Personal protective equipment (PPE)
Personal protective equipment (PPE) helps safeguard the wearer from physical and health hazards. PPE provides the last barrier(s) between the person wearing it and the hazard necessitating it. It isn't a substitute for other safety measures, such as proper workplace engineering and safety practices, but a crucial part of the equation. Effective use of PPE involves training on appropriately putting it on, wearing it, taking it off, and disposing of it.
In addition to being used when working with patients, personal protective equipment is needed when working with certain medications, laboratory specimens, and other substances. Employers, including veterinarians, are responsible for assessing their workplace for hazards, providing employees with appropriate protective equipment and the training to use it, requiring proper use of that equipment, and conveying all workplace hazards and safety measures in written workplace hazard communications.
Required PPE depends on hazards and risks
Key factors to consider in assessing physical and health hazards in veterinary medical settings include:
- Temperament and concurrent health conditions of the patient
- Known or suspected pathogens and their routes of transmission
- Training and skills of involved personnel
- Safety and hazards of the facility or scene
- Performance of the PPE materials
- Potential limiting factors imposed on personnel or tasks by certain PPE (e.g., reduced dexterity, endurance, peripheral vision)
- Hazards of pharmaceutical or other products being handled, disposed, or stored
Accurate assessments then guide, among other things, the assignment of personnel to complete the task and determination of what protective equipment will be used. For instance, drawing blood from a dog suspected or known to have leptospirosis poses greater biological health hazards to the individuals involved than drawing blood from a clinically healthy dog for a heartworm test. While the basic task is the same in both cases, the disease transmission risk associated with leptospirosis warrants elevated caution and PPE (e.g., double glove, face shields or the combination of masks and eye protection, disposable gown, isolation ward).
For more information on risk assessments for proper PPE, see OSHA Standard 1910.120 Appendix B and Personal Protective Equipment for Veterinarians (module 10 of the APHIS Approved Supplemental Training for Accreditation). The latter provides a summary of PPE, hazard and risk assessments to determine appropriate PPE, and clinical scenarios requiring PPE in veterinary medicine.
PPE levels, based on degree of protection
There are four levels of personal protective equipment, discussed here in order from the simplest (level D) to most complex (level A). The levels are divided based on the amount of protection they provide, especially against absorption, inhalation, and ingestion of hazards. Depending on the situation, the typical personal protective equipment used within any level might need to be supplemented with additional equipment to best protect the wearer against hazards. For example, donning leaded eyewear, apron, gloves and thyroid guard is a key enhancement to your regular hospital attire (level D) when taking radiographs.
Level D
This is the lowest level of personal protective equipment and may be considered by some as regular work attire. Level D is used when the air contains no known hazard from which you’d have to protect your skin or respiratory system, and there is no possibility of splashes, immersion, inhalation or contact with chemicals at hazardous levels. Level D personal protective equipment is typically worn by veterinary professionals while performing routine tasks such as handling animals or specimens, conducting herd health program tasks, taking radiographs, and performing dentals.
Here are a few examples of Level D PPE used within the veterinary profession:
- Head, eyes, ears, nose, mouth and neck: Safety glasses, radiology eyewear, face mask, face shield, ear plugs, lead-lined radiology thyroid guard, hardhat
- Hands: Exam gloves, long-cuffed leather gloves known as gauntlet gloves or bite gloves, obstetric gloves, surgery gloves, lead-lined radiology gloves
- Torso, arms and legs: Lab coat, coveralls, scrubs, disposable gown, waterproof apron, lead-lined radiology apron
- Feet: Solid-toed primary footwear with good traction, steel-toed boots, rubber overboots, disposable boots and booties
Level C
Level C is the next step up in protection and requires special training for effective use. The average veterinarian may not have Level C training. However, authorities responding to situations necessitating Level C, B, or A equipment will have the training and needed supplies, or will have access to those who do. Level C is used when the atmospheric contaminants, liquid splashes, or other direct contact will not adversely affect or be absorbed through any exposed skin; the types of air contaminants have been identified, their concentrations measured, and an air-purifying respirator is available that can remove the contaminants; and all criteria for using air-purifying respirators are met. There has been general agreement that level C PPE would be adequate for most microbial diseases, once the biologic risks are properly identified and the appropriate type of air-purifying filter has been assigned.
