Why Proper-fitting PPE Matters

Personal protective equipment (PPE) is one of the signatures of employees hard at work. From the orange vest and hard hats of construction sites to the masks and blue gloves of an operating room, PPE items are often ingrained in the images of specific professions. PPE stands as the most direct form of protection for employees have against hazards, protecting skin from contacting harsh chemicals or employees’ sinuses from noxious aerosols and dusts. It’s the last layer of defense and key to overall employee safety.

Yet despite its ubiquity and the protection it provides, PPE also has a usage problem; many employees simply aren’t wearing their PPE while working.¹ Employees may have many reasons for not using their PPE, but employers should be cognizant of their employees who want to wear PPE but can’t. Ill-fitting PPE, whether it be too big, too small, or simply unsuitable for an employee’s body, can do more harm than good. PPE that doesn’t fit can give employees a sense of security while leaving them open to hazards. One-size-fits-all often doesn’t fit the bill for the modern workforce. A strong occupational health partner like Concentra^® can work with employers to build comprehensive safety plans and strong enforcement policies that not only encourage PPE usage but make sure that all employees have PPE that protects them.

PPE and employee protection

Both the National Institute for Occupational Safety and Health (NIOSH) and Occupational Safety and Health Administration (OSHA) recommend the hierarchy of controls for identifying and protecting employees from hazards.² The five-level control pyramid establishes methods, from most effective to least effective, of protecting employees from hazards. In descending order from most to least effective, the hierarchy recommends:

• Elimination: physically removing the hazard
• Substitution: replacing the hazard
• Engineering control: isolating employees from the hazard
• Administrative controls: changing the way employees work to avoid the hazard
• PPE: protecting employees with personal protective equipment

Although PPE falls at the bottom of the pyramid, this doesn’t make it any less important. Higher-level controls are not always feasible or possible for certain hazards. For example, a road demolition company can use administrative controls, like 15-minute shifts, to make sure employees don’t spend too much time with jackhammers. However, employees will still need to use them. PPE, in the form of hearing protection, is the only thing that can protect employees from the loud machines. In many cases, PPE is best used combined with other control measures.

PPE noncompliance

Employees failing to wear PPE is not a new phenomenon. In a 2010 survey conducted at the American Society of Safety Engineers (ASSE) conference, 98 percent of respondents reported having seen their employees working without their required PPE.³ A further 30 percent of those surveyed said that they often saw their employees leaving PPE by the wayside. Top reasons that employees give for not wearing PPE include that they no longer need equipment after mastering their job’s duties and looking silly or ridiculous in protective wear.⁴ The most common reason for noncompliance is fit: PPE that is uncomfortable, too hot, too tight, or the wrong size.

Not one-size-fits-all

In the summer of 2023, the U.S. Department of Labor proposed a rule change to refine its PPE standard. The proposed change would clarify that PPE must fit each employee properly to protect them from occupational hazards.⁵ The rule change reflects a long-held problem in certain industries, particularly construction and other labor-intensive trades, of PPE only being offered in “standard fit” or “one-size-fits-all” proportions.

Many pieces of PPE, including gloves, hardhats, glasses, and harnesses, are made for the average male body. A typical job site, however, usually contains people that are both smaller and larger than the average male. A 2024 survey of women in construction found that two-thirds of respondents lacked access to gender-appropriate personal protective equipment and many women are forced to wear PPE that is too big on them.⁶ This oversized equipment contains gaps, bulges and a poor overall fit that make it uncomfortable, reduce its effectiveness, and increase the risk for suffering a workplace injury. Beyond gender differences, the one-size-fits-all paradigm impacts small-statured men, larger men, and those who don’t fit tradition gender roles. Although men make up the majority of blue-collar jobs, women are becoming an increasing share of the workforce. From 2011 to 2022, the percentage of women in the construction workforce increased from 9% to 11% and the percentage of blue-collar women workers in the industry rose from 2% to 4%.⁷ “Standard fit” may no longer be so standard.

The impact of ill-fitting PPE

PPE that is too large or too small isn’t just uncomfortable. It can be a safety hazard and productivity drain. Serious issues can arise when PPE interferes with job duties, including the following:

• Gloves. Gloves that are too large and extend past an employee’s fingertips can get caught in machinery or pinched between objects.⁸ When they are too big around the wrist, sawdust or metal shavings can get inside a glove. When gloves are too tight, they reduce hand dexterity and the ability to properly grasp objects. Employees may choose to forgo their gloves, losing valuable hand protection.
• Glasses and goggles. Safety glasses are intended to fit tight on the face, leaving little space for debris. If glasses are too big, there may be gaps for flying projectiles to impact the eye.
• Goggles that are too loose can’t seal properly and don’t protect the wearer from chemicals or airborne hazards.⁹
• Hard hats. Most hard hats allow for adjustments, but some women may find that their heads are too small, even on the tightest setting. When this happens, hard hats can obstruct views and easily fall off. Employees with large heads may exceed the limit of the hat suspension, eliminating the cushioning of the hard hat and increasing the likelihood of injury if a head strike occurs.¹⁰
• Respirators. Respirators cannot fulfill their purpose if they are not individually assessed for the employee wearing them and should never be shared. Respirator fit tests, whether qualitative of quantitative, must be performed to properly protect employees. An experienced occupational health provider should offer both testing techniques to match employer needs.¹¹ 

Employers can work to make sure that PPE properly fits every employee, including training on how to use it. 

The rule change proposed by the U.S. Department of Labor has not yet been finalized, but employers can prepare for the new guidelines now to ensure they are compliant. To learn more about how Concentra’s occupational health experts can support your organization’s efforts to protect employees with proper-fitting PPE use, keep your employees safe and healthy, and address employee injuries should they occur, contact us today.

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NOTES:

1. “Workers Are Risking Injury By Not Wearing Safety Equipment,” by Sandy Smith. EHS Today, August 17, 2010.
2. “Identifying Hazard Control Options: The Hierarchy of Controls,” OSHA, n.d.
3. “Workers Are Risking Injury By Not Wearing Safety Equipment,” by Sandy Smith. EHS Today, August 17, 2010.
4. “Why Your Workers Aren't Wearing Their PPE,” by Grainger Editorial Staff. Grainger, July 1, 2019.
5. “Department of Labor announces proposed rule to clarify personal protective equipment standard, ensure safety of construction industry workers,” by Mandy McClure. U.S. Department of Labor, July 19, 2023.
6. “Women in construction still lack PPE that fits, survey shows,” Safety + Health, May 18, 2024.
7. “Construction Personal Protective Equipment for All Genders and Sizes,” Center for Construction Research and Training, n.d.
8. “Ill-Fitting PPE Hurts Women and Construction,” by Janet Lubman Rathner. “ Laborers’ Health & Safety Fund of North America, n.d.
9. “Find the Right PPE Fit for Your Workers,” EMC Insurance, May 1, 2018.
10. “The Right Stuff: The Importance of Properly Fitting PPE,” by Tom O’Connor. Electrical Contractor Magazine, January 15, 2019.
11. “Respirator Exams,” Concentra, n.d.