Self-contamination risk and failure modes during high-level PPE doffing: A pilot comparison of 2 powered air-purifying respirator (PAPR) hoods

IF 3.8 3区医学 Q2 INFECTIOUS DISEASES

American journal of infection control Pub Date : 2025-01-09 DOI:10.1016/j.ajic.2025.01.002

Kimberly Erukunuakpor MPH, PhD , Jill Morgan RN, BSN , Colleen S. Kraft MD , David Grimm MS , Alexandra Nguyen MS , Joel M. Mumma PhD , Lisa M. Casanova MS, PhD

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引用次数: 0

Abstract

Background

Personal protective equipment doffing protocols can reduce risks of pathogen self-contamination. Powered air-purifying respirators may increase these risks. This study compares viral contamination and errors during simulated doffing of single-layer versus double-layer hood powered air-purifying respirators.

Methods

Eight participants performed 2 simulations (video recorded for failure modes [FMs] and effects analysis): 1 single-layer hood (laid over Tyvek suit) and 1 double-layer hood (top laid over and bottom tucked into suit). Hoods were contaminated with viruses. After doffing, inner gloves, face, hands, and scrubs were sampled.

Results

Virus contaminated at least 1 site in 6/8 single- and 5/8 double-layer simulations. Virus-contaminated inner gloves in single- (6 participants, median 5.42 × 10⁴ plaque-forming units) and double-layer (2 participants, median 7.23 × 10² plaque-forming units) simulations, and hands of 2 participants in single-layer simulations. Single-layer doffing had 13 FMs; double had 31.

Discussion

Double-layer doffing reduced inner glove contamination. The double-layer protocol may reduce glove-face shield contact but allow more opportunities for error. Double-layer doffing errors may less frequently lead to contamination than single layer.

Conclusions

Contamination and FMs may differ between double- and single-layer doffing. Although inner glove contamination was reduced, double-layer doffing may need redesign to reduce FMs and contamination.

查看原文本刊更多论文

高水平个人防护装备降落过程中的自污染风险和失效模式：两种动力空气净化呼吸器（PAPR）罩的比较：一项试点研究。

背景：个人防护装备（PPE）脱布方案可以降低病原体自我污染的风险。电动空气净化呼吸器（papr）可能会增加这些风险。本研究比较了单层和双层遮光罩模拟落纱过程中的病毒污染和误差。方法：8名参与者进行了两次模拟（记录故障模式和影响分析的视频）：一个单层兜帽（铺在Tyvek防护服上），一个双层兜帽（顶部铺在防护服上，底部塞进防护服）。头罩被病毒污染了。落纱后，对内手套、面部、手部和磨砂取样。结果：在6/8次单层模拟和5/8次双层模拟中，病毒至少污染了一个位点。单层模拟（6名参与者，中位数5.42×104 PFU）和双层模拟（2名参与者，中位数7.23×102 PFU）中病毒污染的内手套，以及单层模拟中2名参与者的手。单层落纱有13种破坏模式；Double有31个。讨论：双层落纱减少手套内污染。双层协议可能会减少手套和面罩的接触，但会增加出错的机会。双层落纱误差比单层落纱误差更少导致污染。结论：双层和单层落纱的污染和失效模式可能不同。虽然手套内部污染减少了，但双层落纱可能需要重新设计，以减少失效模式和污染。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

American journal of infection control 医学-传染病学

CiteScore

7.40

自引率

4.10%

发文量

479

审稿时长

24 days

期刊介绍： AJIC covers key topics and issues in infection control and epidemiology. Infection control professionals, including physicians, nurses, and epidemiologists, rely on AJIC for peer-reviewed articles covering clinical topics as well as original research. As the official publication of the Association for Professionals in Infection Control and Epidemiology (APIC)