Personal Protective Equipment (PPE), One Size Does Not Fit All.

In our previous blogpost, we discussed Ebola and the use of personal protective equipment.  Since then the Centers for Disease Control (CDC) has come out with revised guidance on purchasing PPE and protocols for wearing PPE while handling patients with the Ebola virus disease.  Find this information here.  

A disposable nitrile rubber glove. Nitrile gloves are available in different colours, the most common being blue and purpleCitation needed. (Photo credit: Wikipedia)

Fast Company Co.Design's article "Why Protective Gear Isn't Stopping Ebola" has an interesting discussion on the problems with PPE.  This discussion includes the usual complaints that its uncomfortable, it doesn't fit, restricts movement, visibility, etc.  It is interesting that before wearing a tight fitting respirator a worker must be either qualitatively or quantitatively fit tested with the respirator they will be wearing.  However, when it comes to PPE (like gloves or protective suits) there is no fit testing.  If you bought these items as clothing, you would try them on and purchase the best fitting one.
  

Asbestos Hands-on Demonstration

There is an unspoken assumption that the employer will purchase different sizes allowing workers to select the size that fits them the most comfortably.  This assumption is typically wrong and what actually happens is most employers buy larger sizes in the sense that one size fits all or they buy the size that fits the most people.  This results in complaints that wearing the PPE is more hazardous than not wearing it, which of course is the case if you are wearing ill-fitting or incorrect fitting PPE.

Wearing the proper PPE is not only about the right size, it is also about wearing the right type.  How many of you know that protective equipment are tested for how cut resistant they are?  The cut protection performance test (CPPT) is an American Society of Testing Materials (ASTM) F 1790 standard cut test for protective equipment.  A glove's performance rating is classified by the American National Standards Institute (ANSI)/International Safety Equipment Association (ISEA) 105-2005 from a 0-5 level, with 5 being the best cut performance, based on the outcome of the CPPT test.  Gloves are also tested for how long it takes for chemicals to breakthrough, degrade, or permeate the material the glove is made of.  ASTM F739 standard details the process for testing protective equipment for liquid and gas permeation (the video clip below shows how this is done).  Ansell Healthcare produces the "Chemical Resistance Guide" that includes permeation and degradation data for various glove material and a rating system.

When selecting PPE for your workers, unfortunately its not as simple as looking in a catalog and buying the cheapest PPE and/or buying one size that will fit most or all.  As the Occupational Safety and Health Administration (OSHA) standard (1910.133) requires for PPE, you must assess the hazard you want the PPE to protect the worker from and then find the best fitting PPE so the worker will wear it comfortably without creating a greater hazard.

Related articles

• CDC promises Ebola safety supplies being readied for hospitals
• CDC Invests $2.7M In Ebola-Specific PPE Kits
• WHO Updates Guidelines on Ebola Protective Gear
• Why Protective Gear Isn't Stopping Ebola

Ebola Virus - A Proper Perspective.

There has been a lot written about the Ebola viruses and the disease that it causes.  It is important to be well informed so that you can better know what is accurate information and what is misinformation.  In the old days, the main sources of information was television news, newspapers, or libraries.   Today, there is no excuse for succumbing to fear when accurate information is only a few clicks away.  There are several websites that will provide you with accurate information regarding ebola hemorrhagic fever which is caused by several strains of viruses in the Ebolavirus genus.  As a Council-certified Indoor Environmental Consultant one of our first resource website would be the Occupational Safety and Health Administration's (OSHA) Ebola website.  Here you will find information regarding the virus its background information, hazard recognition, medical information, Standards, control & prevention, and additional resources.  The standards section details the regulations OSHA expects employers, whose employees are at risk of being exposed to ebola, to comply with.  Obviously, the bloodborne pathogen (1910.1030); the respirator (1910.134); and the personal protective equipment (PPE) standards must be complied with in addition to the "general duty clause".  When cleaning and disinfecting, the hazard communication (1910.1200) and Sanitation (1910.141) standards would also have to be complied with.

English: Ebola virus virion. Created by CDC microbiologist Cynthia Goldsmith, this colorized transmission electron micrograph (TEM) revealed some of the ultrastructural morphology displayed by an Ebola virus virion. (Photo credit: Wikipedia)

Unfortunately, it is obvious mistakes were made, in Texas & by others, in the selection and wearing the safety equipment necessary to protect the health care workers from being exposed to the Ebola Virus.  The Centers for Disease Control (CDC) is the agency that develops these protocols and provides information and assistance in helping healthcare workers, click here for their Ebola website. Their website has a PPE training program to train you on donning (putting on PPE) and doffing (taking off PPE) the proper safety equipment.  These procedures are designed to ensure you do not contaminate yourself or others,  When properly followed the procedures should reduce the risk of the worker and others being exposed to the Ebola virus.  In addition, the CDC has posted "Advice for Colleges, Universities, and Students about Ebola in West Africa" which provides guidance on study abroad and foreign exchange.

