Medical Protective Clothing: The Complete Guide

Whether it’s SARS or novel coronavirus pneumonia, medical protective clothing plays a vital role in every spread of the virus, and the quality of medical protective clothing is gradually improving with the improvement of production technology. This article will comprehensively explain medical protective clothing from the following 4 aspects.

1 Basic introduction of medical protective clothing
1.1 What is medical protective clothing? Definition and application of medical protective clothing.
1.2 What are the structure and common categories of medical protective clothing.

2 Production of medical protective clothing
2.1 What are the common raw materials and performance of medical protective clothing.
2.2 Manufacture of medical protective clothing.

3 Quality requirements for medical protective clothing
3.1 What are the common quality standards?
3.2 What are the test items?

4 How to use protective clothing correctly?
4.1 Wearing order of medical protective clothing.
4.2 The order to take off the medical protective clothing.
4.3 Precautions for medical protective clothing.

 1 Basic introduction of medical protective clothing 

1.1 What is medical protective clothing? — Definition and Application

Medical protective clothing, also known as medical protective suit, disposable protective coverall, or antivirus suit. Medical protective clothing refers to the protective clothing used by medical personnel (doctors, nurses, public health personnel, cleaners, etc.) and people entering a specific health areas (such as patients, hospital visitors, persons entering the infected area, etc.). Medical protective clothing has good moisture permeability and barrier, has the function of resisting the penetration of alcohol, blood, body fluid, air dust particles, and bacterial virus, effectively protect the safety of personnel and keep the environment clean.

1.2 What are the structure and common categories of medical protective clothing.

Medical protective clothing is a combination of hats, tops, and trousers. There are two kinds of medical protective clothing: isolation gown and protective clothing. The main difference between medical protective clothing and isolation gown is that medical protective clothing is more durable than isolation clothing, the protection grade is higher, the protection performance is better, the protection purpose and the protection principle of them are different.

isolation gown and protective clothing

DifferenceMedical protective clothingIsolation gown
Different usesProtective clothing refers to the clothing worn by personnel in special areas such as medical emergency, entering the infectious disease area and electromagnetic radiation area.Isolation gown refers to the clothes worn on someplace such as medical staff and family members to visit patients.
Different object of useMainly to prevent the infection of medical personnel, belong to one-way isolation.It is two-way isolation to prevent the infection of the medical staff and of the patient.

 2 Production of medical protective clothing 

2.1 What are the common raw materials and performance of medical protective clothing.

The common materials used in disposable medical protective clothing are polypropylene textile adhesive fabric, new polyester fiber, polymer coated fabric, SMS nonwovens, polyethylene breathable film/nonwoven composite. At present, most of them use polytetrafluoroethylene (PTFE) material to make medical protective clothing, PTFE is a kind of high-performance polymer, which cannot only resist water pressure but also discharge water vapor through micropores. The related properties of these materials are as follows:

Protective Clothing MaterialRelated Performance
Polypropylene FabricThe material can go through antibacterial, antistatic treatment, but the hydrostatic pressure resistance is relatively low, the efficiency of blocking virus particles is poor, can only be used as sterile surgical clothing, disinfection bag cloth, and other general protective articles.
New Polyester FiberIt close to the traditional textiles that can be treated with antistatic, antibacterial, antistatic and so on, but the hydrostatic pressure resistance is relatively low, and the efficiency of bocking virus particles is low.
Polymer Coated FabricThere are many kinds of coatings for protective fabrics, such as PVC, polyethylene and so on. The waterproof, barrier bacteria of this kind of protective clothing is good, it can be reused, but the moisture permeability is poor and uncomfortable. The high-end laminated fabric is PTFE, super waterproof and moisture permeable composite fabric.
SMS NonwovensThe fiber diameter is fine, the cloth is fluffy, soft and drapey, the filter resistance is a small and good effect, the hydrostatic pressure resistance is good, but the strength is low and the wear resistance is poor.
Polyethylene Breathable FilmNonwoven composites, which have a good effect on blocking the penetration of bacteria and liquid, good tensile strength, good air permeability, and comfortable wearing.

