clothing, and respirator load also were measured at the end of the test. Data were analyzed using an analysis of variance. Results indicated that heart rate at the end of the test differed by less than 8 BPM between the control condition and the SCBA (heaviest) condition.(ABSTRACT TRUNCATED AT 250 WORDS)

Performance Standards for Improving Chemical Protective Suits

This paper describes the basis and requirements of various standards for the manufacture of chemical protective suits currently under development by the Ameri can Society for Testing and Materials (ASTM) and the National Fire Protection Association (NFPA). Standards of both groups are aimed at improving product doc umentation to allow end users to have better information for selecting chemical pro tective suits for their respective applications. NFPA standards will also establish minimum performance requirements judged necessary to provide acceptable levels of protection for end users involved in hazardous chemical response and operations. These standards cover the full range of chemical protective suits ranging from dis posable coveralls to totally-encapsulating protective ensembles. Documentation and performance requirements apply to suit materials and components as well as to the total suit. ASTM and NFPA expect to complete and promulgate each of the standards by late 1989

Exposure of spray applicators and mixer-loaders to chlorobenzilate miticide in Florida citrus groves.

Exposure of applicators and mixer-loaders to chlorobenzilate in Florida citrus groves was monitored on each person with dermalα-cellulose pads attached at 12 locations on the body and with personal air monitors worn by each subject. Urine samples were analyzed for the presence of chlorobenzilate metabolites. Applicators received about four times the dermal exposure of mixer-loaders but did not have significantly higher urinary metabolite levels. Respiratory exposure was uniformly low. Disposable coveralls reduced urinary metabolite excretion rates 24%. Disposable coveralls and hand protection covering the wrist afforded practical protection.

Worker exposure to paraquat and diquat.

Exposure of workers applying paraquat to fields of tomatoes and citrus, and diquat to waterways containing water hyacinths and hydrilla, was monitored with dermal α-cellulose pads attached at each of ten body locations and with personal air monitors. Estimated total body exposure for tomato applicators was apparently influenced by tractor type. Exposure levels from highest to lowest were: open tractor > enclosed cab tractor ⩾ high-clearance tractor. Citrus applicators' exposure to paraquat averaged 28.5 mg/hr and 12.2 mg/hr, with tank concentrations of 0.11% and 0.07%, respectively. Diquat applicators received minimal exposure. Respiratory exposure was <0.1% of the total body exposure in all experiments. Urine samples collected periodically for all workers were, with one exception, without detectable pesticide contamination. Use of disposable coveralls and regularly washed impermeable gloves should effectively reduce exposure.

Exposure of Florida airboat aquatic weed applicators to 2,4-Dichlorophenoxyacetic acid (2,4-D)

Florida airboat handgun applicators were monitored for exposure to 2,4-Dichlorophenoxyacetic acid (2,4-D). Four applicators were monitored with air samplers, α -cellulose patches, and 24 hr urine samples on 10 separate days. Estimated total body exposure averaged 15 ± 2 mg/hr, of which 74% was to the legs and feet with an additional 18% to the hands and arms. Estimated respiratory exposure was about 0.03% of the total body exposure. Twenty-four hr urinary 2,4-D ranged from 0.190–0.645 mg. The use of disposable coveralls and effective hand protection would markedly reduce this exposure.