---
title: Is PPE a necessary evil?
description: Is PPE a necessary evil?
---

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## Is PPE a necessary evil?

<http://static1.squarespace.com/static/595689fc9de4bbc892200518/t/59568acb5fd63b5f2928782e/1498845456286//img.jpg.com/static/595689fc9de4bbc892200518/t/59568acb5fd63b5f2928782e/1498843851691/1000w/>

In putting together a "surprise" for the  
[IPAC-Canada](http://www.ipac-canada.org/conf_registration.php) and [APIC](http://ac2014.site.apic.org/) conferences it dawned on me that while Lee & I have  
 talked around the various areas that one should consider with respect to  
 determining the safety profile of a disinfectant chemistry we have not gotten  
 into the nitty-gritty of [PPE](http://www.ccohs.ca/oshanswers/prevention/ppe/designin.html).   In my  
 travels, I have had many a HCW tell me they use "the CANCER wipe" and  
 that they would NEVER use the wipe without gloves (goggles and in some cases  
 even masks).  However, try as a I may, I  
 have been unable to find a wipe commercially branded under that name. 

It is true that some of the chemicals used in the  
 manufacturing of disinfectants such as [phenols](http://talkcleantome.blogspot.ca/2012/03/disinfectant-chemistry-report-card-3.html) and [2-Butoxyethanol](http://nj.gov/health/eoh/rtkweb/documents/fs/0275.pdf) are listed  
 by governing bodies as being carcinogens.   
It is also true that some chemistries are known sensitizing agents, are  
 known to cause [occupational asthma](http://www.ncbi.nlm.nih.gov/pubmed/19164328) and are known skin, eye or respiratory  
 irritants.  In fact, it is the toxicity  
 (safety) profile that determines what PPE needs to be worn when working with  
 disinfectants.  In later blogs we'll  
 delve into more detail of how safety profiles are determined.  For the purposes of this blog, I want to  
 focus on the concept of HMIS Ratings (Hazardous Materials Identification  
 System) and Precautionary Statements found on EPA or Health Canada registered  
 disinfectants and how they should be interpreted to ensure the safe (and  
 economic) use of disinfectants.

[HMIS ratings](http://en.wikipedia.org/wiki/Hazardous_Materials_Identification_System) as you may have surmised help identify the  
 risk of the product in terms of health concerns, flammability and physical  
 hazards which in turn determine what type of PPE a user needs to wear and if  
 there are any specific needs in terms of storage or handling of the  
 disinfectant.  On a MSDS they are  
 represented by a numerical rating system generally as "X/X/X" and are  
 rated from 0 (minimal risk) to 4 (severe hazard).  The health risk is represented by the first  
 number and helps determine what PPE (gloves, goggles and/or respiratory protection)  
 is needed.  For OBVIOUS reasons, the  
**lower the number the better!**  A  
 disinfectant with a HMIS rating of 0/0/0 would be considered pretty benign and  
 safe for the user to handle without any form of PPE.

To help illustrate safety differences between  
 disinfectant chemistries the following table summarizes HMIS ratings and PPE  
 requirements for the most commonly used disinfectant wipes:

 

<http://static1.squarespace.com/static/595689fc9de4bbc892200518/t/59568acb5fd63b5f29287831/1498845451286//img.jpg.com/static/595689fc9de4bbc892200518/t/59568acb5fd63b5f29287831/1498843851691/1000w/>

 

 

 

The need or lack thereof for PPE varies widely.  You'll also note that while a MSDS may  
 indicate that no PPE is required, the EPA label may specify that the product  
 can in fact cause eye irritation or even irreversible eye damage.   In my books, that means eye protection  
 should be worn. 

**The economic impact to facilities with respect to  
 Occupational Exposure to chemicals is very real.**  A [2010 report by the CDC](http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5918a2.htm) highlighted that the  
 most common active ingredients responsible for illnesses were Quats (38%),  
 glutaraldehyde (25%), and sodium hypochlorite (18%).  The majority of the types of injuries  
 associated with the use of disinfectants were: 222 as [eye injuries](http://www.cdc.gov/niosh/topics/eye/#stats), 130  
 neurologic injuries (headaches etc) and 121 respiratory injuries.  Of particular interest (at least to me) is  
 that only 15% of the time did the injured worker wear eye protection.....how  
 many products listed above require eye protection when using?  How often do you see HCWs (EVS, nurses,  
 clinical therapists etc) wearing eye protection?

The economic burden of occupational injuries and  
 illnesses are sizable, at least as large as the cost of cancer. Particularly if you know what the cost per  
 claim is.   In the US, the cost per claim  
 for eye injuries, neurologic injuries and respiratory injuries are $118,024,  
 $85,012 and $64,495 respectively. Using  
 the numbers from the CDC study that equates to $26,201,328 for eye injuries,  
 $11,051,560 for neurologic injuries and $7,803,895!  **That's a whopping $45 MILLION spent** over a 5  
 year period in just 4 US states!

Employers have a legal responsibility to provide a safe  
 working environment.  The use of  
 disinfectants has a direct and very costly impact on worker safety.   In an era where we are constantly talking  
 about the bottom line and focusing on the cost of HAIs, perhaps we should also  
 be considering the cost of Occupational illness and cost of PPE.  Choosing an effective disinfectant with the  
 safest HMIS profile will save your facility a considerable amount of money -  
 particularly when the cost of a pair of gloves can be more than **the cost of the  
 wipe the HCW is using to clean and disinfect! **

 

*Bugging Off! *

Nicole

 

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