Researchers Say N95, PPE Re-usage Practices Pose Unacceptably High Risk of Accidental Cross-Contamination

Doos, et al. (2022) remind us that "Personal protective equipment (PPE) is essential to protect healthcare workers (HCWs). The practice of reusing PPE poses high levels of risk for accidental contamination by HCWs. Scarce medical literature compares practical means or methods for safe reuse of PPE while actively caring for patients."

In this study, the researchers conducted observations of 28 experienced clinical participants performing five donning and doffing encounters while performing simulated full evaluations of patients with coronavirus disease 2019. Participants’ N95 respirators were coated with a fluorescent dye to evaluate any accidental fomite transfer that occurred during PPE donning and doffing.

Participants were evaluated using black light after each doffing encounter to evaluate new contamination sites, and were assessed for the cumulative surface area that occurred due to PPE doffing. Additionally, participants’ workstations were evaluated for contamination.

The researchers found that all participants experienced some contamination on their upper extremities, neck and face. The highest cumulative area of fomite transfer risk was associated with the hook and paper bag storage methods, and the least contamination occurred with the tabletop storage method. Storing a reused N95 respirator on a tabletop was found to be a safer alternative than the current recommendation of the Centers for Disease Control and Prevention (CDC) to use a paper bag for storage. All participants donning and doffing PPE were contaminated.

The researchers concluded that PPE re-usage practices pose an unacceptably high level of risk of accidental cross-contamination to healthcare workers. They add that the current design of PPE requires complete redesign with improved engineering and usability to protect healthcare workers.

Reference: Doos D, et al. The dangers of reused personal protective equipment: healthcare workers and workstation contamination. J Hospital Infect. Vol. 127, P59-68, Sept. 1, 2022. Available at: