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similar to the equipment currently used for potentially infectious patients supplemented by SCBA or HEPA filters. It is important to note the current OSHA regulations for response workers require protection levels similar to those required for chemical agents. These regulations should be reevaluated for applicability in light of the risks posed by biological toxins.

Implementing these PPE strategies may prove difficult, as it is human nature to proceed to maximum protection when the perceived danger is unknown or unusual. It is important to emphasize basic principles of infectious disease control and emphasize the lack of person-to-person transmission for the majority of the biological agents when responding to such incidents, so as to maximize the available medical resources to provide care for the largest number of victims.

R&D Needs

Research and development in personal protective equipment has yielded vastly improved protection for the military and, to some extent, civilian first responders. However, the use of even the most up-to-date respirator is greatly restricted by the necessity of air monitoring, time of exposure limitations, and relatively low protection factors. Civilian first responders are also hampered by the weight, size, and heat of the protective suits. Aside from issues surrounding the equipment itself, policy and regulation also influence use and effectiveness of personal protective equipment. As listed below, the committee recommends that research and development continue to focus on better and more effective equipment, but also recommends that current policy and procedures be reviewed as well.


Continue research on new technologies that increase protection factors achieved by respirators.


Continue research on chemical protective suits that better address issues of bulk, weight, and heat stress.


Evaluate current occupational regulations governing use of personal protective equipment in the context of terrorism.


Support current efforts to develop uniform testing standards for protective suits intended for use in response to terrorism.


Research and develop recommendations for selection and use of appropriate personal protective equipment in hospitals.


Research alternatives to respirators for expedient use by the general public (e.g., sheltering in place, ventilation system filters) in terrorist incidents.

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