Personal Protective Equipment | Bloodborne Pathogens

In addition to instituting engineering and work practice controls, appropriate personal protective equipment (PPE) should be used to reduce the risk of exposure. Personal protective equipment is specialized clothing or equipment worn by employees for protection from contact with blood or other potentially infectious materials. Employers must make appropriate personal protective equipment readily available at no cost to at-risk employees. There must be a variety of sizes to provide a good fit.

What is "Appropriate"?

Personal protective equipment will be considered "appropriate" only if it does not permit blood or other potentially infectious substances and contaminated materials to pass through to, or reach, an employee's work clothes, street clothes, undergarments, skin, eyes, mouth, or other mucous membranes. This is considered under normal conditions of use and for the duration of time the protective equipment is in use. Hypoallergenic alternatives must be available to employees who have an allergic sensitivity to protective equipment, such as hypoallergenic or powderless gloves.

Types of PPE

Personal protective equipment consists of, but is not limited to, gloves, face shields, masks, and eye protection, gowns, aprons, and similar items. It is the employer's responsibility to ensure that:

• Appropriate personal protective equipment is used;

• The PPE is used correctly; and

• Protective equipment is properly cleaned, laundered, repaired, replaced, or disposed of as needed.

Disposable gloves should be a standard component of emergency response equipment and should be donned by all personnel prior to initiating any emergency patient care tasks involving occupational exposure. Extra pairs should always be available. There is no single type or thickness of glove appropriate for all situations. Selection criteria should include dexterity, durability, fit, and the tasks that will be undertaken while the gloves are worn.

PPE Declination

An employee may temporarily and briefly decline wearing personal protective equipment under rare and extraordinary circumstances, and when in the employee's professional judgment, it prevents the delivery of health care or public safety services or poses a greater hazard to workers. For example, in the case of emergency responders, this could occur when a firefighter rescues an individual who is not breathing from a burning building and discovers that the necessary resuscitation equipment is lost or damaged and the firefighter must administer cardiopulmonary resuscitation.

When the employee makes this judgment, the circumstances must be investigated and documented to determine whether changes can be instituted to prevent such occurrences in the future. In general, appropriate personal protective equipment is to be used whenever occupational exposure may occur.

The employer also must ensure that employees observe the following precautions for handling and using personal protective equipment:

• Remove garments penetrated by blood or other infectious materials immediately, or as soon as feasible.

• Before leaving the work area contaminated protective equipment must be placed in appropriately designated areas or containers for storing, washing, decontaminating, or discarding.

• Wear appropriate gloves when there is a potential for hand contact with blood, other potentially infectious materials, mucous membranes, and non-intact skin; when performing vascular access procedures; and when handling or touching contaminated items or surfaces.

  An exception to this occurs when an employee in a volunteer blood donation center judges that routine gloving for phlebotomies is not necessary. Replace gloves if torn, punctured, contaminated, or if their ability to function as a barrier is compromised.

• Disposable (single use) gloves, such as surgical or examination gloves, must be replaced as soon as practical when contaminated or as soon as feasible if they are torn, punctured, or when their ability to function as a barrier is compromised. They cannot be washed or decontaminated for reuse.

• Utility gloves may be decontaminated for reuse if the integrity of the glove is not compromised. However, they must be discarded if they are cracked, peeling, torn, punctured, or exhibit other signs of deterioration, or when their ability to function as a barrier is compromised.

• Wear appropriate face and eye protection such as goggles, glasses with solid side shields or chin-length face shields when splashes, sprays, spatters, or droplets of infectious materials pose a hazard to the eyes, nose, or mouth. These should be available on all emergency vehicles.

• Masks in combination with eye protection devices, such as goggles or glasses with solid side shields, or chin-length face shields, shall be worn whenever splashes, spray, spatter, or droplets of blood or other potentially infectious materials may be generated and eye, nose, or mouth contamination can be reasonably anticipated. These should be used in accordance with the level of exposure encountered.

• An extra change of work clothing should be available.