Personal Protective Equipment Standards

The type of personal protective equipment (PPE) required for a disaster response depends on the nature of the incident and other factors such as environmental conditions (Deatley, Allan, Hauda, Dehaven, & Stangby, 2003). For all emergency responses, the minimum level of PPE must include gloves, goggles/safety glasses, and the appropriate clothing for the conditions and weather faced by the responder. Responses related to situations that include potential exposure to hazardous materials (e.g., chemical, biological, radiological) require additional protection. This level of protection requires training specific to the equipment to be used. Only those who are properly trained, fitted, and authorized to don the level of PPE should do so. Also, it is important that responders realistically train and plan for patient assessment while wearing the PPE as this can be a hindrance to normal assessment techniques. 

PPE is characterized by escalating levels of protection, with Level A as the highest level and Level D as the lowest (EPA Levels of Protection).

Level A

Level A protection should be worn when the highest level of respiratory, skin, eye, and mucous membrane protection is needed.

Level B

Level B protection should be selected when the highest level of respiratory protection is needed, but a lesser level of skin and eye protection. Level B protection is the minimum level recommended on initial site entries until the hazards have been further identified and defined by monitoring, sampling, and other reliable methods of analysis, and equipment corresponding with those findings utilized.

Level C

Level C protection should be selected when the type of airborne substance is known, concentration measured, criteria for using air-purifying respirators met, and skin and eye exposure is unlikely. Periodic monitoring of the air must be performed.

Level D

Level D is primarily a work uniform and is used for nuisance contamination only. It requires only coveralls and safety shoes/boots. Other PPE is based upon the situation (types of gloves, etc.). It should not be worn on any site where respiratory or skin hazards exist."

Once the level of appropriate PPE is determined, it can be adjusted based on the needs to the dynamic situation.

Reasons to upgrade to a higher level

• Known or suspected presence of dermal hazards
• Occurrence or likely occurrence of gas or vapor emission
• Change in work task that will increase contact or potential contact with hazardous materials
• Request of the individual performing the task

Reasons to downgrade:

• New information indicating that the situation is less hazardous than was originally thought
• Change in site conditions that decreases the hazard
• Change in work task that will reduce contact with hazardous materials” (EHSO, 2009)