Selection Of Personal Protective Equipment Research Articles

Guarding Our Guardians: Navigating Adverse Reactions in Healthcare Workers Amid Personal Protective Equipment (PPE) Usage During COVID-19.

The widespread utilization of personal protective equipment (PPE) during the COVID-19 pandemic has been crucial for reducing transmission risk among healthcare workers (HCWs) and the public. However, the extensive use of PPEhas brought about potential adverse reactions, particularly among HCWs. This study aims to investigate the prevalence and characteristics of adverse skin reactions associated with PPE use among different categories of HCWs, including faculty, residents, and nursing officers (NOs), in a dedicated tertiary care COVID-19 hospital. The study design was a hospital-based cross-sectional analytical study conducted over one month, involving a total of 240 participants. The participants were required to complete a pre-tested semi-structured questionnaire that covered demographic information, PPE-related data, preventive measures, observed reactions, and self-management strategies. Results indicated that adverse skin reactions were common among HCWs, with reactions reported by all participants. The most commonly used PPE included N95 masks, goggles, gloves, face shields, isolation gowns, and medical protective clothing. Excessive sweating (60% residents, 21.1% NOs, and 16.25% faculties), facial rash, dry palms (>70% of HCWs), and itching were among the most prevalent adverse reactions. Urticarial lesions (28.5% among NOs), pressure marks and pain (100% on the cheek among all HCWs), fungal infections (18.5% among residents at the web space of fingers), and skin breakdown were also reported. Factors such as age, gender, pre-existing skin problems, and oily/acne-prone skin history were found to be significantly associated with adverse skin reactions. In conclusion, the findings highlight the common adverse reactions reported by HCWs during the use of different PPEs. Certain steps taken by HCWs for the prevention of adverse reactions due to PPE emphasize the importance of tailored preventive measures and strategies to mitigate these adverse reactions, such as proper PPE selection, well-fitting equipment, regular breaks, and appropriate skincare practices. These insights contribute to the development of guidelines for optimal PPE usage and support the well-being of HCWs in their essential roles.

Literature analysis on material selection and evaluation for firefighter gloves

PurposeFirefighter Personal Protective Equipment (PPE) is the only barrier between the firefighter and hazardous environment. Gloves are a crucial component of the multi-component PPE. Over time the gloves have reduced the intensity of hand injuries, yet further improvement in terms of material selection and glove design is required to strike the balance between protection and comfort. Focusing on the material aspect, the purpose of this study is to present literature analysis on material selection and testing for firefighter gloves.Design/methodology/approachThe study conducted a literature analysis on material selection and characterization of firefighter PPE. The review summarizes and evaluates past work addressing the characterization of firefighter gloves in accordance with NFPA 1971 requirements and points out found research gaps to aid with foundation of future research.FindingsThe study summarizes several research works to inform readers about the material selection and characterization of firefighter gloves. Based on the analyzed literature, the study resulted in material specification sheets for firefighter gloves. The developed material specification sheets provide information in terms of crucial material properties to be incorporated for accurate functioning of firefighter gloves, testing methods to validate those material properties and materials from analyzed literature exhibiting desired properties.Originality/valueWith large research addressing firefighter PPE, only limited studies focus specifically on gloves. Thus, this study provides a literature analysis covering material selection and testing for gloves. A consolidated firefighter gloves material specification document, which does not appear to be available in the literature, will provide a foundation for the development and characterization of firefighter gloves to better serve the functions along with ensuring user comfort.

RISK-BASED APPROACH WHEN SELECTING PERSONAL PROTECTIVE EQUIPMENT FOR WORKERS IN THE OIL AND GAS INDUSTRY

With the high risk of injury in the oil industry, worker safety is of paramount importance. Personal protective equipment (PPE) plays a critical role in worker protecting from various occupational hazards.Since September 1, 2023, according to the Order of the Ministry of Labor, uniform standard rules using a risk-based approach when issuing personal protective equipment were introduced,. If previously PPE was issued according to uniform standard rules, now standards drawing up will consist of two stages:- selection based on the employee’s position/profession;- selection based on risks at a given workplace.But how to do this and is the risk-based approach effective? Why is the selection of workwear based on anthropometric data very effective and will reduce the risk of injury and increase performance? By adopting a risk-based approach to the PPE selection process, the quality and safety of work can be significantly improved. This paper examines the benefits of using a risk-based approach and its role in occupational safety when choosing PPE.

