Title: Introduction to PPE

1. Importance of PPE in Laboratory Biosafety

- PPE acts as a barrier to minimize the likelihood of exposure to biological agents.

- Reviews of laboratory-associated infections highlight the importance of proper PPE use.

- PPE does not remove the biological agent hazard.

2. Factors Affecting PPE Requirements

- Characteristics of the biological agent being handled

- Volumes and concentrations of the biological agent

- Presence of additional hazards (e.g., extreme temperatures, chemical or radiological hazards)

- Type of work being carried out

- Other risk control measures being used

- Other PPE being worn

- Individual needs of laboratory personnel

- Availability of national regulations and organizational requirements

3. Approach to Laboratory Biosafety

- Adopts a risk- and evidence-based approach to biosafety

- Emphasizes locally relevant, proportionate, and sustainable selection and use of PPE

- Incorporates risk assessment, good microbiological practice and procedure (GMPP), training, and
incident reporting to reduce risks

4. Specialized Topics Covered in Associated Monographs

- Risk assessment

- Laboratory design and maintenance

- Biological safety cabinets and other primary containment devices

- Decontamination and waste management

- Biosafety program management

- Outbreak preparedness and resilience

5. Overview of PPE in Laboratory Requirements

- Selection of PPE based on risk assessment

- PPE options for core requirements, heightened control measures, and maximum containment
measures

- Types of PPE, and how to safely put on, use, and remove PPE items

- Hand hygiene
- Cleaning, maintenance, storage, and disposal of PPE

- Standards and regulations on PPE

6. Principles of Selection and Use of PPE

- Importance of providing instructions, procedures, training, and supervision for workplace safety

- Identification of remaining hazards and the need for PPE to reduce risk

- Employer's responsibility to provide necessary PPE free of charge

- Careful selection of equipment and proper training for personnel

Title: Principles of Selection and Use of PPE in Laboratory Settings

2.1 Risk Assessment

- Describes a stepwise process for controlling biological risks based on a risk assessment.

- Determines whether risk control measures, including PPE, can be applied to reduce risks to
acceptable levels.

2.2 Selection Criteria for PPE

- Questions to be answered before PPE selection, including considerations for exposure, duration of
use, type of biological material, and contraindications.

- Factors to be considered when selecting and using PPE, such as size, fit, comfort, cleaning
requirements, and compatibility with other equipment.

- Importance of appropriate training for high-risk work and checking compatibility of multiple PPE
items.

2.3 National Regulations and Organizational Requirements

- National regulations and organizational procedures that must be considered when selecting PPE.

- The need for a policy on the use of assigned PPE and consistent enforcement.

2.4 Considerations Concerning the Biological Agent(s)

- Factors to consider when determining the type of PPE to be worn, including routes of transmission,
infectious dose, environmental stability, consequences of exposure, and availability of vaccines or
prophylaxis.

2.5 Type of Work Being Carried Out

- Emphasizes the impact of the type of laboratory activity on the required level of control and,
consequently, the type of PPE required.

2.6 Other Hazards

- Importance of considering protection against hazards other than biological agents, such as
allergens, sharps, temperature, radiation, and chemicals, when selecting PPE.

2.7 Other Risk Control Measures

- Dependent on the risk control measures put in place, the type of PPE required for a specific task
may vary.

2.8 Combination of PPE

- Considerations for situations where multiple hazards require different types of PPE with different
properties.

2.9 User Requirements and Feedback

- Importance of user input on comfort and fit of PPE for improved compliance.

- Need for regular feedback to ensure proper functioning of PPE and to address any issues affecting
work effectiveness.

2.10 Availability of PPE

- Employer's responsibility to provide a sufficient selection of appropriate PPE based on a risk

assessment.

2.11 Other Considerations for Selection of PPE

- Additional factors to consider when selecting the most appropriate PPE, such as storage space,
equipment reliability, disposal requirements, and cost considerations.
Title: PPE for Core Requirements in Laboratory Biosafety

Core Requirements and GMPP

- Defined in the Laboratory biosafety manual (5) as a set of minimum requirements and best
practices for working safely with biological agents.

