LETTER TO EDITOR
Personal Protective Equipment and Fire
1-3Department of Anaesthesiology and Critical Care, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
4Department of Obstetrics and Gynecology, District Hospital, Poata, Jodhpur, Rajasthan, India
Corresponding Author: Bharat Paliwal, Department of Anaesthesiology and Critical Care, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India, Phone: +91 9588089378, e-mail: firstname.lastname@example.org
How to cite this article: Paliwal B, Bhatia PK, Kamal M, Purohit A. Personal Protective Equipment and Fire. Indian J Crit Care Med 2021;25(4):473.
Source of support: Nil
Conflict of interest: None
Personal protective equipment (PPE) is worn by healthcare workers to protect themselves from getting infected from the patients. The component of PPE as well as the nature of the material used for PPE is dictated by the disease and its mode of transmission. Coronavirus disease-2019 (COVID-19) infection being an aerosol-transmitted infection mandates PPE consisting of gowns or coverall, head cover, goggles, mask or face shield, gloves, and rubber boots. The stringent standards mandate that coveralls and gowns should be efficient in protecting from exposure to biologically contaminated solid particles and chemical hazards.1 The guidelines from the Ministry of Health and Family Welfare, India, in accordance with WHO state that “the fabric that cleared/passed ‘Synthetic Blood Penetration Resistance Test’ (ISO 16603) and the garment that passed ‘Resistance to penetration by biologically contaminated solid particles’ (ISO 22612:2005) may be considered as the benchmark specification to manufacture Coveralls.”1,2 Hence, coveralls for COVID-19 prevention kit are commonly made from high-density polyethylene formed into a nonwoven fabric that allows heat and sweat to leave the suit while preventing liquids and aerosols from entering it.3 The disposable gowns are typically made of polypropylene, polyester, or polyethylene, whereas the reusable ones carry cotton/polyester blends.3
While the material used for PPE ensures protection from viral infections, being inflammable, it does not so from fire. One such fire incident has already been reported in a COVID-19 patient–caring hospital. Media reports claimed the blaze spreads after a staff member’s PPE kit caught fire. The paramedic staff whose PPE had caught fire while saving the patient sustained 21% burns needing hospitalization.4 In quick succession, another incident of fire is reported in a COVID-19 center, the details of which are awaited.5 The inciting event in these incidences may be preventable, but nevertheless considering the compromised vision and hearing in PPE that affect early detection, communication, and response in incidents of fire; it hints to additional consideration of choosing fire-resistant material for PPE. Nomex or flame-resistant cotton may be used for flame-resistant coveralls or aprons.6 By varying the fiber type, bonding process and fabric finish can change the properties of the material; these fire-resistant materials can be made to be liquid and aerosol resistant as well.3
To conclude, safety concerns may necessitate the material of PPE in COVID-19 care settings to be fire resistant in addition to being liquid and aerosol resistant.
Bharat Paliwal https://orcid.org/0000-0001-7588-9017
Pradeep K Bhatia https://orcid.org/0000-0001-5082-7151
Manoj Kamal https://orcid.org/0000-0001-8314-0348
Anamika Purohit https://orcid.org/0000-0003-4835-6068
1. Novel Coronavirus Disease 2019 (COVID-19): guidelines on rational use of personal protective equipment. Ministry of Health and Family Welfare Directorate General of Health Services [Emergency Medical Relief]. Available from: https://www.mohfw.gov.in/pdf/GuidelinesonrationaluseofPersonalProtectiveEquipment.pdf. Accessed 8 September 2020.
2. COVID-19 technical specifications for personal protective equipment and related IPC supplies, 2020. Available from: https://www.who.int/publications/m/item/technical-specs-PPE-Covid19-07082020. Accessed 24 November 2020.
3. Brittany Henneberry. How to make personal protective equipment (PPE) for COVID-19 (manufacturing and sourcing guide). Available from: https://www.thomasnet.com/articles/plant-facility-equipment/how-to-make-ppe/.
4. TNN. 'Ahmedabad: burst of fire from a table fan singed ICU in 98 seconds'. The Times of India, 2020. Available from: http://timesofindia.indiatimes.com/articleshow/77425332.cms?utm_source=contentofinterest&utm_medium=text&utm_campaign=cppst. Accessed 13 September 2020.
5. Express News Service, Vadodara. 'Gujarat: Fire breaks out at COVID-19 ward of Vadodara hospital.' The Indian EXPRESS, 2020. Available from: https://indianexpress.com/article/cities/ahmedabad/gujarat-ssg-hospital-covid-ward-fire-live-updates-6588252/. Accessed 13 September 2020.
6. Guidelines for Personal Protective Equipment (PPE) - environmental health & safety, University of Washington, 2020, pp. 1-40. Available from: https://www.ehs.washington.edu/system/files/resources/ppeguidelines.pdf. Accessed 13 September 2020.
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