Research: review of personal protective equipment provided in health care settings to manage risk during coronavirus outbreak (COVID-19)

IntroductionExperts from HSE and PHE have carried out a rapid review of the evidence supporting the use of personal protective equipment (PPE) in healthcare and in the context of COVID-19.This work was delivered by HSE for the Government Chief Scientific Adviser. It’s in two parts:

• Part one: Equivalence of N95 and FFP2 masks
• Part two: Aprons, gowns and eye protection

The UK recommends the use of FFP3 respirators when caring for patients in areas where high risk aerosol generating procedures (AGPs) are being performed. When FFP3 respirators are not available, then FFP2 respirators may be used.The World Health Organisation(WHO) recommends FFP2 and N95 respirators for AGPs and these are widely used in other countries. The N95 respirator is not CE marked but has been tested against standards similar to European standards.To optimise the choice of respirators available a group of experts were convened from PHE and HSE to carry out a rapid review of the evidence supporting the use of N95 in the context of COVID-19.Review findingsThe conclusions drawn from the review are based on the limited studies available, particularly in the area of qualitative research.The key findings are:

• no material difference between the N95 respirator and the FFP2 disposable respirator. They provide comparable protection against coronavirus as long as the wearer has passed a face fit test
• aprons and gowns both appear suitable for caring for patients with suspected COVID-19. However, there is weak evidence to suggest that gowns appear to offer more protection
• eye protection is necessary when there is a risk of contamination of the eyes from splashing such as aerosol generating procedures
• the selection of appropriate PPE should be determined by local risk assessment and reference to PHE guidance

These conclusions were supported by international experts.Further information

• HSE guidance relating to the requirement for face fit testing during the coronavirus outbreak
• Advice on the Public Health England (PHE) web pages
• A Public Heath England (PHE), National Health Service (NHS) and Academy of Medical Royal College letter about PPE (PDF)- Portable Document Format

AcknowledgmentsThe authors of the research would like to acknowledge the contribution of:

• Public Health England (PHE)
• National Health Service (NHS)
• Department of Health and Social Care (DHSC)
• The Partnership for European Research in Occupational Safety and Health
• The National Institute for Occupational Safety and Health (NIOSH)

 Resources

• Rapid evidence review - review of personal protective equipment provided in health care settings to manage risk during coronavirus outbreak (COVID-19)(PDF)