Investigation of the selection and use of "other" personal protective equipment to prevent mucous membrane exposure in nurses: A cross-sectional study.

Selection and use of personal protective equipment (PPE) to prevent non-percutaneous body fluid exposure (NP BFE) is determined by a clinical assessment of risk. The aim of this study was to explore the selection and use of PPE, particularly masks and eye protection to prevent NP BFE, by nurses. This quantitative single-site two-phased study was guided by the Health Belief Model (HBM). Phase 1 was a retrospective electronic database audit of body fluid exposure surveillance data. Phase 2 included a cross-sectional survey. The highest incidence of reported NP BFE to non-intact skin and mucous membranes during the study period were identified in the emergency department (ED) at 51.3% (20/39), intensive care unit (ICU) at 30.8% (12/39), operating theatre (OT) with 12.9% (5/39), and inpatient renal ward with 5.1% (2/39). Reported PPE use during NP BFE was: 0% face shields or masks, 10% gown/apron, and 15% goggles. Survey results related to Prevention of mucocutaneous exposures were similar across all high-risk units, though ED nurses reported poorer compliance with the use of PPE to prevent exposure. Risk assessment for prevention of NP BFE was reported, yet there was a lack of compliance. The ICU results indicated a positive safety culture in contrast to the ED. The findings are consistent with research identifying inadequate prevention of NP BFE, although nurses are aware of the importance of risk assessment. The HBM has the potential to increase understanding of the differences in nurses' perceptions of risk in safety culture.

Problems of using personal protective equipment in modern conditions

The use of personal protective equipment (PPE) is one of the ways to preserve the health of employees in adverse working conditions. PPE remains one of the key tools for minimizing the impact of harmful and dangerous factors. Scientists create and use PPE to reduce accidents, serious injuries, poisoning, the likelihood of developing professionally caused, occupational diseases that often remain undetected. It is important to use PPE efficiently by employees of various industries. The effectiveness of their use in the workplace largely depends on the right choice, the employer's awareness of the risks, training in ways to check the serviceability, correct use, control. The lack of training or its insufficiency leads to inevitable mistakes in the selection and application of PPE. Unfortunately, not all existing PPE are effective enough, because they are not always of proper quality, are not individually selected, and are not able to give warning signals about the presence of danger. Employees should take into account that PPE can create: harmful and sometimes dangerous inconveniences for health; a false sense of security in case of improper use, loss of efficiency in case of incorrect storage or maintenance; complicate working conditions. The correct use of PPE depends on the behavior of the worker. It is advisable to take into account the nature of labor operations and the severity of the work performed; the protective properties of PPE, depending on the type and quality of materials used for their manufacture; product design. Competent selection of PPE, compliance with the terms of their operation can reduce professional risks. To date, specialists have developed modern "smart" PPE, as well as intelligent systems to improve the efficiency of existing PPE.

The planetary health effects of COVID-19 in dental care: a life cycle assessment approach.

Aims COVID-19 has significantly impacted the safety guidelines for personal protective equipment (PPE) within dental services. We quantified and compared the environmental impact of different forms of PPE.Methods The PPE items were divided into three categories: 1) the body protection category, which included disposable and reusable gowns; 2) the eye protection category, which included a visor with a disposable face shield and a reusable visor; and 3) the respiratory protection category, which included respirator FP2SLw, respirator FFP2 and surgical masks. The OpenLCA software was used for analysing and comparing the environmental impact of all PPE products in the three categories.Results The life cycle assessment results of this study showed that damage to human health was more significant for the reusable gown than the disposable gown for the body-protection-category PPE. A visor with a disposable face shield had a higher environmental footprint than the reusable visor across all impact categories for the eye protection category. In addition, a visor with a disposable face shield released five times more carbon dioxide equivalent emissions and used four times more dissipated water and three times more fossil fuels than the reusable visor. A disposable gown used four times more dissipated water and three times more fossil fuels than reusable gowns. For respiratory PPE, the FP2SLw respirator had the highest burden in all 16 categories, followed by the FFP2 respirator and then the surgical mask.Conclusion The environmental impact of PPE is notable and could be reduced through using less damaging domestic products and increased usage of reusables. In addition, the selection of PPE that are reusable and made of recyclable materials can help to minimise the environmental impact and reduce environmental resource depletion.

