PPE in healthcare: from plague masks to modern protection

You may have wondered how face masks, plastic gloves, and hairnets became part of everyday medical practice. The PPE in healthcare history goes back much further than most people realize. From plague masks to modern protective clothing, this article explores the inventions and innovations that changed healthcare forever.

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The beginning of PPE in healthcare history

The plague mask was one of the first inventions aimed at protecting against infections. However, it did not serve the same function as the face masks we know today.

The mask was a way for doctors to protect themselves from the plague pandemics that swept through Europe, mainly between the fourteenth and seventeenth centuries. At that time, people believed diseases were spread by bad air and vapors, not by bacteria or fleas. That’s why doctors wore a long leather coat, leather gloves, a hat, and of course, the leather plague mask.

This mask featured a long beak, which is why it was also known as the bird mask. The beak was filled with lavender, vinegar, or camphor. People believed these substances could purify the bad air. The doctors carried a stick or staff that allowed them to point at patients without touching them.

In practice, this outfit offered no real protection. The substances in the mask did not filter bacteria — something people simply didn’t know about at the time. The clothing also failed to protect against fleas or bodily fluids, meaning the plague bacterium Yersinia pestis could still spread. However, it did have a psychological effect: doctors felt more protected, and patients could easily recognize them.

From Pasteur to rubber gloves

When French chemist Louis Pasteur (1822–1895) proved that microorganisms cause disease, he revolutionized the way people understood protection in healthcare.

Following Pasteur’s discovery, British surgeon Joseph Lister introduced carbolic acid as a disinfectant. Dr. William Stewart Halsted, working at Johns Hopkins Hospital in Baltimore, adopted this approach and instructed his surgeons and nurses to wash their hands with soap, followed by a solution of potassium permanganate, a hot oxalic acid bath, and mercury chloride.

When nurse Caroline Hampton announced she wanted to quit because the chemicals were damaging her hands, Halsted intervened. Determined to keep her on his team, he proposed replacing the harsh washing process with rubber gloves in 1889. Hampton embraced the idea, and soon her colleagues ordered gloves for themselves as well.

After surgeon Joseph Bloodgood demonstrated that the gloves significantly reduced infection risks, hospitals across the country quickly adopted surgical gloves as standard practice.

Face masks and sterile clothing

In the early twentieth century, doctors and nurses started wearing gauze face masks, mainly during surgeries. These masks quickly gained acceptance worldwide, and their use rose sharply in the 1940s. At the time, they served primarily to protect the surroundings from the wearer’s breath rather than shielding the wearer from outside infections.

White coats and sterile clothing also became standard. Hospitals chose white because it symbolized cleanliness, order, and professionalism. By the 1960s and 1970s, however, people recognized that white clothing wasn’t ideal for surgery. The strong contrast between white fabric and red blood strained the eyes. As a result, hospitals switched to blue, green, or turquoise coats. Colors that were far easier on the eyes of surgeons and nurses who spent hours at the operating table.

Modern PPE in healthcare

Since the 1980s, the use of PPE such as face masks, face and eye protection, isolation gowns, and gloves has become mandatory.

During the pandemic, PPE use reached its peak, sparking widespread discussions about sustainability in healthcare workwear. All that disposable material has to go somewhere. That’s why more sustainable initiatives have emerged, such as washable isolation gowns and plant-based head covers.

Looking back at the long PPE in healthcare history, it’s clear that innovation and protection have always gone hand in hand. I expect these developments will only accelerate in the coming years. We now know how to protect ourselves from bacteria. The next step is figuring out how to protect the world from our waste.

Curious how nurses used to dress? Read the article about a unique doll collection that shows how nursing uniforms have changed over the years.

Best,

Aileen

Last update: 20 juni 2026