{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T00:21:50Z","timestamp":1777681310952,"version":"3.51.4"},"reference-count":33,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2019,6,1]],"date-time":"2019-06-01T00:00:00Z","timestamp":1559347200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Health Security"],"published-print":{"date-parts":[[2019,6,1]]},"abstract":"<jats:p>In response to the 2014 Ebola outbreak in West Africa and resulting cases in the United States, the Occupational Safety and Health Administration developed a personal protective equipment selection matrix to help employers protect workers from exposure to Ebola virus in the event of additional US cases. Now, the world's second largest Ebola outbreak on record continues to expand in the Democratic Republic of Congo, where more than 70 Ebola-infected healthcare workers serve as reminders of the importance of robust infection prevention measures in keeping infectious disease responders from becoming victims themselves. Toward facilitating preparedness for cases associated with the ongoing or future outbreaks, this article discusses the matrix of personal protective equipment recommendations. The matrix applies to a variety of job tasks in health care, laboratories, waste handling, janitorial services, travel and transportation, and other sectors where workers may be exposed to the Ebola virus during outbreak events. A discussion of the information sources and decision-making process for developing the matrix forms the basis of the recommendations. The article then emphasizes challenges and considerations for formulating the matrix, including identifying information sources to help characterize occupational exposures, aligning recommendations among stakeholders with varying viewpoints, and balancing worker protections with feasibility concerns. These considerations highlight issues that remain relevant for preparedness efforts ahead of future US cases of Ebola or other emerging infectious diseases.<\/jats:p>","DOI":"10.1089\/hs.2019.0014","type":"journal-article","created":{"date-parts":[[2019,6,7]],"date-time":"2019-06-07T14:36:22Z","timestamp":1559918182000},"page":"213-228","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Developing a Personal Protective Equipment Selection Matrix for Preventing Occupational Exposure to Ebola Virus"],"prefix":"10.1177","volume":"17","author":[{"given":"Christopher K.","family":"Brown","sequence":"first","affiliation":[{"name":"Christopher K. Brown, PhD, MPH, CPH, is Senior Health Scientist, and Denise L. Matthews, MSPH, is Director, both in the Office of Emergency Management and Preparedness; Richard J. Thomas, MD, MPH, is Deputy Director, Office of Occupational Medicine and Nursing; and Amanda L. Edens, MSPH, is Director; all in the Directorate of Technical Support and Emergency Management, Occupational Safety and Health Administration, US Department of Labor, Washington, DC."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Denise L.","family":"Matthews","sequence":"additional","affiliation":[{"name":"Christopher K. Brown, PhD, MPH, CPH, is Senior Health Scientist, and Denise L. Matthews, MSPH, is Director, both in the Office of Emergency Management and Preparedness; Richard J. Thomas, MD, MPH, is Deputy Director, Office of Occupational Medicine and Nursing; and Amanda L. Edens, MSPH, is Director; all in the Directorate of Technical Support and Emergency Management, Occupational Safety and Health Administration, US Department of Labor, Washington, DC."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard J.","family":"Thomas","sequence":"additional","affiliation":[{"name":"Christopher K. Brown, PhD, MPH, CPH, is Senior Health Scientist, and Denise L. Matthews, MSPH, is Director, both in the Office of Emergency Management and Preparedness; Richard J. Thomas, MD, MPH, is Deputy Director, Office of Occupational Medicine and Nursing; and Amanda L. Edens, MSPH, is Director; all in the Directorate of Technical Support and Emergency Management, Occupational Safety and Health Administration, US Department of Labor, Washington, DC."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amanda L.","family":"Edens","sequence":"additional","affiliation":[{"name":"Christopher K. Brown, PhD, MPH, CPH, is Senior Health Scientist, and Denise L. Matthews, MSPH, is Director, both in the Office of Emergency Management and Preparedness; Richard J. Thomas, MD, MPH, is Deputy Director, Office of Occupational Medicine and Nursing; and Amanda L. Edens, MSPH, is Director; all in the Directorate of Technical Support and Emergency Management, Occupational Safety and Health Administration, US Department of Labor, Washington, DC."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2019,6,14]]},"reference":[{"key":"e_1_3_2_2_2","unstructured":"World Health Organization. Ebola Virus Disease: Democratic Republic of the Congo. External Situation Report 32. March 12 2019. https:\/\/apps.who.int\/iris\/bitstream\/handle\/10665\/311242\/SITREP_EVD_DRC_20190310-eng.pdf?ua=1. Accessed March14 2019."