WHO 2019 NCoV PPE Specifications 2020.1 Eng
WHO 2019 NCoV PPE Specifications 2020.1 Eng
WHO 2019 NCoV PPE Specifications 2020.1 Eng
© World Health Organization 2020. Some rights reserved. This work is available under the CC BY-NC-SA 3.0 IGO licence.
Contents
Acknowledgements. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . iv
Abbreviations. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . v
1. Methodology. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
References. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
Annex 1. Tables of standards and values: respirators; medical face masks; isolation and surgical
gowns; medical examination gloves (non-sterile); surgical gloves (sterile) (not exhaustive). . . . . . . . . 9
Contents iii
Acknowledgements
We are grateful to World Health Organization (WHO) consultants Ying Ling Lin and Erol Ozbakir, for drafting the
technical specifications and the standards and checklists.
Input is acknowledged from the following members of the Technical Advisory Group of Experts on Personal
Protective Equipment (TAG PPE), specifically group 1 on standards, technical specifications and quality assurance:
Faisal Al Shehri, Razan Asally, Ehab Atia, Patricia Ching, Nagwa Hasanin, Emilio Hornsey, Ayse Ayzit Kilinc, Selcen
Kilinc-Balci, Melissa Leavitt, Claudio Meirovich, John McGhie, Alison Syrett, Nasri Yussuf. All members of TAG PPE
provided Conflict of Interest declarations, which were reviewed by WHO and no conflicts of interest were found.
Revision, technical input and alignment to WHO guidelines and guidance was received from the following WHO
staff (including from the Pan American Health Organization, South-East Asia Region, European Region and Eastern
Mediterranean Region): April Baller, Antoine Delaitre, Murilo Freitas, Bruce Gordon, Tifenn Humbert, Agnes Kijo,
Alexandre Lemgruber, Fernanda Lessa, Ismail Mohamed, Houda Langar, Madison Moon, Adriana Velazquez.
The project was coordinated by Adriana Velazquez, Lead for Medical Devices and In Vitro Diagnostics, Policy,
Norms and Standards, Medicines and Health Products, World Health Organization, Geneva, Switzerland.
Special thanks to copyeditor Vivien Stone (Etchingham, United Kingdom of Great Britain and Northern Ireland).
Abbreviations v
1. Methodology
Each personal protective equipment (PPE) item listed is considered a priority medical device for COVID-19
(1). The technical specifications define the minimum requirements for the product to ensure good quality,
safety and efficacy. The methods used to develop the following technical specifications involved review of the
infection prevention and control (IPC) COVID-19 guidelines, review of PPE products available in the market, and
PPE products approved by stringent regulatory agencies, and analysis of international, regional and country
standards on PPE. The four COVID-19 guidelines analysed were: Rational use of personal protective equipment
for coronavirus disease (COVID-19) and considerations during severe shortage (2), Advice on the use of masks in
the context of COVID-19 – in the community, during home care, and in health care settings (3), COVID-19 advice
for the public: when and how to use masks (4), Analysis of the PPE required to perform the clinical management
of COVID-19 patients (5), and the Disease commodity package for novel coronavirus (6).
The specifications were reviewed by members of the Technical Advisory Group of experts on Personal Protective
Equipment (TAG PPE), who also provided technical input; and by WHO staff and consultants from WHO regional
offices. All experts and consultants provided Conflict of Interest declarations and no conflicts were found.
1. Methodology 1
2. Context and considerations
The present publication defines the basic technical characteristics of PPE. The decision as to the appropriate
clinical use of each of these devices is reserved to medical staff and according to IPC guidance.
It should be noted that in some economic regions, some PPE is considered a medical device and therefore the
relevant regulations are to be followed. In other regions, some PPE may be considered an industrial protection
garment and not tagged for medical use.
Due to limited manufacturing capacity some products might come from other economic regions or might
have “emergency use authorizations” from regulatory agencies. Therefore, the requirements listed below might
apply only to the COVID-19 period and may be updated; otherwise, they will be valid for up to 2 years following
publication.
Goggles, glasses Good seal with the skin of the face, flexible PVC frame to EN 166
protective easily fit with all face contours with even pressure, enclose ANSI/ISEA Z87.1
eyes and the surrounding areas, accommodate wearers Or alternative equivalent set of standards
with prescription glasses, clear plastic lens with fog- and
scratch-resistant treatments. Adjustable band to secure
firmly so as not to become loose during clinical activity.
