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      Environment and body contamination: A comparison of two different removal methods in three types of personal protective clothing


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          This study aimed to examine the body contamination rates and environmental contamination levels during the removal of 3 types of personal protective clothing (PPC) by the individual accustomed removal method (IARM) and gown removal methods recommended by the Centers for Disease Control and Prevention (CDC).


          Fifty participants performed IARM and CDC-recommended gown removal methods to remove 3 types of PPC (ie, cotton gown, water resistant gown, and plastic apron) in random order at 2 separate sessions after applying Glo Germ simulated germ lotion on the gown's surface. A video demonstrating the CDC-recommended gown removal method was shown between the 2 sessions. After PPC removal, fluorescent stains were counted by an ultraviolet scan under dim light.


          Following IARM, contaminants were splashed in the surroundings, particularly on the front part of the subject. The plastic apron and cotton gown obtained the highest and lowest contaminative hazards, respectively, to the hands, shoes, and environment. Females, nurses, and senior staff had serious hand or shoe contamination. The CDC removal method more significantly reduced body and environmental contamination of small fluorescent stains (<1 cm 2), but not of large patches (>1 cm 2), than IARM.


          The effect of gown removal, PPC type, discarding PPC location, training of infection control measures, hand hygiene, and special work shoes should be considered daily.

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          Most cited references9

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          Environmental contamination due to methicillin-resistant Staphylococcus aureus: possible infection control implications.

          To study the possible role of contaminated environmental surfaces as a reservoir of methicillin-resistant Staphylococcus aureus (MRSA) in hospitals. A prospective culture survey of inanimate objects in the rooms of patients with MRSA. A 200-bed university-affiliated teaching hospital. Thirty-eight consecutive patients colonized or infected with MRSA. Patients represented endemic MRSA cases. Ninety-six (27%) of 350 surfaces sampled in the rooms of affected patients were contaminated with MRSA. When patients had MRSA in a wound or urine, 36% of surfaces were contaminated. In contrast, when MRSA was isolated from other body sites, only 6% of surfaces were contaminated (odds ratio, 8.8; 95% confidence interval, 3.7-25.5; P < .0001). Environmental contamination occurred in the rooms of 73% of infected patients and 69% of colonized patients. Frequently contaminated objects included the floor, bed linens, the patient's gown, overbed tables, and blood pressure cuffs. Sixty-five percent of nurses who had performed morning patient-care activities on patients with MRSA in a wound or urine contaminated their nursing uniforms or gowns with MRSA. Forty-two percent of personnel who had no direct contact with such patients, but had touched contaminated surfaces, contaminated their gloves with MRSA. We concluded that inanimate surfaces near affected patients commonly become contaminated with MRSA and that the frequency of contamination is affected by the body site at which patients are colonized or infected. That personnel may contaminate their gloves (or possibly their hands) by touching such surfaces suggests that contaminated environmental surfaces may serve as a reservoir of MRSA in hospitals.
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            Virus Transfer from Personal Protective Equipment to Healthcare Employees’ Skin and Clothing

            We evaluated a personal protective equipment removal protocol designed to minimize wearer contamination with pathogens. Following this protocol often resulted in virus transfer to hands and clothing. An altered protocol or other measures are needed to prevent healthcare worker contamination.
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              Contamination: a comparison of 2 personal protective systems.

              The purpose of this study was to examine the difference in self-contamination rates and levels of contact and droplet protection associated with enhanced respiratory and contact precautions (E-RCP) and a personal protective system that included a full body suit, personal protective equipment and a powered air-purifying respirator (PAPR).

                Author and article information

                Am J Infect Control
                Am J Infect Control
                American Journal of Infection Control
                Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc.
                26 March 2014
                April 2014
                26 March 2014
                : 42
                : 4
                : e39-e45
                [a ]Institute of Textiles and Clothing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China
                [b ]Schools of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China
                Author notes
                []Address correspondence to Yi Li, PhD, Institute of Textiles and Clothing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong, China. tcliyi@ 123456polyu.edu.hk tcliyi@ 123456inet.polyu.edu.hk
                Copyright © 2014 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

                Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.


                isolation gown/apron,cdc protocol,cross infection,fluorescent stain,training


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