Arc-Flash Personal Protective Equipment Selection: A Simplified Constant-Energy-Line Based Table Method

A challenge faced by employers and workers is determining the appropriate rating of arc-flash personal protective equipment (PPE) when an engineering calculation has not been performed. Some standards include tables to assist the user in selecting arc-flash PPE for specific equipment types and voltage ranges. However, to use these and similar tabular methods requires the user to determine the fault current and the fault clearing time (FCT). Determining these values is at best difficult for the electrical worker, and in some circumstances, all but impossible.

ANALİTİK HİYERARŞİ PROSESİ METODU İLE UYGUN KİŞİSEL KORUYUCU EKİPMAN SEÇİMİ

The main principles of safety risk reduction are elimination, substitution, and engineering controls. Hazardous conditions, safe work practices, and other forms of managerial controls should be provided for a safe work environment. For this reason, the use of personal protective equipment (PPE) is inevitable for employees. PPE can help mitigate accidents and injuries associated with hazardous materials or other potentially unsafe working conditions. Thus, the selection of a suitable PPE is a significant step in a safe working environment. PPE selection process is complex and involves multiple criteria decision making since several parameters affect PPE selection. In this study, factors affecting PPE selection were determined as Safety Features, Comfort and Efficiency, Design Principles, and Customer Support. In the present study, a systematic methodology to select an appropriate PPE was performed using the Analytic Hierarchy Process (AHP). The results indicate that Safety Features main criterion is the most significant factor, followed by Comfort and Efficiency, Design Principles, and Customer Support main criteria, respectively.

Large animal veterinarians' knowledge, attitudes, and practices regarding livestock abortion-associated zoonoses in the United States indicate potential occupational health risk.

To understand large animal veterinarians' knowledge of select zoonotic diseases that cause livestock abortions and identify barriers to using personal protective equipment (PPE). A convenience sample of 469 veterinarians currently working with livestock. We sent an electronic survey invitation to large animal veterinarians through various veterinary organizations. Respondents answered questions addressing knowledge and prior experience with select abortion-associated zoonotic diseases, resources available for infection control, attitudes and barriers to PPE use, and demographics. Median participant age was 49 years (range, 22 to 82 years), and 54% (235/438) were male. Half of veterinarians (185/348) were contacted 5 or fewer times per year to consult on livestock abortions. No veterinarians surveyed answered all questions on zoonotic disease transmission correctly. Personal protective equipment access varied, from 99% (289/290) having access to gloves to 20% (59/290) having access to respirators. Concerns for spreading disease to other animals (136/289 [47%]) and to other humans (108/287 [38%]) ranked as the most common reported motivators for PPE use. Reported barriers to PPE use among survey participants were the inconvenience of taking PPE into the field (101/286 [35%]) and the inconvenience of wearing PPE (97/286 [34%]). Access to PPE was not correlated with PPE use. Surveyed veterinarians had limited knowledge of transmission of select abortion-associated zoonotic diseases. Incomplete understanding might lead to inappropriate PPE selection, preventable disease exposure, or missed opportunities for client education. Inconvenience was a primary reason PPE was not used.

Framework to Improve the Attitudes of Construction Workers towards Safety Helmets

Construction workers in various studies across the globe have indicated that there is some discomfort with the use of safety helmets, and that some workers do not use safety helmets as required, resulting in a compromise to their health and safety protection. This study investigates the processes involved in the selection and procurement of safety helmets for construction workers and assesses these efforts by interrogating the discomforts experienced by users in spite of these selection considerations. The study focuses on safety helmets used by construction workers, as this is a common form of personal protective equipment (PPE) usually given out on construction sites to prevent head injuries, which are among the severest forms of occupational accidents in the industry. Primary data were obtained through a questionnaire survey conducted with construction firms operating in Ghana and semi-structured interviews with construction workers. The findings from the study indicate that in spite of the purported considerations by construction firms in the selection and procurement of PPE, construction workers continually experience several discomforts with the use of safety helmets. The study proposes a Behaviour-Based Safety Intervention Framework to guide the selection and procurement of user-friendly PPE that improves the user experience of safety helmets.

