Personal protective equipment (PPE) is the term given to items worn to help safeguard the wearer from physical and health hazards. PPE provides the last barrier(s) between the person wearing it and the hazard necessitating it, but is not a substitute for other safety measures, such as proper workplace engineering and safety practices. Furthermore, effective use of PPE involves training on appropriately donning (putting on), wearing, doffing (taking off), and disposing of PPE.
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.
Key factors to consider in assessing physical and health hazards in veterinary medical settings include:
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 personal protective equipment (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, visit OSHA Standard 1910.120 Appendix B and Personal Protective Equipment for Veterinarians (module 10 of the APHIS Approved Supplemental Training for Accreditation), the latter of which provides a summary of PPE, hazard and risk assessments to determine appropriate PPE, and clinical scenarios requiring PPE in veterinary medicine.
There are four levels of personal protective equipment, which are discussed below in order from the simplest (level D) to the 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.
This is the lowest level of personal protective equipment and may be considered by some as their 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 in the veterinary profession while performing routine tasks such as handling animals or specimens, conducting herd health program tasks, taking radiographs, and performing dentals.
Below are a few examples of Level D personal protective equipment used within the veterinary profession:
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 personal protective 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 have been measured, and an air-purifying respirator is available that can remove the contaminants; and all criteria for the use of air-purifying respirators are met. There has been general agreement that level C personal protective equipment 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, among other items:
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 percent 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:
Level A personal protective equipment is the next step up from Level B and is used when the greatest level of skin, respiratory and eye protection is required, such as 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 person protective equipment, nor for responding to or otherwise working in situations necessitating 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 things:
There are several options available for veterinarians who would like to be trained in the use of personal protective equipment:
National Association of State Public Health Veterinarians
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)