Personal protective equipment for preventing highly infectious diseases due to exposure to contaminated body fluids in healthcare staff

Verbeek, Jos; Rajamaki, Blair; Ijaz, Sharea; Tikka, Christina; Ruotsalainen, Jani; Edmond, Michael B.; Sauni, Riitta; Balcı, Faruk

doi:10.1002/14651858.cd011621.pub3

Cited by 88 publications

(83 citation statements)

References 156 publications

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“…38,42 A re-analysis of a simulated exposure study using fluorescent stain found that gowns are superior to aprons in reducing contamination caused by simulated splashes. 43,44 Similar comparisons have also favoured superiority of sealed suits over traditional gown and gloves (OR 0.68). 44,45 In the UK, where HCWs follow the 'bare below the elbow' policy, unlike their international counterparts whose uniforms cover the forearms, gowns are likely to provide more skin coverage than apron alone and minimise contamination by respiratory secretions and fomites.…”

Section: Body Hand and Eye Protectionmentioning

confidence: 85%

Evaluating the national PPE guidance for NHS healthcare workers during the COVID-19 pandemic

Thomas

Srinivasan²,

Wickramarachchi

et al. 2020

Clinical Medicine

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Tragically, many of the infections and deaths recorded in the global coronavirus disease 2019 (COVID-19) pandemic have occurred in healthcare workers. Some have attributed this to inadequate provision of personal protective equipment (PPE). In the UK, several organisations have voiced their concerns that the national PPE guidance issued by Public Health England is inadequate. Despite recent revisions to these guidelines, concerns remain that they offer insufficient protection to frontline NHS healthcare workers. In this report, we evaluate whether these concerns are merited, through critical appraisal of the available evidence, review of international PPE guidance, and consideration of the ethical implications.

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Section: Body Hand and Eye Protectionmentioning

confidence: 85%

Evaluating the national PPE guidance for NHS healthcare workers during the COVID-19 pandemic

Thomas

Srinivasan²,

Wickramarachchi

et al. 2020

Clinical Medicine

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“…16,38,39 Given the increased risk of transmission from high-risk AGMPs that airway managers and their airway assistants will be performing, and evidence of incomplete coverage provided by standard airborne, droplet, and contact precautions alone, we propose modifications that include head and neck protection as well as a second pair of gloves. 40 These additions address the heavy respiratory secretion contaminant load that occurs with high-risk…”

Section: Respiratory Droplets-what Healthcare Providers Need To Knowmentioning

confidence: 99%

“…If you are performing (or directly assisting in) the AGMP itself, then airborne, droplet, and contact precautions should be worn that additionally include a AAMI level-3 gown, neck cover, and 2 pairs of gloves (both panels C and D are considered equivalent levels of PPE) during movement. 40 Gowns may offer better protection than aprons. 40 Personal protective equipment for airborne, droplet, and contact precautions consist of head covering, eye protection, N95 respirator, an AAMI level-2 (or higher) gown, and a single pair of gloves overlapping the gown sleeve enough that movement does not expose the wrists.…”

Section: Respiratory Droplets-what Healthcare Providers Need To Knowmentioning

confidence: 99%

Équipements de protection individuelle (EPI) pour anesthésiologistes et autre personnel en charge des voies aériennes: principes et pratiques pendant la pandémie de COVID-19

Lockhart

Duggan

Wax

et al. 2020

Can J Anesth/J Can Anesth

161

177

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“…8 Based on experience with other viruses spread by respiratory droplets, the consistent use of recommended personal protective equipment (PPE) is critical to reducing nosocomial transmission. 9 Recent guidelines from the United States (U.S.) Center for Disease Control and Prevention (CDC) recommend respirator use when caring for patients with suspected or confirmed COVID-19 and the universal use of masks at work. 10 Joint guidelines from governing health bodies in Europe, including the National Health Service in the United Kingdom (U.K.), issued similarly graduated PPE recommendations dictated by the intensity of clinical exposure and likelihood of contact with bodily secretions.…”

Section: Introductionmentioning

confidence: 99%

Risk of COVID-19 among frontline healthcare workers and the general community: a prospective cohort study

Nguyen

Drew

Joshi

et al. 2020

Preprint

383

385

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medRxiv preprint 2 Background: Data for frontline healthcare workers (HCWs) and risk of SARS-CoV-2 infection are limited and whether personal protective equipment (PPE) mitigates this risk is unknown. We evaluated risk for COVID-19 among frontline HCWs compared to the general community and the influence of PPE. Methods:We performed a prospective cohort study of the general community, including frontline HCWs, who reported information through the COVID Symptom Study smartphone application beginning on March 24 (United Kingdom, U.K.) and March 29 (United States, U.S.) through April 23, 2020. We used Cox proportional hazards modeling to estimate multivariate-adjusted hazard ratios (aHRs) of a positive COVID-19 test. Findings: Among 2,035,395 community individuals and 99,795 frontline HCWs, we documented 5,545 incident reports of a positive COVID-19 test over 34,435,272 person-days. Compared with the general community, frontline HCWs had an aHR of 11·6 (95% CI: 10·9 to 12·3) for reporting a positive test. The corresponding aHR was 3·40 (95% CI: 3·37 to 3·43) using an inverse probability weighted Cox model adjusting for the likelihood of receiving a test. A symptom-based classifier of predicted COVID-19 yielded similar risk estimates. Compared with HCWs reporting adequate PPE, the aHRs for reporting a positive test were 1·46 (95% CI: 1·21 to 1·76) for those reporting PPE reuse and 1·31 (95% CI: 1·10 to 1·56) for reporting inadequate PPE. Compared with HCWs reporting adequate PPE who did not care for COVID-19 patients, HCWs caring for patients with documented COVID-19 had aHRs for a positive test of 4·83 (95% CI: 3·99 to 5·85) if they had adequate PPE, 5·06 (95% CI: 3·90 to 6·57) for reused PPE, and 5·91 (95% CI: 4·53 to 7·71) for inadequate PPE. Interpretation: Frontline HCWs had a significantly increased risk of COVID-19 infection, highest among HCWs who reused PPE or had inadequate access to PPE. However, adequate supplies of PPE did not completely mitigate high-risk exposures.

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Personal protective equipment for preventing highly infectious diseases due to exposure to contaminated body fluids in healthcare staff

Abstract: Personal protective equipment for preventing highly infectious diseases due to exposure to contaminated body fluids in healthcare sta (Review)

Cited by 88 publications

References 156 publications

Evaluating the national PPE guidance for NHS healthcare workers during the COVID-19 pandemic

Evaluating the national PPE guidance for NHS healthcare workers during the COVID-19 pandemic

Équipements de protection individuelle (EPI) pour anesthésiologistes et autre personnel en charge des voies aériennes: principes et pratiques pendant la pandémie de COVID-19

Risk of COVID-19 among frontline healthcare workers and the general community: a prospective cohort study

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