Selecting Protective Clothing for Emergency Medical Operations

By Stull, Jeffrey O. | Occupational Hazards, November 1993 | Go to article overview

Selecting Protective Clothing for Emergency Medical Operations


Stull, Jeffrey O., Occupational Hazards


OSHA requires "appropriate personal protective equipment" to guard workers potentially exposed to bloodborne pathogens, but how do you choose what is "appropriate"? NFPA 1999 offers safety professionals an important guideline.

With the proliferation of infectious agents, emergency personnel are increasingly at risk for being exposed to deadly diseases, such as AIDS and hepatitis, in the course of their normal duties. In addition, laboratory and other clinical personnel who handle blood can be similarly exposed.

This threat of exposure has required a new awareness as to how emergency responders and others approach situations involving blood or other infectious fluids, both in their practices and in what they wear to protect themselves. Until recently, however, there were no standards which addressed protective clothing worn by personnel engaged in emergency patient care and other emergencies where the exposure to blood and other body fluids is probable.

Now, NFPA 1999, Standard on Protective Clothing for Emergency Medical Operations, provides complete and comprehensive performance specifications for emergency responders. This standard, developed by the National Fire Protection Assn.'s Technical Committee on Fire Service Protective Clothing and Equipment, addresses specific concerns that emergency responders have about their protection against liquid-bome pathogens and blood.

NFPA 1999 allows end users to more easily select the types of protection that they need. The standard fills a significant gap in the industry for defining the minimum required performance for most emergency medical operations and related applications. This is particularly true since the new OSHA standard on Bloodborne Pathogens (29 CFR 1910.1030) contains no specific provisions for determining acceptable protective clothing performance. The OSHA rule states:

"When there is occupational exposure, the employer shall provide, at no cost to the employee, appropriate personal protective equipment, such as, but not limited to, gloves, gowns, laboratory coats, face shields or masks, and eye protection, and mouthpieces, resuscitation bags, pocket masks, or other ventilation devices. Personal protective equipment will be considered 'appropriate' only if it does not permit blood or other potentially infectious materials to pass through to or reach the employee's work clothes, street clothes, undergarments, skin, eyes, mouth, or other mucous membranes under normal conditions of use and for the duration of time which the protective equipment will be used."

Under this rule, individuals in professions which provide emergency patient care are considered health care workers and must have a program in place to limit their exposure to contact with blood and other bodily fluids. This program must address the selection and use of appropriate protective clothing.

Therefore, NFPA 1999 becomes a valuable tool in preparing an infectious disease control program because it establishes protection against liquid-borne pathogens and defines liquid-proof performance for protective clothing used in emergency medical operations consistent with the OSHA final rule.

What is NFPA 1999 About?

NFPA 1999 addresses three different clothing types:

Garments -- Either full body clothing covering the wearer's torso, arms, legs, and head, or partial body clothing, such as jackets, aprons, sleeve protectors, or shoe covers. Both types of clothing must provide complete wearer protection for the portion of the body covered. This allows end users to pick the type and configuration of protective garments that best meet their needs.

Gloves -- Full hand elastomeric gloves designed for physical and barrier protection that also offer high tactility and dexterity. These gloves must go beyond the wrist and provide equal protection for all areas of the hand.

Facewear -- Items such as masks, goggles, safety glasses, or respirators. …

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