Indirect venting to avoid fogging. May be reusable (provided
appropriate arrangements for decontamination are in place)
or disposable.
Face shield Made of clear plastic and providing good visibility to both EN 166 (if reusable)
the wearer and the patient. Adjustable band to attach firmly ANSI/ISEA Z87.1 (if reusable)
around the head and fit snuggly against the forehead, fog Or alternative equivalent set of standards
resistant (preferable). Completely cover the sides and length
of the face. May be reusable (made of robust material which
can be cleaned and disinfected) or disposable.
Fit test kit To evaluate effectiveness of seal for tight fitting respiratory OSHA 29 CFR 1910.134 Appendix A
protection devices.
Particulate respirator Good particle filtration (minimum 94% or 95%), good Fluid resistant respirator:
breathability with design that does not collapse against the • Minimum NIOSH approved (42 CFR Part 84)
mouth (e.g. duckbill, cup-shaped). May be tested for fluid and FDA cleared “surgical N95”
resistance (NIOSH/FDA surgical N95, EN 149 FFP2+Type IIR, • EN 149, minimum “FFP2“ and EN 14683 Type
GB 19083 Grade/Level 1). IIR
• GB 19083, minimum “Grade/Level 1”
• Or alternative equivalent standard
2. WHO. Rational use of personal protective equipment for coronavirus disease (COVID-19) and considerations
during severe shortages: interim guidance. Geneva: World Health Organization; 6 April 2020 (https://www.
who.int/publications/i/item/rational-use-of-personal-protective-equipment-for-coronavirus-disease-(covid-
19)-and-considerations-during-severe-shortages, accessed 30 October 2020).
3. WHO. Advice on the use of masks in the context of COVID-19: interim guidance; 5 June 2020 (https://www.who.
int/publications/i/item/advice-on-the-use-of-masks-in-the-community-during-home-care-and-in-healthcare-
settings-in-the-context-of-the-novel-coronavirus-(2019-ncov)-outbreak, accessed 30 October 2020).
4. WHO. Coronavirus disease (COVID-19) advice for the public: when and how to use masks; 20 October 2020
[website]. Geneva: World Health Organization; 2020 (https://www.who.int/emergencies/diseases/novel-
coronavirus-2019/advice-for-public/when-and-how-to-use-masks, accessed 30 October, 2020).
6. WHO. Disease commodity package for novel coronavirus. Geneva: World Health Organization; 11 January 2020
(https://www.who.int/publications/i/item/disease-commodity-package-for-novel-coronavirus, accessed 30
October 2020).
References 7
Selected further reading
AAMI (2020). AAMI offers free standards and resources to help fight coronavirus. Arlington (VA): Association for
the Advancement of Medical Instrumentation (https://www.aami.org/detail-pages/press-release/aami-offers-
free-standards-and-resources-to-help-fight-coronavirus, accessed 12 August 2020).
ASTM (2020). ASTM standards & COVID-19. West Conshohocken (PA): ASTM International (https://www.astm.org/
COVID-19, accessed 12 August 2020).
BSI (2020). Personal protective equipment: COVID-19 response. London: British Standards Institution (https://
www.bsigroup.com/en-GB/topics/novel-coronavirus-covid-19/medical-devices-ppe/, accessed 12 August 2020).
CDC (2020). Strategies for optimizing the supply of N95 respirators: crisis/alternate strategies. 28 June 2020.
Atlanta (GA): Centers for Disease Control and Prevention (https://www.cdc.gov/coronavirus/2019-ncov/hcp/
respirators-strategy/index.html, accessed 12 August 2020).
EU (2020). Commission recommendation (EU) 2020/403 of 13 March 2020. Luxembourg: Publications Office of
the European Union (https://eur-lex.europa.eu/legal-content/EN/TXT/?uri=CELEX%3A32020H0403, accessed 12
August 2020).
ISO (2020). COVID-19 freely available ISO standards. Geneva: International Organization for Standardization
(https://www.iso.org/covid19, accessed 12 August 2020).
PAHO (2020). Technical and regulatory aspects of the extended use, reuse, and reprocessing of respirators
during shortages, 10 June 2020. Washington (DC): Pan American Health Organization (https://iris.paho.org/
handle/10665.2/52431, accessed 12 August 2020).
