Choosing the right personal protective equipment for the job

By Leslie Canham, CDA, RDAThe best reason to wear Personal Protective Equipment (PPE) is for protection from blood, body fluids, and other hazardous materials. Other reasons include patient protection and compliance with OSHA regulations. Dental patients and dental heath-care workers can be exposed to pathogenic microorganisms including cytomegalovirus, hepatitis B, hepatitis C, herpes simplex virus types 1 and 2, HIV, mycobacterium tuberculosis, staphylococci, streptococci, and other viruses and bacteria that colonize or infect the oral cavity and respiratory tract. These organisms can be transmitted in dental settings through 1) direct contact with blood, oral fluids, or other patient materials; 2) indirect contact with contaminated objects (e.g., instruments, equipment, or environmental surfaces); 3) contact of conjunctival, nasal, or oral mucosa with droplets (e.g., spatter) containing microorganisms generated from an infected individual and propelled a short distance (e.g., by coughing, sneezing, or talking), and inhalation of airborne microorganisms that can remain suspended in the air for long periods.¹Per OSHA regulations, employers are responsible for providing, maintaining, and laundering PPE for employee use. This means the employer pays for the PPE, repairs, or replaces PPE when it no longer protects the employee, and launders PPE. According to OSHA, it is a violation for employees to take contaminated PPE into their homes for laundering. A frequently asked question is, what kind of clinical jacket should be worn? A clinical jacket must protect the wearer’s skin and street clothing from contact with blood or body fluid. The clinical jacket can be reusable or disposable. Ideally it should be high-necked/high-collared, have long sleeves, and cover the knees when seated (if performing sit-down dentistry). The material should be a comfortable fabric that breathes.²OSHA requires employers to provide appropriate PPE for the task to be performed. For example, tasks such as greeting and seating patients require no PPE. On the other hand, when performing an aerosol-generating procedure on a patient, several items of PPE must be worn. Each dental office should have a protocol for what types of PPE should be worn for various tasks. To help select appropriate PPE, look at the table called “The Right PPE for the Purpose.”²