Sufficient personal protective equipment training can reduce COVID-19 related symptoms in healthcare workers: A prospective cohort study

BackgroundThe association between inadequate personal protective equipment during the COVID-19 pandemic and an increased risk of SARS-CoV-2 infection in frontline healthcare workers has been proven. However, frontline healthcare workers with an adequate supply of personal protective equipment still showed an increased risk of contracting COVID-19. Research on the use of personal protective equipment could provide insight into handling present and future pandemics. ObjectivesThis study aims to investigate the impact of the availability, training and correct selection of personal protective equipment on the incidence of SARS-CoV-2 infection or positive suspect cases in healthcare workers during the COVID-19 pandemic in Belgium. DesignThis was a prospective cohort study involving Belgian healthcare workers: nurses, nursing aides, and midwives working in hospitals, home care services, and residential care services. MethodsRespondents were invited from May to July 2020 (period 1) followed by a second time in October 2020 (period 2) to complete a digital survey on personal protective equipment availability, training, personal protective equipment selection, screening ability, COVID-19 testing and status, and symptoms corresponding with the COVID-19 suspect case definition. The main outcome was a composite of COVID-19 status change (from negative to positive) during the study or a positive suspect case definition in period 2. ResultsFull data were available for 617 participants. The majority of respondents were nurses (93%) employed in a hospital (83%). In total, 379 respondents provided frontline care for COVID-19 patients (61%) and were questioned on personal protective equipment availability and personal protective equipment selection. Nurses were more likely to select the correct personal protective equipment compared with nursing aides and midwives. Respondents working in residential care settings were least likely to choose personal protective equipment correctly. Of all healthcare workers, 10% tested positive for COVID-19 during the course of the study and a composite outcome was reached in 54% of all respondents. Working experience and sufficient personal protective equipment training showed an inverse relation with the composite outcome. The relationship between personal protective equipment availability and the composite outcome was fully mediated by personal protective equipment training (-0.105 [95% confidence interval -0.211 — -0.020]). ConclusionsProper training in personal protective equipment usage is critical to reduce the risk of COVID infection in healthcare workers. During a pandemic, rapid dissemination of video guidelines could improve personal protective equipment knowledge in practitioners.Tweetable abstract: Proper training in personal protective equipment usage is critical to reduce the risk of COVID infection in healthcare workers.

Perception of Gastrointestinal Endoscopy Personnel on Society Recommendations on Personal Protective Equipment, Case Selection, and Scope Cleaning During Covid-19 Pandemic: An International Survey Study.

Background/AimsThe Thai Association for Gastrointestinal Endoscopy published recommendations on safe endoscopy during the coronavirus disease 2019 (COVID-19) pandemic. This study aimed to assess the practicality and applicability of the recommendations and the perceptions of endoscopy personnel on them. MethodsA validated questionnaire was sent to 1290 endoscopy personnel globally. Of these, the data of all 330 responders (25.6%) from 15 countries, related to the current recommendations on proper personal protective equipment (PPE), case selection, scope cleaning, and safety perception, were analyzed. Ordinal logistic regression was used to determine the relationships between the variables. ResultsDespite an overwhelming agreement with the recommendations on PPE (94.5%) and case selection (95.5%), their practicality and applicability on PPE recommendations and case selection were significantly lower (p=0.001, p=0.047, p<0.001, and p=0.032, respectively). Factors that were associated with lower sense of safety in endoscopy units were younger age (p=0.004), less working experience (p=0.008), in-training status (p=0.04), and higher national prevalence of COVID-19 (p=0.003). High prevalent countries also had more difficulty implementing the guidelines (p<0.001) and they considered the PPE recommendations less practical and showed lower agreement with them (p<0.001 and p=0.008, respectively). A higher number of in-hospital COVID-19 patients was associated with less agreement with PPE recommendations (p=0.039).ConclusionsUsing appropriate PPE and case selection in endoscopic practice during a pandemic remains a challenge. Resource availability and local prevalence are critical factors influencing the adoption of the current guidelines.

Evaluating the Effectiveness of the Chemical-Mass Casualty Incident Response Education Module (C-MCIREM): A Pilot Simulation Study With a Before and After Design.

