Airborne Precautions: Need for Personal Protective Equipment
Jul 06, 2020
An airborne disease is any disease that results from pathogens that are transmitted through the air by small particles. We all agree that prevention is better than cure. Taking appropriate measures against airborne diseases, perhaps with personal protective equipment, will go a long way to curbing their widespread. Most especially for healthcare practitioners who have direct contact with patients who have infectious diseases, there is a great need to protect oneself. These diseases include Measles, Severe Acute Respiratory Syndrome (SARS), Varicella (chickenpox), and Mycobacterium tuberculosis. Therefore, while healthcare professionals will want to make use of airborne precaution PPE, individuals who are known or suspected to have been infected by these disease-causing microorganisms will also have to take appropriate precautions.
Various isolation precautions are taken to ensure the confinement of these diseases. The isolation precautions are based on the modes of transmission of these diseases, and they include;
- Contact
- Droplets
- Airborne isolation.
The working mechanism of airborne isolation is to cut the chain of transmission of disease-causing organisms that are in aerosol particles <5 micrometers in size. Some of these disease-causing organisms transmitting through airborne route include tuberculosis (TB), severe acute respiratory syndrome coronavirus (SARS-CoV) (though not generally accepted under this classification, reason below), varicella, measles, Middle East respiratory syndrome coronavirus (MERS-CoV), hemorrhagic fever viruses e.g Ebola), and also, highly disease-causing/infectious avian influenza viruses such as H5N1 and others.
However, for droplet isolation, you can make use of this method to curb the spread of diseases like diphtheria, meningitis for the first day of treatment, epiglottitis, and influenza. Research has shown that Covid-19 which can cause SARS is transmitted during close contact through respiratory droplets (such as coughing). This indicates that this virus can spread from one person to the other; from a patient to the caregiver. If a known COVID-19 patient coughs and produces droplets that get to another person's mouth, nose, or even eyes, this one could contract the disease. This is why personal protective equipment is vital. It could also be that since these droplets are too heavy to be airborne, they rest on materials and surfaces around an individual who has the virus. When medical personnel or any other person comes around to touch these contaminated surfaces and unconsciously take it to their mouth, nose, or eyes, they too will become infected. And can even pass it to other patients in the ward.
Aerosol generating procedures during clinical care of COVID-19 patients show that there is a possibility of transmission through smaller droplet nuclei (airborne transmission) that propagate through the air at distances longer than 100cm. However, detecting a virus in the air when undergoing sensitive experimental procedures does not give proof that the virus can cause human infection through the airborne spread. In fact, we cannot even conclude from it that wearing a medical/surgical mask is less protective than an N95 mask. Not to even mention the fact that most human respiratory viruses including adenovirus and parainfluenza are detected in air samples. The fact remains though, that not all is known about COVID-19. Therefore, it is necessary to be devoted to the use of personal protective equipment both droplets precautions and airborne.
There are standard precautions for all patients' care. One of these is to "use PPE whenever there is an expectation of possible exposure to infectious materials". And these precautions are a function of proper risk assessment. So healthcare workers, for example, make use of common-sense practices and airborne precaution personal protective equipment to protect themselves from infections and prevent the spread of infection from patient to patient. The safety of these precious health workers will benefit patients, health care institutions, society at large, and, of course, the healthcare staff and their families.
A cogent part of the work safety of healthcare practitioners is the respiratory protection from airborne and droplet particles. For infections that are transmitted via airborne route, the particles are buoyant and remain suspended in the air for longer durations, traveling long distances. This way, they get to be inhaled by others who might be susceptible. For example, a considerable number of health officials were infected during the surge of HIV-related TB transmission in New York. About 16 million Americans work in the health sector, and these good people are always on the front lines for most public health emergencies, such as an influenza pandemic. All health workers encounter critical risks to their health and safety during both routine and emergency work.
The following strategies might work in protecting healthcare specialist from airborne transmissible diseases:
HEALTH ORGANIZATIONS SHOULD ALWAYS BE PREPARED
The health system should always be prepared to curtail and defend a potential outbreak of infectious respiratory disease. Many organizations today prepare for why might occur in the future, and not wait till it occurs before taking practical steps. The U.S cybersecurity agencies will keep improving with the latest technologies and would not wait until they are being attacked. In fact, energy industries have been paying more attention to peak load forecasting, trying to prepare for the energy demand of the nearest future. In like manner, the health sector needs not to be deliberating on whether a respiratory pandemic will occur, but be predicting when it will occur, having all necessary equipment to combat it. The health system should make practical steps now to protect their staff and the community at large not if a respiratory pandemic occurs again, but when it does.
HEALTHCARE CHIEFS SHOULD PRIORITIES WORKERS HEALTH AND SAFETY
The leaders in the health sector need to ensure that the safety of their workers is secured to the maximum possible level. Safety metrics for health care staff need to be reported as often as they are for patients. They also need to promote existing programs and institute more, which will enhance clinicians' well-being and reduce burnout.
HARMONY BETWEEN THE HEALTH SECTOR, EQUIPMENT MANUFACTURING COMPANIES AND POLICY MAKERS
This alliance will enhance the successful implementation of amazing respiratory protection programs in health care settings. It will define the roles of health practitioners, equipment manufacturers, and policymakers. So, when these diverse sectors collaborate, it will foster faster development and testing of novel products and processes.
USING AIRBORNE PRECAUTION PPE
There are recommended personal protective equipment against the spread of airborne diseases. These include:
- Droplet precautions: medical and surgical gloves.
- Face protection: goggles or face shield.
- Contact precautions: gowns and gloves.
- Airborne PPE: N95 mask.
A respirator is the most effective airborne precaution PPE used in the prevention of airborne disease-causing organisms. It also safeguards us from radiological, nuclear, and chemical substances. Different types of equipment offer different levels of safety and protection. Let's consider a few:
This is fluid-resistant, and it offers protection against large droplets, splashes, or sprays of bodily hazardous fluids. It also protects from the wearer's respiratory emissions. It is loose-fitting and does not protect from inhaling smaller airborne particles. For this reason, they are not recognized as respiratory protection. It is discarded after each use.
This prevents particle inhalation, including very small size aerosol particles and large droplets. It is tight-fitting and filters not less than 95% of airborne particles. It is also discarded after each encounter with patients. It is a negative pressure medical or surgical respirator. It is called N95 based on its percentage filter efficiency of the air.
This helps to prevent contracting infectious diseases transmitted via pathogenic droplets. With the use of appropriate hand-gloves, health care professionals, other patients, and the community will have measured protection from infectious droplets of patient's emissions. It is disposed of after each use. However, the use of hand gloves does not stop one from appropriately making use of sanitizers.
These are airborne personal protective equipment that protects the face from splashes, dust, oil, and sprays. Goggles have a snug fit on the face, and they are commonly used together with other PPEs, therefore known as adjunctive PPE.
