In the midst of the Coronavirus comes the great need for health and safety products such as Personal Protective Equipment. The ongoing shortage leads many of us to question if some of these PPEs can be reused to maximize resources.
In this article, we outlined the 7 major types of PPE and covered their differences in grades. We also put into consideration which ones you can reuse to save on scarce supplies.
What is PPE Clothing?
Before we go further, let’s clarify what PPE clothing is. PPE clothing or “Protective clothing” is anything worn on the body to protect it from physical injury or infectious diseases. It should effectively protect your body from what it’s made for.
For example, hazmat suits and bunny suits are worn in highly-contaminated areas to protect the skin from deadly viruses.
On the other hand, PPE workwear such as hi vis workwear, electrical PPE and hard hats are used to protect workmen from possible injuries from handling heavy-equipment.
These are all further described in the CDC PPE Selection Guide.
Who Needs PPE Now?
According to the Centers for Disease Control and Prevention, these are the ones who will be prioritized for PPE supplies.
- Patients – these are people who are tested positive of the COVID-19 disease.
- Doctors, Nurses and Healthcare Personnel – hospital staff handling COVID-19 patients should wear PPE.
What is PPE in the Healthcare Setting?
Why is it important for healthcare workers to wear personal protective equipment? The simple answer is it protects patients and healthcare workers from infections.
Full PPE wear helps nurses, doctors, staff and patients from cross-contaminating Covid-19 and the spread of germs in the hospital.
In the medical setting, protective wear can be masks, guards or shields and PPE suits worn in cleanroom environments. Overall garments are also worn to protect the cleanroom or sterile environment from hair or saliva contamination of the wearer.
Differences Between PPE Categories
There are many types of PPE (Personal Protective Equipment) in the market. Each has different uses, which you should know how to distinguish from.
Some of which are safety workwear used to protect employees from falling objects, such as in construction sites and fire. These are governed under the guidelines of OHSAS. On the other hand, medical PPE are worn by healthcare workers for protection against infectious diseases or splatters. These are FDA-regulated.
The most in-demand PPE today are the ones worn by healthcare personnel (HCP) due to the global pandemic which started in late 2019. The need for safety wear in the healthcare industry posed serious shortages across the globe.
Hence, you would need to know first the specific differences in PPE types to make sure you’re not wasting supplies or expenses on buying the wrong ones.
How Many Types of PPE are There?
You may have to use several personal protection devices in the hospital or medical laboratory, but there are different types and grades you should know of. This is so you’re sure you’re wearing an effective protective barrier against germs and fluid contaminants.
There are different types of respirators and masks and face and skin protectors. If you want to know if you are buying or using the right one, we have intricately discussed each type and the regulations which cover their manufacturing, supply and distribution.
7 Types of PPE in Healthcare Settings
Have a look at this complete Personal Protective Equipment List for people and staff in a hospital or medical laboratory.
✅Masks and Respirators – protect mouth, nose and some designs include the face.
✅Medical Gloves – protect hands
✅Medical Gowns & Safety Coveralls – protect skin/clothing
✅Eye Protection Goggles – protect eyes
✅Face Shield – protect face, nose, eyes and mouth
✅Head Cover – protect the head
✅Shoe Covers – protect the cross contamination as Covid-19 leave traces on the floor
Now let’s further demystify each type.
Disposable masks and respirators provide the same purpose: to stand as a barrier or protection between the wearer’s mouth and nose from its environment. They do have differences which you should know of.
What is a Surgical Mask?
- Surgical face masks/disposable surgical masks have loose-fits around the face and are used to minimize the spread of Covid-19 and germs.
- It’s a type of face mask which provides one-way protection for the environment and other patients/people.
- Can only protect the wearer from large droplet emissions, fluids and sprays.
- Made of non-woven fabrics, such as polypropylene plastics, and have a filtering surface
Who Needs Surgical Masks?
