General Guidelines on the Use of PPE, with a Focus on Face Masks

Since January 2020, due to the outbreak of the pandemic, we have been facing a situation that is new and different. Everyone in our society is required to follow different, adapted guidelines and stricter hygiene practices until a vaccine becomes available. The mandated additional hygiene measures and the 1.5-meter social distancing rule apply both in private life and in the workplace.

Education and training remain an ongoing process, as new insights continue to emerge over time.  

Practical experience shows that the availability and correct use of appropriate personal protective equipment (PPE) are crucial components in the response to the COVID-19 virus. From the outset, there has been an ongoing discussion about how PPE can be used correctly to provide adequate protection. Furthermore, some doubt has arisen regarding the importance and effectiveness of wearing face masks. Availability issues and misunderstandings in this discussion ultimately led to the requirement that non-medical face masks must be worn on public transportation as of June 1, 2020. Within the industry, the appropriate type of face mask is determined based on the risks associated with the work.

According to the RIVM, FFP2 face masks provide sufficient protection against the coronavirus in this case. The FFP2 type was chosen because it offers protection against water- and oil-based aerosols and airborne biological agents such as pollen and bacteria. It is the tiny microscopic particles (aerosols) that pose the risk of infection because these small droplets are lighter, remain in the air longer, and thus increase the likelihood of further spread.

WHAT DO WE KNOW FROM PRACTICAL EXPERIENCE?

Practical experience has shown that singing in a group—for example, in a choir—or being present in an enclosed space (such as a church) poses a high risk of infection. All similar activities, such as events with large crowds and physical exertion, are prohibited. Wearing face masks in such circumstances is pointless because, on the one hand, even an FFP2 or FFP3 mask cannot provide the required protection, and on the other hand, face masks can only absorb moisture for a limited period of time and cannot meet all other basic requirements (hygiene, sufficient distance) cannot be met. Timely replacement of face masks at events is also not an option. Protection against the COVID-19 virus requires a comprehensive approach that includes all measures established by the government to date.

HOMEMADE MASKS OR MASKS WITHOUT A CERTIFICATION MARK ARE COUNTERPRODUCTIVE

Various homemade face masks, made from different materials and in different designs, have now come into circulation. These types of face masks do not meet the FFP2 or FFP3 industrial safety specifications; using them in an industrial setting is not a good idea in any case. Due to insufficient availability, the government has determined that FFP2 masks should preferably be reserved for frontline healthcare workers. This risk assessment has not simplified the discussion about face masks. Care facilities and nursing homes report having insufficient protection to perform their work safely and healthily.

This necessity has led to the offering and use of alternative, homemade face masks. This has created a situation that does not meet the required safety specifications, quality standards, and certification requirements for face masks (false sense of security).

Short-term use of a homemade mask in crowded areas may offer “protection” more to others than to yourself. The likelihood of reducing the spread of aerosols has decreased. This, however, depends heavily on the material from which the face mask is made. For employees in the workplace—including office staff working in this environment—the recommendation remains to wear the required, approved PPE. In the event of a shortage, office staff outside of operational areas may use disposable surgical face masks if necessary.

Proper information and instruction regarding hygiene and social distancing rules can then provide protection. A sound PPE policy regarding the COVID-19 virus starts with knowing what is expected of you to protect yourself and others from infection. Namely, applying the full set of preventive measures established by the RIVM, using PPE correctly, and being and remaining consistent in your behavior.

CORRECT USE OF FACE MASKS

When you wear a face mask, you expect it to provide the protection for which it is intended. Before choosing which mask to use, you must first conduct an assessment or risk analysis. In the current situation, there is a risk of COVID-19 infection and a likelihood of becoming ill. Being able to continue performing your work safely and healthily is important. Making the right choice and using PPE correctly is a given within the industry. Another protective factor is your own consistent behavior, to ensure safety not only for yourself but also for those around you.

In addition to being familiar with the work (and its risks), you must now also follow the standard RIVM guidelines when performing your duties.  In addition to industrial risks and the application of the required standards (protection levels), a new risk applies in the current situation: the risk of COVID-19 infection for yourself and/or others, both in your personal and work environments.

