• Where possible, install physical barriers

such as clear plastic sneeze guards in reception or intake areas.

• Review and increase housekeeping vigilance to control the spread of infectious

agents through additional cleaning of contact surfaces, and through prompt and thorough waste disposal.

Administrative Controls

Healthcare facilities need to follow existing

guidelines and facility standards of practice

for identifying and isolating infected individuals and for protecting workers. Develop and

implement policies that reduce exposures.

• Post signs requesting patients and family

members to immediately report symptoms

of respiratory illness on arrival at the facility

and use disposable tissues to cover the

nose and mouth when coughing.

Very high exposure risk occupations are

those with high potential for exposure to

known or suspected sources of pandemic influenza during specific medical or laboratory

procedures:

• Healthcare workers performing aerosolgenerating procedures on known or suspected pandemic patients.

• Healthcare or laboratory personnel collecting or handling specimens from known or

suspected pandemic patients.

High exposure risk occupations are those

with high potential for exposure to known or

suspected sources of pandemic virus:

• Healthcare delivery and support staff exposed to known or suspected pandemic patients.

• Staff providing medical transport of known

or suspected influenza patients in enclosed

vehicles.

• Staff performing autopsies on known or

suspected pandemic patients.

Engineering Controls

These types of controls involve making

changes to the work environment to reduce

work-related hazards.

• Healthcare facilities equipped with isolation

rooms need to use them when performing

aerosol-generating procedures for patients

with known or suspected pandemic influenza.

• Only Biosafety Level 2 or 3 laboratory facilities (depending on the procedures performed) should process specimens from

known or suspected pandemic patients.

FactSheet

Healthcare Workplaces Classified as

Very High or High Exposure Risk

for Pandemic Influenza

What to do to protect workers

If your workplace requires your workers to have contact with people who are

known or suspected to be infected with the pandemic virus, there are important

practices to reduce the risk of infection and to protect your workers.

Very

High

High

Medium

Lower Risk (Caution)

➜

➜

Occupational Risk Pyramid for Pandemic Influenza
Work Practices

Train workers in work practices such as hand

hygiene, facility hygiene, and other infection

control measures. For details see Pandemic

Influenza Preparedness and Response Guidance for HealthcareWorkers and Healthcare

Employers at www.osha.gov/Publications/

3328-05-2007-English.html.

• Provide conveniently located masks, tissues

and alcohol-based hand rubs for waiting

areas and patient evaluation areas to reduce the spread of infection.

Personal Protective Equipment (PPE)

For those who work closely (within 6 feet)

with people known or suspected to be infected with pandemic influenza:

• Use NIOSH-certified respirators that are

N95 or higher. When both fluid protection

(e.g., blood splashes) and respiratory protection are needed, use a "surgical N95"

respirator that has been certified by NIOSH

and cleared by the FDA.

• Consider NIOSH-certified elastomeric respirators (e.g., cartridge respirators) for essential workers who may have to decontaminate

and reuse respirators in the event that there

is a shortage of disposable respirators.

• Consider NIOSH-certified powered air-purifying respirators for essential workers who

may have to decontaminate and reuse respirators, wear respirators for prolonged periods of time, be exposed to high-risk

procedures, or work in high-risk environments. Loose-fitting hooded powered airpurifying respirators have the additional

advantage of not requiring fit testing.

This is one in a series of informational fact sheets highlighting OSHA programs, policies or

standards. It does not impose any new compliance requirements. For a comprehensive list of

compliance requirements of OSHA standards or regulations, refer toTitle 29 of the Code of Federal

Regulations. This information will be made available to sensory impaired individuals upon request.

The voice phone is (202) 693-1999; teletypewriter (TTY) number: (877) 889-5627.

DTSEM 5/2009

• Be fit tested and trained in the proper use

and care of a respirator. (www.osha.gov/

SLTC/respiratoryprotection/index.html).

• Use gloves made of latex, vinyl, nitrile, or

other synthetic materials as appropriate,

when there is contact with blood and other

bodily fluids, including respiratory secretions.

• Wear an isolation gown when it is anticipated that soiling of clothes or uniform with

blood or other bodily fluids, including respiratory secretions, may occur.

• Use eye and face protection if sprays or

splatters of infectious material are likely.

Goggles should be worn during the performance of aerosol-generating procedures.

Use of a full face shield in front of a respirator may also prevent bulk contamination of

the respirator.

Education and training material need to be

easily understood and available in the appropriate language and literacy level for all workers. Employers must have a respiratory

protection program that complies with

OSHA’s Respiratory Protection Standard at 29

CFR 1910.134, including worker fit testing,

medical evaluation, and training in the proper

use and care of a respirator.

For more information, please refer to OSHA

Publication No. 3328, Pandemic Influenza

Preparedness and Response Guidance for

HealthcareWorkers and Healthcare Employers,

which can be accessed at: www.osha.gov.

Additional information can be found at

www.pandemicflu.gov.

U.S. Department of Labor

www.osha.gov

(800) 321-OSHA

For more complete information: