Guidance on 

Preparing Workplaces for an

Influenza Pandemic

OSHA 3327-02N 2007
Employers are responsible for providing a safe and

healthful workplace for their employees. OSHA’s

role is to assure the safety and health of America’s

employees by setting and enforcing standards;

providing training, outreach and education; establishing partnerships; and encouraging continual

improvement in workplace safety and health. 

This handbook provides a general overview of a

particular topic related to OSHA standards. It does

not alter or determine compliance responsibilities in

OSHA standards or the Occupational Safety and

Health Act of 1970. Because interpretations and enforcement policy may change over time, you should

consult current OSHA administrative interpretations

and decisions by the Occupational Safety and Health

Review Commission and the Courts for additional

guidance on OSHA compliance requirements.

This publication is in the public domain and may be

reproduced, fully or partially, without permission.

Source credit is requested but not required.

This information is available to sensory impaired

individuals upon request. Voice phone: (202) 693-

1999; teletypewriter (TTY) number: (877) 889-5627.

Edwin G. Foulke, Jr.

Assistant Secretary of Labor for

Occupational Safety and Health
U.S. Department of Labor

Occupational Safety and Health Administration

OSHA 3327-02N

2007

Guidance on 

Preparing Workplaces 

for an Influenza Pandemic
2

Contents

Introduction . . . 3

The Difference Between Seasonal, Pandemic Influenza 

and Avian Influenza . . . 5

How a Severe Pandemic Influenza Could Affect 

Workplaces . . . 7

Who Should Plan for a Pandemic . . . 8

How Influenza Can Spread Between People . . . 9

Classifying Employee Exposure to Pandemic Influenza 

at Work . . . 10

How to Maintain Operations During a Pandemic . . . 12

How Organizations Can Protect Their Employees . . . 16

The Difference Between a Surgical Mask and 

a Respirator . . . 20

Steps Every Employer Can Take to Reduce the Risk of

Exposure to Pandemic Influenza in Their Workplace . . . 26

Workplaces Classified at Lower Exposure Risk (Caution) for

Pandemic Influenza: What to Do to Protect Employees . . . 28

Workplaces Classified at Medium Exposure Risk for Pandemic

Influenza: What to Do to Protect Employees . . . 29

Workplaces Classified at Very High or High Exposure Risk for

Pandemic Influenza: What to Do to Protect Employees . . . 32

What Employees Living Abroad or Who Travel 

Internationally for Work Should Know . . . 35

For More Information . . . 37

OSHA Assistance . . . 38
Introduction

A pandemic is a global disease outbreak. An influenza pandemic

occurs when a new influenza virus emerges for which there is little

or no immunity in the human population, begins to cause serious

illness and then spreads easily person-to-person worldwide. A

worldwide influenza pandemic could have a major effect on the

global economy, including travel, trade, tourism, food, consumption

and eventually, investment and financial markets. Planning for

pandemic influenza by business and industry is essential to

minimize a pandemic's impact. Companies that provide critical

infrastructure services, such as power and telecommunications,

also have a special responsibility to plan for continued operation

in a crisis and should plan accordingly. As with any catastrophe,

having a contingency plan is essential.

3

This guidance is advisory in nature and informational

in content. It is not a standard or a regulation, and it

neither creates new legal obligations nor alters existing

obligations created by OSHA standards or the

Occupational Safety and Health Act (OSH Act). Pursuant

to the OSH Act, employers must comply with hazardspecific safety and health standards as issued and

enforced either by OSHA or by an OSHA-approved State

Plan. In addition, Section 5(a)(1) of the OSH Act, the

General Duty Clause, requires employers to provide

their employees with a workplace free from recognized

hazards likely to cause death or serious physical harm.

Employers can be cited for violating the General Duty

Clause if there is a recognized hazard and they do not

take reasonable steps to prevent or abate the hazard.

However, failure to implement any recommendations in

this guidance is not, in itself, a violation of the General

Duty Clause. Citations can only be based on standards,

regulations, or the General Duty Clause.
In the event of an influenza pandemic, employers will play a

key role in protecting employees' health and safety as well as in

limiting the impact on the economy and society. Employers will

likely experience employee absences, changes in patterns of

commerce and interrupted supply and delivery schedules. Proper

planning will allow employers in the public and private sectors to

better protect their employees and lessen the impact of a pandemic

on society and the economy. As stated in the President’s National

Strategy for Pandemic Influenza, all stakeholders must plan and be

prepared. 

