Federal guidelines say know risks, protections
Federal guidelines say know risks, protections
Workplaces at risk for flu targeted
The Occupational Safety and Health Administration (OSHA) has unveiled guidance for employers to help them prepare for and deal with the possibly debilitating effects of an influenza pandemic.
OSHA deputy director for guidance and standards Amanda Edens describes the potential effects on workplaces as severe. "During a pandemic, workplaces can likely experience high absenteeism — probably as much as 40% of the workforce," says Edens.
For the occupational health nurse (OHN), keeping a business or health care facility productive by keeping as many employees healthy requires more than just encouraging workers to be vaccinated. In a recent article in the American Association of Occupational Health Nursing Journal, author Erin Andersen, MS, RN, OHNP, a nurse practitioner with the University of California at San Francisco's employee health center, describes these scenarios:
- as many as 30% of nurses, physicians, technicians, clerks, and housekeeping staff not coming to work because they are sick;
- another substantial percentage of staff staying home out of fear of becoming sick;
- employees demanding vaccine or prophylactic medication that is not available or available only on a stringent rationing schedule.
Workplaces classified by risk
The new OSHA guidance categorizes workplaces and industries into four groups based on risk for exposure — very high, high, medium, and lower — and suggests preparation and expectations:
- Highest risk
As numerous previous reports on influenza have done, OSHA's new guidelines rank health care providers, particularly those who are likely to come in contact with known or suspected pandemic patients during specific, aerosol-generating procedures, among the highest-risk workers. Cough-inducing procedures, bronchoscopies, dental procedures, and invasive specimen collection, are among procedures that can increase risk by causing aerosol droplets to be generated.
Lab workers who collect or handle specimens from known or suspected pandemic patients are also at highest risk, OSHA says.
- High risk
At high risk are health care delivery and support staff — for example, anyone who must enter a known or suspected flu patient's room. Paramedics, emergency medical technicians, or anyone else who must transport patients, as well as workers who perform or assist with autopsies on flu patients, are also a high-risk group.
- Medium and low exposure risk
Anyone working in frequent contact (within six feet) with the general public — in schools, in crowded work environments, and in some high-volume retail settings, for example — are considered to be at medium risk for exposure. People who have only minimal occupational exposure to coworkers or the public are considered at the lowest risk for exposure.
Depending on the type of worker population the OHN works with, there may be a need to factor in the importance to the community in keeping those employees healthy, OSHA advises. Employers of critical infrastructure and key resource employees (such as law enforcement, emergency response, or public utility employees) may want to upgrade protective measures beyond the minimum requirements for these employees due to the necessity of such services as well as the potential difficulties in replacing them during a pandemic (i.e., due to extensive training or licensing requirements).
For more employers in the low- and medium-risk exposure groups, hand-washing, disinfecting surfaces, and social distancing (reducing the frequency of occupational contacts and increasing the distance between people who do come in contact with each other at work) will be the primary safeguards.
Social distancing and hygiene are part of the "hierarchy of controls" framework by which occupational health and safety professionals choose intervention strategies to systematically remove exposure hazards from the workplace. The OHN should evaluate his or her workplace and fit a control plan that suits the employees, environment, and risk level. (See information below for descriptions of control measures.)
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