Personal Protective Equipment: Good Intentions and Unintended Consequences
Updated: Apr 27, 2020
By Chris Higgins
The ongoing COVID-19 pandemic has brought both personal hygiene and personal protective equipment (PPE) to a new level of awareness among the general public. Everywhere you look, you see people wearing all types of masks, ranging from cloth bandanas to N-95 masks.
However, the most frequently used PPE I have noticed are latex or nitrile gloves, which are increasingly being worn by store cashiers and restaurant workers. Although disposable gloves are worn with good intentions to protect against the transmission of diseases, they can still very easily spread disease when used improperly.
As an environmental consultant with 30+ years of experience, I have worked with all manner of hazardous media. I have also received extensive training in the selection, donning, and doffing of PPE, from simple nitrile gloves to Tyvek hazmat suits. Proper use of PPE is critical to safety. Improper use (or disposal) can expose the wearer and/or waste disposal personnel to hazardous materials.
In the EHS field, we perform sampling for a wide range of hazardous chemicals, metals, bacteria, fungi, and, in some cases, viruses. We wear gloves when sampling and follow very specific protocols. For instance:
Hands should be thoroughly cleaned prior to donning a pair of gloves
Gloves should be changed between samples to prevent cross contamination
When exchanging gloves, they must be removed using a technique that minimizes the likelihood of transferring contamination onto the hands and/or body of the wearer
Users should not touch their body, especially the face, while wearing gloves
Gloves should be discarded appropriately
Proper protocols and awareness of cross-contamination are two aspects of PPE usage that frequently elude people who lack training. Here is an example:
A female grocery store cashier wearing nitrile gloves is checking out customers. You are second in line. There are marks on the floor six feet apart so that social distancing guidelines are maintained. The male customer currently checking out is infected with COVID-19 and has handled his merchandise with unclean hands prior to placing it on the conveyor belt.
The cashier scans his items, inadvertently transferring some COVID-19 virus from the merchandise to her gloves. Next, the merchandise is bagged. The customer pays using a credit card machine, collects his bag, and leaves. Your items are next on the conveyor, and the cashier does not replace her gloves prior to scanning your items. You complete your credit card purchase, touching the same keypad as the prior customer.
If you do not clean both your hand and merchandise, you will be at risk of exposure. Meanwhile, the cashier may continue checking out several dozen customers before replacing her gloves, unknowingly contaminating many additional items. If the cashier absentmindedly touches her face during this time, she will risk exposing herself. Even if the cashier properly removes and disposes of her gloves without contaminating herself, she has still likely contaminated the products of several other customers.
To protect customers, gloves must be changed out or disinfected between each customer with no exceptions. Alternatively, the cashier could forego the gloves and instead clean her hands with disinfecting hand sanitizer in between customers. (Disinfectant must be designed for viruses and not bacteria. Studies have shown that hand sanitizers containing 60% ethanol or 70% isopropanol alcohol will inactivate viruses that are genetically related to and with similar physical properties as COVID-19).
The biggest issue with gloves is that they give people a false sense of security, which can lead to complacency. People may actually be less careful and clean their hands less often or less thoroughly when wearing gloves, because they feel protected.
Gloves are much better suited for specific tasks, such as cleaning. The gloves go on before you start cleaning and come off when you are finished. Of course, it's still very important to wash your hands after removing the gloves.
Protocols are what keep you safe. Not equipment.
Social distancing and washing your hands frequently throughout the day for 20 seconds with soap and water are your best defense against COVID-19. If you cannot wash your hands, have a bottle of disinfectant in your car and use it. It is not as effective as soap and water, but is still better than doing nothing. Most importantly, avoid touching your face, especially if you have not recently washed your hands.
Finally, don't hide in your house. One of the best things you can do to stay healthy (physically and mentally) is to get outside, enjoy the fresh air, laugh and play, and soak up the sun to get some vitamin D.
If you do decide to wear PPE, remember that it is only effective when used properly. Improper use may increase your chance of exposure rather than lessening it. If someone in a restaurant or store is wearing gloves, do not assume they are clean.