Standardization Administration of China (various dates). Beijing, China. Translated Chinese standards: ftp://ftp.
cencenelec.eu/EN/COVID19/ENGTranslationsOfChineseStandards_Q4.1.zip
WHO (2020). Priority Medical Devices for COVID-19 [website]. Geneva: World Health Organization (https://www.
who.int/medical_devices/priority/COVID-19/en/, accessed 17 August 2020).
WHO (2020). Technical Specification for Medical Devices [website]. Geneva: World Health Organization (https://
www.who.int/medical_devices/management_use/mde_tech_spec/en/, accessed 18 May 2020).
Respirators
Europe (EN 149) USA (NIOSH CFR PART 84) China (GB 2626) China (GB 19083)
Filtration (NaCl) ≥ 94% (FFP2) ≥ 95% (N95) ≥ 95% (KN95) ≥ 95% (Grade 1)
Filtration (paraffin oil) ≥ 94% (FFP2) N/A N/A N/A
Breathing resistance ≤ 70 Pa (@ 30 L/min) ≤ 343 Pa (@ 85 L/min) ≤ 350 Pa (@ 85 L/min) ≤ 343 Pa (@ 85 L/min)
(inhalation) ≤ 240 Pa (@ 95 L/min)
≤ 500 Pa (clogging)
Breathing resistance ≤ 300 Pa (@160 L/min) ≤ 245 Pa (@ 85 L/min) ≤ 250 Pa (@ 85 L/min)
(exhalation)
Fit Tested with 10 human Fit testing upon arrival 10 participants, see below Fit factor of 100, with
participants, see below according to OSHA, not 8 subjects
required by NIOSH
Total inward leakage ≤ 8% leakage N/A ≤ 8% leakage
(arithmetic mean) (arithmetic
mean)
CO2 of inhalation air ≤ 1% N/A ≤ 1%
Synthetic blood If type IIR, 120 mmHg If surgical N95, None If surgical N95,
penetration (≥ 29/32 passing masks 120 mmHg 120 mmHg (5 masks)
(≥ 29/32 passing masks)
Annex 1: Tables of standards and values: respirators; medical face masks; isolation and surgical gowns; medical examination gloves (non-sterile);
9
surgical gloves (sterile) (not exhaustive)
Isolation and surgical gowns
Europe (EN 13795) US (AAMI PB70, ASTM F3352, China (YY T/0506)
ASTM F2407)
Water resistance < 4.5 g (AAMI Level 1)
(impact penetration) ≤ 1.0 g (AAMI Level 2, 3)
(AQL 4%, RQL = 20%
Water resistance ≥ 20 cmH2O (critical area, standard ≥ 20 cm (AAMI Level 2) ≥ 20 cmH2O (critical area, standard
(hydrostatic pressure) performance) ≥ 50 cm (AAMI Level 3) performance)
≥ 100 cmH2O (critical area, high (AQL 4%, RQL = 20% ≥ 100 cmH2O (critical area, high
performance) performance)
≥ 10 cmH2O (less critical area, ≥ 10 cmH2O (less critical area,
standard and high performance) standard and high performance)
Viral penetration Pass (AQL 4%, RQL = 20% (AAMI
Level 4)
Resistance to wet ≤ 2.8 IB (critical areas, standard ≤ 2.8 IB (critical areas, standard
bacterial penetration performance) performance)
≤ 6.0 IB (critical areas, high ≤ 6.0 IB (critical areas, high
performance) performance)
Resistance to dry ≤ 300 CFU (less critical areas, ≤ 300 CFU (less critical areas,
microbial penetration standard and high performance) standard and high performance)
Cleanliness microbial ≤ 300 CFU (all areas, standard and ≤ 300 CFU (all areas, standard and
high performance) high performance)
Bursting strength (dry) ≥ 40 kPa (all areas, standard and ≥ 40 kPa (all areas, standard and
high performance) high performance)
Bursting strength ≥ 40 kPa (critical areas, standard ≥ 40 kPa (critical areas, standard
(wet) and high performance) and high performance)
Tensile strength (dry) ≥ 20 N (all areas, standard and ≥ 30 N ≥ 20 N (all areas, standard and
high performance) high performance)
Tensile strength (wet) ≥ 20 N (critical areas, standard and ≥ 20 N (critical areas, standard and
high performance) high performance)
Other criteria to Optional: China (GB 38462) gown standard,
consider • water vapour transmission rate in effect October 2020
(ASTM D6701)
• evaporative resistance (ASTM
F1868, Part B)
Annex 1: Tables of standards and values: respirators; medical face masks; isolation and surgical gowns; medical examination gloves (non-sterile);
11
surgical gloves (sterile) (not exhaustive)
12
Annex 2.