- GMPP covers a code of practice applicable to all types of activities with biological agents, including
general behaviors, best working practices, and technical procedures.

PPE Core Requirements

- Laboratory coats, footwear, gloves, and eye protection are considered core requirements for
working with biological agents.

- Respiratory protection is not generally required as a core requirement but may be needed as a
heightened control measure based on risk assessment.

3.1 Laboratory Coats

- Design and features of laboratory coats for core requirements, including fit, sleeve length,
fastening, designated areas for wear, decontamination, and laundering.

- Additional recommendations for laboratory coats, such as high-necked, side-fastening, splash-

resistant, and flame-resistant materials.

3.2 Footwear

- Requirements for laboratory footwear, including design to minimize slips and trips, coverage of the
top of the foot, fit, and comfort for task performance.

3.3 Gloves

- Guidelines for wearing appropriate gloves for procedures involving contact with blood, body fluids,
and infectious materials.

- Recommendations for glove inspection, availability of different types and sizes, and avoidance of
disinfecting or reusing disposable gloves.

3.4 Eye Protection

- Requirement for wearing safety glasses, goggles, face shields, or other protective devices to protect
the eyes and face from splashes, flying objects, and artificial ultraviolet radiation.

- Guidelines for cleaning and decontaminating reusable eye protection, and the recommendation
against using personal prescription glasses as a form of eye protection.
Title: PPE for Heightened Control Measures

Heightened Control Measures

- Additional PPE may be required based on risk assessment for more specialized work and/or
hazardous biological agents.

- Local risk assessment outcomes guide the selection of control measures, considering available
resources, personnel competency, and practicality.

4.1 Laboratory Coats and Additional Body Protection

- Additions or alternatives to normal laboratory coats for heightened control measures, including
overlap at the front, alternative protective clothing, additional aprons, and appropriate
decontamination of reusable items.

- Hazard-specific splash protection may require additional aprons for certain procedures.

- Gowns and coveralls offer a similar range of coverage as laboratory coats, with disposable and
reusable options.

4.2 Footwear

- Footwear may need to be changed to prevent cross-contamination, for specific splash protection,
or if personal footwear is inappropriate for laboratory work.

4.3 Gloves

- Additional gloves, such as double gloving or cut-resistant gloves, may be required for certain
activities, with consideration for proper fitting and dexterity.

4.4 Eye Protection

- Eye protection is required in the same circumstances as outlined in the core requirements and
must be compatible with respiratory protection if worn.

4.5 Respiratory Protection

- Respiratory protective equipment is designed to protect the wearer from inhaling particles
containing biological agents.

- Selection and use of respiratory protective equipment must be based on a risk assessment and
used by trained personnel.
Title: PPE for Maximum Containment Measures

Maximum Containment Measures

- Maximum containment facilities are used for work with high-consequence biological agents or in
exceptional circumstances that require increased protection for personnel and the wider
community.

- These facilities are highly regulated, expensive to build and maintain, and offer the highest level of
protection.

5.1 Cabinet Line Facilities

- Class III BSCs or isolators are used for high-risk activities, with detailed requirements for entering
the laboratory, clothing, glove use, and decontamination.

- Additional PPE such as eye, face, and respiratory protection may be required based on risk
assessment.

5.2 Positive-Pressure Suits

- Positive-pressure suits provide a total barrier between personnel and the laboratory environment,
requiring a direct connection to the facility's breathing air system.

- Features of positive-pressure suits, maintenance, testing, and training requirements are detailed,
including the need for rigorous training before high-risk activities.
Title: Laboratory Coats, Gowns, Aprons, and Coveralls

6.1 General Information

- PPE such as laboratory coats, gowns, aprons, and coveralls protect against contamination and must
be worn as recommended, in designated areas, and checked before use.

- Protection requirements vary based on the nature of work, environment, and specific hazards, with
markings on garments identifying their intended use.

