Personal Protective Equipment
a. Gloves. Research indicates that the thickness of the gloves used in handling HD's is more important than the type of material, since all materials tested have been found to be permeable to some HD's.3,19,53 The best results are seen with latex gloves. Therefore, latex gloves should be used for the preparation of HD's unless the drug-product manufacturer specifically stipulates that some other glove provides better protection.19,53,72,93,100 Thicker, longer latex gloves that cover the gown cuff are recommended for use with HD's. Gloves with minimal or no powder are preferred since the powder may absorb contamination.3,104
The above referenced sources have noted great variability in permeability within and between glove lots. Therefore, double gloving is recommended if it does not interfere with an individual's technique.3 Because all gloves are permeable to some extent and their permeability increases with time, they should be changed regularly (hourly) or immediately if they are torn, punctured, or contaminated with a spill. Hands should always be washed before gloves are put on and after they are removed. Employees need thorough training in proper methods for contaminated glove removal.
b. Gowns. A protective disposable gown made of lint-free, low-permeability fabric with a closed front, long sleeves, and elastic or knit closed cuffs should be worn. The cuffs should be tucked under the gloves. If double gloves are worn, the outer glove should be over the gown cuff and the inner glove should be under the gown cuff. When the gown is removed, the inner glove should be removed last. Gowns and gloves in use in the HD preparation area should not be worn outside the HD preparation area.3
As with gloves, there is no ideal material. Research has found nonporous Tyvek and Kaycel to be more permeable than Saranex-laminated Tyvek and polyethylene-coated Tyvek after four hours of exposure to the CD's tested.54 However, little airflow is allowed with the latter materials. As a result, manufacturers have produced gowns with Saranex or polyethylene reinforced sleeves and front in an effort to decrease permeability in the most exposure prone areas, but little data exists on decreasing exposure.
c. Respiratory Protection. A BSC is essential for the preparation of HD's. Where a BSC is not currently available, a NIOSH-approved respirator appropriate for the hazard must be worn to afford protection until the BSC is installed. [NIOSH recommendation at the time of this publication is for a respirator with a high-efficiency filter, preferably a powered, air-purifying respirator.] The use of respirators must comply with OSHA's Respiratory Protection Standard,105 which outlines the aspects of a respirator program, including selection, fit testing, and worker training. Surgical masks are not appropriate since they do not prevent aerosol inhalation. Permanent respirator use, in lieu of BSC's, is imprudent practice and should not be a substitute for engineering controls.
d. Eye and Face Protection. Whenever splashes, sprays, or aerosols of HD's may be generated that can result in eye, nose, or mouth contamination, chemical-barrier face and eye protection must be provided and used in accordance with 29 CFR 1910.133. Eyeglasses with temporary side shields are inadequate protection.
When a respirator is used to provide temporary protection as described above, and splashes, sprays, or aerosols are possible, employee protection should be:
- a respirator with a full face piece; or
- a plastic face shield or splash goggles complying with ANSI standards2 when using a respirator of less than full-face piece design.
Eyewash facilities should also be made available.
Courtesy of: OSHA
https://www.osha.gov/dts/osta/otm/otm_vi/otm_vi_2.html
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