Table 3.

PPE fit by item – Qualitative responses.

PPE	Qualitative Summary
Gloves	Good fit was only true if the correct size was available. Half of the comments related to excessive moisture forming within the gloves resulting from poor fit and leading to sores, dryness or cracked skin.
Aprons	Two thirds of qualitative responses were concerned with how easily the aprons tore. Further issues pertained to aprons slipping to the side when moving patients and not providing protection at the rear when seated, for example, when visiting a patient in a residential setting. Examples of references to aprons included the following: “huge and flappy”; “Aprons don't feel like they protect our scrubs at all”; and, “I don't feel the aprons add anything.”
Fluid Resistant Surgical Gowns	Some healthcare workers found themselves having to adapt gowns by cutting thumb holes in sleeves that were too long, wrapping the gown around themselves as they were too large, or shortening “to prevent trips.” Participants also shared that they were not fully protected as their backs were exposed.
Surgical Masks	Masks were described as awkward to anchor, slipping easily and regularly, and ill-fitting particularly across the bridge of the nose. One woman captured this succinctly: “Had to tape it down to the bridge of my nose to avoid constant slipping and digging on the glasses/goggles.” Several commented that masks “gape at the side” whilst another indicated that masks were “itchy after a while with soreness around ears and facial rashes.” One concern was the spreading of more “germs” to the face “as the mask was loose”, which were then “fiddled with more frequently” and “necessitating hand-to-face movement.” The elastic was highlighted by several as the cause of the problem with one person advising that the “original tie masks fit just right and stayed secure, however elasticated masks snap easily and the bands are too loose.” The combination of masks and eye protection led to the eye protection fogging up for some. A further respondent stated that, “some staff keep taking the masks off due to irritation or feeling hot.” Indications were that on occasion, sizing depends on the quality or brand of the masks provided. Headaches and sweating were other reported side effects of mask usage.
FFP2/3 (Filtering Face Piece)	Fit was very dependent upon mask type/brand. One woman noted that she had, “Failed multiple fit tests for different masks before the current supply arrived. So did about 50% of my female colleagues.” Another stated that she, “Had to be re-fit tested for FFP3 after passing fit test as steaming up glasses. Now have mask that fits but leaves rub marks on face.” A third was told by her fitter that she would need to “gain a stone in weight” to help her mask fit. Feedback from a respondent who had mask-fitting responsibilities showed concern at the multiple tests that were often required to ensure a ‘fit’, stating, “if staff members can't get a pass on a mask very easily then we shouldn't be trying over and over again as in clinical practice they would probably spend less time putting the FFP3 mask than when mask fit tested.” She went on to state, “The mask fitters within our Trust have massive concerns about other Trusts that are using qualitative testing methodology to mask fit as it is subjective and relies on staff to be truthful when they are putting a lot of pressure on themselves. It also relies on [sense of] taste which has been proven as a side effect of COVID,” and as such, without a negative COVID-19 test, this aspect of the fit test cannot be relied upon.
Respirators	Issues were reported regarding incidence of “pressure sores” and “friction burns” with irritation beneath the eyes where the face is smaller.
Visor/Face Shield	Visors were found to fog up, and one woman “wished the visors weren't so large.”
Goggles/Glasses	Responses focused on problems with misting up or falling off, especially when the head was lowered to look down. Some struggled due to requiring reading glasses to be worn beneath the goggles, with another indicating face protection was “uncomfortable behind my ears” due to simultaneously wearing glasses, goggles and mask. It wasn't clear to some whether this PPE was disposable, so they relied on other staff members cleaning them thoroughly.
Surgical Scrubs	Respondents advised that good fit depended on availability of sizing.