Checklists: respirators; medical face masks; isolation and surgical gowns;
medical examination gloves (non-sterile); surgical gloves (sterile)
Technical compliance to relevant performance standards for respirators (face filtering)
Supplier:. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Manufacturer:. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Model:. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Standard test title Reference standard Minimum acceptable Compliant Claimed performance (class, Year/version of standard Reference document (pdf)
Annex 2: Checklists: respirators; medical face masks; isolation and surgical gowns; medical examination gloves (non-sterile); surgical gloves (sterile)
13
14
Standard test title Reference standard Minimum acceptable Compliant Claimed performance (class, Year/version of standard Reference document (pdf)
performance level Yes No type or measured)
Flammability 16 CFR Part 1610 Class 1
EN 149, Clause 7.11 < 5 seconds
GB 19083, 4.10 < 5 seconds
Compatibility with skin EN 149, Clause 7.10 —
GB 19083, 4.11 Max. score of 1
Shelf life 5 years
Comfort characteristics
Breathing resistance EN 149, Clause 7.16 Max. 0.7 mbar (FFP2)
(inhalation) @ 30 L/min 70 Pa
Max. 1.0 mbar (FFP3)
100 Pa
Breathing resistance EN 149, Clause 7.16 Max 2.4 mbar (FFP2)
(inhalation) @ 95 L/min 240 Pa
Max 3.0 mbar (FFP3)
Annex 2: Checklists: respirators; medical face masks; isolation and surgical gowns; medical examination gloves (non-sterile); surgical gloves (sterile)
15
16
Technical compliance to relevant performance standards for medical face mask
Supplier:. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Manufacturer:. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Model:. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Standard test title Reference standard Minimum acceptable Compliant Claimed performance (class, Year/version of standard Reference document (pdf)
performance level Yes No type or measured)
Test report origin
ILAC accredited lab ISO 17025 Compliant
National notifying body ISO 17025 Compliant
Local, non-accredited ISO 17025 Compliant
Whole mask performance
Annex 2: Checklists: respirators; medical face masks; isolation and surgical gowns; medical examination gloves (non-sterile); surgical gloves (sterile)
17
18
Standard test title Reference standard Minimum acceptable Compliant Claimed performance (class, Year/version of standard Reference document (pdf)
performance level Yes No type or measured)
Regulatory clearance
EU PPE Regulation 2016/425 Valid, issued < 5 years
EN MD Directive 93/42/EEC Valid, issued < 5 years
US FDA 510(k) Valid, issued < 5 years
NMPA, export clearance Valid, issued < 5 years
NMPA, internal use Valid, issued < 5 years
Manufacturer:. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Model:. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Standard test title Reference standard Minimum acceptable Compliant Claimed performance (class, Year/version of standard Reference document (pdf)
performance level Yes No type or measured)
Test report origin
ILAC accredited lab ISO 17025 Compliant
National notifying body ISO 17025 Compliant
Local, non-accredited ISO 17025 Compliant
Whole gown performance, surgical
Liquid barrier performance AAMI PB70 Level 1
Liquid barrier performance AAMI PB70 Level 2
Liquid barrier performance AAMI PB70 Level 3
Liquid barrier performance AAMI PB70 Level 4
Surgical clothing and drapes EN 13795 Standard performance
Surgical clothing and drapes EN 13795 High performance
Protective clothing against EN 13034 Compliant Hydrostatic head pressure:
liquid chemicals cmH2O
Surgical gowns YY/T 0506 Compliant
Sterilization of medical EN 556 Compliant (sterile)
devices
Whole gown performance, isolation
Isolation gowns ASTM F3352 Compliant
Protective clothing against EN 13034 Compliant
liquid chemicals
Annex 2: Checklists: respirators; medical face masks; isolation and surgical gowns; medical examination gloves (non-sterile); surgical gloves (sterile)
19
20
