title: Personal protective equipment management and policies: European Network for Highly Infectious Diseases data from 48 isolation facilities in 16 European countries.
abstract: OBJECTIVE
  To collect data about personal protective equipment (PPE) management and to provide indications for improving PPE policies in Europe.
  
  
  METHODS
  Descriptive, cross-sectional survey.
  
  
  METHODS
  Data were collected in 48 isolation facilities in 16 European countries nominated by National Health Authorities for the management of highly infectious diseases (HIDs).
  
  
  METHODS
  Data were collected through standardized checklists at on-site visits during February-November 2009. Indications for adequate PPE policies were developed on the basis of a literature review, partners' expert opinions, and the collected data.
  
  
  RESULTS
  All facilities have procedures for the selection of PPE in case of HID, and 44 have procedures for the removal of PPE. In 40 facilities, different levels of PPE are used according to a risk assessment process, and in 8 facilities, high-level PPE (e.g., positive-pressure complete suits or Trexler units) is always used. A fit test is performed at 25 of the 40 facilities at which it is applicable, a seal check is recommended at 25, and both procedures are used at 17. Strategies for promoting and monitoring the correct use of PPE are available at 42 facilities. In case of a sudden increase in demand, 44 facilities have procedures for rapid supply of PPE, whereas 14 facilities have procedures for decontamination and reuse of some PPE.
  
  
  CONCLUSIONS
  Most isolation facilities devote an acceptable level of attention to PPE selection and removal, strategies for the promotion of the correct use of PPE, and ensuring adequate supplies of PPE. Fit test and seal check procedures are still not widely practiced. Moreover, policies vary widely between and within European countries, and the development of common practice procedures is advisable.
authors.affiliation: National Institute for Infectious Diseases L. Spallanzani, Rome, Italy. giusideiaco@gmail.com
authors.forename: Giuseppina
authors.initials: G
authors.lastname: De Iaco
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Puro
authors.forename: Francesco Maria
authors.initials: FM
authors.lastname: Fusco
authors.forename: Stefan
authors.initials: S
authors.lastname: Schilling
authors.forename: Helena C
authors.initials: HC
authors.lastname: Maltezou
authors.forename: Philippe
authors.initials: P
authors.lastname: Brouqui
authors.forename: René
authors.initials: R
authors.lastname: Gottschalk
authors.forename: Barbara
authors.initials: B
authors.lastname: Bannister
authors.forename: Hans-Reinhard
authors.initials: HR
authors.lastname: Brodt
authors.forename: Heli
authors.initials: H
authors.lastname: Siikamaki
authors.forename: Christian
authors.initials: C
authors.lastname: Perronne
authors.forename: Arne Broch
authors.initials: AB
authors.lastname: Brantsæter
authors.forename: Anne Lise
authors.initials: AL
authors.lastname: Fjellet
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Ippolito
mesh_terms: D057189:Checklist; D003140:Communicable Disease Control / Q000379:methods*; D003430:Cross-Sectional Studies; D005060:Europe; D055819:Hospitals, Isolation; D006801:Humans; D016273:Occupational Exposure / Q000517:prevention & control*; D016134:Organizational Policy; D011481:Protective Clothing / Q000382:microbiology / Q000592:standards* / Q000600:supply & distribution