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rubber latex was a commonly used material for these gloves but concerns about latex sensitivity mean that many healthcare organizations have adopted gloves made of alternative materials such as vinyl. There is some evidence that vinyl may be a less effective barrier than latex, but all gloves carry a risk of failure, often not visible to the naked eye (Korniewicz et al. 2002), hence the need for hand hygiene regardless of whether or not gloves are worn. Whatever the material, these gloves are single use – they should be used for the task for which they are required and then removed and disposed of. They cannot be cleaned and reused for another task (MHRA 2006, Pratt et al. 2007).

Disposable aprons

Single-use disposable aprons may be obtained either in a box or linked together on a roll. Presentation is not important as long as it is compatible with the dispensers in use and the product meets the requisite standards (i.e. is ‘CE’ marked). Aprons are normally made of thin polythene and are available in a range of colours. Different coloured aprons can be used to designate staff doing different tasks or working in different areas to give a visible reminder of the risk of cross-infection. As with disposable gloves, disposable aprons should be used for the task for which they are required and then removed and disposed of (MHRA 2006, Pratt et al. 2007).

Sterile gloves

Single-use sterile gloves, both latex and latex free, should be available in any area where their use is anticipated. Sterile gloves are packed as a left-and-right pair and are manufactured in a wide range of full and half sizes (similar to shoe sizes) so as to fit closely and provide the best possible compromise between acting as a barrier and allowing the wearer to work normally. Natural rubber latex is still one of the best materials for this, so sterile gloves are more often made of this than of alternative materials. Care must be taken to ensure alternatives are available for patients with sensitivity to latex.

Sterile gowns

To provide ‘maximal barrier precautions’ during surgery or other invasive procedures carrying a high risk of infection, or where infection would have serious consequences such as insertion of a central venous catheter, a sterile gown will be required in addition to sterile gloves. Modern sterile gowns are most often single-use disposable products made of water-repellent material as multiple-use fabric gowns may, over time, lose their effectiveness as a barrier.

Eye protection

Eye protection will be required in any situation where the mucous membranes of the eyes may be exposed to body fluid droplets generated during aerosol-generating procedures or surgery with power tools. Both single-use and multiple-use options are available. Goggles are normally sufficient as long as they are worn in conjunction with a fluid-repellent mask. If greater protection is required, or a mask is not worn for any reason, a face shield should be used. Face shields may also be more appropriate for people who wear glasses; prescription glasses will often not provide sufficient protection and should not be relied upon.

Masks and respirators

If dealing with organisms spread by the airborne or droplet route, a facemask or respirator will be required. When using a respirator (usually used to prevent the transmission of respiratory viruses), a good fit is essential to ensure that there is no leakage around the sides. Staff who are likely to need to use respirators should be ‘fit tested’ using a taste test to ensure that they have the correct size. A taste test consists of wearing the respirator while being exposed to a strong-tasting vapour (normally inside a hood to contain the vapour); if the subject can taste the vapour then the respirator is not properly fitted. Fit testing is normally carried out by the infection prevention and control team or occupational health department. Note that facial hair under the edge of the respirator will prevent a proper seal; staff with beards may therefore be unable to work safely if a respirator is required.

Single-use