Erukunuakpor Kimberly, Morgan Jill, Kraft Colleen S, Grimm David, Nguyen Alexandra, Mumma Joel M, Casanova Lisa M
Department of Population Health Sciences, School of Public Health, Georgia State University, Atlanta, GA.
Serious Communicable Diseases Program, Emory Healthcare, Atlanta, GA.
Am J Infect Control. 2025 May;53(5):582-587. doi: 10.1016/j.ajic.2025.01.002. Epub 2025 Jan 9.
Personal protective equipment doffing protocols can reduce risks of pathogen self-contamination. Powered air-purifying respirators may increase these risks. This study compares viral contamination and errors during simulated doffing of single-layer versus double-layer hood powered air-purifying respirators.
Eight participants performed 2 simulations (video recorded for failure modes [FMs] and effects analysis): 1 single-layer hood (laid over Tyvek suit) and 1 double-layer hood (top laid over and bottom tucked into suit). Hoods were contaminated with viruses. After doffing, inner gloves, face, hands, and scrubs were sampled.
Virus contaminated at least 1 site in 6/8 single- and 5/8 double-layer simulations. Virus-contaminated inner gloves in single- (6 participants, median 5.42 × 10 plaque-forming units) and double-layer (2 participants, median 7.23 × 10 plaque-forming units) simulations, and hands of 2 participants in single-layer simulations. Single-layer doffing had 13 FMs; double had 31.
Double-layer doffing reduced inner glove contamination. The double-layer protocol may reduce glove-face shield contact but allow more opportunities for error. Double-layer doffing errors may less frequently lead to contamination than single layer.
Contamination and FMs may differ between double- and single-layer doffing. Although inner glove contamination was reduced, double-layer doffing may need redesign to reduce FMs and contamination.
个人防护装备脱卸规程可降低病原体自我污染风险。电动空气净化呼吸器可能会增加这些风险。本研究比较了单层与双层头罩式电动空气净化呼吸器在模拟脱卸过程中的病毒污染情况及失误。
8名参与者进行了2次模拟（录制视频用于失效模式[FMs]和效应分析）：1次单层头罩（覆盖在特卫强防护服上）和1次双层头罩（上层覆盖并将下层塞进防护服）。对头罩进行病毒污染。脱卸后，对内层手套、面部、手部和手术服进行采样。
在6/8次单层模拟和5/8次双层模拟中，病毒污染了至少1个部位。在单层模拟中有6名参与者（中位数为5.42×10噬斑形成单位）和双层模拟中有2名参与者的内层手套被病毒污染，在单层模拟中有2名参与者的手部被污染。单层脱卸有13个失效模式；双层有31个。
双层脱卸减少了内层手套污染。双层规程可能减少了手套与面罩的接触，但增加了失误机会。双层脱卸失误导致污染的频率可能低于单层。
双层和单层脱卸的污染情况和失效模式可能不同。虽然内层手套污染减少了，但双层脱卸可能需要重新设计以减少失效模式和污染。