Level C personal protective equipment includes the following, among other items:
- Full-face or half-mask, air-purifying respirators approved by the National Institute for Occupational Safety and Health (NIOSH) (require fit-testing)
- Hooded chemical-resistant clothing (overalls; two-piece chemical-splash suit; disposable chemical-resistant overalls)
- Inner and outer gloves, both chemical-resistant
Level B
Level B personal protective equipment provides greater protection than Level C and requires more training for effective use. Level B is used when the type and atmospheric concentration of substances have been identified and require a high level of respiratory protection, but less skin protection than Level A; when the atmosphere contains less than 19.5% oxygen; or when the presence of incompletely identified vapors or gases is detected by instruments, but vapors and gases are not suspected of containing high levels of chemicals harmful to skin or capable of being absorbed through skin. Level B is used to protect personnel working in situations described above, such as emergency personnel responding to a hazardous chemical incident. Level B is rarely if ever needed in the veterinary profession; but if it were needed, trained responders would soon be on site assessing the risks, facilitating evacuation or other safety measures, and working to contain and control the hazards.
Level B equipment includes, among other items:
- Positive-pressure, full-face-piece, self-contained breathing apparatus (SCBA), or positive-pressure, supplied air respirator with escape SCBA (must be NIOSH approved and fit-tested)
- Hooded chemical-resistant clothing (overalls and long-sleeved jacket; coveralls; one or two-piece chemical-splash suit; disposable chemical-resistant overalls)
- Inner and outer gloves, both chemical-resistant
- Chemical-resistant steel toe and shank outer boots
Level A
Level A personal protective equipment is used when the greatest level of skin, respiratory and eye protection is required, such as in hazardous materials situations involving a high concentration of or likely exposure to dangerous vapors, gases, or particulates. Similar to Levels C and B, the average veterinarian has not been trained to use Level A equipment, nor for responding to or working in situations that require it. If an incident requiring Level A were to occur, trained responders would soon be on site assessing the risks, facilitating evacuation or other safety measures, and working to contain and control the hazards.
This equipment includes, among other items:
- Positive-pressure, full-face-piece SCBA, or positive-pressure supplied air respirator with escape SCBA (must be NIOSH approved and requires fit-testing)
- Totally encapsulating chemical-protective suit
- Inner and outer gloves, both chemical-resistant
- Chemical-resistant steel toe and shank outer boots
- Disposable protective suit, gloves and boots (depending on suit construction, may be worn over totally-encapsulating suit)
Getting trained in PPE Levels A, B, and C
There are several options available for veterinarians who would like to be trained in the use of personal protective equipment:
- Contact your local emergency management agency
- Check with your local fire department
- Check with your local Community Emergency Response Team (CERT)
- Take courses offered by the Center for Domestic Preparedness (See each course page for prerequisites and details.)
- Hazard Assessment and Response Management for CBRNE Incidents (HARM)
- Hospital Emergency Response Training for Mass Casualty Incidents (HERT)
Related pages
- Guidelines for hazards in the workplace
- Veterinary facility occupational risks for pregnant workers
- Ebola virus resources for veterinarians
Additional resources
National Association of State Public Health Veterinarians
- Compendium of Veterinary Standard Precautions: Zoonotic Disease Prevention in Veterinary Personnel (PDF)
U.S. Centers for Disease Control and Prevention (CDC)
U.S. Department of Agriculture in collaboration with the Center for Food Security and Public Health
U.S. Department of Labor, Occupational Safety and Health Administration (OSHA)