Personal Protective Equipment for COVID-19

COVID-19 has already caused enormous human and economic costs in the United States and, as no vaccine is available, nonpharmaceutical interventions (NPIs) are the only defenses against its spread. The disease is believed to spread primarily via the respiratory tract, with the eyes being another possible means of attack.

Respirators (such as N95 and better) provide the best protection against inhalation of contagious aerosols, and are mandatory in jobs that require respiratory protection per OSHA or other regulations. If so, then a respiratory protection program that meets the requirement of the Code of Federal Regulations (CFR) is required. Respirators with exhaust valves do not protect others but it is simple enough to put an ordinary mask over the valve to overcome this drawback at least partially.

The good news is that jobs that OSHA defines as medium risk, i.e. most jobs outside of health care, emergency response, and similar activities, are unlikely to require respiratory protection per "Guidance on Preparing Workplaces for COVID-19." When respirators are not available for these jobs, or for individual protection outside the workplace, face masks must be used. Surgical face masks that meet ASTM Level 1 through 3 are known quantities and are likely to be superior to improvised face masks.

There are however two elephants in the living room. The first is that most people have no experience with any kind of PPE, which leads to resistance to its use. The second is that most masks are not designed to prevent leakage around their sides. The ASTM standards for surgical masks point out, in fact, that the test methods do not assess leakage. On the other hand, respirators must meet NIOSH leakage standards for approval, and users must perform seal tests when using them.

It is therefore necessary to educate workers and other stakeholders, including the public, why face mask usage is important. People need to understand that the mask protects them against dangerous airborne materials that can hurt them. In addition, the performance of face masks can be improved with models that tie behind the head (as used against the 1918 Spanish Flu pandemic), ear loop tighteners that pull the ear loops behind the head for a tighter fit, and mask sealers and braces that press the mask firmly against the face. Suppression of air leakage makes any face mask far more effective as protection for both the wearer and others. 

There is also substantial evidence that goggles and/or face shields should be worn to protect the eyes, and a face shield can partially intercept aerosols before they can reach whatever respirator or face mask is worn.

Why Should You Attend

Personal protective equipment (PPE) is a last line of defense against COVID-19 but, if selected and used properly, it can be very effective. The importance of PPE cannot be overemphasized as it has been estimated that each face mask that is worn properly can save thousands of dollars in health care and related costs. Respirators are the best PPE but are not universally available. The performance of surgical and improvised face masks can however be improved enormously by reducing leakage, and recent information shows that eye protection also may be instrumental in preventing contagion. 

Objectives of the Presentation 

•  PPE is indispensable for reopening workplaces and keeping them open when other options like telecommuting are not available. 
• PPE protects the wearer from contagious aerosols exhaled by others, and others from contagion exhaled by the wearer, to at least some degree. This reduces the ability of the disease to spread.
• PPE compliance is mandatory in workplaces where respiratory protection is required, in which case respirators and a written respiratory protection program that meets the requirements of 29 CFR 1910.134.
• Surgical face masks meet ASTM requirements for particulate and bacterial filtration efficiencies. The elephant in the living room is the fact that these tests are performed on the filter medium and do not assess leakage around the sides. We are therefore calling upon the mask to do something for which it was not really designed, but there are three ways to partially overcome this.
• Research published in The Lancet shows that absence of eye protection triples one's risk of getting COVID-19 because the eyes are mucous membranes ("Should You Wear Goggles to Protect Against Coronavirus? Here's What Experts Told Us" https://www.health.com/condition/infectious-diseases/coronavirus/goggles-covid). Face shields and goggles are fortunately available in hardware stores and also from safety supply companies.

Areas Covered in the Session 

•  Educate stakeholders on the health and business benefits of PPE use in and outside the workplace. PPE has an indispensable role in impeding the spread of COVID-19, and also in continuity of business operations.
•  Know when respirators, and a respiratory protection program, is required, and what the organization must then do to meet regulatory requirements.
•  Recognize the benefits and limitations of surgical and improvised face masks. The issue of leakage around the side is very important.
•  Know how to improve the performance of surgical and improvised face masks with (1) superior off the shelf designs, (2) mask tighteners, and (3) mask sealers and braces.
•  Recognize the potential benefits of eye protection, and how to achieve it.

Who Will Benefit 

•  All people with OH&S responsibilities related to COVID-19, and also individuals