None - This image is in the public domain and thus free of any copyright restrictions. As a matter of courtesy we request that the content provider be credited and notified in any public or private usage of this image. (Photo credit: Wikipedia)

New York State's Department of Health has an Ebola website, too.  This website provides information for the public, health care providers, hospitals, & EMS providers.  Information for the public includes "School Guidance on the Ebola Outbreak", which advises the health personnel for schools to stay informed about the current situation and have access to up-to-date, reliable information as events unfold.

As you can see there are plenty of websites and sources of information regarding Ebola and that's just the US websites.  Another excellent website is the World Health Organization's (WHO) Ebola website.  Their website also includes information on PPE, travel advice, fact sheets, and discussion of trials and production of ebola vaccine.  So don't allow fear to ruin your day, get the information you need to help you move forward,  As Franklin Delano Roosevelt said "The only thing we have to fear is fear it'self - nameless, unreasoning, unjustified, terror, which paralyzes needed efforts to convert retreat into advance."  So lets move forward!

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Protecting Yourself During Restoration or Renovation Projects

Many of you know one of our main issues is protecting yourself and your family from the contaminants that you can be exposed to in construction work (including remodeling, restoration, or renovation work).  In our classes, we discuss the USA Today Special Report in 2000 "Workers unwittingly take home toxins".  This report discusses how workers through the years have been exposed to toxins and brought them home to contaminate their families.  Contaminates included asbestos, lead, mercury, radiation, animal growth hormones, dry cleaning chemicals, explosive toxins and carcinogens.  It has been our opinion for years, that the standard safety equipment for construction workers should also include disposable clothing or uniforms, that are left at the jobsite, and respirators.  This would be in addition to the typical hard hat, reflective vests, and safety shoes.  The new silica standard, if it goes through, will be interesting since it will probably require respirators for workers performing dusty tasks.

We have also discussed, in our classes, the emergency workers who worked at the Ground Zero site and all the different toxins they were exposed to like: asbestos, lead, dioxin, volatile organic compounds (VOCs), mercury, silica, polycyclic aromatic hydrocarbons (PAHs) and polychlorinated biphenyls (PCBs).  Some of these workers are so sick that we had to provide special medical coverage through the Zadroga Bill, costing the US billions of dollars.

Old House (Photo credit: WaywardShinobi)

To further prove our point, a recent Morbidity and Mortality Weekly Report (MMWR) News Synopsis for January 2, 2014 discussed a Histoplasmosis Outbreak Associated with the Renovation of an Old House in Quebec Canada.  Histoplasmosis is a respiratory disease caused by the inhalation of fungus spores excreted by bats and birds, that can persist in the environment for several years.  Outbreaks can occur during demolition/renovation activities that create dust containing bird or bat droppings.  The MMWR outbreak happened during the renovation of an old house, 30 workers and residents were exposed to dust containing bird or bat droppings previously hidden in the brick walls.  14 of the workers/residents developed symptoms of histoplasmosis.  Of the four who were laboratory-confirmed, two were hospitalized.  Unfortunately, stories like this keep happening over and over, again.

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OSHA Issues Clarifications on PPE

Sorry for the long lead time on this issue. However, this issue seems like it should be common sense. On December 12, 2008, OSHA published a final rule clarifying emloyers' duty to provide personal protective equipment (PPE) and train each employee. This rule revises the OSHA standards to clarify that, for employers to be in compliance, they must provide PPE and hazards training for each employee covered by the standards. Each employee not protected may be considered a separate violation and penalties assessed accordingly. The revison is consistent with language in other standards for which per-employee citatiuons have been upheld.

In addition, realize by May 15, 2008, OSHA also required all employers to provide PPE at no cost to their employees (the employer must pay for the PPE). These requirements addressed many kinds of PPE, such as: hard hats, gloves, goggles, safety shoes, safety glasses, welding helmets and goggles, faceshields, chemical protective equipment, fall protection equipment, and other types of safety equipment. Certain safety equipment were excluded from the provision of employer payment of PPE, these excluded items are certain safety-toe shoes and boots, prescription safety eyewear, and logging boots. OSHA considers these three items personal in nature, are used from jobsite to jobsite (employer to employer), and are typically used off the jobsite.