Form 0920-0953 PPE (Personal Protective Equipment) Survey

Form Approved
OMB No. 0920-0953
Exp. Date 07/31/2018

PPE Survey
1.

For what occupations are you involved in PPE selection (check all that apply)?
Firefighter
Emergency medical service
Law enforcement
Health care
Other, please specify

2.

What categories of PPE are you involved in selecting (check all that apply)?
Body protection
Eye and face protection
Foot and leg protection
Hand and arm protection
Head protection
Hearing protection
Respiratory protection
Other, please specify

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 they are encountered at about the same frequency.
Most common

Second most
common

Third most
common

Rarely

Never

Falls
Sprain/strain
Falling object
Noise
Gunshot
Stab
Thermal
Electrical
Chemical-fire smoke & gas
Chemical-other
Biological
Radiation
Other

4.

On average, about how frequently do you need to go through the process of selecting PPE?
More often than weekly
Weekly
Monthly
Every few months
Annually
Less often than annually

5. What types of information do you look for when selecting PPE, and what resources do you use to obtain this information? The matrix below lists different

types of information in the rows and different sources of information in the columns. Check all applicable cells in the matrix and explain any responses of
"other" in the spaces provided below.

PPE Selection Information Matrix

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

Definitions of key terms used in the above PPE Information Selection Matrix
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 with 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 with 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 Selection Information Matrix, which are the most important and why?

7.

Of the rows in the PPE Selection Information Matrix, which are the most difficult to obtain?

8.

Of the columns in the PPE Selection Information 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? 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.

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).