How can PPE prevent the spread of coronavirus at work? Mike Sopp summarises Government guidance on when and where PPE should be used.
PPE and the coronavirus
The coronavirus (Covid-19) epidemic continues in the UK. As we move to the “recovery phase” or the “new normal” as it is often referred to, employers are expected to plan for the return to work of employees where they are not able to work from home.
The official guidance covering PPE has been gathered together at the Government’s Personal Protective Equipment (PPE) Hub.
Note that health issues are devolved matters and consequently there may be variations to guidance for each home nation. For further information, see:
The UK Government has published Covid-19 Secure working safely guidance for workplaces that provides a hierarchy of risk control measures that employers and the self-employed are expected to follow when reviewing their risk assessments for Covid-19 hazards.
The various guidance documents state the following.
“When managing the risk of Covid-19, additional PPE beyond what you usually wear is not beneficial. This is because Covid-19 is a different type of risk to the risks you normally face in a workplace, and needs to be managed through social distancing, hygiene and fixed teams or partnering, not through the use of PPE.
“Workplaces should not encourage the precautionary use of extra PPE to protect against Covid-19 outside clinical settings or when responding to a suspected or confirmed case of Covid-19.
“Unless you are in a situation where the risk of Covid-19 transmission is very high, your risk assessment should reflect the fact that the role of PPE in providing additional protection is extremely limited.
“However, if your risk assessment does show that PPE is required, then you must provide this PPE free of charge to workers who need it. Any PPE provided must fit properly.”
Note (1): There is an exception to the above statements in work environments where close contact is required throughout the working day with clients in settings such as hairdressers. The relevant guidance from the respective administrations should be referred to for further detail.
Note (2): Where an employer is required to provide PPE in relation to the mitigation of transmission risks from Covid-19, the requirements of the Personal Protective Equipment at Work Regulations 1992 will apply.
The Government’s PPE Plan
The UK Government has published a Coronavirus (Covid-19): Personal Protective Equipment (PPE) Plan. This contains guidance on who needs PPE, what type of PPE is required and in what circumstances. It states that PPE is “a precious resource and must be used only where there is a clinical need to do so”.
In summary, the guidance recommends that:
any clinician or care professional working within 2m of a confirmed or suspected Covid-19 patient should wear an apron, gloves, a surgical mask and eye protection
clinicians carrying out tasks that could generate airborne droplets are required to use an even higher standard of protection, including disposable gowns, filtering respirators and face shielding visors
those cleaning non-healthcare settings, those involved in the care and management of the deceased and first responders may require some PPE, depending on the risk of Covid-19.
The guidance then states: “Beyond these roles, the current clinical evidence says there is not a widespread benefit from wearing PPE. Instead, the best way to protect yourself and others is to regularly wash your hands and to keep at least two metres between you and other people whenever you leave your house”.
PPE in health and care settings
Those most at risk within the UK are professionals working in the health and social care sectors. This is because these sectors are responsible for providing essential treatment and care for those who are either confirmed to have Covid-19, are symptomatic or are highly vulnerable.
They are often in prolonged close contact with individuals who are symptomatic or particularly vulnerable to infection.
They are also the professionals who are most likely to conduct the most high-risk procedures — called aerosol generating procedures (AGPs) — for which the highest level of PPE is recommended.
It is therefore fundamental that health and care workers who are conducting these procedures are prioritised for access to and supply of PPE so that they can do their job safely.
The UK Government has produced various guidance documents in relation to the use of PPE in health and care settings:
PPE for cleaning
The guidance on Cleaning of Non-healthcare Settings states the following.
“The minimum PPE to be worn for cleaning an area where a person with possible or confirmed coronavirus (Covid-19) has been is disposable gloves and an apron. Hands should be washed with soap and water for 20 seconds after all PPE has been removed.
“If a risk assessment of the setting indicates that a higher level of virus may be present (for example, where unwell individuals have slept such as a hotel room or boarding school dormitory) or there is visible contamination with body fluids, then the need for additional PPE to protect the cleaner’s eyes, mouth and nose might be necessary. The local Public Health England (PHE) Health Protection Team (HPT) can advise on this.