DUTCH INSPECTION REGULATIONS ON MASK USE

The Dutch SZW Inspectorate and the RIVM have deemed the Chinese GB 2626-2006 standard and the U.S. NIOSH 42 CFR 84 standard equivalent to the European standards EN-149:2001+A1:2009 and NEN-EN 14683:2019 for mouth-and-nose masks. This conclusion is based on the fact that it can contribute to patient safety. This does not mean, however, that the quality of the masks is considered equivalent. The face masks comply with the European Directive on medical devices (Directive 93/42/EEC or EU 2017/745).

For employees directly involved in the development and production of products or services, it is important to continue to follow the required PPE safety and product specifications. The standard requirement to wear face masks demands strict adherence to usage and hygiene protocols.

An especially annoying side effect of having to wear a face mask as standard, in combination with safety glasses, is the fogging of the lenses, resulting in insufficient visibility while performing work tasks. This is especially true for employees who wear prescription glasses.

Many tips are well-known, but consider wearing wide-view goggles, as these not only reduce fogging of the lenses but also provide better protection for the eyes (in addition to the mouth and nose).

If FFP2 masks are in short supply, administrative staff may consider using disposable surgical face masks (standard NEN-EN 14683:2019). This must be accompanied by proper instruction, information, hygiene practices, and careful waste management to ensure that users understand the level of protection these masks provide and know how to use them correctly.

WHY DON’T FFP1 MASKS WORK, AND WHY SHOULD THEY DEFINITELY NOT BE REUSED?

Using face masks other than FFP2 or FFP3 in industrial settings is not a good idea.

The required safety specifications, supply, storage, and maintenance needed in the workplace cannot then be followed.

Necessity knows no law, and for lack of a better option, you have to do something. Implementing the use of other non-approved, non-standardized face masks requires an update to the previously approved Risk Assessment and Evaluation (RI&E).

The use of homemade face masks may provide some protection, but it can also increase the risk of exposure and infection, including with COVID-19.

While homemade masks are intended to protect others, they do not comply with the new EU PPE Regulation 2016/425. Their protection factor is therefore very low.

Effective June 1, 2020, the government requires everyone aged 13 and older to wear a face mask (including homemade masks) on public transportation (trains, trams, and buses). This protection is intended to supplement the 1.5-meter social distancing rule, the well-known hygiene measures, and the advice to stay home if experiencing symptoms.

Proper education is needed to prevent the misuse of homemade face masks. People tend to reuse these face masks for too long and repeatedly. They also tend to wear them around their necks, let the masks dry out, and fail to replace or clean them. In crowded situations—which you should avoid—a homemade face mask (which quickly becomes a damp cloth) is a source of contamination and actually increases the risk of infection and/or transmission to yourself and others. The goal of protecting others when you find yourself in a crowded environment is then completely missed.

THE RECOMMENDATION IS TO CHOOSE THE RIGHT FACE MASK AND USE IT CORRECTLY

After all, face masks are meant to provide protection and should not cause new or additional infections. The FFP class indicates how effectively the mask filters harmful substances when inhaled. The masks are labeled FFP1 (blocks at least 80% of particles), FFP2 (94%), or FFP3 (99%). The masks also bear a CE mark and comply with the European Personal Protective Equipment Regulation (EC 2016/425).

The higher the number, the better the mask’s ability to filter out harmful particles and viruses when inhaled. This effectiveness depends on choosing the right mask and using it correctly.

Always wash your hands with soap before putting on the mask. Touch only the straps to put on the mask. Do not touch the inside of the mask, and once it is on, do not touch the outside either. Make sure the mask fits snugly (you should not have excessive facial hair or a beard). After taking off and discarding the face mask, wash your hands again with soap.

