Ensuring that personal protective equipment (PPE) is a good fit for the user is critical – it enables work to be carried out safely in situations where the risk of contamination, be it from contact, droplets, or airborne particles, is present. This is especially important when it comes to respiratory protective equipment (RPE), which is why carrying out a face fit test is a vital part of the RPE selection process. Still, several factors can compromise even well-fitting PPE.
Finding the right fit is a key consideration when selecting any protective equipment, from respiratory protection to protective overalls to gloves. For example, if the size is too small, the PPE will be uncomfortable to wear and may even rip or expose skin during movement. On the other hand, too large garments and gear may restrict movement and get caught on surrounding equipment, increasing the risk of tearing. Fit testing helps identify the type of PPE that is best suited for the user. This is essential when selecting tight-fitting RPE equipment, as the user’s facial features, facial hair, and hairstyles will affect the fit. Poor fit is a major cause of leaks and can quickly compromise safety, regardless of the other PPE the user is wearing.
Tight-fitting RPE
There are many factors to consider when performing a face fit test, which is why the testing process needs to be carried out by a qualified professional. Some of the key considerations, however, are the same as when selecting other types of PPE: seal with skin, compatibility with other PPE, and comfort.
If tight-fitting RPE doesn’t seal well with the skin, the wearer can be exposed to risk without even realising it. This issue can be made worse by using non-compatible PPE: if the rest of the protective equipment is not designed to accommodate the RPE, it can cause a mask to shift, exposing the user. Like other PPE, RPE is worn for long periods of time, so it should be as comfortable as possible. Discomfort increases the chance of the wearer adjusting PPE during use, or removing it completely, and can heighten the risks when doffing at the end of the day. Consider, for example, a healthcare worker wearing a tight-fitting RPE together with a protective coverall and gloves correctly throughout their entire shift, only to remove the face mask at the end of the day to wipe the sweat off their forehead with a gloved hand.
It is vital to bear in mind that all the effort put into fit-testing, and indeed personal protective equipment, may be of little use if correct donning and doffing procedures are not followed. To safely don and doff PPE, the wearer will need to know how to connect PPE together correctly and how to remove it securely, in the correct order, to minimise the possibility of contamination. This requires special attention during doffing, as most self-contamination occurs when doffing incorrectly: without due care, the contaminated surface of the protective garment or equipment can get in contact with the wearer’s skin, hair, clothes or their assisting colleague.
A helping hand
As it can be challenging to put PPE on or take it off properly without help, a co-worker should always be on hand to assist. They can help ensure garments are correctly sealed and adjust the fit with adhesive tape where necessary, for example, to achieve a better seal between the sleeve and gloves. Crucially, they will be able to see if there are any gaps where the skin is exposed as some RPE, and pieces of garments such as hoods, can leave the user with a limited visual field.
The process for donning and doffing a coverall for healthcare use illustrates perfectly why following the correct procedure is critical for safety. When donning, the process starts in a contamination-free changing room. First, the coverall is pulled over the arms and shoulders and zipped up to the chest. Then it is time to put on face protection and adjust the hood to ensure the fit is tight. Once the RPE is in place, only then is the coverall zipped up all the way, and internal and external gloves put on. Adhesive tape is then used to seal the outer gloves to the sleeves, and facial protection to the hood. Here, the hood can be used to optimise the fit of the RPE used, for example, by tightening it over a half mask and sealing it with adhesive tape. Finally, the user should stretch to ensure fit during movement and to identify potential weak spots, which can then be covered with tape.
Cross-contamination
It is easy to see that the donning process would be difficult to complete satisfactorily without assistance. The doffing process, however, is even more complicated as the PPE is likely to be contaminated. That’s why it’s also vital that the person assisting is wearing appropriate protective equipment, including a mask, gown or coverall, and gloves. Protection can be further enhanced by disinfecting the contaminated gloves before beginning doffing.
The doffing process starts with the removal of the taping from the zip of the coverall. The suit can then be opened to the waist. Next, the hood is removed by turning it inside out and the sleeves and outer gloves removed together from behind. The assistant will then place hands inside the coverall and roll it down, effectively wrapping the contaminated surface inside the clean inside of the coverall, before removing any protective boots. Finally, face protection equipment is removed, and the user can remove the second pair of gloves they have been wearing.
As the above examples demonstrate, there are several steps PPE users should follow to optimise safety. Having personal protective equipment that fits well and is the right match for the risk at hand is a good start, but even the best protection can be compromised if not worn, or removed, correctly. The right training is key to educating users on high-risk activities and highlighting the processes they need to follow to ensure that their PPE delivers on its promise and keeps them safe throughout the day.
Stephen Watkins is an account manager at DuPont Personal Protection