},{"key":"e_1_3_2_3_2","unstructured":"Occupational Safety and Health Administration. PPE selection matrix for occupational exposure to Ebola virus. OSHA-3761. November 24 2014. https:\/\/www.osha.gov\/Publications\/OSHA3761.pdf. Accessed January16 2019."},{"key":"e_1_3_2_4_2","unstructured":"Occupational Safety and Health Administration. Disaster cleanup and recovery PPE matrix. OSHA-3898. October 2016. https:\/\/www.osha.gov\/Publications\/OSHA3898.pdf. Accessed January16 2019."},{"key":"e_1_3_2_5_2","unstructured":"Occupational Safety and Health Administration. OSHA\/NIOSH Interim Guidance (April 2005). Chemical - Biological - Radiological - Nuclear (CBRN) Personal Protective Equipment Selection Matrix for Emergency Responders. 2005. https:\/\/www.osha.gov\/SLTC\/emergencypreparedness\/cbrnmatrix\/index.html. Accessed January16 2019."},{"key":"e_1_3_2_6_2","unstructured":"Centers for Disease Control and Prevention. Epidemiologic risk factors to consider when evaluating a person for exposure to Ebola virus. October 27 2014. https:\/\/web.archive.org\/web\/20141028031924\/http:\/\/www.cdc.gov\/vhf\/ebola\/exposure\/risk-factors-when-evaluating-person-for-exposure.html. 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Infection prevention and control recommendations for hospitalized patients under investigation (PUIs) for Ebola virus disease (EVD) in U.S. hospitals. Updated September 3 2015. http:\/\/www.cdc.gov\/vhf\/ebola\/healthcare-us\/hospitals\/infection-control.html. Accessed January16 2019."},{"key":"e_1_3_2_13_2","unstructured":"Centers for Disease Control and Prevention. Interim guidance about Ebola virus infection for airline flight crews cleaning personnel and cargo personnel. Updated August 2 2014. https:\/\/web.archive.org\/web\/20140803034710\/http:\/\/www.cdc.gov\/quarantine\/air\/managing-sick-travelers\/ebola-guidance-airlines.html. Accessed January16 2019."},{"key":"e_1_3_2_14_2","unstructured":"Centers for Disease Control and Prevention. Guidance for collection transport and submission of specimens for Ebola virus testing. Reviewed June 1 2018. http:\/\/www.cdc.gov\/vhf\/ebola\/hcp\/interim-guidance-specimen-collection-submission-patients-suspected-infection-ebola.html. Accessed January16 2019."},{"key":"e_1_3_2_15_2","unstructured":"Centers for Disease Control and Prevention. Identify isolate inform: emergency department evaluation and management for patients under investigation (PUIs) for Ebola virus disease (EVD). Updated December 29 2015. https:\/\/www.cdc.gov\/vhf\/ebola\/healthcare-us\/emergency-services\/emergency-departments.html. Accessed January16 2019."},{"key":"e_1_3_2_16_2","unstructured":"Centers for Disease Control and Prevention. Guidance for safe handling of human remains of Ebola patients in U.S. hospitals and mortuaries. Updated February 11 2015. https:\/\/www.cdc.gov\/vhf\/ebola\/healthcare-us\/hospitals\/handling-human-remains.html. Accessed January16 2019."},{"key":"e_1_3_2_17_2","unstructured":"Centers for Disease Control and Prevention. Guidance on personal protective equipment (PPE) to be used by healthcare workers during management of patients with confirmed Ebola or persons under investigation (PUIs) for Ebola who are clinically unstable or have bleeding vomiting or diarrhea in U.S. hospitals including procedures for donning and doffing PPE. Updated November 17 2015. http:\/\/www.cdc.gov\/vhf\/ebola\/hcp\/procedures-for-ppe.html. Accessed January16 2019."},{"key":"e_1_3_2_18_2","unstructured":"National Institute for Occupational Safety and Health. Considerations for selecting protective clothing used in healthcare for protection against microorganisms in blood and body fluids. January 30 2018. https:\/\/www.cdc.gov\/niosh\/npptl\/topics\/protectiveclothing\/default.html. Accessed January16 2019."},{"key":"e_1_3_2_19_2","doi-asserted-by":"crossref","unstructured":"Respiratory Protection. 29 C.F.R. 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June 1 2018. https:\/\/www.cdc.gov\/vhf\/ebola\/laboratory-personnel\/safe-specimen-management.html. Accessed January16 2019."},{"key":"e_1_3_2_31_2","unstructured":"Centers for Disease Control and Prevention. For U.S. healthcare settings: donning and doffing personal protective equipment (PPE) for evaluating persons under investigation (PUIs) for Ebola who are clinically stable and do not have bleeding vomiting or diarrhea. November 7 2015. https:\/\/www.cdc.gov\/vhf\/ebola\/healthcare-us\/ppe\/guidance-clinically-stable-puis.html. Accessed January16 2019."},{"key":"e_1_3_2_32_2","unstructured":"Centers for Disease Control and Prevention. Interim guidance for Ebola virus cleaning disinfection and waste disposal in commercial passenger aircraft. February 18 2016. https:\/\/www.cdc.gov\/vhf\/ebola\/prevention\/cleaning-commercial-passenger-aircraft.html. 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