Research: review of personal protective equipment provided in health care settings to manage risk during the coronavirus pandemic

Introduction

Experts from HSE and PHE carried out a rapid review of the evidence supporting the use of personal protective equipment (PPE) in healthcare and in the context of COVID-19 in March 2020.

This work was delivered by HSE for the Government Chief Scientific Adviser. It's in two parts:

  • Part one: Equivalence of N95 and FFP2 masks
  • Part two: Aprons, gowns and eye protection

From the commencement of the pandemic, the UK recommended the use of FFP3 respirators when caring for patients in areas where high risk aerosol generating procedures (AGPs) are being performed. Following the review, it was agreed that when FFP3 respirators were not available, then FFP2 respirators could be used for AGPs.  

The World Health Organisation (WHO) recommends FFP2 and N95 respirators for AGPs and these are widely used in other countries. The N95 respirator is not CE marked but has been tested against standards similar to European standards. A group of experts were convened from PHE and HSE to carry out a rapid review of the evidence supporting the use of N95 in the context of COVID-19, to optimise the choice of respirators available at that time.

Since this review the UK IPC guidance has been updated and requires FFP3 respirators to be worn where AGPs are being performed.

Review findings

The conclusions drawn from the review are based on the limited studies available, particularly in the area of qualitative research.

The key findings (for use in healthcare settings only) are:

  • no material difference between the N95 respirator and the FFP2 disposable respirator. They provide comparable protection against coronavirus as long as the wearer has passed a face fit test
  • aprons and gowns both appear suitable for caring for patients with suspected COVID-19. However, there is weak evidence to suggest that gowns appear to offer more protection
  • eye protection is necessary when there is a risk of contamination of the eyes from splashing such as aerosol generating procedures
  • the selection of appropriate PPE should be determined by local risk assessment and reference to PHE guidance

These conclusions were supported by international experts.

Further information

Acknowledgments

The authors of the research would like to acknowledge the contribution of:

We review and update this page regularly to reflect any changes in guidance.

Page last reviewed: 19 July 2021

Next review due: 31 July 2021

2021-07-08