Researchers have tested 10 different personal protective equipment (PPE) donning and doffing protocols recommended by various health organizations to investigate the risk of self-contamination and challenges associated with doffing PPE, and to compare the various protocols. Results of the study were recently published in the American Journal for Infection Control.

The researchers worked with 10 participants who were each assigned three different PPE protocols. Fluorescent lotion and spray were applied to the external surfaces of the PPE after donning to simulate contamination. After doffing, the researchers used ultraviolet light to count fluorescent patches on the skin. 

Large patches were found after using the World Health Organization’s coverall and 95 sequence and the North Carolina coverall and N95 sequence. Donning and doffing sequences recommended by the Centers for Disease Control and Prevention and Health Canada resulted in small patches of fluorescent contamination. 

Some of the most commonly reported problems with PPE included breathing difficulty, suffocation, heat stress and fogged glasses. Of the 30 participants, 18 rated the ease of donning/doffing PPE high, and 11 rated it medium. Researchers also concluded that PPE sequences that recommend powered air-purifying respirators and assisted doffing generally had fewer problems.