Recent developments regarding COVID19 and PPE

17-Apr-2020

There is still concern and confusion in the workplace about PPE. ASMOF is negotiating with the Ministry regarding the correct application of PPE and the nature of PPE that should be worn. We affirm the previous position of the CEC that members working in Emergency Departments should be wearing PPE in any ED clinical area.

Fit testing

Fit testing is covered by an Australian Standard and we believe it should be mandatory and should be provided for all staff required to wear P2/N95 masks.

It is unfortunate that at this point in time the Ministry does not agree with this position.

We have also been made aware of P2 masks being withdrawn in South Australia as not fit for purpose. And also, an unknown number of masks removed from St Vincents as not fit for purpose.

We have today sought urgent reassurances from the Ministry as to the suitability/fit for purpose attributes of all P2 masks being provided in NSW

The Health Secretary’s recent update remains valid:

  • Staff are to wear prescribed PPE as instructed
  • Staff are not to undertake or be required to undertake tasks requiring PPE if the PPE is not available for use. Any such tasks are not to proceed until required PPE is available
  • Any staff member who is concerned about their safety must raise their concerns immediately to their manager.

SafeWork Australia - COVID19 page.

The SafeWork COVID19 page is very useful and has a section on Can a worker be directed not to wear a mask?

SafeWork Australia says:

Some workers may want to wear a mask even though it does not offer protection, such as a surgical mask, and even if the employer has considered that it is an unnecessary control measure .

This is a stressful time for all Australians and some workers may be wearing the mask because they feel unsure or anxious about their health. Employers should consult with workers on this issue and find out why they want to wear a mask at work. Employers should also inform workers of the control measures that have been implemented in the workplace to minimise the worker’s exposure to the COVID-19 virus.

Whether an employer can direct an employee not to wear a mask will depend on whether the direction is permitted by the model WHS laws or is otherwise lawful and reasonable. This will need to be determined on a case by case basis depending on the circumstances.

However, if a worker was working on their own at home and using their own masks, it would be unlikely the direction would be reasonable. Similarly, if the worker was a frontline health worker, a direction of this kind would also be unreasonable.


The important thing is that the employer has actively considered whether a mask is an appropriate control measure in minimising exposure to the COVID-19 virus and has done so in consultation with workers, and in combination with other reasonably practicable, known control measures such as physical distancing – keeping everyone at the workplace at least 1.5 metres physically apart.

International advice on PPE

A new guidance has been published for the UK on 2 April 2020. The accompanying message being “In response to the emerging epidemiology and evidence, urgent work has been under way to review the existing UK-wide Personal Protective Equipment (PPE) guidance”

The main changes are:

  • enhanced PPE recommendations for a wide range of health and social care contexts
  • inclusion of individual and organisational risk assessment at local level to inform PPE use
  • recommendation of single sessional (extended) use of some PPE items
  • re-usable PPE can be used. Advice on suitable decontamination arrangements should be obtained from the manufacturer, supplier or local infection control
  • guidance for when case status is unknown and SARS-CoV-2 is circulating at high levels
  • recommendation on patient use of facemasks

Key differences between the new UK advice and current Australian advice include:

  • The UK has a much wider definition as to who should be considered a potential case (divided into inpatient definition and for those well enough to remain in the community. For those in the community it is now continuous cough and/or high temperature). This is relevant as lots of the guidance around use of PPE relates to where patients are a confirmed or potential case (in Australia suspected case)
  • The masks recommended in the UK for airborne risk are FFP3s, these filter 99% compared to the P2/N95 which filter 94% and 95% respectively.
  • Surgical masks in the UK are divided into 2 types – these being surgical masks, and fluid resistant (Type IIR) surgical masks. There are very few situations where the use of surgical masks is being recommended in the UK whereas these are the masks being recommended in NSW hospitals for all routine care of COVID -19 patients. (In the UK they are being used to protect patients who are considered very vulnerable to risk of transmission from the healthcare worker rather than to protect the healthcare worker). The recommended masks for droplet precautions are the fluid resistant IIR surgical masks

Detailed advice around PPE in a range of settings can be found here

Helpful tables have been produced that show which PPE is indicated and when:

Table 1 shows PPE in secondary care, inpatient settings. (this recommends that in addition to wearing the air filtering masks when performing a single aerosol generating procedure on a possible or confirmed case, that they are also worn when working in a high-risk acute care area containing one or more possible or confirmed cases)

Table 2 shows PPE in primary, outpatient and community

Table 3 shows PPE in ambulance, paramedics and first responders

Table 4 shows PPE additional considerations this is a major difference as it talks about the use of PPE where the patient is not considered a possible or confirmed case, and essentially allows for PPE to be used (and outlines which PPE), where an individual staff member considers there is a risk to themselves or to the individuals they are caring for. It also sets out that PPE for airborne transmission should be used when undertaking any aerosol generating procedure (for patients who are not a confirmed or possible case).

Again if you have an issue about PPE, or any other Work Health and Safety issue about COVID19 contact us at allocation@asmof.org.au