2.2 Manufacture of medical protective clothing.

The common medical protective clothing usually consists of a hat, top and trousers. Through cutting, stitching, tightness, adhesive pressing tape and other manufacturing technology, we can produce qualified medical protective clothing. In the whole process, the machine involved is mainly sewing machine and glue pressing machine.

Manufacture of medical protective clothing

 3 Quality requirements for medical protective clothing 

In response to a large number of medical workers who were infected during the treatment, WHO and the United States CDC suggested that appropriate protective equipment should be selected to control the spread of the highly contagious virus. Medical protective clothing should be able to block the passage of microorganisms, particulate matter and fluid, withstand disinfection treatment, durable, wear-resistant, tear-resistant, puncture-proof, anti-fiber strain; no toxic ingredients, no velvet, good cost-effective, comfortable and safe to comply with OSHA regulations.

3.1 What are the common quality standards?

StandardTest Content
EN 14126Protective clothing – Performance requirements and tests methods for protective clothing against infective agents
EN 13795Surgical drapes, gowns and clean air suits, used as medical devices for patients, clinical staff and equipment – General requirements for manufacturers, processors and products, test methods, performance requirements and performance levels
NFPA 1999Standard on protective clothing and ensembles for emergency medical operations
ISO 16603Clothing for protection against contact with blood and body fluids – Determination of the resistance of protective clothing materials to penetration by blood and body fluids – Test method using synthetic blood
ISO 16604Clothing for protection against contact with blood and body fluids – Determination of resistance of protective clothing materials to penetration by blood-borne pathogens – Test method using Phi-X174 bacteriophage

NFPA 1999: Pay attention to the overall protective performance of protective clothing, liquid barrier performance testing use over the Liquid Integrity method of ASTM F1359, and the specimen seam is required to have a certain strength and resistance to microbial penetration.
ISO 16603, ISO 16604: The performance requirements for disposable protective clothing materials are similar, and the same detection methods are adopted in the synthetic blood penetration test and microbial penetration test.
EN 13795: Pay attention to the protective performance test of disposable surgical clothing under both dry and wet conditions.

3.2 What are the test items?

Medical protective clothing is a safety protection equipment with a very high level, the quality inspection is very strict, and need to test a lot of items. Meet only one standard, there need to test multiple performances. Due to the particularity of the use environment, the common test items for medical protective clothing are spray rating, sterilization performance, disinfection requirements, breaking strength, elongation at break, filtration efficiency, flame resistance, etc., which can be divided into three aspects.

3.2.1 Barrier Performance Testing

Barrier is the most important performance of protective clothing, including three aspects: liquid barrier performance, microbial barrier performance, filtration performance.

Liquid barrier refers to the medical protective clothing should be able to prevent the penetration of water, blood, alcohol and other liquids, with more than 4 levels of hydrophobicity, to avoid the virus carried by patient’s blood, body fluids and other secretions which infect the medical staff. Microbial barrier refers to the protective clothing against bacteria and viruses, mainly to prevent the contact transmission between medical staff and patients and cross-infection. Filtering performance refers to preventing viruses transmitted through the air in the form of aerosols which inhaled or attached to the skin surface that result in infection.

Common test standards and requirements are as follows:

Test projectEN 13795NFPA 1999ISO 16603, ISO 16604
Liquid barrier performanceEN 20811, Hydrostatic testASTM F135, Over Liquid Integrity
Synthetic blood penetrationASTM F1359, Over Liquid IntegrityISO 16603
Microbial filtrationEN ISO 22612,EN ISO 22610ASTM F1671,Phi-x-174ISO 16604,Phi-x-174

3.2.2 Physical Strength and Durability

This test is designed to ensure that the material has sufficient strength to resist physical damage, such as immersion, impact, puncture, and tearing. Take NFPA 1999 as an example. The performance indicators are as follows:

Test projectBreaking strengthBursting strengthAnti-puncture forceTearing strengthBreaking strength at seams
NFPA 1999≥133.5N≥345KPa≥24.5N≥35.6N≥66.7N