“Non-healthcare workers should be trained in the correct use of a surgical mask, to protect them against other people’s potentially infectious respiratory droplets when within 2 metres, and the mask use and supply of masks would need to be equivalent to that in healthcare environments.”
PPE for first responders
The Government has published guidance for first responders, as defined in the Civil Contingencies Act 2004, and others who may have close contact with individuals with potential coronavirus infection.
This includes professionals and members of voluntary organisations who, as part of their normal roles, provide immediate assistance requiring close contact until further medical assistance arrives. It also encompasses employees who are trained for and are required to deliver first aid to employees and others, such as members of the public, while awaiting further medical assistance.
Section 7 of the Guidance for First Responders states the following in relation to PPE.
“Where it is not possible to maintain a 2m or more distance away from an individual, disposable gloves and a disposable plastic apron are recommended. Disposable gloves should be worn if physical contact is likely to be made with potentially contaminated areas or items.
“The use of a fluid repellent surgical face mask is recommended and additional use of disposable eye protection (such as face visor or goggles) should be risk assessed when there is an anticipated risk of contamination with splashes, droplets of blood or body fluids.”
PPE for first-aid trained persons
Health and Safety Executive guidance states that where a first-aid trained person is providing CPR, they should wear, if available:
a fluid-repellent surgical mask
apron or other suitable covering.
Employers should review their first-aid needs assessment to determine whether the above PPE is required by first-aid trained employees.
Further information can be found on the HSE website.
PPE in schools and childcare settings
The Government in England currently does not recommend the wearing of face coverings or masks in schools or other educational settings.
The guidance, Safe working in Education, Childcare and Children’s Social Care Settings, including the use of personal protective equipment (PPE) continues as follows.
“The majority of staff in education, childcare and children’s social care settings will not require PPE beyond what they would normally need for their work, even if they are not always able to maintain a distance of 2 metres from others.
“PPE is only needed in a very small number of cases:
where an individual child, young person or other learner becomes ill with coronavirus (Covid-19) symptoms and only then if a distance of 2 metres cannot be maintained
where a child, young person or learner already has routine intimate care needs that involve the use of PPE, in which case the same PPE should continue to be used.
“The PPE that should be used in the following situations when caring for someone with symptoms of coronavirus (Covid-19) is as follows:
a face mask should be worn if a distance of 2 metres cannot be maintained
if contact is necessary, then gloves, an apron and a face mask should be worn
if a risk assessment determines that there is a risk of fluids entering the eye from, for example, coughing, spitting or vomiting, then eye protection should also be worn.”
Further information can be found on the GOV.UK website.
In Scotland, the use of PPE in educational and childcare settings is based on the outcomes of risk assesments. Further information can be found at www.gov.scot.
In Wales, the guidance reflects that in England. Further information can be found at gov.wales.
In Northern Ireland, the same approach is also being taken. Further information can be found at ni.gov.uk.
Care and management of the deceased
The UK Government’s Guidance for Care of the Deceased covers various settings and scenarios where PPE may be necessary. This includes at a GP surgery, for first responders and funeral directors. The guidance should be referred to for each scenario.
The Government’s Covid-19 Secure guidance states that covering the face may be “marginally beneficial as a precautionary measure”. The evidence indicates that wearing a face covering does not protect the wearer but may protect others if you are carrying the virus.
Face coverings are not a substitute for other forms of risk control in the workplace.
Guidance for England states that “Wearing a face covering is required by law when travelling as a passenger on public transport in England”. There are some exceptions for age, health and equality reasons. Wearing of face masks is optional in other places, including workplaces in England. Further information can be found at GOV.UK.
In Scotland, in enclosed spaces, where physical distancing is more difficult and where there is a risk of close contact with multiple people, a face covering should be worn. They are also mandatory in public transport settings. Further information can be found at www.gov.scot.
In Wales, the advice is to use a three-layer non-medical face covering where it may be difficult to maintain 2 metres social distancing. Their use is not mandatory on public transport. Further information can be found at gov.wales.
In Northern Ireland, the use of face coverings is mandatory on public transport (from 10 July 2020) and strongly advised in enclosed spaces where social distancing is difficult. Further information can be found at www.publichealth.hscni.net.
Employers who have employees working or travelling for work where circumstances require the use of face coverings should consider providing face coverings.
Last reviewed 8 July 2020