- Healthcare personnel, infected patients and the general public
Considerations for Selection Masks:
- Fluid Resistance – usually measured in mmHg
- Bacteria Filtration Efficiency (BFE)
Different Types of Surgical Masks
ASTM lists 4 types of surgical face masks. These masks are available with different grades depending on the level of protection needed.
- Surgical Molded Utility Masks – Having the lowest performance level againsts bacteria, molded utility masks are only used for minor procedures and exams.
- Level 1 Surgical Face Masks – Level 1 surgical masks have a low barrier protection used for low risk contamination exams. They can bear fluid splashes, sprays and aerosols with up to 80mmHg force. They also have a BFE of 95%.
- Level 2 Surgical Disposable Masks – Having a moderate level of protection against bacteria and viruses, these medical masks can withstand 120 mmHg fluid forces. It also protects the wearer against sprays and aerosol and has a BFE of 98%.
- ASTM Level 3 Surgical Disposable Masks – Used for heavy to moderate fluid sprays and exposure, with 160 mmHG fluid resistance. These masks have a BFE of 98%.
Can Surgical Masks be Reused?
Ideally, 3-ply disposable surgical masks are meant to be for one-time use only, and are meant to be discarded every after a patient meeting.
However, due to the shortage of production of surgical masks, some medical staff and nurses opt to reuse surgical masks in hospitals.
Dr. Michael Chang, a Pediatric Infectious Disease Specialist at McGovern Medical School at UT Health Science Center in Houston, says:
“Some healthcare workers are reusing surgical masks for the same patient for at least one day or one shift”.
If you do want to reuse your surgical mask, you can…
“isolate it in a closed, preferably non-airtight container for about 72 hours”, Dr. Chang further says.
What is a Respirator?
- Respirator Masks are tight-fitting on the face, leaving less vulnerability from contracting diseases from contaminated fluids.
- They provide an extra, two-way protection from small aerosols such as bacteria and viruses.
Who Needs Respirators?
- Doctors, nurses, and healthcare personnel PPE shield for mouth and nose
- Due to the global shortage, the CDC recommends surgical N95 respirators to be reserved for HCP working in sterile environments. These work areas have high velocity blood splatters, sprays
Major Differences Between Surgical Masks and Respirators
Now let’s talk about what sets apart a surgical mask and respirator. Surgical masks have different grades defined by the minimum percent of bacteria it can filter. On the other hand, Face Mask Respirators are also differentiated by the amount of protection they can render.
What’s the major difference between surgical masks and respirators?
The main difference is that respirators are designed for enhanced protection than surgical masks. Where mask respirators are tight-fitting, surgical masks have loose fits.
Another thing is the material itself. While surgical masks can only provide the wearer with a barrier from inhaling large particles of sprays and splashes, respirators can go further. Respirator filters can sieve out up to 99.97% (or above) of smaller airborne contaminants, dusts and particles.
The most common respirator today, due to the Covid-19 outbreak, is the N95 respirator.
Here are the major differences of Surgical Masks and Respirators according to the CDC:
|Surgical Mask||N95 Respirator Mask|
|Purpose||Protects a patient from an infected wearer. Protects the wearer from large emissions of droplets and sprays.||Protects the wearer from smaller aerosols and droplets|
|Fit test requirement||No||Yes|
|User Seal Check Requirement||No||Yes (checked each time the wearer puts it on)|
|Leakage||Fluid resistant; Leakage around the mask edge when the wearer inhales||When worn properly, only minimal leakage occurs around the edge of the mask when inhaling|
|Testing and Approval||Clearance and Approval from the Food and Drug Administration (FDA), regulated under 21 CFR 878.4040||A regulated NIOSH Respirator, evaluated, tested and approved under 42 CFR Part 84.|
Different Types of Respirators
Below is a list of the most common types of respirators used as a PPE for the mouth and nose.
a. Standard N95 Respirator and Surgical N95 Respirator
As mentioned earlier, there are two types of PPE for the mouth and nose, which are the FDA-regulated Surgical mask and the NIOSH-approved N95 respirator. Between these two types is another type of particulate respirator called the Surgical N95 Respirator.
