On November 8-9, AMWA Leaders Dr. Eliza Chin (Executive Director) and Dr. Saralyn Mark (COVID-19 Lead) participated in a workshop on Equitable Personal Protective Equipment (PPE) Protections Workshop hosted by the Center for Disease Control (CDC) National Institute for Occupational Safety and Health (NIOSH) Personal Protective Technology Program.
This two-day virtual workshop was held to “highlight ongoing activities and discuss prominent issues regarding the equitable PPE protections of all United States workers.”
The workshop highlighted the research, current issues, barriers, advocacy efforts, and knowledge gaps in this area. Facilitated break-out discussions allowed ample opportunity for all stakeholders to share their perspectives.
The key question posed to all stakeholders was, What does equitable PPE protection look like?
Use – Protects from intended hazards and does not create other risks
Acceptability – Designs that are sensitive to social, cultural, comfort, and physiological considerations
Access – Located at the point of use—”when and where it is needed”
Availability – Procurable without undue burden/challenge
Knowledge – Correctly selected, used, and maintained
This workshop highlighted NIOSH’s commitment to a National Strategy for Equitable PPE Protections for all United States workers. In addition, NIOSH recognized the presence of underserved PPE user groups, including “workers who are of an atypical size; members of a gender, racial, ethnic, or linguistic minority group; perform nontraditional worker activities; or are members of subdisciplines that are not the primary focus of the current PPE activities within their larger field.”
This issue of sex differences in PPE fit has been an area of advocacy for AMWA since the beginning of the COVID-19 pandemic. We submitted feedback to the BARDA Mask Innovation Challenge about the importance of considering sex differences in the design of new mask models. Our leaders have also engaged in studies to measure PPE fit. Dr. Mark recently published an opinion piece in The Hill, “Respirator Masks Weren’t Designed to Fit Most People – It’s Time to Change That.” In May, AMWA wrote a letter to NIOSH advocating for better fitting PPE for women. Dr. John Howard, Director of NIOSH responded in a letter addressing AMWA’s concerns and inviting AMWA to the public workshop.
AMWA has also partnered extensively with iGIANT® (impact of Gender/Sex on Innovation and Novel Technologies), an organization founded by Dr. Mark that is committed to gendered innovation and design including for PPE. In April 2021, AMWA co-hosted an iGIANT Retail Design Summit which addressed PPE fit. Dr. Mark states, “We see the world trying to operate with suboptimal designs at the outset of innovation. Products including PPE don’t fit right, drugs aren’t prescribed correctly, devices aren’t able to work as well from one individual to the next. This lack of a gender/sex-specific perspective creates gaps which present both threats and opportunities. The threats include financial liability, inequity in quality and inadequate treatment for diverse populations. The opportunities include more successful innovation, increased market share, and increased customer/employee satisfaction and loyalty. iGIANT® provides a new lens for success, helping corporations and groups to see and address pre-production issues by applying gender/sex-based design thinking.”
Susan Sokowloski, PhD, Founding Director and Associate Professor of the Sports Product Design Graduate Program, at the University of Oregon and an iGIANT Outreach Committee Member, was a 2nd place winner ($15,000) in the recent NIOSH Protective Clothing Challenge and a breakout speaker for the workshop.
During the workshop, AMWA provided feedback regarding:
- The importance of gender considerations in PPE design and fit due to reports from women on inadequate PPE fit
- Gender equity barriers that might dissuade women from providing input on poor PPE fit for fear of repercussions
- The importance of equitable gender representation in leadership to ensure that diverse voices are heard
- The need for streamlined communication of national recommendations down to individual healthcare facilities
NIOSH will be developing a new partnership to bring together all interested stakeholders to continue the work forward. AMWA looks forward to joining the partnership and continuing to engage in efforts to promote more equitable access to PPE that is optimized for the needs of women.
Upcoming challenges include one addressing counterfeit N95 masks and a respirator fit challenge which will be announced in January 2023. Past challenges include the NIOSH Protective Clothing Challenge and the Barda Mask Innovation Challenge.
Join AMWA’s Sex and Gender Health Collaborative to continue discussions about sex differences in PPE fit and how we can optimize protection for women, whether as patients or practitioners. To participate in upcoming discussions about PPE and women, please contact admin@amwa-doc.org.
by Eliza Chin, MD, MPH
