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Disposable Coverall:Why can't protective clothing be comfortable

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Disposable Coverall:Why can't protective clothing be comfortable


Since the outbreak of the epidemic, the wide medical protective clothing has replaced the white coat as the identity mark of medical staff. After working for a long time, they were tired and sweating in protective clothing.

A front-line nurse once told the media that there are nine steps in the process of wearing protective equipment before entering the isolation area. The whole process takes nearly 30 minutes. Layers of protection are airtight, and unloading is more cumbersome. At this point, it is very likely that COVID-19 has been attached to the protective equipment. Nurses with infectious diseases will compare the protective clothing to the "bomb disposal", and "go through four doors" and "wash hands more than ten times" before returning to the clean area.

The strict wearing and taking off steps ensure the effectiveness of protective clothing, but the insufficient size has brought a lot of inconvenience to the front-line medical staff.

For many female medical staff, protective clothing is often too fat, and some crotch even hangs to the knee, which is sloppy and hinders their movement. Some protective clothing has no waist retraction design. Nurses in the outpatient support center of Wuhan Pulmonary Hospital often use rope as a belt for convenient movement. Each gap of protective clothing needs to be pasted with sealing tape to isolate contact with the outside world. Too large size increases the gap between human body and protective clothing. Many female medical staff should use more adhesive tapes to ensure the tightness of protective clothing. After working for a long time, the wrists are scratched by the rubber strip, and the rash will appear due to poor air permeability.

There are still solutions for too large protective clothing, and too small protective clothing can't be used at all. Wang Haipeng, the chief physician of the Department of Cardiology of the Third Hospital of Hangzhou, who rushed to the Guanggu District of Wuhan Tongji Hospital, was 185cm tall and weighed 86kg. When he first arrived in Wuhan, there was a shortage of materials, and the largest type of protective clothing could not cover his head. After multi-party coordination, he finally found a 185 size protective clothing, which is still not fit, "the crotch is still hanging". Because the protective clothing is too small, Wang Haipeng can only stand and work continuously after entering the infected area. When he is tired, he leans against the wall for a short rest. "As soon as I sit down, my protective clothing may be broken.".

After the SARS epidemic in 2003, China formulated the technical requirements for medical disposable protective clothing (hereinafter referred to as the "technical requirements") for the first time. The current standard is the revised version in 2009. In the normative references of the two editions of standards, there is no indication of the Chinese adult body size standard. Zhaochaoyi, director of the Ergonomics Laboratory of the China Institute of standardization, which is responsible for measuring the human body size of Chinese adults, said: "if the protective clothing can be designed in strict accordance with our standards, and a certain amount of surplus is left, the fitness will be improved."

The formulation of the two editions of standards is six years apart, but there is no change in the requirements for the model and specification of protective clothing. The smallest model of protective clothing is 165 cm long and the largest model is 188 cm long. All models have no difference in the size of cuffs and trouser legs. According to the report on nutrition and chronic diseases of Chinese residents (2015), the average height of Chinese adult women is 155.8 cm, nearly 10 cm shorter than the smallest model.

"The design of protective clothing is different from ordinary clothing. In order to adapt one size to more people, it will be designed more loosely." Zhao Chaoyi pointed out. But loose can't solve the problem caused by the difference between the two sexes.

The design of protective clothing is based on the male figure, and women can only wear small size at work. "The proportion of women's chest circumference, waist circumference, leg length and arm length is very different from that of men. The protective clothing simply reduced according to the proportion of men's body must not fit." Zhao Chaoyi pointed out. In practice, women account for 60% of the front-line medical staff and more than 90% of the nurses. They are the main users of protective clothing in the epidemic.

In addition to the lack of fit in design, the comfort of medical disposable protective clothing fabrics is also lacking. The design of disposable medical protective clothing considers short-term use, and the wearing time will not exceed two hours. The protection is the number one standard for performance evaluation, and the comfort is not taken into account. However, during the epidemic, there is a shortage of protective clothing, and medical staff often need to wear protective clothing to work continuously for more than 6 hours, so comfort becomes very important.

A large amount of water volatilizes from the surface of the human body every day, most of which is discharged in the form of sweat. Most of the clothes we wear are sweat wicking, comfortable and breathable. In order to enhance the protective force of medical protective clothing, the fabric is usually laminated or coated, which is thick and has poor air permeability and moisture permeability. China's "technical requirements for medical disposable protective clothing" stipulates that the moisture permeability of protective clothing is far lower than the standard of human comfort.

In that case, why not choose reusable protective clothing? This is because its technology is not mature enough. It needs washing and disinfection after each use. After high-temperature sterilization, it is difficult to ensure the stability of the fabric. Disposable medical protective clothing has the advantages of simple manufacturing process and low cost. It can be discarded after use, which can effectively avoid cross infection and the decline of protective force caused by repeated use. Therefore, medical disposable protective clothing is the most widely used all over the world.

In addition to its own technical defects, at present, China only has technical standards for disposable medical protective clothing, and reusable protective clothing lacks national standards, so it is impossible to control and evaluate the quality. Therefore, although there are companies in the market that can produce protective clothing materials that can be used for many times and repeatedly, it is still far from large-scale production.

Finding new protective materials may find a balance between the protection and comfort of medical protective clothing. Wang Huaping, a researcher at the Research Institute of Donghua University, proposed that the clothes worn by athletes have high water permeability. If the same materials and structures are applied to protective clothing, the comfort will be greatly improved.

With the development of textile based flexible sensor technology, the intellectualization of medical protective clothing has become possible. The sensor is embedded in textile materials and can monitor human physiological indexes such as respiration, pulse, heart rate and body temperature. Uploading the monitored human body data can master the physical condition of medical staff in real time, so as to effectively avoid the risk of health damage and even sudden death of medical staff due to overwork.

However, the cost of new technologies is very high, and it is difficult to really serve daily life at present.

The wearing experience reveals other defects in the design of protective clothing. Medical protective clothing has no pockets. During work, medical staff cannot carry common tools such as pens, flashlights, tape and mobile phones. They need to go back and forth to the nurse desk many times to increase the workload. In order to solve the storage problem, many members of medical institutions and Wuhan medical team have made satchels and waist bags by themselves.

"The purpose of design is people, not products." This is the idea put forward by Bauhaus University in Weimar, Germany, the origin of industrial design. It is obvious that the design of personal protective clothing is not convenient and can not be improved.



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