Surgical N95 Respirator masks are approved by NIOSH as an N95 face mask, and at the same time, regulated by the FDA as a surgical mask.
These types of masks are worn under surgical procedures where blood splashes and sprays are in extreme amounts and where sterile conditions are maintained. Surgical N95 respirators can protect you from airborne droplets which contain bacteria or viruses, while performing surgeries.
For healthcare personnel not operating in surgical environments, they may use the non-surgical N95 respirator.
b. Half Face Mask Respirator and Full Face Mask Respirator
In case you missed it from their names, Half Face Respirator is a PPE for the mouth and nose, while Full Face Respirator covers the whole face. Both respirators are health and safety supplies creating a unique face seal. They can effectively filter the airflow coming in and coming out from the wearer.
c. Valved and Non-Valved Respirators
Valved respirators are designed for wearers to breathe easily, while providing a safe fit. The design makes it possible to produce less moisture, unlike its non-valved design. N95 Valved respirators are ideal for construction and lifting work.
But they don’t filter the outgoing air. So if you’re possibly carrying a deadly disease, you don’t want to wear a non-valved respirator as it cannot entirely protect the ones around you. This is one of the reasons why medical staff don’t often use this type of mask.
Different Respirator Standards:
There are different standards covering different types of respirators. Here’s a summary.
|Country||Respirator Standard||Min Filtering Efficiency*||Requirement for Sale or for import|
|EU||FFP1 & P1||80%||
*Capability of mask to remove particles which have diameters of 0.3 microns and up
**For US: N – Non-Oil, R – Oil-resistant, P – Oil & Dust;
***For China: KN: Non-oily, KP: Oil & Dust
Here are some of the equivalents you might be looking for:
N95 (95%) ≈ FFP2/P2 (94%) ≈ KN95 (95%)
N99 (99%) = FFP3 (99%)
N100 (99.97%) ≈ P3 (99.95%) ≈ KN100 (99.97%)
2. Medical Gloves
Medical gloves protect the hands from contaminants, germs and viruses. These hand protection PPE also help in reducing the spread of the Coronavirus.
Take note that PPE gloves are not substitutes for good hand hygiene. The CDC has repetitively emphasized the importance of washing the hands with soap and water or applying alcohol-based hand sanitizer to rid it from Covid-19.
It is also important to observe proper hand hygiene after using nitrile gloves. Use hand sanitizer gel with 60% to 95% alcohol content to make sure any traces of Coronavirus are killed.
When to Use Medical Gloves?
- Medical Gloves are worn when you’re about to handle operations involving emissions of body fluids, secretions, urine, feces or vomit.
Considerations for Glove Use:
- Patient care or chemical handling
- Material type
- Sterile and nonsterile
- One or two pair
Glove Material Types
The ASTM provides a complete standard for these types of PPE gloves according to its material and size. In general, medical gloves for patient care and examination have lengths of 220mm to 230mm. Glove extensions or double gloving are not necessary when handling Covid-19 patients.
These glove-types according to materials are:
- Natural Rubber Latex Gloves
- Nitrile Gloves
- Vinyl Gloves
- Polyurethane Gloves
Type of PPE Safety Gloves for Healthcare
- Examination Gloves
- Surgical Gloves
- Chemotherapy Gloves
Which Type of Glove According to Material Should You Use?
There are three types of materials used for glove manufacture. These are latex, nitrile and vinyl, which are also commonly used by healthcare personnel. Here is a quick comparison of the three.
|Latex Gloves||Nitrile Gloves||Vinyl Gloves|
|Level of Protection||Bacteria and Viruses, including Coronavirus||Viruses, Germs and Chemicals||Chemicals|
|Purpose||Surgical operations, highly-sensitive tasks, procedures with high risk of contamination||Healthcare tasks, used in medical procedures||Chemical testing, Medical tasks, food handling, chemical, oil industries, DIY work and painting job|
|Safety Standards for Gloves||
Can Disposable Gloves be Reused?
