Form 0920-0953 PPE Survey

Form Approved

OMB No. 0920-0953

Exp. Date 07/31/2018

Type of Respondent

1. For what occupations are you involved in PPE selection (check all that apply)?

   1. Firefighter (Structural and Wildland Firefighting)

   2. Emergency medical service

   3. Law enforcement

   4. Health care

   5. Other

2. What categories of PPE are you involved in selecting (check all that apply)?

   1. Body protection

   2. Eye and face protection

   3. Foot and leg protection

   4. Hand and arm protection

   5. Head protection

   6. Hearing protection

   7. Respiratory protection

   8. Other: __________

3. Using the scale below, please indicate how commonly your workers encounter a particular hazard relative to all hazards faced. Multiple hazards can be assigned the same value if are encountered at about the same frequency

   Most common	Second most common	Third most common	Rarely	Never
   1	2	3	4	5

   1. Falls

   2. Sprain/strain

   3. Falling object

   4. Noise

   5. Gunshot

   6. Stab

   7. Thermal

   8. Electrical

   9. Chemical, fire smoke & gas

   10. Chemical, other

   11. Biological

   12. Radiation

   13. Other: __________

Public reporting burden of this collection of information is estimated to average 1 hour per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to CDC/ATSDR Information Collection Review Office, 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; ATTN: PRA (0920-0953).

4. On average, about how frequently do you need to purchase/select PPE?

1. More often than weekly

2. Weekly

3. Monthly

4. Every few months

5. Annually

6. Less often than annually

PPE Selection Process

	Own knowledge	Peers	Trade shows/ conventions	Trade association publications, websites, buyer's guides, etc.	Government agency resources	Academic literature	Distributers	Manufacturers	In-house evaluation	Certification bodies	Other source
Voluntary standards
Laws and regulations
Specific product features
User reviews
Prices
Warranties
Compatibility with existing equipment
Fit and comfort
Durability
Level of conformity assessment
Other information

5. The matrix below lists different types of information in the rows and different sources of information in the columns. Please indicate what types of information you look for when selecting PPE and what resources you use to obtain this information by checking all applicable cells in the matrix. Please explain any responses of "other" in the spaces provided below. Definitions of key terms are provided below.

Other information: ________________________________________________________________________________

Other source: ____________________________________________________________________________________

Definitions:

• Voluntary standard: Standards developed by non-governmental standards developing organizations, such as the American National Standards Institute (ANSI), ASTM International, or the National Fire Protection Association (NFPA).

• Laws and regulations: Legal requirements, including standards, related to PPE design or use. Some voluntary standards have been adopted in laws and regulations.

• Level of conformity assessment: The method used to ensure that a product conforms to a standard. Methods include government certification, third body testing, or supplier declaration.

• Certification body: An organization that conducts conformity assessment and certifies that a product conforms to a standard.

• Government agency resources: Many government agencies, such as NIOSH, the Healthcare Infection Control Practices Advisory Committee, the Food and Drug Administration, the U.S. Fire Administration, and the National Institute of Justice, to name a few, provide standards, information, and guidance to assist with PPE selection.

6. Of the rows in the PPE selections process matrix, which are the most important and why?

7. Of the rows in the PPE selections process matrix, which are the most difficult to obtain?

8. Of the columns in the PPE selections process matrix which are the most important and why?-

9. If there are specific resources that you find particularly useful (e.g., websites, publications, conventions), please list them here: __________

10. What resources that are not currently available would you like to have to improve your PPE selection process?

11. Does your agency require you to purchase PPE according to standards

    1. If yes, what are your most frequently cited standards.

12. Please provide us with any additional information about the strategy you use or the challenges you face when selecting/purchasing PPE.