BackgroundWith the occurrence of a number of major disasters around the world, there is growing interest in chemical disaster medicine. In South Korea, there is a training program for mass casualty incidents (MCI) and backup by legal regulations by the Framework Act on the Management of Disasters and Safety. However, there is no program focusing on chemical disasters. Thus, the authors newly created a program, the Chemical-Mass Casualty Incident Response Education Module (C-MCIREM) in September 2019. This was a pilot study to verify the educational effect of the program.MethodA pre/post study was conducted of a chemical MCI training program based on simulation. A total of 25 representative and qualified participants were recruited from fire departments, administrative staff of public health centers, and healthcare workers of hospitals in the Gyeonggi-do province of South Korea. They participated in a one-day training program. A knowledge test and confidence survey were provided to participants just before training, and again immediately following the training online. The authors compared improvements of pre/post-test results. In the tabletop drill exercise, quantified qualitative analyses were used to measure the educational effect on the participants.ResultsIn the knowledge test, the mean (standard deviation) scores for all 25 participants at baseline and after training were 41.72 (15.186) and 77.96 (11.227), respectively (p < 0.001). In the confidence survey for chemical MCI response for all 25 participants, all the sub-items concerning personal protective equipment selection, antidote selection, antidote stockpiling and passing on knowledge to colleagues, zone setup and decontamination, and chemical triage were improved compared to the baseline score (p < 0.001). The tabletop exercise represented a prehospital setting and had 11 participants. The self-efficacy qualitative survey showed pre- and post-exercise scores of 64/100 and 84/100 respectively. For a hospital setting exercise, it had 14 participants. The survey showed pre/post-exercise scores of 26/100 and 73/100 respectively. Twenty-two (88%) participants responded to the final satisfaction survey, and their overall mean scores regarding willingness to recommend this training program to others, overall satisfaction with theoretical education, overall satisfaction with tabletop drill simulation, and opinion about whether policymakers need this training were all over 8 out of 10 respectively.ConclusionC-MCIREM, the newly created chemical MCI program, provided effective education to the selected 25 participants among Korean chemical MCI responders in terms of both knowledge and practice at a single pilot trial. Participants were highly satisfied with the educational material and their confidence in disaster preparedness was clearly improved. In order to prove the universal educational effect of this C-MCIREM in the future, more education is needed.

Facing the Coronavirus Pandemic: An Integrated Continuing Education Program in Taiwan.

This study aimed to identify knowledge gaps regarding coronavirus disease 2019 (COVID-19) and develop an integrated educational program for healthcare workers. First, we designed and validated ten multiple-choice questions to identify knowledge gaps among healthcare workers. Within one month of the online test and curriculum offering, 5533 staff had completed the test, with a completion rate of 84.97%. There were 2618 healthcare workers who answered the pre-test 100% correctly. Those who did not answer the pre-test 100% correctly took multiple tests after learning through the online teaching materials. Eventually, 5214 staff passed the test (pre-test or post-test with 100% correct answers). The result showed that all staff had a low correct rate for personal protective equipment (PPE) use recommendations. The Infection Control Center conducted training sessions for hospital staff on how to wear protective clothing. Information on the selection and use of PPE for infection prevention was provided, and participants were allowed time to practice and familiarize themselves with the correct way to wear PPE. Moreover, the Department of Education and Research continued updating the online learning materials based on the most important updated peer-reviewed published articles. The attending teaching physicians helped to search, translate, and take notes on articles in the local language (traditional Chinese) for other colleagues to read easily. We expect to increase learning opportunities for healthcare workers, even during uncertain times such as the current coronavirus pandemic through (1) the hospital-wide course announcements, (2) the continuous placement of test questions and learning files on the digital learning platform, (3) the placement of journal highlights in cloud folders, and (4) the use of the digital learning platform on mobile phones accessible outside the hospital.

Selection of Personal Protective Equipment - a complex issue of multi-criteria analysis

It is known the fact that in both the Member States of the European Union and the United States, the provision of Personal Protective Equipment (PPE) to workers who are carrying out their activity in different sectors is done in accordance with existing legislation and regulations specific to each state. However, choosing a suitable PPE for a particular workplace is a difficult task to perform given that there are a variety of PPE on the market that perform, in different ways these functions: to prevent an accident - from the same place of work. to protect the health and safety of workers and to minimize damage from any possible accident. Comparing the alternatives, in order to find the most favourable protective equipment specific to a particular workplace, is a complex multi-criteria decision problem that sometimes is difficult to solve. In this paper we approached a method of multi-criteria analysis of the decision, respectively we applied a Analytical Hierarchy Process (AHP) to select PPE -favourable to a certain job: mechanical locksmith. Our work allowed us to find the dominant criteria and the critical factors in the products evaluation, multi-criteria evaluation AHP of employees’ requirements, regarding PPE and ergonomic aspects.