No. Medical gloves are strictly disposable, which means you may only use them once before you discard them. Remember to always change your gloves, especially every after patient care.
As we are experiencing PPE shortage for hand protection, this also does not mean you can wash your gloves and reuse them. Doing so can only scratch the surface of the gloves and defeat its purpose of lessening the spread of Coronavirus and protecting your hands.
3. Medical Gowns & Safety Coveralls
Medical gowns and safety coveralls are protective clothing for healthcare workers. Examples of medical gowns are surgical gowns, coveralls and isolation gowns.
Safety overalls and gowns prevent the spread of virus and protect patients and the wearer from cross-contamination of infection.
There are also hospital gowns worn by patients which are called Medical Patient Gowns.
Major Differences Between Medical Gowns and Safety Coveralls
|Characteristics||Covers the torso and has long sleeves, which are fitted around the wrist.||Made of breathable protective fabrics to protect wearer from blood splatters and hazardous chemicals|
|Manufacturing Standards for Safety Clothing||Medical gowns are tested using the following standards according to the FDA:
ASTM F2407 – standard for testing surgical gowns which includes:
ANSI/AAMI PB70 – describes the classification of surgical gowns and its liquid barrier performance
*For more information, visit the FDA Regulations for Protective Apparels
|According to WHO:
4. Eye Protection Goggles
In surgery or medical settings where there are a lot of blood and fluid splatters, Eye Protective Goggles are meant to shield the eyes from these bodily fluids. They are snug-fitted, anti-fog PPE shields worn during surgical operations or hazardous testing procedures.
Safety goggles are specially designed to protect eyes from bacterial transmission, and at the same time, maintain clear visibility while working. They are also used as personal protective equipment in medical laboratories when handling hazardous chemicals.
Specifically, protective goggles guard the eyes’ mucous membranes from contracting bacteria or infection.
5. Face Shield
Face Shields are PPE for the face, which includes the eye, nose and mouth protection. They can be worn as an alternative for face masks or safety goggles. An effective face shield must be able to provide a barrier from the forehead to below your chin. It should also cover the side of your face.
Are Face Shields Better Than Masks for COVID-19?
To answer this, let’s see the findings of a cough aerosol simulation where a healthcare worker stands 18 inches away from the cough source. The result shows that a face shield can provide an immediate barrier from the virus and can decrease vulnerability by 96%.
Furthermore, according to Dr. Eli Perencevich, a Professor of Internal Medicine, “Face shields may provide a better option” than face masks.
Here are some of the advantages of Face Shields over masks according to Dr. Perencevich and his team:
- Face shields are reusable, requiring only to clean the surface with soap and water or disinfectants.
- Face shields are more convenient to wear and discourages people from touching their face.
- A good reminder for maintaining social distancing
- Lip movements can be seen through the transparent surface of the shield
6. Head Cover
Head covers are usually worn to prevent the spread of viruses and bacteria through a person’s hair. Infectious particles can potentially be transferred through a person’s head onto another location/person. Wearing a head cover can shield the hair from possible germ transmission.
7. Shoe Covers
Disposable shoe covers are easy-to-wear garments which snugly fit over your shoes. They are used to provide protection of the wearer and prevent viral transmission across the floor. They can also prevent hazardous particles from being transferred in and out of rooms, especially clean rooms.
We hope this article helped you know more about the different types of PPEs and their proper usage and disposal.
There are a lot of PPE manufacturers in the market, however, supplies are depleting very rapidly due to the Coronavirus pandemic.
Where to Buy Medical PPE for Sale?
If you are looking for bulk surgical masks, safety goggles, coveralls and other PPE, visit HisoMedical to place your order now!
HisoMedical offers a streamlined process for manufacturing, supplying and delivery of PPE items and providing the right certificates for faster custom clearances for your country. Contact us for more info.