Personal Protective Equipment

PPE is the equipment worn by workers to minimize their exposure to occupational hazards. PPE includes gloves, aprons, footwear (e.g., steel-toed shoes), goggles, face shields, respirators, hard hats, and protective clothing, such as gowns or chemical protective suits. PPE may protect the whole body or just individual parts, such as the eyes. Gloves, gowns, and air-purifying respirators used for protection against tuberculosis (TB) and other airborne infectious agents are the most common types of PPE used in the healthcare setting. Hearing protection and PPE related to bloodborne pathogens are fully addressed under separate standards and are covered in OSHA's Occupational Noise Exposure Standard and OSHA's Bloodborne Pathogens Standard.

The responsibility for selecting, training, and managing the use of PPE falls within the purview of several individuals at a hospital. The infection preventionist (IP) is typically responsible for ensuring PPE compliance with OSHA's bloodborne pathogens standard and general CDC infection control guidelines (such as the use of gloves), as well as disease-specific guidelines, such as recommendations on the use of respirators certified by the National Institute for Occupational Safety and Health (NIOSH).

However, all respirator uses, whether for protection from TB or toxic chemicals, are governed by OSHA's respiratory protection standard, and OSHA compliance is often under the purview of the hospital safety officer, who is also typically in charge of PPE outside of the infection control context—for example, the use of helmets to protect against falling objects. PPE related to ionizing radiation is overseen by the radiation safety officer, as required by the Nuclear Regulatory Commission (NRC) (10 CFR § 35.24). The risk manager, however, is charged with organization-wide risk management and, as such, must be familiar with all these areas.

Providing medical diagnoses, treatment, and care creates occupational hazards, and compared with other industrial sectors, healthcare has the second largest number of occupational illnesses and injuries (Boiano et al.). While healthcare personnel can face the same occupational health problems, such as exposure to hazardous chemicals or electrical hazards, as workers in other industries, some hazards are specific to healthcare. For example, exposure to airborne infectious diseases, such as TB and the H1N1 virus, or blood or other potentially infectious materials (OPIM) as defined by OSHA is a hazard for any worker in patient care and support services areas.

But the risk of infection is not the only occupational hazard uniquely associated with the provision of healthcare. Ionizing radiation is a hazard in diagnostic and surgical settings such as interventional radiology, and patients who ingest a radiopharmaceutical may pose risks to those who handle their waste. Pharmacists, pharmacy technicians, and nurses who prepare and administer hazardous drugs, such as antineoplastic agents, may be at risk from those drugs. In addition, clinical laboratory workers may be exposed to a variety of hazardous chemicals, and...