Fig 4 . PPE exposure when using a power sprayer : ( A ). Face shield and chest area ; ( B ). Chin and neck area ; ( C ). Gown and gloves ; ( D ). Foot and leg area of boot covers . Courtesy of APIC / AJIC
Fig 5 . PPE exposure during simulated manual cleaning of a ureteroscope : ( A and B ). Held above the surface of the water ; ( C and D ). Held underneath the surface of the water ; ( E ). Moisture observed inside the purple extended-cuff glove ; ( F ). Droplet- detection paper affixed inside gloves turned white due to fluid exposure . Courtesy of APIC / AJIC though , they suited up from head to toe . They used the tall shoe-cover boots that go to the knee , but they did not prevent droplets from hitting them . They told me it was happening , but you must see it for yourself . The skin exposure happened within seconds of every activity . It wasn ’ t like they ’ re working in there and after two hours , they eventually get a little bit of material on them . In this study , we could only detect big droplets . Either we would see the spray and document it on video or we could see it on the blue paper . We couldn ’ t detect airborne transmission , but we know it ’ s happening , and it ’ s disturbing .”
Particularly in light of the pandemic , which raised awareness of risks associated with aerosol-generating procedures . As we know , the Centers for Disease Control and Prevention ( CDC ) recommended administrative and engineering controls and the use of PPE as risk mitigation strategies . The guidance included wearing respiratory and eye protection by personnel who could be exposed to aerosols , as well as fluid-resistant surgical N95 respirators worn by workers needing protection from both fluid and airborne hazards . As Ofstead , et al . ( 2022 ) note , “ Although sterile processing and endoscopy personnel are at high risk for exposure to fluids and aerosols , they generally wear a regular face mask and a drop-down face shield or a face mask with a pop-up face shield ( not N95 respirators ).”
That said , there are challenges associated with wearing a full suit of PPE , and research has indicated that discomfort is one of the reasons why healthcare personnel do not wear certain articles of PPE properly .
“ We need better PPE products and I think a redesign is advisable ,” Ofstead advocates . “ We need face shields that don ’ t steam up and improved neck protection . When I ’ m wearing a full set of PPE and we ’ re doing sample-collection tasks for our research , I must choose between wearing glasses and wearing a face shield because if I wear a face mask , face shield and glasses , the glasses and the face shield steam up . We need a system similar to what is used during orthopedic implant surgeries where you ’ re going to protect the whole head space with tolerable equipment that workers can stand to wear and that can let them function in the way they need to . They must be able to see , obviously . So , that