Face masks are intended for single-use only. This means do not reuse them, and do not collect masks to have them cleaned again. This is because no guarantee can be given regarding their effectiveness, as it is known that the filter material does not return to its original form after cleaning or disinfection. There is a risk that the effectiveness and protection may simply be different after cleaning. Wash homemade face masks intended for personal use by boiling them. When used at work, washing them at home poses a risk because substances such as pigments can permanently damage the washing machine and other equipment. Incidentally, advice has previously been given here not to use homemade face masks in industrial settings.

Valves in face masks reduce breathing resistance, but they also offer less protection and thus increase the risk of viral infection. The duration of use depends on the level of physical exertion at work, but do not wear face masks for longer than three hours. Always replace face masks if they are soiled, too damp, or damaged. Also, be sure to disinfect safety goggles, acid-resistant goggles, wide-view goggles, or a face shield beforehand. Ensure and verify that the workspace remains well-ventilated at all times.

Apart from other industrial risks, and if in stock and available, approved FFP2 face masks for COVID-19 are the recommended protective equipment in this exceptional situation.

Preventing the spread of and infection with the coronavirus means adequately following the RIVM measures, as well as correctly using PPE and being and remaining consistent in your behavior.

OUR EXPECTATIONS DURING THE CORONAVIRUS ERA

As has been reported in the news several times, we’d like to reiterate clearly—and especially why—we must continue to adhere to the 1.5-meter social distancing guidelines.

Wash your hands regularly and frequently, paying close attention. Know how to do it, but also actually do it.

First, wet your hands. Add soap, and rub your hands, fingers, and fingertips thoroughly. Wash your hands for at least 20 seconds. Rinse with running water. Always dry your hands with a single-use paper towel or tissue. Turn off the faucet with the paper towel or tissue, then throw it immediately into a trash can. Rub your hands regularly with an alcohol-based hand sanitizer in between washes. If your hands are very dirty, use a nail brush.

Always wash your hands after coughing, sneezing, or blowing your nose; when preparing food; before and after eating; after using the restroom; after contact with animals; and as you see fit. Washing with soap is very effective because soap breaks down the protective layer surrounding the virus, ultimately preventing it from surviving.

Limit and avoid direct contact, maintain a distance of 1.5 meters at all times, avoid crowded places, and do not spit in public.

If you have a cold, a runny nose, a cough, or a sneeze, a sore throat, a fever (38 gr), or difficulty breathing, do not wait—consult your family doctor or the GGD. Cough and sneeze into the inside of your elbow.

Coughing and sneezing can release droplets into the air that can be inhaled or cause infection through the mouth and mucous membranes. In the Netherlands, it has been agreed that 1.5 meters is a safe distance to help limit this. This is because the droplets do not remain suspended in the air but fall quickly.

Aerosols—microscopically small particles—are smaller and lighter; they remain in the air slightly longer and can therefore spread further.

Make sure your workspace is well-ventilated and be mindful of each other’s work positions and postures to avoid infecting one another (the airflow [upwind] carries the risk away from you).

Take good care of yourself by eating a healthy diet that includes fruits and vegetables. Rinse fruits and vegetables beforehand with clean running water. When you get home, always wash your hands first and touch your face, mouth, nose, and eyes as little as possible.

Do not shake hands, kiss on the cheeks, or kiss each other on the lips. The virus spreads very easily via the hands, nose, mouth, and mucous membranes. Preferably, do not use coins or paper money to pay. Use your debit or credit card instead.

Follow the normal laundry instructions. Do not wash work clothes at home. Do not wear dirty clothes; wash soiled, contaminated clothing in an industrial washer at temperatures between 60 and 90 degrees.

HOW LONG DOES THE CORONAVIRUS SURVIVE ON SURFACES?

The virus can also remain on surfaces for some time. Depending on the type of material, the virus may remain on the surface for a shorter or longer period, potentially leading to transmission (cardboard, rubber, plastic). After delivery, let PPE sit for a while (a few days) before using it.

Always wear a face mask when moving around at work. In short, prevent the spread of the virus.

A good example sets a good precedent. Proper behavior ensures effective prevention in terms of health and safety. By consistently following the guidelines above, you’re doing everything possible to protect yourself and others against the COVID-19 virus, as recommended by the RIVM.