Standard test title Reference standard Minimum acceptable Compliant Claimed performance (class, Year/version of standard Reference document (pdf)
performance level Yes No type or measured)
Material performance
Water resistance (impact AATCC 42 < 4.5 g (AAMI Level 1) AQL
penetration) 4%, RQL = 20%
≤ 1.0 g (AAMI Level 2) AQL
4%, RQL = 20%
Water resistance (hydrostatic AATCC 127 ≥ 20 cm (AAMI Level 2) AQL
pressure) 4%, RQL = 20%
≥ 20 cm (AAMI Level 3) AQL
4%, RQL = 20%
Viral penetration ASTM F1671 Pass (AQL 4%, RQL = 20%
(AAMI Level 4)
Clothing for protection ISO 16604 Class 5
against contact with blood
and body fluids
Resistance to wet bacterial ISO 22610 ≥ 2.8 IB (critical area,
Annex 2: Checklists: respirators; medical face masks; isolation and surgical gowns; medical examination gloves (non-sterile); surgical gloves (sterile)
21
22
Technical compliance to relevant performance standards for medical examination gloves (non-sterile)
Supplier:. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Manufacturer:. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Model:. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Standard test title Reference standard Minimum acceptable Compliant Claimed performance (class, Year/version of standard Reference document (pdf)
performance level Yes No type or measured)
Test report origin
ILAC accredited lab ISO 17025 Compliant
National notifying body ISO 17025 Compliant
Local, non-accredited ISO 17025 Compliant
Whole glove performance
Annex 2: Checklists: respirators; medical face masks; isolation and surgical gowns; medical examination gloves (non-sterile); surgical gloves (sterile)
23
24
Standard test title Reference standard Minimum acceptable Compliant Claimed performance (class, Year/version of standard Reference document (pdf)
performance level Yes No type or measured)
Powder residue
Powder free ASTM D6319 < 2.0 mg (N = 5)
Powder free EN 455-3 < 2.0 mg
Size
Thickness ASTM D6319 Finger > 0.05 mm AQL <
4.0, S2
Palm > 0.05 mm AQL <
4.0, S2
EN 455 N/A
Length EN 455-2 ≥ 240 mm
(all sizes)
ASTM D6319 ≥ 220 mm AQL < 4.0, S2
(xs, s and 6–7)
ASTM D6319 ≥ 230 mm AQL < 4.0, S2
Annex 2: Checklists: respirators; medical face masks; isolation and surgical gowns; medical examination gloves (non-sterile); surgical gloves (sterile)
25
26
Technical compliance to relevant performance standards for surgical gloves (sterile)
Supplier:. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Standard test title Reference standard Minimum acceptable Compliant Claimed performance (class, Year/version of standard Reference document (pdf)
performance level Yes No type or measured)
Test report origin
ILAC accredited lab ISO 17025 Compliant
National notifying body ISO 17025 Compliant
Local, non-accredited ISO 17025 Compliant
Whole glove performance
Annex 2: Checklists: respirators; medical face masks; isolation and surgical gowns; medical examination gloves (non-sterile); surgical gloves (sterile)
27
28
Standard test title Reference standard Minimum acceptable Compliant Claimed performance (class, Year/version of standard Reference document (pdf)
performance level Yes No type or measured)
Tensile strength (before ASTM D3577 Compliant
ageing) (Type 2)
Ultimate elongation (before Compliant
ageing)
Stress at 500% elongation Compliant
(before ageing)
Tensile strength (after Compliant
ageing)
Ultimate elongation (after Compliant
ageing)
Breaking force (before EN 455-2 Compliant
ageing)
Breaking force (after ageing) Compliant
Powder residue
Annex 2: Checklists: respirators; medical face masks; isolation and surgical gowns; medical examination gloves (non-sterile); surgical gloves (sterile)
29
30
Standard test title Reference standard Minimum acceptable Compliant Claimed performance (class, Year/version of standard Reference document (pdf)
performance level Yes No type or measured)
Regulatory clearance
EU PPE Regulation 2016/425 Valid, issued < 5 years
EN MD Directive 93/42/EEC Valid, issued < 5 years
US FDA 510(k) Valid, issued < 5 years
NMPA, export Valid, issued < 5 years
NMPA, internal Valid, issued < 5 years