Considerations for selecting PPE for workers at risk of infectious disease exposure include:

1. Type of anticipated exposure: For example, workers may be exposed through splashes or sprays, and blood, body fluids, or other contaminated liquids (sewage, contaminated water, etc.) that might penetrate regular clothing or get into mucous membranes.

2. Durability and appropriateness of the PPE for the task: This will affect, for example, whether an apron, gown, or full protective suit is selected for PPE. It is also important to know if the protective clothing needs to be fluid resistant, fluid proof, or neither. For cleaning/disinfecting tasks, the type of cleaning products used will impact PPE selection.

3. Fit: PPE must fit the individual user. The employer must provide PPE in the appropriate size for the wearers. This is particularly important for respiratory protection. Poorly-fitted respirators will allow contaminants to enter.

Workers and their representatives (e.g., union steward or other representative) have a right to obtain a copy of the PPE assessment.

Gloves

Most patient care activities require the use of a single pair of nonsterile gloves made of latex, nitrile, or vinyl. However, because of allergy concerns, some facilities have eliminated or limited latex products, including gloves, and now use gloves made of nitrile or other material.

For jobs and tasks that do not involve patient care, the type of glove will depend on the risk of exposure, type of transmission route, cleaning and disinfecting chemicals being used, and potential exposure to sharp objects. Some gloves do not provide a snug fit on the hand, especially around the wrist, and therefore should not be used if extensive contact is likely, or the gloves should be taped to protective clothing to eliminate gaps.

Protective Clothing

Depending on the pathogen(s) present, cleanup workers or emergency personnel may need to wear one or two layers of full-covering protective clothing: the inner suit may be a hooded fiber suit (such as Tyvek®), while the outer suit may be a full-body garment constructed of durable viral penetration-resistant material.

Key factors in selecting appropriate clothing are chemical resistance, water resistance, and suit design. Suit design refers to how a garment is put together. The material seams may be sewn or sealed (welded) by cementing or welding tape over the stitched seam. Welded seams provide greater protection for the wearer.

Face Shields

PPE is available to protect all or parts of the face from contact with potentially infectious material. Face shields may be worn over certain respirators to protect the face from splashed or sprayed substances.

Goggles provide barrier protection for the eyes. Personal prescription lenses do not provide optimal eye protection and should not be used as a substitute for goggles. Goggles should fit snuggly over and around the eyes or personal prescription lenses. Goggles with antifog features will help maintain clarity of vision.

Respiratory Protection

Respirators are used to protect workers from hazardous or infectious aerosols, such as TB. Respirators that filter the air before it is inhaled provide significantly more protection against airborne contaminants than masks. The most commonly-used respirators in healthcare settings are particulate respirators. These are air-purifying respirators that rely on filters to remove contaminants from the air as the wearer breathes in. Air-purifying respirators use cartridges to filter specific contaminants and may cover the nose and mouth (half-face) or the eyes, nose, and mouth (full-face). When the wearer breathes in, the suction that occurs is momentary negative pressure in the respirator facepiece. If there is a leak or improper seal due to a poor fit, then contaminants can enter.

Note: Respirator cartridges vary and protect against different contaminants. Not all cartridges used to protect workers against infectious particles effectively protect them from exposure to certain chemicals used in waste packaging procedures, or for cleaning and decontaminating equipment and surfaces.

Powered air-purifying respirators (PAPR) use a small, lightweight battery-operated blower to draw air through the purifying cartridge and blow it into the facepiece. The blower delivers air at a constant rate and keeps a positive pressure inside the facepiece. This reduces the likelihood of contaminants leaking into the respirator when the user inhales.

If even greater protection is needed (for example in extremely hazardous or unknown environments) the worker may need to use a respirator that provides clean air from a tank, the self-contained breathing apparatus or SCBA.