Developing a Personal Protective Equipment Selection Matrix for Preventing Occupational Exposure to Ebola Virus

In response to the 2014 Ebola outbreak in West Africa and resulting cases in the United States, the Occupational Safety and Health Administration developed a personal protective equipment selection matrix to help employers protect workers from exposure to Ebola virus in the event of additional US cases. Now, the world's second largest Ebola outbreak on record continues to expand in the Democratic Republic of Congo, where more than 70 Ebola-infected healthcare workers serve as reminders of the importance of robust infection prevention measures in keeping infectious disease responders from becoming victims themselves. Toward facilitating preparedness for cases associated with the ongoing or future outbreaks, this article discusses the matrix of personal protective equipment recommendations. The matrix applies to a variety of job tasks in health care, laboratories, waste handling, janitorial services, travel and transportation, and other sectors where workers may be exposed to the Ebola virus during outbreak events. A discussion of the information sources and decision-making process for developing the matrix forms the basis of the recommendations. The article then emphasizes challenges and considerations for formulating the matrix, including identifying information sources to help characterize occupational exposures, aligning recommendations among stakeholders with varying viewpoints, and balancing worker protections with feasibility concerns. These considerations highlight issues that remain relevant for preparedness efforts ahead of future US cases of Ebola or other emerging infectious diseases.