Public Health Agency

Personal protective equipment

Personal Protective Equipment (PPE) use in Standard Infection Control Precautions

  • Gloves, aprons, long sleeved gowns, surgical masks, eye goggles, face visors and respirator masks are all examples of PPE that may be worn in the provision of healthcare.
  • PPE is used in healthcare settings to create a barrier between healthcare workers and an infectious agent from the patient and to reduce the risk of transmitting micro-organisms from healthcare workers to patient(s). In addition PPE may sometimes be used by the patient’s family / visitors, particularly if they are providing direct patient care e.g. assisting patient with toileting. In these circumstances carers must be fully inducted in the use of PPE and Hand Hygiene.
  • The choice of PPE should be based on a risk assessment of potential exposure to blood / body fluids / infectious agents.
  • PPE should be available at the point of use in both community and acute healthcare settings and staff should receive training on the correct use and disposal of PPE.
  • If used inappropriately PPE can increase the risk of transmitting infections and put people at risk of acquiring an infection

Legislative requirement

  • Employers must provide the appropriate PPE to protect employees against infection risks associated with their work. Employees are responsible for ensuring that they wear the appropriate PPE to protect themselves from possible exposure to infectious agents (refer to local COSHH guidelines).
  • Employers should provide, and maintain accurate records of, training on the appropriate use of PPE. Employees should attend mandatory IPC training and know how to use PPE.

PPE used in healthcare includes gloves, aprons, long sleeved gowns, goggles, fluid-repellant surgical masks, face visors and respirator masks. The initial risk assessment of whether or not PPE is required is based on the level of risk of transmission to and from the patient. Standard IPC precautions are required to be implemented by all healthcare workers for the care of all patients and their environment’s. When these measures alone are insufficient to interrupt transmission, additional transmission based precautions appropriate to the mode of spread are indicated.


Gloves should be worn when there may be exposure to blood, bodily fluids, secretions or excretions and when handling contaminated equipment. Gloves should also be worn when patients require transmission based precautions (insert link to TBP). Increased awareness among healthcare workers of the potential for gloves to provide protection against various pathogenic microorganisms, has led to the increased use of gloves in health care. However, gloves cans sometimes be used inappropriately and failure to remove them at the correct time and complete hand hygiene effectively can increase the risk of transmitting infections to vulnerable patients. Each healthcare worker should understand the rationale for glove use and assess the potential risk that each task carries.

N.B. Gloves do not replace the requirement for good hand hygiene (link to Hand Hygiene section). Gloves should be changed when they have become contaminated i.e. between patients and between different procedures on the same patient. Hands should always be decontaminated following the removal of gloves. Gloves are single-use items and should not be washed or reused.

Types of Glove

Polythene: Thin and have a tendency to tear. They are not an appropriate choice for healthcare settings.

Vinyl: Have been shown to be less effective than latex gloves in providing an impermeable barrier against microorganisms. They are also loose fitting and unsuitable for procedures that require manual dexterity. The use of vinyl gloves in healthcare is limited.

  • Latex including DPNRL (De Proteinised Natural Rubber Latex): Closer fitting than vinyl and provide a more effective barrier against microorganisms. They should be non-powdered and have the lowest level of extractable protein available. If a healthcare worker has a suspected latex allergy, they should not wear latex gloves. Similarly, when caring for a patient who is known to be sensitive to latex, an alternative should also be available for use. Most Healthcare settings are now becoming latex free due to the allergy risk to patients and staff.
  • Nitrile (acrylonitrile): Comparable to natural rubber latex in providing a biological barrier but arguably afford less elasticity. Nitrile gloves are the common choice of gloves for use where a latex free environment is required. There have however been reports of healthcare workers also developing allergic reactions to nitrile.
  • Neoprene: Also have similar properties to natural rubber latex and are often a popular replacement in situations when a latex-free glove is required and manual dexterity is important e.g. surgery. They are a more expensive alternative to natural rubber latex gloves.


  • Gloves should be stored in their original packaging on a clean dry surface or in a wall mounted unit and healthcare workers should not carry gloves in the pockets of their clothes/uniforms.


  • Gloves should be put on immediately before the commencement of a task and removed as soon as it has been completed.
  • Hands should be decontaminated and dried before applying gloves; cuts and broken skin should be covered with a waterproof dressing.
  • Gloves must never be decontaminated and reused. They are a single use item and should only be worn once and then discarded.
  • After gloves have been removed, hands should be washed and dried or decontaminated with alcohol handrub.
  • Gloves should be disposed of into the appropriate waste receptacle immediately after use.
  • If gloves cause irritation, healthcare workers should consult the Occupational Health service or seek medical advice.

Limit the potential for “touch contamination” by unnecessary contact of e.g. your face/environmental surfaces when wearing gloves that may have been contaminated.

