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Test FAQ Personal Protective Equipment (PPE) -Gloves
Frequently Asked Questions (FAQs) On Dental Infection Control - Personal Protection Equipment

 

Frequently Asked Questions for Personal Protection Equipment (PPE)

View FAQs for Personal Protective Equipment (PPE), select subcategory for additional FAQs or enter search terms.

  • Gloves

Q
Does OSAP have a reference or rationale that could be used to explain to an affirmative action officer about the "absence of type IV latex allergy" in the dental world?
QWhat role does cornstarch play in latex allergies?
QShould the gloves used for staff protection during instrument processing be made of nitrile?
QMust you wear latex gloves while using a trimmer?
QCan lotion be worn under gloves?
QCan the thin food handling gloves, be used over latex gloves and not compromise the latex?
QWhat is the best way to disinfect utility gloves?
QIs there a possibility of contact dermatitis with vinyl gloves?
QShould we use powder-free vinyl or nitrile gloves for patients with latex allergies?
QCan hand lotions affect the integrity of latex gloves?
QWhat specific infection control recommendations apply to oral surgery procedures?
QWe have our assistants and hygienists do a clean wipe of their room with a pair of heavy duty utility gloves and a clean wipe with a different pair of heavy duty utility gloves. We have one hygienist that refuses to use the utility gloves. She will only use latex. She thinks that using the same pair of utility gloves will contaminate what she has just cleaned. What are the OSHA rules on this?
QIt has come to our attention that we need a written policy for latex sensitive employees. Does OSAP have any guidelines for such a policy?
QI am looking for information concerning the management of latex allergic patients. Can OSAP send me information or point me in the right direction on how to find it?

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QWhat are your guidelines for proper barriers when handling any contaminated materials?
A
Select the type of personal protective equipment based on the degree of exposure anticipated. For handling contaminated items without risk of splashing, spilling, or spattering, heavy-duty gloves should be sufficient. For procedures in which contaminated droplets may be generated, mask, eye protection, and coverings such as gowns or lab coats should be worn.

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Q
Could an employee subcontract with a doctor to take soiled personal protective equipment (PPE) home and launder it?
AOSHA states that, "Home laundering by employees is not permitted since the standard requires that the laundering be performed by the employer at no cost to the employee. Home laundering is unacceptable because the employer cannot ensure that proper handling or laundering procedures are being followed and because contamination could migrate to the homes of employees…. If PPE is not cleaned, laundered, and disposed of by the employer, or if the employer cleans the PPE but there is a charge to the employee, then paragraph (d)(3)(iv) should be cited.”(1) Considering the position of OSHA as defined in this compliance directive, it would be imprudent to subcontract an employee to fulfill this duty at home.References:
(1) OSHA. Compliance Directive CPL 2-2.69 - Enforcement Procedures for the Occupational Exposure to Bloodborne Pathogens. Available at http://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=DIRECTIVES&p_id=2570&p_text_version=FALSE

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QHow does one appropriately wash eyewear?
AWashing with soap and water should be sufficient for the decontamination of protective eyewear. If disinfectants are used, ensure all residual disinfectant is rinsed from all surfaces of the eyewear to prevent the potential for contact with potentially sensitizing disinfectants chemicals. If eyewear is visibly contaminated with blood or other potentially infectious materials, first clean, then disinfect the eyewear with anintermediate-level disinfectant compatible with the eyewear's materials. Consult the manufacturer of the safety glasses, goggles, or side shields to determine appropriate agents.

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QShould a mask be worn under the face shield?
ACompliance Directive CPL 2-2.69 - Enforcement Procedures for the Occupational Exposure to Bloodborne Pathogens states that "Depending on the degree and type of anticipated exposure, protection for the face would consist of a surgical mask in conjunction with goggles or eye glasses with solid side shields or, alternatively, a chin length face shield.(1)” It would be best to assume that in those situations where a face shield is needed to protect against splash or splatter of fluids a mask would also be indicated.

The 1993 Centers for Disease Control and Prevention (CDC) guidelines for dental infection control recommend a mask and protective eyewear or a faceshield(2).

References:
(1) OSHA. Compliance Directive CPL 2-2.69 - Enforcement Procedures for the Occupational Exposure to Bloodborne Pathogens. Available at http://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=DIRECTIVES&p_id=2570&p_text_version=FALSE
(2) CDC/Centers for Disease Control and Prevention. Recommended infection-control practices for dentistry, 1993. MMWR Morbid Mortal Weekly Rep 1993;42(RR-8):1-14. Available at http://www.cdc.gov/mmwr/preview/mmwrhtml/00021095.htm

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Q
Can you use antimicrobial soap on protective glasses?
AAntimicrobial hand soaps should be safe for use on protective eyewear. It is important to ensure that soap is thoroughly rinsed from the eyewear following washing. Repeated exposure to soaps and other materials may cause fogging or discoloration of lens material over time, requiring replacement of the eyewear.