The most basic test here is the breaking strength, such as in NFPA 1999, the breaking strength test reference standard ASTM D5034, and the test instrument is Textile Tensile Testing Machine.Textile Tensile Testing Machine

3.2.3 Comfort performance

Protective clothing is made of isolation material, so the heat is not easy to emit, if the heat accumulates too much, people will feel uncomfortable, affecting the efficiency and quality of work. Comfort includes air permeability, water vapor resistance, drape, weight, surface thickness, electrostatic properties, reflectivity, odor, and skin sensitization, among which the most important are air permeability and water vapor permeability.

For example, air permeability, European and American countries often use high-tech materials (PTFE microporous membrane, etc.) to improve the air permeability of medical protective clothing. NFPA 1999 uses overall heat loss (THL) to indicate the heat dissipation performance of protective clothing, requiring that the THL must be greater than 450 W/m². The reference test standard is ASTM F1868 and the test instrument is Swatting Guarded Hotplate.

Sweating Guarded Hotplate

In addition to the previous performance, medical protective clothing also needs to have the following disinfection tolerance: good color fastness to washing, non-flammable, prevent shrinkage, non-toxic and non-irritating, no harm to the skin, etc. Because there are many items to be tested, the corresponding test standards and instruments are not listed here, here is more information on textile testing instruments.

 4 How to use the protective clothing correctly? 

The use of protective clothing is closely related to our life and health, so it is essential to select protective clothing that meets quality requirements. At present, the main well-known brands are Dupont of the United States, the United States Lakeland, 3M, Sperian, and so on. After getting the protective clothing, the correct use is also more important.

4.1 Wearing order of medical protective clothing.

Wearing order of medical protective clothing - 01
4.1.1 According to the place of use, personal height, chest circumference, choose the appropriate protective clothing model and size.
Wearing order of medical protective clothing - 02
4.1.2 Read the instructions and notes before you wear it, and save the instructions for viewing when needed.
4.1.3 Wear protective clothing in designated safety areas.
Wearing order of medical protective clothing - 04
4.1.4 Wear safety shoes. The protective clothing should cover your ankles and the uppers of the safety shoes.
Wearing order of medical protective clothing - 05
4.1.5 Wear suitable face protective equipment correctly: protective masks and goggles and so on.
Wearing order of medical protective clothing - 06
4.1.6 Wear the protective clothing completely: wear the protective hat, pull the zipper and paste the zipper door flap.
Wearing order of medical protective clothing - 07
4.1.7 Wear suitable protective gloves according to the needs of the environment.
Wearing order of medical protective clothing - 08
4.1.8 Check the suitability of protective clothing: before leaving the safe wear area and entering the dangerous work area, the suitability of protective clothing can be evaluated by raising the arms, bending down, squatting and other simple actions.

4.2 The order to take off the medical protective clothing.

In the buffer zone between the contaminated area and the semi-contaminated area:
Take off the outer shoe cover →
Take off the disposable isolation gown and roll it into the center →
Take off the outer gloves →
Take off the goggles →

Enter the buffer zone between the semi-polluted area and the clean area:
Take off the shoe cover →
Take off protective clothing →
Take off the gloves →
Take off the mask and take care not to touch the outer surface of the mask →
Take off the disposable isolation cap, change the slippers, and disinfect your hand →

Enter the clean area, after washing and changing clothes, can return to the living area.

4.3 Precautions for medical protective clothing.

Proper training, use and maintenance of protective clothing are important for safety. In any case, please confirm that the product is complete, the place of use, wear correctly, wear it all the time during exposure and replace it if necessary.

Before use, if you need to wear other safety protective equipment (masks, goggles, etc.), the user should read the product instructions carefully to ensure that the protective equipment is properly matched.

After use, in the process of taking off the protective clothing, wash hands or disinfect hands in all aspects of the process, to avoid pollution. The above protective articles, except the protective mirror to be sterilized, the other disposable articles should be placed in a designated waste bin for centralized treatment.

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