Further information on glove usage can be found here


Disposable Plastic Aprons / Gowns are designed to protect uniforms / clothing from moisture / soiling during direct patient care. In the majority of cases, plastic aprons will be appropriate for standard precautions. In some cases, where extensive contamination of blood / body fluids is anticipated e.g. maternity units, ED units or when the patient requires a significant amount of direct care with close skin-to-skin contact, a long sleeved fluid repellent gowns may be more appropriate. Gowns do not need to be sterile unless used for an aseptic procedure such as central line insertion or in an operating theatre.

  • Aprons/Gowns should be stored in a clean area. Wall-mounted storage units are available for storing PPE and the storage unit should be cleaned regularly.
  • Aprons/Gowns should not be worn routinely during shifts and must be changed between patients. They may also need to be changed between different procedures on the same patient.
  • Care should be taken to remove aprons / gowns carefully using ties and taking care not to touch the outer surface. The apron/ gown should be folded / rolled into a ball before disposal into a waste receptacle.
  • Used aprons / gowns should be discarded immediately after use.
  • Hands should always be decontaminated after removal of apron/gown and gloves.
  • When colour coded aprons are worn the colour must be appropriate to the task e.g. green aprons for serving food.

Eye protection, visors or full face protection

Eye and face protection must be worn when there is risk of splashing body fluids onto mucous membranes e.g. eyes/nose. Eyes can be protected by wearing either goggles or a visor. Personal glasses are not a suitable substitute. If reusable eye/face protection is used, it should be decontaminated in accordance with the manufacturer’s guidelines. Hands should always be decontaminated after removing the equipment.

Suitable protective eye/face equipment should:

  • cover the entire face area (e.g. face shield) if protection of the mouth and nose area is also required
  • be changed if visibly soiled
  • be removed using the ear-pieces / head-band to avoid touching potentially contaminated surfaces
  • be disposed of after use if single-use or placed into a receptacle for reprocessing
  • fit over personal glasses and anti-fog properties should be considered


Surgical masks (Fluid Repellent)

  • Provide barrier protection to the wearer from splashes and droplets to the area of the wearer’s nose, mouth and respiratory tract. They do not provide protection against aerosolised particles and are not classified as Respiratory Protective Equipment.
  • Should be worn appropriately (covering nose and mouth) by all members of the theatre surgical team. If splashes of blood / body fluids are anticipated they can be replaced with a full face visor.
  • Should be worn when performing procedures such as lumbar puncture / spinal anaesthesia.
  • Must be compliant with the Medical Devices Directive (MDD 93/42/EEC) and be “CE” marked.
  • Should be single-use and discarded immediately when soiled / following use. They should not be left attached around the wearer’s neck following use and be reused.
  • Should be stored in their original packaging prior to use and care should be taken to avoid contamination.
  • Should be removed using the ties/strings and disposed of in the appropriate waste stream (e.g. clinical waste).
  • Fluid-repellent masks with eye visors attached are also available for use.

FFP3 respirator masks

  • The purpose of respiratory protection is to protect the wearer from pathogens spread by the airborne route e.g. measles, chickenpox, tuberculosis, and when performing aerosol generating procedures on patients with suspected or known influenza or other respiratory tract infections. Advice on their use is available from the IPC Team and may be required by healthcare workers and visitors in certain circumstances.
  • All healthcare workers that may require protection using a FFP3 respirator mask should be fit-tested prior to use and should also receive training on the use of the mask; this will be facilitated by the Occupational Health Department.
  • Individuals are responsible for checking the seal on their own mask before each use.
  • FFP3 respirator masks should be changed after every use or when visibly soiled. They should also be changed if breathing becomes difficult


Coia, J.E. Ritchie, L. Adisesh, A. Makison-Booth, C.Bradley, C. Bunyan, D. Carson, G. Fry, C. Hoffman, P. Jenkins, D. Phin, N. Taylor, B. Nguyen-Van-Tam, Zuckerman, M. (2013) Guidance on the use of respiratory and facial protection equipment Journal of Hospital Infection 85: 170-182

FRAISE, A . and BRADLEY, C. (2009) Ayliffe’s Control of Healthcare-Associated Infection: A Practical Handbook Fifth Ed. CRC Press, Croydon

Guidance for the selection of PPE

Health Protection Scotland (2015) Standard Infection Control Precautions Literature Review available at

HSE (2005) Personal Protective Equipment at work 2nd ed. HSE Books, Norwich

HSENI: Health & Safety at Work (Amendment) (Northern Ireland) Regulations 2006. [Available at

NICE TB Guidelines

RCN (2012) Essential practice for infection prevention and control: Guidance for nursing staff 2nd ed. RCN, London