The design and development of PPE are influenced by the key factors shown in Figure 3-1. Since meeting the regulatory standards is mandatory and not optional, the design and development of PPE often involve major compromises while attempting to simultaneously achieve a maximal degree of protection with the highest level of comfort at the lowest possible cost. For example, the degree of protection provided by protective clothing, such as a gown, can be considerably enhanced by the use of polyethylene film without substantial additional expense, but at a significant loss of comfort for the user. On the other hand, a high degree of protection and comfort can be achieved, but at a much higher cost, by using a breathable impervious nonwoven material (Pasko, 2007). Thus, although materials and manufacturing technologies exist that can maximize any one design driver, designing the product to achieve the appropriate balance is ultimately dictated by the requirements of the end user.
As will be described in Chapter 4, a number of barriers and reasons have been identified by healthcare workers regarding why they choose not to wear PPE. These reasons include not having enough time to don the equipment (particularly in emergency response situations), the equipment is not available or they have not received training, the equipment is uncomfortable or difficult to use, the equipment interferes with their interaction with the patient and affects dexterity or the ability to perform a medical procedure, or they do not see the situation as a high risk. Better guidance is required on the unique needs of healthcare workers so that appropriate performance requirements can be developed and