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QShould you wear a disposable gown rather than a cotton gown?
AThe standard for meeting the OSHA requirement for protective apparel is that the material "does not permit blood or other potentially infectious materials to pass through to or reach the employee's work clothes, street clothes, undergarments, skin, eyes, mouth, or other mucous membranes under normal conditions of use and for the duration of time which the protective equipment will be used.”(1)

For general dentistry, disposable gowns do not necessarily provide a better barrier than reusable gowns, but may be more convenient because you do not launder it. No matter which you use, it should be changed daily or as soon as feasible if it becomes visibly soiled with blood.

References:
(1) OSHA Bloodborne Pathogens Standard, Final Rule. Available at http://www.osha.gov/SLTC/bloodbornepathogens/index.html

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QWhere can I find a laundry service that can handle contaminated lab coats and gowns service?
ATry contacting local hospitals or large medical clinics to ask if they use a professional service for contaminated laundry.

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QI am a dental hygienist who works part-time in more than one dental office. Does each employer have to provide and launder a smock to be worn when working in that particular office?
AYour job puts you at risk for exposure to blood and other potentially infectious materials, which, according to the Occupational Safety and Health Administration (OSHA), includes saliva. The OSHA Bloodborne Pathogens Standard requires that appropriate personal protective attire be provided at no cost to you by your employer. If you have more than one employer at different worksites, each employer must provide appropriate protective attire in the proper size. Employers also are responsible for maintaining personal protective equipment, including laundering and replacing as needed.(1).References:
1) OSHA. 29CFR 1910.1030. Bloodborne Pathogens, Final Rule. Available at http://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=STANDARDS&p_id=10051

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QI need information on the proper donning, removal, and disinfection of gowns, gloves, respirators, eyeshields, leg coverings, and shoe covers?
AThe majority of dental offices do not perform procedures that require the use of shoe covers and leg coverings.

Further, outside of hospital dental clinics, dental workers do not provide dental treatment to patients with active pulmonary tuberculosis, and exposure to patients with active TB is the only treatment consideration that would require a dental worker to use a NIOSH-approved (National Institute of Occupational Safety and Health) respirator. Respirators must be test-fitted to ensure their efficacy, and manufacturer's instructions and hospital protocol should be followed concerning donning, wearing, removal, cleaning, and disinfection of reusable respirators.

Eyeshields should be washed with soap and water; if they had been visibly soiled with blood, follow the cleaning with disinfection according to the manufacturer's instructions.

Gowns are either disposable or reusable. Reusable gowns must be laundered by the employer, or at the employer's expense. Patient-care gloves must always be disposed of after each use; utility gloves may be washed and disinfected, but they must be discarded and replaced if they are torn, punctured, discolored, or show any signs of deterioration.

Leg and shoe covers are typically disposable.

For step by step procedures, you may want to consider obtaining any one of several resources(1,2,3) that address dental infection control, including personal protective equipment.

References:
(1) Cottone JA, Terezhalmy GT, Molinari JA. Practical Infection Control in Dentistry, 2nd edition. Philadelphia: Williams & Wilkins, 1996.
(2) Miller CH, Palenik CJ. Infection Control and Management of Hazardous Materials for the Dental Team 2nd edition. St. Louis: Mosby, 1998.
(3) Eklund KJ, Bednarsh H, Haaland CO.OSAP Interact Employee Infection Control & Safety Training System. Brunswick, Maine, 1999.

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QI need some information on handwashing agents in dentistry.
AThe Centers for Disease Control and Prevention (CDC) issued a new Guideline for Hand Hygiene in Health-Care Settings in October 2002. This document provides guidelines for selecting and using hand cleaning agents such as plain soap, alcohols, chlorhexidine (CHG), chloroxylenol (PCMX), hexachlorophene, iodine and iodophors, quaternary ammonium compounds, and triclosan. Becoming familiar with each of these product classifications will help you make informed choices for your practice setting.

Some of the issues to consider in selecting a handwashing agent:

the type of procedure performed (i.e. surgical v. nonsurgical),
how to make the agent readily available to all users,
persistent antimicrobial activity (particularly for surgical hand asepsis),
inhibition of the active ingredient in the presence of organic material such as blood, and
user preferences.
For most routine procedures, washing with plain soap/detergent appears adequate. Use antimicrobial soap/agents/products for more invasive procedures, such as surgery. Conveniently placed sinks, towels, and soaps encourage their use. When possible, use alternative sink controls such as foot- or sensor-activated faucets. When you have to use your hands to turn off the water, use a paper towel to contact the faucet.

