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Contamination: a comparison of 2 personal protective systems
Jorge E Zamora1, John Murdoch, Brian Simchison
1Department of Anesthesiology, Queen's University, Kingston, Ont. zamoraj@kgh.kari.net
Summary
Enhanced respiratory and contact precautions (E-RCP) led to higher self-contamination rates compared to powered air-purifying respirators (PAPR). PAPR systems required more time and had more donning violations, but offered better protection against contamination.
Area of Science:
- Infection Control
- Occupational Safety
- Biomedical Engineering
Background:
- Healthcare settings require effective personal protective equipment (PPE) to prevent pathogen transmission.
- Evaluating the efficacy of different PPE systems is crucial for patient and healthcare worker safety.
- Enhanced respiratory and contact precautions (E-RCP) and powered air-purifying respirators (PAPR) are two such systems with varying protection levels.
Purpose of the Study:
- To compare self-contamination rates between E-RCP and PAPR systems.
- To assess the contact and droplet protection offered by each PPE type.
- To identify specific areas of the body most susceptible to contamination with each system.
Main Methods:
- A prospective, randomized, controlled crossover study involving 50 participants.
- Participants donned and removed E-RCP and PAPR ensembles in a random order.
- Surrogate contamination using fluorescein and UV-detectable paste, followed by blinded inspection for contamination presence and area.
Main Results:
- E-RCP use resulted in significantly higher rates and larger areas of skin and base-clothing contamination (p < 0.0001).
- Anterior neck, forearms, wrists, and hands were the most frequently contaminated areas with E-RCP.
- PAPR use led to more donning procedure violations (p = 0.0034) and longer donning/removal times (p < 0.0001).
Conclusions:
- E-RCP systems are associated with a greater risk of self-contamination compared to PAPR.
- While PAPR systems require more time and adherence to donning procedures, they provide superior protection against contamination.
- Findings highlight the importance of proper PPE selection and training to minimize healthcare-associated infections.
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