Unions demand a flu-related standard

Emergency rule would require N95s

The AFL-CIO and other unions representing health care workers want the U.S. Occupational Safety and Health Administration (OSHA) to create an emergency temporary standard to protect first responders from the risk of exposure to pandemic influenza.

Amid a massive federal effort to prepare for a possible pandemic, occupational health should not be left to voluntary efforts, the unions said in a petition to the agency. They proposed a standard that would have greater requirements for respiratory protection than those currently recommended by the Centers for Disease Control and Prevention in Atlanta.

"With the potential for exposure to what we fear will be a lethal agent, we could be facing the most significant occupational safety and health threat that the country and world have seen," says Peg Semanario, MS, safety and health director for the AFL-CIO. "We feel it is imperative that we be prepared and have precautions and procedures and equipment put in place in the nation's health care facilities to protect other workers who will be on the front line."

Workers who don't feel safe simply won't report to work during a pandemic, Semanario asserts. And while voluntary guidance is helpful, it is not enough, she says. Preparing for a pandemic must be mandatory, she says. "Absent having a regulation, you won't have the widespread implementation that's needed," she says.

The AFL-CIO also called the federal plan to use surgical masks to prevent spread of flu in health care facilities "dangerous" and "irresponsible." The AFL-CIO proposes a standard that includes a requirement for N95-filtering facepiece respirators as a minimum requirement for protection against pandemic influenza.

Although infection control professionals say that droplet precautions are appropriate for all types of influenza, the petition asserts that influenza may be spread by droplet nuclei.

"In all other occupations where you have an airborne hazard, there is respiratory protection, [with] NIOSH [National Institute for Occupational Safety and Health]-certified respirators required," she says. "It would be insane not to provide workers with the basic protections and be ready to protect them."

The unions propose a standard that would be patterned after the bloodborne pathogen standard. Hospitals would develop an exposure control plan to determine who would be at risk in the event of a pandemic and how to implement programs, such as medical surveillance and vaccination, which would mitigate that risk.

As in the bloodborne pathogens standard, employers would be required to solicit input from "nonmanagerial employees responsible for direct patient care," the petition states.

The petition also proposes a provision for medical removal protection, so that health care workers who are furloughed with flu symptoms would still receive their pay and benefits.

An emergency temporary standard would trigger a fast-track process for creating a permanent standard, says Semanario. Even if pandemic influenza doesn't occur, the standard would be useful for other airborne infectious diseases, she says.

"There are still exposures every day in health care settings to [seasonal] influenza, to tuberculosis, to a whole array of infectious disease hazards," she says. "We need to have these measures put in place and ready to be implemented fully."

OSHA had not responded to the petition as of late May.