PURPOSE: To establish a national ongoing, continuous PPE usage surveillance system for HCWs in the US. The IOM committee on PPE submitted in 2007 that during Pandemic Influenza, HCWs will feel more secure only when PPE usage is as safe and effective as vaccines and medications. The expected outcomes are to enhance timely interventional response during disasters such as Pandemic Influenza from hospital to hospital, PPE policies and standard of operating procedures (SOPs) for first receivers and responders nationwide. METHODS: Monitor the PPE (e.g. respirator) selection, use, fit, supplies, defects, audits, recalls, and effectiveness in each of the selected facilities among HCWs; especially workers with direct patient care. Conduct a daily and ongoing active and passive surveillance using a standardized format and questionnaire using the Early Aberration Reporting System (EARS). When an incident of interest (IOI) occurs, e.g. lapses or disease transmission, investigation is initiated by the project officer. RESULTS: The expected outputs are to describe/document the evaluation and monitoring of PPE selection, usage, nonusage, defects, fitting and effectiveness of respirators in the hospital environment. Secondly, to develop a functioning model that ensures hospitals are better prepared for Pandemic Influenza and other disasters (natural and man-made). Thirdly, to disseminate the findings in professional journals and present at appropriate conferences. CONCLUSION: The value of monitoring and evaluating the activities and resources regarding PPE use among HCWs and safety prevention programs in major hospital systems will be formally assessed.