When is it Acceptable to Re-use Single Use Coveralls, Gowns And Chemical Suits?

The two important questions are:-

Is the garment damaged?

Clearly if a garment is damaged it will not protect as designed and should not be re-used. Only undamaged garments with functioning components such as any zip fastening should be re-used.

Can a damaged garment be repaired?

Under normal circumstances we would say no, but, on the basis that pathogens can only enter the suit through penetration and not permeation and that contamination remains on the surface,  in extremis small tears or abrasions might be sealed with a good quality, hi-adhesive gaffa or barrier tape, ensuring it is carefully applied with no creases. We would stress that this will not entirely remove the risk associated with damaged protective clothing and normally we would say this is absolutely not an option - partly because there is no practical way of knowing if the integrity of the garment is unaffected, and it may be difficult if not impossible where damage occurs on seams or on areas more difficult to access. But to stress the point again, this blog is based on the premise that there is no alternative to re-use because no new clothing is available, in which case taping up small tears and re-using the garment is probably lower risk than not using any protection at all.

Unfortunately, major damage and tears cannot realistically be repaired.

Is the garment contaminated?

Again, if the garment is undamaged and uncontaminated then there is no reason why it should not be re-used in any case. If it is contaminated then the possibility of re-use must be ideally avoided and if not avoided, very carefully considered.

The problem in the case of protection against infective agents is that it is likely to be impossible to know whether the garment is contaminated or not. Thus part of an assessment of the possibility of re-use might be to address the question "how likely is it that the garment is contaminated?"

For example, if the garment has been used by front line medical staff in the care of known infected patients then it is highly likely that contamination has occurred - in fact it is reasonable to assume so, in which case re-use of garments should be an absolute last resort and additional measures to mitigate the risk of cross contamination must be all the more stringent.

On the other hand if the garment has been used as part of a cleaning process of surfaces in a room or environment where suspected cases have or may have been present - such as the image here of the worker disinfecting the interior of a bus - then the likelihood of contamination is much lower, the risk less and the suitability of re-use, with precautions, more acceptable.

Once again, this type of analysis cannot remove risk - but can help towards a greater understanding of it, reducing it and thus minimizing the probability of cross contamination.

Can contamination be removed from a garment before re-use?

We have received several questions regarding the possibility of decontaminating or sterilizing contaminated garments in preparation for re-use.

Whilst we cannot advise on specific types of sterilization and whether they will kill the virus - although evidence suggests most standard sterilization/disinfection processes should kill it, the challenge is not killing or removing the virus, it is doing so without damaging the garment and being certain that all traces of the virus have been removed. In particular the latter, knowing whether the process has removed all traces of contamination before re-using, is the key problem. Since there is no easy solution to this it is sensible to assume that all of it has NOT been removed and some residual contamination may remain.

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