# Guidance on Preparing Workplaces for an Influenza Pandemic/Workplaces Classified at Medium Exposure Risk for Pandemic Influenza: What to Do to Protect Employees

​ Workplaces Classified at Medium Exposure Risk for Pandemic Influenza: What to Do to Protect Employees
Medium risk workplaces require frequent close contact between employees or with the general public (such as high-volume retail stores). If this contact cannot be avoided, there are practices to reduce the risk of infection. In addition to the basic work practices that every workplace should adopt (see page 26), medium risk occupations require employers to address enhanced safety and health precautions. Below are some of the issues that employers should address when developing plans for workplace safety and health during a pandemic.
Work Practice and Engineering Controls
* Instruct employees to avoid close contact (within 6 feet) with other employees and the general public. This can be accomplished by simply increasing the distance between the employee and the general public in order to avoid contact with large droplets from people talking, coughing or sneezing.
* Some organizations can expand internet, phone-based, drive-through window, or home delivery customer service strategies to minimize face-to-face contact. Work with your employees to identify new ways to do business that can also help to keep employees and customers safe and healthy.
* Communicate the availability of medical screening or other employee health resources (e.g., on-site nurse or employee wellness program to check for flu-like symptoms before employees enter the workplace).
* Employers also should consider installing physical barriers, such as clear plastic sneeze guards, to protect employees where possible (such as cashier stations).
Administrative Controls
* Work with your employees so that they understand the office leave policies, policies for getting paid, transportation issues, and day care concerns.
* Make sure that employees know where supplies for hand and surface hygiene are located.
* Work with your employees to designate a person(s), website, bulletin board or other means of communicating important pandemic flu information.
* Use signs to keep customers informed about symptoms of the flu, and ask sick customers to minimize contact with your employees until they are well.
* Your workplace may consider limiting access to customers and the general public, or ensuring that they can only enter certain areas of your workplace.
Personal Protective Equipment (PPE) Employees who have high-frequency, close contact with the general population that cannot be eliminated using administrative or engineering controls, and where contact with symptomatic ill persons is not expected should use personal protective equipment to prevent sprays of potentially infected liquid droplets (from talking, coughing, or sneezing) from contacting their nose or mouth. A surgical mask will provide such barrier protection. Use of a respirator may be considered if there is an expectation of close contact with persons who have symptomatic influenza infection or if employers choose to provide protection against a risk of airborne transmission. It should be noted that wearing a respirator may be ​physically burdensome to employees, particularly when the use of PPE is not common practice for the work task. In the event of a shortage of surgical masks, a reusable face shield that can be decontaminated may be an acceptable method of protecting against droplet transmission of an infectious disease but will not protect against airborne transmission, to the extent that disease may spread in that manner.
Eye protection generally is not recommended to prevent influenza infection although there are limited examples where strains of influenza have caused eye infection (conjunctivitis). At the time of a pandemic, health officials will assess whether risk of conjunctival infection or transmission exists for the specific pandemic viral strain.
Employees should wash hands frequently with soap or sanitizing solutions to prevent hands from transferring potentially infectious material from surfaces to their mouths or noses. While employers and employees may choose to wear gloves, the exposure of concern is touching the mouth and nose with a contaminated hand and not exposure to the virus through non-intact skin (for example, cuts or scrapes). While the use of gloves may make employees more aware of potential hand contamination, there is no difference between intentional or unintentional touching of the mouth, nose or eyes with either a contaminated glove or a contaminated hand. If an employee does wear gloves, they should always wash their hands with soap or sanitizing solution immediately after removal to ensure that they did not contaminate their hand(s) while removing them.
When selecting PPE, employers should consider factors such as function, fit, ability to be decontaminated, disposal, and cost. Sometimes, when a piece of PPE will have to be used repeatedly for a long period of time, a more expensive and durable piece of PPE may be less expensive in the long run than a disposable piece of PPE. For example, in the event of a pandemic, there may be shortages of surgical masks. A reusable face shield that can be decontaminated may become the preferred method of protecting against droplet transmission in some workplaces. It should be noted that barrier protection, such as a surgical mask or face shield, will protect against droplet transmission of an infectious disease