agencies emphasize the need to prevent occupational transmission of SARS through early recognition, work procedures and engineering controls. 

Early Recognition involves knowing the signs and

symptoms of SARS and appropriately isolating

affected individuals. Symptomatic workers

should seek medical attention immediately and

receive medical clearance prior to returning to the

worksite. When seeking healthcare for a possible

diagnosis of SARS, symptomatic individuals

should alert the healthcare facility so that proper

precautions can be taken. Patients suspected of

SARS infection should wear a surgical mask and

have appropriate isolation to prevent the spread

of infection. Healthcare workers with an unprotected high-risk exposure to SARS should be

excluded from duty for 10 days after exposure. 

Work Procedures to prevent the spread of disease

include frequent hand cleansing and avoiding

direct contact with body fluids of SARS patients.

Personal protective equipment (PPE) is appropriate in healthcare facilities and certain occupational

settings, such as airline clean-up, when SARS

infection is a known risk. Staff should not sort

soiled linens suspected of SARS contamination at

the point of use. Laundering soiled linens in

warm water and detergent has been advised.

Compressed air should not be used for cleaning

areas where SARS patients or their body fluids

were present. 

Transmission

SARS is spread primarily by close contact with a

SARS patient or contact with respiratory secretions/body fluids from a SARS patient.

Transmission from contaminated objects has

been reported. The incubation period is typically

between two and seven days.

Signs and Symptoms

SARS presentation is typical of a respiratory viral

illness. Patients usually present with a high fever

(>100.4 F), cough, chills and headache. Most will

progress to develop pneumonia and some will

even require mechanical ventilation. 

Diagnosis and Treatment

In the United States, the Centers for Disease

Control and Prevention (CDC) classifies patients as

either suspect or probable cases, depending on

symptoms, history of exposure or other evidence

of disease. A number of serological and other

testing methods are being developed, including

those to detect evidence of a newly identified

SARS-associated coronavirus (SARS-CoV).

Antiviral agents, steroids and other treatment

options have been used to treat SARS patients

with varying success; some SARS patients have

required ventilator support.

Workplace Policies and Procedures 

OSHA and the CDC have published SARS-related

guidance for several occupational settings. Both

FactSheet

Severe Acute Respiratory Syndrome

(SARS) An overview of worker protection issues

SARS: Description and Concerns 

SARS is a severe viral illness that was first reported in Asia in February 2003. The

illness is characterized by a variety of symptoms including fever, cough, shortness

of breath. In a minority of patients (6-9%), SARS may even progress to death. SARS

has been reported in North America among persons returning from travel to Asia,

among health care workers, and among others in contact with individuals with

SARS. Because new outbreaks may occur, workers should be aware of the recommended measures to prevent occupational SARS infection.
Engineering Controls include use of airborne

isolation rooms or negative air pressure environments for aerosol generating procedures

(e.g. sputum induction in SARS patients) and

handling laboratory specimens in biological

safety cabinets. 

Protective Equipment for 

Healthcare Facilities

Healthcare workers face a real risk of acquiring

SARS through their jobs and the precautions recommended for them are stringent. To prevent

transmission of SARS in healthcare settings, PPE

appropriate for standard, contact and airborne

precautions, in addition to eye protection, is recommended for all contact with SARS infected

patients. Standard precautions include hand

washing. Contact precautions include the use of

gown and gloves for contact with the patient or

the patient’s environment. Airborne precautions

include the use of a respirator approved by the

National Institute for Occupational Safety and

Health (NIOSH) (see below). 

PPE is only effective if used correctly. SARS infection in health care workers has been reported in

locations where infection control precautions

were not followed and PPE was not appropriately

used. Special attention should be given to the

use of disposable PPE (or proper disinfection of

re-usable PPE) and proper donning and doffing

procedures to prevent the spread of infectious

particles through PPE use.

This is one of a series of fact sheets highlighting U.S. Department of Labor programs. It is intended as 

a general description only and does not carry the force of legal opinion.This information will be made

available to sensory impaired individuals upon request.Voice phone: (202) 523-8151.

TDD message referral phone: 1-800-326-2577.

Respirator Considerations for 

Healthcare Facilities

Respirators should be used in the context of a

complete respiratory protection program in accordance with OSHA regulations. Appropriate respirators are NIOSH approved and are at least as

effective as N-95. Hood or helmet powered airpurifying respirators (PAPRs) provide protection

for workers who have fit limitations (e.g. facial

hair). PAPRs and higher levels of respirator protection (e.g. full face piece) have been used during

certain aerosol-generating procedures. Although

surgical masks provide protection for large

droplets, they are not adequate protection against

airborne or aerosol particles.

Due to documented transmission through contaminated objects, disposable respirators and

other PPE should be discarded after use. Reusable

respirators should be decontaminated after each

use according to manufacturer recommendations.

Removal of PPE should minimize the potential for

self-contamination and workers should be educated on standard procedures. Hand cleansing is

necessary following the removal of PPE.

Additional Information 

The OSHA web site

(http://www.osha.gov/dep/sars/index.html) provides further information. More detailed guidance

for specific settings, case definitions and clinical

recommendations are available on the CDC SARS

website (http://www.cdc.gov/ncidod/sars). 

U.S. Department of Labor

www.osha.gov

(800) 321-OSHA

Think Safety!

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