Assessing Viral Transfer During Doffing of Ebola-Level Personal Protective Equipment in a Biocontainment Unit

Details

• Personal Author:
  Casanova LM ; DuBose J ; Durso FT ; Erukunuakpor K ; Ferguson AN ; Gipson CL ; Jacob JT ; Kraft CS ; Mumma JM ; Walsh VL ; Zimring C
• Description:
  Background: Personal protective equipment (PPE) protects healthcare workers (HCWs) caring for patients with Ebola virus disease (EVD), and PPE doffing is a critical point for preventing viral self-contamination. We assessed contamination of skin, gloves, and scrubs after doffing Ebola-level PPE contaminated with surrogate viruses: bacteriophages MS2 and phi6. Methods: In a medical biocontainment unit, HCWs (n = 10) experienced in EVD care donned and doffed PPE following unit protocols that incorporate trained observer guidance and alcohol-based hand rub (ABHR). A mixture of phi6 (enveloped), MS2 (nonenveloped), and fluorescent marker was applied to 4 PPE sites, approximating body fluid viral load (phi6, 105; MS2, 106). They performed a patient care task, then doffed. Inner gloves, face, hands, and scrubs were sampled for virus, as were environmental sites with visible fluorescent marker. Results: Among 10 HCWs there was no phi6 transfer to inner gloves, hands, or face; 1 participant had phi6 on scrubs at low levels (1.4 × 102). MS2 transfer (range, 101-106) was observed to scrubs (n = 2), hands (n = 1), and inner gloves (n = 7), where it was highest. Most (n = 8) had only 1 positive site. Environmental samples with visible fluorescent marker (n = 21) were negative. Conclusions: Among experienced HCWs, structured, observed doffing using ABHR protected against hand contamination with enveloped virus. Nonenveloped virus was infrequent on hands and scrubs but common on inner gloves, suggesting that inner gloves, but not necessarily ABHR, protect against hand contamination. Optimizing doffing protocols to protect against all types of viruses may require reinforcing careful handling of scrubs and good glove/hand hygiene with effective agents. [Description provided by NIOSH]
• Subjects:
  Body Fluids Communicable Diseases Environmental Exposure Health Personnel Occupational Health Personal Protective Equipment Safety Skin Viral Diseases
• Keywords:
  Author Keywords: Ebola Body Fluids Contagious Diseases Ebola Virus Disease Environmental Exposure Gloves Health Care Personnel Health Care Workers Occupational Health Personal Protective Equipment PPE Sampling Skin Exposure Viral Diseases Viral Infections Virus

  More +
• ISSN:
  1058-4838
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article
• Place as Subject:
  Georgia ; OSHA Region 4
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  66
• Issue:
  6
• NIOSHTIC Number:
  nn:20064434
• Citation:
  Clin Infect Dis 2018 Mar; 66(6):945-949
• Contact Point Address:
  Lisa M. Casanova, Georgia State University, PO Box 3995, Atlanta, GA 30303
• Email:
  lcasanova@gsu.edu
• Federal Fiscal Year:
  2018
• Performing Organization:
  Georgia State University
• Peer Reviewed:
  True
• Start Date:
  20150901
• Source Full Name:
  Clinical Infectious Diseases
• End Date:
  20180831
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:aa08314af5d16b0d83619f8591707d27404e031c95b06ee27d738ffaa89f7639eddbc5b4bfde6e076a49069b50221c8d10552849794d06e7d4f1591fba986545
• Download URL:
  https://stacks.cdc.gov/view/cdc/222891/cdc_222891_DS1.pdf
• File Type:
  [PDF - 119.35 KB ]