Assessing Policies Versus Practices Utilizing the CDC Infection Control Assessment and Response Tool

Background: The Infection Control Assessment and Response (ICAR) tool was developed by the CDC following the 2014 Ebola outbreak. Over a 3-year period, the CDC dispensed Funding: to all public health divisions in all 50 states to implement and promote the ICAR. The ICAR was developed as a self-assessment tool to evaluate policies, competencies, and practices across healthcare settings. The primary aim of the tool and associated Funding: was to guide quality improvement activities by addressing the identified gaps in infection prevention (IP). Independent of state funding, we sought to use the ICAR to evaluate whether there were differences in reported policies from observed practices related to hand hygiene (HH) and personal protective equipment (PPE) use in long-term care facilities (LTCFs), ambulatory surgical centers (ASCs), and outpatient pain clinics (OPCs). Methods: From November 2018 to August 2019, we conducted in-person ICAR assessments in 7 LTCFs in 3 states (Arizona, Utah, and Idaho), 2 ASCs in 2 states (Arizona, Indiana), and 5 OPCs in 1 state (Arizona). All on-site assessments were conducted with the ICAR tool by a board-certified infection preventionist. The paper form was converted to a mobile compatible digital audit tool utilizing Microsoft Forms on the Microsoft 365 platform. Once a survey was completed, it was sent to an Excel database and analyzed utilizing SPSS software. Results: All facilities (14 of 14, 100%) had a designated person responsible for coordinating and/or directing the IP program. Moreover, 4 of 7 LTCFs (57%), 2 of 2 ASCs (100%), and 5 of 5 OPCs (100%) reported having written IP policies that met evidence-based guidelines, regulations, or standards (eg, CDC/HICPAC). None of the 7 LTCFs (0%), 2 of 2 ASCs (100%), and none of the 5 OPCs (0%) reported active surveillance to monitor and document adherence to proper PPE selection and use. During direct observation of hand hygiene opportunities, compliance was 23% for LTCFs (7 of 31 opportunities), 37% for ASCs (7 of 19 opportunities), and (11 of 28 opportunities) 39% in OPCs. Conclusions: Our results indicate that the ICAR tool remains a useful resource for distinguishing between the reporting of IP polices from the actual implementation of evidence-based practices. Although all facilities had a designated role for IP and most had written evidence-based IP polices, this did not translate to the observation of recommended HH and PPE practices. By utilizing this tool, healthcare facilities can support their evidence-based IP polices and further promote patient safety by identifying and mitigating gaps in practices.Funding: NoneDisclosures: None

Cross-continental comparison of safety and protection measures amongst urologists during COVID-19.

ObjectivesTo determine the well‐being of urologists worldwide during the coronavirus disease 2019 pandemic, and whether they have adequate personal protective equipment knowledge and supplies appropriate to their clinical setting.MethodsUrologists worldwide completed a Société Internationale d’Urologie online survey from 16 April 2020 until 1 May 2020. Analysis was carried out to evaluate their knowledge about protecting themselves and others in the workplace, including their confidence in their ability to remain safe at work, and any regional differences.ResultsThere were 3488 respondents from 109 countries. Urologists who stated they were moderately comfortable that their work environment offers good protection against coronavirus disease 2019 showed a total mean satisfaction level of 5.99 (on a “0 = not at all” to “10 = very” scale). A large majority (86.33%) were confident about protecting themselves from coronavirus disease 2019 at work. However, only about one‐third reported their institution provided the required personal protective equipment (35.78%), and nearly half indicated their hospital has or had limited personal protective equipment availability (48.08%). Worldwide, a large majority of respondents answered affirmatively for testing the healthcare team (83.09%). Approximately half of the respondents (52.85%) across all regions indicated that all surgical team members face an equal risk of contracting coronavirus disease 2019 (52.85%). Nearly one‐third of respondents reported that they had experienced social avoidance (28.97%).ConclusionsOur results show that urologists lack up‐to‐date knowledge of preferred protocols for personal protective equipment selection and use, social distancing, and coronavirus disease 2019 testing. These data can provide insights into functional domains from which other specialties could also benefit.

