Fundamentally, the personal protective equipment (PPE) required to protect two workers – one responding to a hazmat (hazardous materials) incident and one providing care to an infectious disease patient – differ considerably from one to another, but most Americans, including those working in the emergency-response and medical communities, commonly refer to both types of equipment as PPE.  This dual use of the PPE acronym can result in confusion – e.g., when the DHS (Department of Homeland Security) Hospital Preparedness Program Grant Guidance documents suggest that local communities develop caches of PPE to prepare for potential threats, but it is not always clear to which type of PPE a specific guidance document is meant.

Although the fundamentals of NIMS (National Incident Management System) resource typing demand clarity and consistency in the categorization of response assets, each government agency seems to have its own definition of PPE. The Federal Emergency Management Agency (FEMA), for example, defines PPE in its NIMS guidelines, as “Equipment and clothing required to shield or isolate personnel from the chemical, physical, thermal, and biological hazards that may be encountered at a hazardous materials incident.” That definition, it should be noted, does not include any medical protective garb.

The Office of Safety and Health Administration (OSHA), on the other hand, uses two definitions. One, which applies to hazmat gear; states that PPE “is designed to protect employees from serious workplace injuries or illnesses resulting from contact with chemical, radiological, physical, electrical, mechanical, or other workplace hazards.” The second OSHA definition, used for “healthcare settings,” describes PPE as “specialized clothing or equipment worn by an employee for protection against infectious materials.”

There is yet a third definition, though – one used by the Food and Drug Administration (FDA) – that covers both areas of risk: “PPE is any type of specialized clothing, barrier product, or breathing (respiratory) device used to protect workers from serious injuries or illnesses while doing their jobs,” according to the FDA definition.  Depending upon the varying workplaces or experiences of individual employees, it seems reasonable to suggest, the expression “PPE” can be interpreted as referring to a rather broad spectrum of clothing and/or equipment items.

However, the confusion over “PPE” can be readily clarified through the recognition and identification of two functional classes or sub-categories of PPE. Each sub-category might be given its own acronym: PPE-HM to describe hazmat gear; and PPE-HC to describe the gear to be used in a healthcare setting. Acceptance of the two new acronyms would allow for the adoption by FEMA (and any other agency – state, federal, or local – working in the hazmat or healthcare fields) of three standard definitions. The FDA’s current definition could be used to refer to PPE generically, and OSHA’s two current definitions could be adopted to define the two new sub-categories.

For additional information about the definitions cited above see: (a) Typed Resource Definitions: Law Enforcement and Security Resources, FEMA 508-6; July 2007; (b) Personal Protective Equipment, OSHA Fact Sheet, U.S. Department of Labor, 2002; and (c) Guidance for the use and selection of Personal Protective Equipment (PPE) in healthcare settings, Centers for Disease Control and Prevention. 

Dennis Jones

Dennis Jones, RN, BSN, was the first health community preparedness director for the Georgia Division of Public Health and in that post directed the statewide health community program in its preparations to prepare for and respond to all health-emergency events, including the planning for Pandemic Influenza. A finalist in Atlanta’s 2003 Healthcare Hero award, the first chairperson of the Atlanta Metropolitan Medical Response System Healthcare Section, and a nationally recognized expert in hospital disaster preparedness, he is now serving as an executive consultant with Collaborative Fusion Inc.

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