Personal protective equipment for preventing highly infectious diseases due to exposure to contaminated body fluids in healthcare staff
Verbeek, Jos H., et al.
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Background: Healthcare workers treating patients with infections such as coronavirus (COVID‐19) are at risk of infection themselves. Healthcare workers use personal protective equipment (PPE) to shield themselves from droplets from coughs, sneezes or other body fluids from infected patients and contaminated surfaces that might infect them. PPE may include aprons, gowns or coveralls (a one‐piece suit), gloves, masks and breathing equipment (respirators), and goggles. PPE must be put on correctly; it may be uncomfortable to wear, and healthcare workers may contaminate themselves when they remove it. Some PPE has been adapted, for example, by adding tabs to grab to make it easier to remove. Guidance on the correct procedure for putting on and removing PPE is available from organisations such as the Centers for Disease Control and Prevention (CDC) in the USA. This is the 2020 update of a review first published in 2016 and previously updated in 2019. What did we want to find out? We wanted to know: what type of PPE or combination of PPE gives healthcare workers the best protection; whether modifying PPE for easier removal is effective; whether following guidance on removing PPE reduced contamination; whether training reduced contamination. What did we find? We found 24 relevant studies with 2278 participants that evaluated types of PPE, modified PPE, procedures for putting on and removing PPE, and types of training. Eighteen of the studies did not assess healthcare workers who were treating infected patients but simulated the effect of exposure to infection using fluorescent markers or harmless viruses or bacteria. Most of the studies were small, and only one or two studies addressed each of our questions.