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A simulation study to assess fluid leakage through the glove-gown interface in isolation settings

  • Zafer Kahveci
    Affiliations
    U.S. Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health (NIOSH), National Personal Protective Technology Laboratory (NPPTL), Pittsburgh, PA
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  • F. Selcen Kilinc-Balci
    Correspondence
    Address correspondence to F. Selcen Kilinc-Balci, PhD, U.S. Centers for Disease Control and Prevention (CDC), National Institute for Occupational Safety and Health (NIOSH), National Personal Protective Technology Laboratory (NPPTL), 395 E St., SW, Patriots Plaza, Suite 9200, Washington, DC 20201.
    Affiliations
    U.S. Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health (NIOSH), National Personal Protective Technology Laboratory (NPPTL), Washington, DC
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  • Patrick L. Yorio
    Affiliations
    U.S. Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health (NIOSH), National Personal Protective Technology Laboratory (NPPTL), Pittsburgh, PA
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Published:August 21, 2021DOI:https://doi.org/10.1016/j.ajic.2021.08.013

      Highlights

      • The glove-gown interface is one of the most vulnerable areas of the PPE ensemble.
      • Current standards do not consider the interface regions of the PPE system.
      • Leakage through the glove-gown interface depends on multiple design factors.
      • There is a need to develop a method to evaluate leakage at glove-gown interface.

      Background

      Isolation gowns are recommended to protect healthcare personnel, patients, and visitors from transfer of microorganisms and body fluids in patient isolation situations. Standards provide limited information about barrier performance of isolation gowns for possible exposure scenarios. One of the most vulnerable areas of the personal protective equipment ensemble is considered the glove-gown interface. However, current isolation gown classification standards do not consider the interface regions of the personal protective equipment system while assessing the level of protection. The purpose of this study was to quantitatively evaluate the fluid leakage through the glove-gown interface by simulating exposures and healthcare personnel arm movements in patient care for isolation settings.

      Methods

      We tested fluid leakage of two examination gloves with different cuff lengths and seven isolation gown models designed with varying levels of barrier resistance and multiple cuff types.

      Results

      Our results demonstrated that leakage through the glove-gown interface depends on multiple factors, including glove cuff length and gown cuff design. Gowns with the thumb loop design provided better protection than the elastic cuff design, and the elastic cuff design provided better protection compared to the knit cuff design for a given AAMI PB70 level. More importantly, a substantial penetration through gown fabrics was observed.

      Conclusions

      This research identifies a need to develop a standardized method to evaluate leakage at the glove-gown interface to improve worker protection.

      Key Words

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