Infection control and prevention
Infection control principles and practices for local public health
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Personal protective equipment (PPE)
For communicable disease exposure Personal protective equipment (PPE)
is specialized clothing or equipment used to prevent contact with
hazardous substances. Its use is an integral part of infection control
and prevention measures that protect workers from exposure to blood,
body fluids, and other potentially infectious materials. PPE such as
gowns, gloves, masks, and goggles provide physical barriers that prevent
the hands, skin, clothing, eyes, nose, and mouth from coming in contact
with infectious agents. PPE is used to reduce transmission of
communicable diseases when other measures such as engineering controls
and work practices cannot completely eliminate exposure.
Employers are required by OSHA standard 29
CFR Part 1910.132 (exit DHS) to assess
the workplace for hazards that necessitate the use of PPE and document
that such an assessment has been done. They must also provide
appropriate PPE in the workplace, store and maintain PPE in good working
order, train employees on proper use of PPE, and ensure that employees
use PPE appropriately. The following PPE affords protection of mucous
membranes, skin, and clothing from infectious agents. Local public
health agencies must have these items readily available at all times for
use by employees with exposure to communicable diseases. Items such as
uniforms, pants, blouses, and eye wear not intended to protect against
communicable diseases are not considered PPE.
Gloves
Clean, disposable gloves are worn during direct contact with
blood/body fluids, mucous membranes, non-intact skin, or any other
potentially infectious material. They are also worn as a part of
contact precautions (for persons infected with pathogens transmitted
by the contact route, such as MRSA, VRE, and RSV) while directly
touching the patient or when in the immediate patient environment.
Disposable gloves are available in latex, vinyl, and nitrile
materials. Since many individuals are allergic to latex, vinyl or
nitrile gloves are recommended alternatives. Vinyl gloves can be used
for brief patient contact but nitrile gloves provide greater barrier
protection for extended patient care activities or those requiring
more manual dexterity. Local public health agencies can select either
vinyl or nitrile products for their clinical functions.
Discard gloves at point of use and wash hands immediately after
removing gloves.
Gowns
Isolation gowns are used as part of standard and contact
precautions to protect clothing and arms of health care workers. When
used for standard precautions, gowns are worn only if contact with
blood/body fluids is expected. Fluid resistant gowns should be used
when splashes or sprays of blood/body fluids are expected. For contact
precautions, gowns are worn during all patient contact and when in the
patient’s environment. Gowns are always worn in combination with
gloves, and with other PPE when indicated. Remove at point of use and
discard disposable gowns or place cloth gowns in laundry container.
Wash hands immediately after removing all PPE.   
Surgical masks
Surgical masks are used to protect the mouth and nose from splashes
or sprays of blood/body fluids, or respiratory secretions, and to
place on coughing patients to reduce dissemination of respiratory
secretions. They may have either ear loops or ties, and can be either
pleated or made of molded material.
Surgical masks are cleared by the FDA as having fluid-resistant
properties.
Procedure masks
Procedure or isolation masks may also be used to protect the mouth
and nose, but are not cleared by the FDA for fluid resistant
properties. There is no evidence to show that surgical masks are more
protective than procedure masks, but there may be more variation in
quality and performance among procedure masks. Many procedure masks
have built-in eye protection, and are available in pleated or molded
styles.
Local public health agencies may select either surgical or
procedure masks, depending on employees’ preference.
Eye protection
Goggles or face shields are used to protect eyes from splashes or
sprays of blood/body fluids. Personal eye glasses or contact lenses
are not considered adequate eye protection. Goggles and face shields
should wrap around the sides of the face to protect splashes from all
angles.
Respiratory protection
PAPRs are battery operated respirators that filter the air before
it enters a hood worn over the head. Loose fitting PAPRs do not
require fit-testing but users must undergo a medical evaluation prior
to wearing. Many users prefer PAPRs over an N-95 FFP as a more
comfortable option for respiratory protection. Unlike N-95 FFPs, PAPRs
require battery maintenance and cleaning procedures between uses.
Filtering face pieces (FFP) and respirators such as powered
air-purifying  respirators (PAPR) are used to filter the air of small
infectious particles such as TB bacteria or the SARS virus before
entering the respiratory tract. The type of FFP used to protect
against infectious diseases is a NIOSH approved N-95 filtering face
piece, which is available in many styles, including pleated, molded,
and duck-billed. Wearers must be fit-tested and receive a medical
evaluation before they can use a FFP or a respirator.
Employees who share the same air space with suspect or known TB
patients, Avian influenza patients, or who will be in direct contact
with pandemic influenza patients need to wear a NIOSH approved
fit-tested N-95 FFP or a PAPR until they are no longer in the air
space shared by the infectious person.
PPE Purchase Information
Vendor
information and a Respirator and Facemask Calculator for Pandemic
Influenza
More Resources
Wisconsin DHS Introduction
to PPE
Contacts
Gwen Borlaug, Infection Control Epidemiologist
Wisconsin Division of Public Health
Bureau of Communicable Diseases and Emergency Response
(Phone 608-267-7711) (Fax 608-261-4976)
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Last Revised:
January 16, 2013 |