Vigorously rubbing lathered hands together under a stream of water for a minimum of ten seconds is adequate for routine handwashing. Always follow the handwashing agent's label instructions for contact time. Follow with thorough rinsing under a stream of water, then dry hands well.

OSAP's Infection Control Guidelines note the following:
Adequate handwashing will remove or inhibit both transient and resident organisms. [Dental healthcare workers] should wash hands before donning gloves, upon removal of gloves, and after inadvertent barehanded touching of contaminated surfaces or objects."

For more handwashing info, check out CDC's Hand Hygiene FAQs.


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QShould face masks be changed between each patient whether there is visible contamination or not?
AYes, face masks should not only be changed between patients but they should also be changed anytime they become wet.

The Centers for Disease Control and Prevention's (CDC) Infection Control Guidelines for Dental
Healthcare Settings states the following:

A surgical mask protects against microorganisms generated by the wearer, with >95% bacterial filtration efficiency, and also protects DHCP from large-particle droplet spatter that might contain bloodborne pathogens or other infectious microorganisms. The mask's outer surface can become contaminated with infectious droplets from spray of oral fluids or from touching the mask with contaminated fingers. Also, when a mask becomes wet from exhaled moist air, the resistance to airflow through the mask increases, causing more airflow to pass around edges of the mask. If the mask becomes wet, it should be changed between patients or even during patient treatment, when possible. (1)

1. Wear a surgical mask and eye protection with solid side shields or a face shield to protect
mucous membranes of the eyes, nose, and mouth during procedures likely to generate
splashing or spattering of blood or other body fluids (IB, IC). (1)
2. Change masks between patients or during patient treatment if the mask becomes wet (IB). (1)

In addition, the authors of Infection Control & Management of Hazardous Materials for the Dental Team state that the mask should be changed with every patient because its outer surface becomes contaminated with droplets from sprays of oral fluids from the previous patient or from touching the mask with saliva coated fingers. Also, when a mask becomes wet from moist exhaled air, the resistance to airflow through the mask increases, causing more unfiltered air to pass by the edges of the mask. Thus one should replace wet masks to maintain high filterability. (2)

Resources:

1) Centers for Disease Control and Prevention's (CDC) Infection Control Guidelines for Dental
Healthcare Settings:

http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5217a1.htm

2) Infection Control & Management of Hazardous Materials for the Dental Team. Third Edition.
By Miller and Palenik. Elsevier/Mosby Publishers. Copyright 2005


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QWhat is the criteria for dental masks? How much filtration for general practice? Cone or elastic fit behind the ears?
AAccording to the Centers for Disease Control and Prevention's (CDC) Infection Control Guidelines for Dental Healthcare Settings, in part, states that a surgical mask that covers both the nose and mouth and protective eyewear with solid side shields or a face shield should be worn by DHCP during procedures and patient-care activities likely to generate splashes or sprays of blood or body fluids. Protective eyewear for patients shields their eyes from spatter or debris generated during dental procedures. A surgical mask protects against microorganisms generated by the wearer, with >95% bacterial filtration efficiency, and also protects DHCP from large-particle droplet spatter that might contain bloodborne pathogens or other infectious microorganisms. The mask's outer surface can become contaminated with infectious droplets from spray of oral fluids or from touching the mask with contaminated fingers. Also, when a mask becomes wet from exhaled moist air, the resistance to airflow through the mask increases, causing more airflow to pass around edges of the mask. If the mask becomes wet, it should be changed between patients or even during patient treatment, when possible.

It is a personal choice as to which designed face one wears. The authors of Infection Control & Management of Hazardous Materials for the Dental Team, in part, state that the surgical masks commonly used in dentistry are dome shaped or pliable. They may be secured with an elastic band, ear loops, or ties. Because surgical masks do not provide a perfect seal around the edges, unfiltered exhaled and inhaled air can pass through these sites. Thus selection of a mask that fits the face well is important to minimize passage of unfiltered air. (2)

Resource:

1) Centers for Disease Control and Prevention's (CDC) Infection Control Guidelines for Dental
Healthcare Settings. http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5217a1.htm

2) Infection Control & Management of Hazardous Materials for the Dental Team, 3rd. Edition. By
Miller and Palenik. Elsevier Mosby Publisher. Copyright 2005.


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