Confusion remains over protection from airborne infections in healthcare settings

A leading workplace protection body has issued new guidance to keep health workers and patients safe from airborne infections including Sars-Cov-2, the virus that causes Covid-19, in light of continued “compromises and confusion” over disease control.

The British Occupational Hygiene Society (BOHS) has published technical guidance for healthcare employers to make correct decisions on appropriate personal protective equipment (PPE) to guard against airborne risks.

“The compromises and confusion arising from the pandemic period have left many employers uncertain about the scientific and legal necessity to use the right PPE to protect healthcare workers,” says BOHS president Adrian Parris.

“Some unfortunate messages about the poor management of PPE have made the situation worse. This guidance, which has had the input of leading experts from healthcare bodies, manufacturers, safety professionals and experts in the Health and Safety Executive, aims to clarify things,” says Parris.

BOHS says there is “a legal obligation on employers to prevent healthcare workers themselves from getting infections” but in practice neither staff nor the patients they care for are being properly protected against airborne risks.

Healthcare settings in the UK still lack a systematic protection system for workers against the risk of airborne infections.

The Society has not singled out any particular institutions but says it is concerned that “an inference is circulating” in senior infection prevention and control practice which incorrectly suggests that standard surgical masks offer to the wearer the same protection as respirators such as FFP3, FFP2 and N95 face masks.

Since the onset of the Covid pandemic, the UK’s approach to infection prevention and control has “continued to be a problematic one, with a focus on controlling contact and so-called droplet-spread infections, but without any national system for tracking hospital-acquired airborne infections for healthcare workers or patients”.

According to the technical guidance issued by BOHS, the advent of the Covid pandemic was the first time apparatus designed to protect healthcare workers themselves against inhalation of pathogens was deployed.

Respirators are a type of PPE designed to reduce or eliminate the risk of inhalation of infected particles, as opposed to the commonly used blue surgical masks that prevent fluid droplets from passing to patients but which do not prevent the passage of airborne infection.

Confusion has developed between the use of the respirators and the surgical masks.

“Covid-19 should have been a wake-up call that we are not properly equipped to protect our healthcare infrastructure from airborne infections,” says Parris.

“We are concerned that uncertainties about management practicalities may be preventing healthcare employers from taking the legally required steps to keep their workforce at work and healthy,” he says.

BOHS states that while vaccination is important it is not totally effective.

“While vaccination can work for many people to lessen the effects of infections such as Covid-19, it does not protect everyone and it does not protect completely. Nor does it prevent healthcare workers from carrying infections to vulnerable patients. The impact on other workers when people have to take time off is to be counted in mental health and fatigue,” says Professor Raymond Agius, a leading expert in occupational medicine and former BOHS president.

Employee absences because of airborne disease cost the NHS over £1bn last year.

“We can’t afford ignorance of the requirement to use proper Respiratory Protective Equipment to make those matters worse,” says BOHS CEO Professor Kevin Bampton.

A journal article published in July found that wearing an FFP2 or FFP3 respirator and local ventilation were the most effective interventions for preventing the spread of Covid-19.

British Occupational Hygiene Society: “Healthcare Workers Still Exposed. Experts demand action to keep healthcare workers and patients safe.”

Journal Article: Mark Paul Carlo Cherrie, Miranda Loh, John William Cherrie, The relative effectiveness of personal protective equipment and environmental controls in protecting healthcare workers from Covid-19, Annals of Work Exposures and Health, Volume 69, Issue 7, August 2025, Pages 777–788, https://doi.org/10.1093/annweh/wxaf040

Please support The Fitzrovia News. Consider helping us cover our costs by visiting our secure payment page.