Download Infectious disease control: Personal Protective Equipment (PPE) and

NSA Contingency Planning Secretariat
Infectious disease control:
Personal Protective Equipment (PPE) and general preventive measures:
In light of the Ebola outbreak there is a need for objective and practical advice on relevant preventive
and protective measures for crew operating where there may be a risk of infectious diseases,
including in ports in Ebola affected countries. Furthermore, crew that takes part in SAR operations
involving large numbers of refugees at sea (as currently in the Mediterranean) should take certain
precaution in order to avoid becoming infected by various contagious diseases.
At the request of the Norwegian Shipowners’ Association, the Norwegian Institute for Public Health
(FHI) has recommended what a basic personal protective equipment “kit” for infectious disease
control should include. Such products are widely available internationally. This type of products and
measures are used by primary health care representatives in their daily work in many countries.
The main purpose of using the kit is to avoid contamination. It is particularly important to protect
mucous membranes (eyes, mouth, nose) and open wounds. Hand hygiene is the best prevention!
Note that the PPE is only necessary when you:
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risk direct or indirect contact with bodily fluids of a suspected infected person (alive or dead)
handle or assist persons that may be infected by contagious diseases.
handle textiles or waste belonging to a possibly infected person (alive or dead). Make sure
such waste is disposed of properly, see the CDC link below.
clean areas which have been contaminated by bodily fluids of possibly infected persons.
A sensible and appropriate kit should consist of the following:

Anti-bacterial gel/sanitizer – each crew member should carry individual packages, in addition
to dispensers on the ship.

Area disinfectant for surface cleaning– chlorine based products are low price and efficient.

Fluid-resistant, impermeable coat with long sleeves and cuffs. Tychem coveralls should be
used if one gets involved in handling/carrying persons who may be infected.

Gloves (latex or nitrile) – Gloves should be of an internationally required standard: CE
marked with the standard testing EN 455-1, EN 455-2 and EN 455-3. Gloves can be used
underneath work gloves to avoid rifts etc. when handling persons who may be infected.

Respiratory protection: FFP3 mask (equivalent to the N95 US standard), if unavailable FFP2
or surgical face mask. Note that the mask should be properly fitted to the face. Beards and
large moustaches could make proper fitting difficult.

Eye protection: Face shield or goggles.

Hair and shoe protection can also be considered but are not vital.
NSA Contingency Planning Secretariat

Body bags (particularly relevant for SAR operations). The contact with dead bodies should be
limited and the bodies must be isolated and kept in body bags. Note that in terms of the risk
of infection, dead bodies should be treated in the same way an infected patient.
Note the reference to the international standards for medical equipment.
Know how to use the items/ equipment!
It is essential that the crew receives instructions as to how to use the equipment and that the
equipment is used only when necessary. Wearing some of the items over a prolonged period of time,
or putting on / removing the protective gear the wrong way, may result in an increased danger of
contagion. Crew should know how to properly dispose of items that can have been contaminated.
See the CDC website instruction manual.
A lot of equipment and items are now for sale in light of the Ebola outbreak, targeted at ship
operators / crew. Some of it is either too complicated to use for crew members or is without effect.
Medical evacuation or handling Ebola infected persons on board a vessel.
Ships calling Ebola affected areas should review their medical emergency and evacuation procedures.
In a worst case scenario where a crew member or other person onboard a ship is suspected of having
been infected by Ebola, the whole crew is potentially in danger. Rapid evacuation of the affected
crew member /person will then be vital.
FHI points out that the evacuation of Ebola patients can be logistically difficult. Currently the
availability of aircraft that accept transporting Ebola infected patients is extremely limited.
Therefore routines and procedures on how to handle an Ebola outbreak on board should be
reviewed. The relevant World Health Organization (WHO) recommendations for ships can be found
here (scroll down to 3.3 Recommendation for ships)
Your comments and questions are welcome.
With kind regards
Norwegian Shipowners’ Association, Contingency Planning Secretariat
[email protected]
Crisis Management Support +47 90095001
Haakon Svane, Director: Email - [email protected], Mob: +47 901 99 082
Line Falkenberg Ollestad, Consultant: Email - [email protected], Mob: +47 924 41 860