Medicine

PPE in NYC

As the COVID19 pandemic continues, there has been much discussion surrounding personal protective equipment, or PPE.  Hospitals have struggled to get sufficient supplies of protective equipment for the healthcare professionals who are working tirelessly keep the public safe.  How would this be relevant to the Municipal Archives? Conservators and archivists in many cultural institutions, including the Municipal Archives, use PPE  such as N95 masks and nitrile gloves while working with items contaminated by dust, mold spores, or other harmful elements. Since we are now working remotely and not handling archival items, the Department of Records and Information Services (DORIS) recently donated its stock of N95 masks and nitrile gloves for use by healthcare workers.

Recent reports indicate that the City is receiving large quantities of PPE from around the country. But every bit helps and to donate boxes of unopened PPE visit NYC.GOV/ppedonations  

The existence of PPE goes back thousands of years. In the first century AD, Pliny the Elder wrote about using masks made from animal bladders to protect Roman miners from breathing in toxic dust. Wearing gloves and aprons for various purposes is so ancient that their origin cannot be traced. 

The use a full protective outfit for doctors probably originated in the early 1600s, when a French physician named Charles de Lorme proposed a head-to-toe protective costume for treating plague patients. The attire consisted of a long waxed coat, a brimmed hat, goggles, leather gloves, and a distinctive mask shaped like a bird’s beak. At the time, bad smells were thought to  cause  the plague, and the long beak was designed to hold flowers and fragrant herbs to mask this “miasma” while allowing the doctor to breathe. Over the next two centuries doctors adopted this distinctive get-up for treating plague victims.  The most obvious element—the bird’s beak mask—lodged itself so deeply in the popular imagination that it became a common feature of scary costumes for Venetian masquerades. The mere sight of the doctor’s mask was enough to terrify. 

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The  beaked mask may have hindered bad smells, but it was not effective at blocking germs. A better technology was a mask that passed air through a filter as the wearer breathed. In the 16th century, Leonardo da Vinci suggested using a wet cloth as a respirator to prevent inhaling toxic gas, a technique still used as a last resort in fire emergencies. By the end of  the 18th century, modern masks began to appear, some using charcoal to filter the air. In 1889, William Stewart Halsted invented surgical rubber gloves to protect doctors and nurses during medical procedures. By this time, medical personnel used cloth surgical masks during procedures, and lab technicians wore medical gowns over their clothes.

Wearing protective garment while developing X-rays, Municipal Sanatorium, Otisville, N.Y. Department of Public Charities Collection. NYC Municipal Archives.

Wearing protective garment while developing X-rays, Municipal Sanatorium, Otisville, N.Y. Department of Public Charities Collection. NYC Municipal Archives.

Operating room nurses with protective masks and gloves, Bellevue Hospital, May 1950. Department of Public Charities Collection. NYC Municipal Archives.

Operating room nurses with protective masks and gloves, Bellevue Hospital, May 1950. Department of Public Charities Collection. NYC Municipal Archives.

Masked operating room nurses, Bellevue Hospital, May 1950. Department of Public Charities Collection. NYC Municipal Archives.

Masked operating room nurses, Bellevue Hospital, May 1950. Department of Public Charities Collection. NYC Municipal Archives.

Masked operating room personnel, Kings County Hospital. Department of Public Charities Collection. NYC Municipal Archives.

Masked operating room personnel, Kings County Hospital. Department of Public Charities Collection. NYC Municipal Archives.

Not only did PPE change over time, but so did the way it was worn. As our understanding of infectious disease  grew, so has awareness of the most effective uses of PPE. Early photographs in the Department of Public Charities collection at the Municipal Archives show doctors wearing masks covering only their mouths. Today, this would be considered incorrect, as it still allows the wearer to breathe in unfiltered air. In fact, today, the goal is to prevent air from passing around the edges, forcing all air to be inhaled through the material of the mask. Modern masks are designed with a metal strip at the top that can be shaped to the bridge of the nose. The N95 mask also includes two straps that hold it tightly against the face. When worn properly, the N95 filters 95% of breathed air.

As a large city and trade port with a diverse population, New York City frequently has been at the forefront in the fight against infectious disease. Collections such as the Archives’ Almshouse ledgers, Department of Health and Mental Hygiene records, and Department of Public Charities and Hospitals photographs provide ample documentation for research in topics related to public health. Of particular relevance today is New York City’s response to outbreaks of diseases such as typhoid and cholera in the 18th and 19th centuries, and to the erroneously named “Spanish” flu pandemic of 1918.

“New Operating Room,” with models. Exhibit in the Golden Jubilee at the Grand Central Palace, 1948. Department of Public Charities Collection. NYC Municipal Archives.

“New Operating Room,” with models. Exhibit in the Golden Jubilee at the Grand Central Palace, 1948. Department of Public Charities Collection. NYC Municipal Archives.

Nurse taking notes with infant patient, Bellevue Hospital, 1950. Department of Public Charities Collection. NYC Municipal Archives.

Nurse taking notes with infant patient, Bellevue Hospital, 1950. Department of Public Charities Collection. NYC Municipal Archives.

“Surgery in Progress,” painting, Harlem Hospital Conference room. Public Design Commission Collection. NYC Municipal Archives.

“Surgery in Progress,” painting, Harlem Hospital Conference room. Public Design Commission Collection. NYC Municipal Archives.