6.2 Pre-use Checks

- Before use, PPE should be checked for integrity, including unintended holes, loose stitching, and
tears, with any identified loss of integrity leading to disposal or repair.

6.3 Putting on Body Protection

- Care should be taken to avoid damaging the material when putting on laboratory coats and
additional body protection, especially for single-use garments.

6.4 Removing Body Protection

- Different types and styles of laboratory coats and additional body protection require specific steps
for removal, including considerations for gloves used during the process.

6.4.1 Laboratory Coats

- Detailed steps for removing a laboratory coat, including opening the front, pulling the arms out of
the sleeves, and handling for disposal, decontamination, or laundering.

6.4.2 Gowns

- Instructions for removing a gown, including untying the fastening and rolling it from inside to
outside.

6.4.3 Aprons

- Steps for removing disposable and reusable aprons, including untying or breaking fastenings, rolling
the apron, and decontamination for reusable aprons.

6.4.4 Coveralls

- Process for removing disposable coveralls, including slipping it over the shoulders, pulling the arms
from the sleeves, rolling it inside out, and removing the coverall and boots if necessary.
Title: Footwear in the Laboratory

1. Requirement and Purpose

- Suitable, closed-toe footwear is necessary in the laboratory to minimize slips, trips, and injury from
falling objects.

- Shoe covers may be used for spill cleanup or by visitors, and changing footwear may be required to
prevent contamination or provide additional foot protection.

2. Types and Performance Requirements

- Footwear comes in various styles, such as shoes, low ankle boots, and high ankle boots, each with
mandatory and optional performance requirements.

- Factors to consider include size, material, fastening, sole properties, and resistance to various
elements.

3. Selection and Usage Considerations

- Considerations for selecting and using footwear, including size, material, fastening, sole properties,
and other protective features.

- When boots are required, it may be helpful to use a slightly larger size for ease of removal without
increasing the risk of tripping.

4. Protective Footwear Against Chemicals

- Resistance to specific chemicals is determined through standardized testing in accordance with

international standards. See section 14 for standards and regulations.

5. Non-Slip Footwear

- While there is no "non-slip" footwear, certain sole materials and tread patterns offer better
performance.

- Biomechanical machine tests and alternative assessment techniques are available to evaluate slip
resistance, with some providing more realistic and meaningful results.
Title: Gloves in the Laboratory

1. Importance and Usage

- Hands are susceptible to contamination during laboratory work, necessitating the use of
appropriate gloves for procedures involving contact with blood, body fluids, and other infectious
materials.

- Disposable and reusable gloves are used, with proper cleaning, disinfection, and removal
procedures for reusable gloves.

2. Sizing and Selection

- Correct glove size is crucial to avoid overstretching or slipping, with a range of sizes available for
laboratory personnel.

- Different types of gloves are used based on the specific tasks, considering protection against
biological agents, chemicals, temperature extremes, and mechanical hazards.

3. Protection Factors and Materials

- Manufacturers provide information on protection levels and detailed specifications for different
glove materials, including nitrile, latex, and alternatives to powdered latex gloves.

- Protection against various hazards, including chemical, biological, extreme temperatures, and
mechanical hazards, is considered based on standardized testing procedures.

4. Pre-Use Checks

- Gloves are checked for protection against specific hazards and imperfections before use,
considering the acceptance quality level (AQL) for each batch.

- Visual and inflation checks are performed to ensure glove integrity, especially for thicker reusable
gloves.

5. Putting on Gloves

- Proper technique for putting on gloves is emphasized, including the use of talcum powder for
disposable gloves and the use of longer-cuffed gloves over laboratory coat cuffs.

- Best practices for using reusable gloves to protect against residual contamination are outlined.

6. Using Gloves

- Disposable gloves should not be disinfected or reused, and contaminated gloves must be disposed
of appropriately.
- Specialized reusable gloves require rigorous cleaning and decontamination according to
manufacturer's instructions, and any loss of integrity requires immediate removal and disposal.