Conservation Practices for Personal Protective Equipment: A Systematic Review with Focus on Lower-Income Countries

Cassandra L. Thiel (), Pallavi Sreedhar, Genevieve S. Silva, Hannah C. Greene, Meenakshi Seetharaman, Meghan Durr, Timothy Roberts, Rajesh Vedanthan, Paul H. Lee, Gizely Andrade, Omar El-Shahawy and Sarah E. Hochman
Additional contact information
Cassandra L. Thiel: Department of Population Health, NYU Grossman School of Medicine, New York, NY 10016, USA
Pallavi Sreedhar: Columbia College, Columbia University, New York, NY 10027, USA
Genevieve S. Silva: Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
Hannah C. Greene: Social Science Division, New York University Abu Dhabi, Abu Dhabi P.O. Box 129188, United Arab Emirates
Meenakshi Seetharaman: College of Literature, Science, and Arts, University of Michigan, Ann Arbor, MI 48109, USA
Meghan Durr: Department of Population Health, NYU Grossman School of Medicine, New York, NY 10016, USA
Timothy Roberts: Health Sciences Library, NYU Grossman School of Medicine, New York, NY 10016, USA
Rajesh Vedanthan: Department of Population Health, NYU Grossman School of Medicine, New York, NY 10016, USA
Paul H. Lee: Department of Oral and Maxillofacial Surgery, NYU Grossman School of Medicine, New York, NY 10016, USA
Gizely Andrade: Department of Emergency Medicine, Lewis Katz School of Medicine, Temple University, Philadelphia, PA 19140, USA
Omar El-Shahawy: Department of Population Health, NYU Grossman School of Medicine, New York, NY 10016, USA
Sarah E. Hochman: Department of Medicine, Division of Infectious Diseases and Immunology, NYU Grossman School of Medicine, New York, NY 10016, USA

IJERPH, 2023, vol. 20, issue 3, 1-23

Abstract: During the start of the COVID-19 pandemic, shortages of personal protective equipment (PPE) necessitated unprecedented and non-validated approaches to conserve PPE at healthcare facilities, especially in high income countries where single-use disposable PPE was ubiquitous. Our team conducted a systematic literature review to evaluate historic approaches for conserving single-use PPE, expecting that lower-income countries or developing contexts may already be uniquely conserving PPE. However, of the 50 included studies, only 3 originated from middle-income countries and none originated from low-income countries. Data from the included studies suggest PPE remained effective with extended use and with multiple or repeated use in clinical settings, as long as donning and doffing were performed in a standard manner. Multiple decontamination techniques were effective in disinfecting single use PPE for repeated use. These findings can inform healthcare facilities and providers in establishing protocols for safe conservation of PPE supplies and updating existing protocols to improve sustainability and overall resilience. Future studies should evaluate conservation practices in low-resource settings during non-pandemic times to develop strategies for more sustainable and resilient healthcare worldwide.

Keywords: PPE; sustainability; waste; resilience; conservation; efficiency (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2023
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