Personal protective equipment (PPE) — Healthcare

Scope

Healthcare workers have exposure to a litany of harmful agents while caring for patients and performing other tasks. Common hazards faced by these hardworking lifesavers include:

• Dermal exposure to chemicals and surface contaminants;
• Skin-to-skin contact with sick people;
• Exposure to airborne pathogens that have been coughed or sneezed;
• Exposure to gases, chemicals, and radiation used for patient care and treatment;
• Exposure to blood and other potentially infectious materials;
• Exposure to laboratory chemicals in the healthcare facility; and
• Exposure to cleaning agents and other chemicals like ethylene oxide, formaldehyde, lead, mercury, and nitrous oxide.

Regulatory citations

• 29 CFR 1910 Subpart I — Personal Protective Equipment
• 29 CFR 1910.141 — Sanitation
• 29 CFR 1910 Subpart Z — Toxic and Hazardous Substances

Key definitions

• Administrative control: A type of workplace hazard control that uses procedures, policies, supervision, scheduling, and training as a means of protecting workers.
• Contaminant: A substance that poisons or pollutes.
• Engineering control: A type of workplace hazard control that places barriers between the worker and the hazard, such as guarding or eliminating harmful equipment or chemicals.
• Hazard assessment: Method of evaluating and assessing workplace risks and hazards to which workers are exposed to determine the best, feasible protection methods.

Summary of requirements

OSHA requires employers to provide a workplace for healthcare workers free of recognized, serious hazards. This includes implementing engineering controls, administrative controls, and PPE to protect these workers from infectious diseases, harmful gases and chemicals, and dangerous or faulty equipment or processes.

Engineering controls, such as proper ventilation, and administrative controls, such as work procedures and handwashing protocols, are popular protection methods in healthcare. Routinely pre-cleaning surfaces before applying an EPA-registered, hospital-grade disinfectant to frequently touched surfaces or objects for appropriate contact times are essential administrative safety controls. However, when those methods don’t provide adequate protection, PPE is required to fill the gaps and ensure workers’ safety and health.

The correct PPE is chosen based on the likelihood and risk level of exposures, as well as the frequency of exposures. Feasibility is also a factor, and PPE must not create a greater hazard to the worker. PPE for healthcare workers may include any combination of protective head coverings, safety glasses or goggles, face shields, respiratory protection (or masks), gowns, gloves, aprons, protective sleeves, and shoe coverings. Healthcare workers must use proper PPE when exposed to patients with suspected or confirmed illnesses and when handling chemicals, gases, or other contaminants.

While PPE regulations are found at 29 CFR 1910 Subparts I and Z, for “guidance” on hazard assessment and PPE selection, visit Appendix B to Subpart I of 29 CFR 1910.