Best practices in veterinary personal protective equipment

Personal protective equipment (PPE) is used every day in veterinary practice. In the context of infectious disease control, PPE functions as a barrier against disease transmission and spread. It is selected based on a disease risk assessment and the circumstances in which it is to be used. Higher levels of protection require more complex PPE. However, PPE is only effective as a barrier if it corresponds to the level of protection needed for the infectious agent involved and its chain of transmission; fits the employee correctly and remains uncompromised; is put on (donned) and taken off (doffed) according to a protocol that minimises contamination; is disposed of safely; and no errors occur during patient examination or any of the other steps in the process. Training veterinary personnel in the use of PPE is often neglected and ample evidence in the literature suggests that fewer than 50% of healthcare workers receive such training and use the equipment according to protocol. Developing evidence-based training programmes that allow employees to demonstrate their proficiency is an opportunity to improve PPE use. Methods that highlight potential contamination and let employees assess their performance are highly desirable. This paper will discuss which factors determine PPE selection, what PPE options are available, and the different training levels that should be considered.

Relative contributions of transmission routes for COVID-19 among healthcare personnel providing patient care

The routes of COVID-19 transmission to healthcare personnel from infected patients is the subject of debate, but is critical to the selection of personal protective equipment. The objective of this paper was to explore the contributions of three transmission routes—contact, droplet, and inhalation—to the risk of occupationally acquired COVID-19 infection among healthcare personnel (HCP). The method was quantitative microbial risk assessment, and an exposure model, where possible model parameters were based on data specific to the SARS-CoV-2 virus when available. The key finding was that droplet and inhalation transmission routes predominate over the contact route, contributing 35%, 57%, and 8.2% of the probability of infection, on average, without use of personal protective equipment. On average, 80% of inhalation exposure occurs when HCP are near patients. The relative contribution of droplet and inhalation depends upon the emission of SARS-CoV-2 in respirable particles (<10 µm) through exhaled breath, and inhalation becomes predominant, on average, when emission exceeds five gene copies per min. The predicted concentration of SARS-CoV-2 in the air of the patient room is low (< 1 gene copy per m3 on average), and likely below the limit of quantification for many air sampling methods. The findings demonstrate the value of respiratory protection for HCP, and that field sampling may not be sensitive enough to verify the contribution of SARS-CoV-2 inhalation to the risk of occupationally acquired COVID-19 infection among healthcare personnel. The emission and infectivity of SARS-CoV-2 in respiratory droplets of different sizes is a critical knowledge gap for understanding and controlling COVID-19 transmission.

Fentanyl and carfentanil permeation through commercial disposable gloves

In 2018, the Centers for Disease Control and Prevention reported that opioid overdose deaths (including fentanyl and carfentanil) comprised 46,802 (69%) of the 67,367 total drug overdose deaths. The opioid overdose epidemic affects Americans not only at home but also in the workplace. First responders may be at risk of opioid exposure during incidents such as vehicle searches and responses to overdose calls. To reduce direct exposure to opioids and other hazardous drugs, first responders rely in part on personal protective equipment (PPE) as their last line of defense. First responders seek guidance from the National Institute for Occupational Safety and Health (NIOSH) regarding appropriate PPE selection for potential opioid exposure. There is limited empirical glove performance data for illicit drugs. Empirical data are needed to validate NIOSH’s current recommendations regarding gloves to help prevent exposure to illicit drugs (i.e., powder-free nitrile gloves with a minimum thickness of 5 ± 2 mil [0.127 ± 0.051 millimeters]); however, no industry standard or test method currently exists for specifically evaluating PPE performance against fentanyl and its analogs. To understand the permeation qualities of gloves when challenged against fentanyl and carfentanil solutions, the ASTM International (formerly American Society for Testing and Materials) ASTM D6978-19 standard for chemotherapy drug glove permeation was adapted to test fentanyl and carfentanil hydrochloride solution permeation through twelve disposable glove models, including five models in which the manufacturers claim fentanyl protection. No nitrile glove models showed fentanyl or carfentanil permeation rates above the chemotherapy drug threshold criterion of 0.01 µg/cm2/min (i.e., thereby meeting the performance requirement) as calculated using the ASTM D6978-19 standard within the 240-min test. Latex and vinyl glove materials exhibited fentanyl and carfentanil permeation with permeation rates above this threshold. These findings are among the first empirical data to support NIOSH’s current opioid glove recommendations and define procedures that could be used to support industry standards for evaluating opioid permeation through air-impermeable PPE materials.