As winter draws in there will inevitably be a rise in cases of respiratory diseases including Covid. SARS (Severe Acute Respiratory Syndrome) viruses thrive in lower temperatures, so in winter it’s only to be expected. To add to this, the low numbers of influenza cases in the last two years, along with increasing numbers already seen in some countries leads to an expectation of increasing pressure on health services. Levels of vaccination and natural immunity mean Covid is unlikely to bring the chaos we saw in 2020, but the prognosis means now is a good time to review PPE type and availability.
Health and emergency service workers are at greater risk simply because too often the job means coming into close regular contact with viral and bacterial infections. Whether responding to serious accidents, cleaning up a crime scene or front-line care of patients, ensuring the right PPE is provided is vital. So what are the key elements to look for in your infective agent PPE?
The Key European Standards
EN 14126 is the European standard for clothing for protection against infectious agents such as Covid-19. Ensuring selected clothing is certified to this standard – as indicated by the inclusion of the pictogram shown in the image – is the first step. However, ensuring staff are protected means going further and understanding the contents of the standard, which provides a simple 3 step process for selection.
1. Ensure the clothing is tested to the right bacterial penetration resistance test.
Mention PPE for Covid and the first thought for most is masks to prevent direct inhalation. Masks may be important (though must be of the correct type and must be worn correctly!), but are only part of the story. Viruses can transmit in several ways; by direct contact with contaminated blood, via contaminated aerosol droplets or particles exhaled, coughed, or sneezed from an infected person, or by contact with infected surfaces such as a doorknob.
It is this last which may be the most common route of transmission. SARS viruses have been known to remain viable for up to 8 hours on a surface – or even longer depending on conditions – so hand contact followed by transmission to the face can occur long after the original contamination. And this is where protective clothing is important. It prevents infections settling on workers own clothing or skin from where it can be transferred by hands to the face. (On average we touch our faces between 15 and 25 times every minute!)
EN 14126 therefor contains four tests assessing garment fabric resistance to different types of transmission. Via infected blood or body fluids, in liquid aerosols, dry and wet microbial penetration. Yet not all garments are tested to all four tests. In fact, a garment can still be certified if it has been subject to only one of the four tests and achieved only the minimum performance level!
So, when selecting PPE, it’s important to ensure the appropriate tests have been conducted according to your application and the type of transmission likely to occur.
2. Ensure a sufficient level of protection is achieved in the tests conducted.
The results of each of the four tests are classified as Class 1 to 3 or 1 to 6 (two tests classify 1 to 3 and two 1 to 6). The highest number represents the highest level of protection. So, it is important to look at the results or classifications achieved, and that they are sufficient for your protective needs.
This might relate to the hazard level of the virus. A relatively low hazard virus such as flu might mean a lower classification is acceptable whilst a high hazard haemorrhaging fever virus such as Ebola might need the highest classification. Or it could relate to a required viral load for infection to occur. However, the easiest option may be to simply require that the highest classification is met. That way you know you have the best protection.
3. Select clothing according to chemical protective clothing Types
The tests in EN 14126 address only the fabric ability to resist viral penetration. Yet the greater risk is contamination that goes “around” the PPE rather than through the fabric. In other words, it penetrates through some element of the garment construction – the seams if they are stitched and have holes, or the zip if not covered appropriately. Thus, in addition to the fabric penetration resistance tests, EN 14126 requires that garments are also certified to at least one of the EN chemical protective clothing Types.
EN standards define five Types of chemical protective clothing – Type 1,3,4,5 and 6, with 6 being the lowest and 1 the highest protection level (originally there was a Type 2, but that was withdrawn for a number of reasons). Certification for each consists of a series of tests to determine performance and each requires specific design elements. So, for example, Types 4 to 1 must feature sealed seams to prevent penetration through stitch holes.
Thus, selecting garments according to the chemical protective clothing Types and considering the demands of the infection or contamination route (so, again, for example, a high hazard virus such as Ebola probably demands sealed seams, so Type 3 or above), will help ensure protection is as it should be.
Conclusion: A simple 3-step process.
EN 14126 is the important standard to know when it comes to selecting clothing for protection of workers from infectious agents such as Covid-19. However, its important to understand what’s in the standard and the testing it requires, and to apply that knowledge to your PPE selection process. Helpfully, the standard provides for a simple 3 step process to ensure your protective clothing is providing the best protection.
The pandemic of 2020-21 is over, but the threat from Covid and other viral infections is still around, and there are regular news reports and predictions of increasing numbers of cases as we move into winter. For those at greatest risk of infection ensuring PPE is both appropriate and available is vital. And the next pandemic may be just around the corner. So don’t wait until its too late. Now is the time to make sure you have a ready supply of PPE, and that that PPE is appropriate and will protect as it should.