The Occupational Safety and Health Administration (OSHA)

developed this pandemic influenza planning guidance based upon

traditional infection control and industrial hygiene practices. It is

important to note that there is currently no pandemic; thus, this

guidance is intended for planning purposes and is not specific to a

particular viral strain. Additional guidance may be needed as an

actual pandemic unfolds and more is known about the characteristics of the virulence of the virus, disease transmissibility, clinical

manifestation, drug susceptibility, and risks to different age groups

and subpopulations. Employers and employees should use this

planning guidance to help identify risk levels in workplace settings

and appropriate control measures that include good hygiene,

cough etiquette, social distancing, the use of personal protective

equipment, and staying home from work when ill. Up-to-date

information and guidance is available to the public through the

www.pandemicflu.gov website.

4
The Difference Between Seasonal,

,

Pandemic Influenza and Avian Influenza 

Seasonal influenza refers to the periodic outbreaks of respiratory

illness in the fall and winter in the United States. Outbreaks are

typically limited; most people have some immunity to the

circulating strain of the virus. A vaccine is prepared in advance of

the seasonal influenza; it is designed to match the influenza

viruses most likely to be circulating in the community. Employees

living abroad and international business travelers should note that

other geographic areas (for example, the Southern Hemisphere)

have different influenza seasons which may require different

vaccines. 

Pandemic influenza refers to a worldwide outbreak of influenza

among people when a new strain of the virus emerges that has

the ability to infect humans and to spread from person to person.

During the early phases of an influenza pandemic, people might

not have any natural immunity to the new strain; so the disease

would spread rapidly among the population. A vaccine to protect

people against illness from a pandemic influenza virus may not be

widely available until many months after an influenza pandemic

begins. It is important to emphasize that there currently is no

influenza pandemic. However, pandemics have occurred

throughout history and many scientists believe that it is only a

matter of time before another one occurs. Pandemics can vary in

severity from something that seems simply like a bad flu season

to an especially severe influenza pandemic that could lead to high

levels of illness, death, social disruption and economic loss. It is

impossible to predict when the next pandemic will occur or

whether it will be mild or severe.

Avian influenza (AI) – also known as the bird flu – is caused

by virus that infects wild birds and domestic poultry. Some forms

of the avian influenza are worse than others. Avian influenza

viruses are generally divided into two groups: low pathogenic

5
avian influenza and highly pathogenic avian influenza. Low

pathogenic avian influenza naturally occurs in wild birds and can

spread to domestic birds. In most cases, it causes no signs of

infection or only minor symptoms in birds. In general, these low

path strains of the virus pose little threat to human health. Low

pathogenic avian influenza virus H5 and H7 strains have the

potential to mutate into highly pathogenic avian influenza and

are, therefore, closely monitored. Highly pathogenic avian

influenza spreads rapidly and has a high death rate in birds.

Highly pathogenic avian influenza of the H5N1 strain is rapidly

spreading in birds in some parts of the world. 

Highly pathogenic H5N1 is one of the few avian influenza

viruses to have crossed the species barrier to infect humans and it

is the most deadly of those that have crossed the barrier. Most

cases of H5N1 influenza infection in humans have resulted from

contact with infected poultry or surfaces contaminated with

secretions/excretions from infected birds.

As of February 2007, the spread of H5N1 virus from person to

person has been limited to rare, sporadic cases. Nonetheless,

because all influenza viruses have the ability to change, scientists

are concerned that H5N1 virus one day could be able to sustain

human to human transmission. Because these viruses do not

commonly infect humans, there is little or no immune protection

against them in the human population. If H5N1 virus were to gain

the capacity to sustain transmission from person to person, a

pandemic could begin.

An update on what is currently known about avian flu can be

found at www.pandemicflu.gov.

6
How a Severe Pandemic Influenza 

Could Affect Workplaces

Unlike natural disasters or terrorist events, an influenza pandemic

will be widespread, affecting multiple areas of the United States

and other countries at the same time. A pandemic will also be an

extended event, with multiple waves of outbreaks in the same

geographic area; each outbreak could last from 6 to 8 weeks. Waves

of outbreaks may occur over a year or more. Your workplace will

likely experience: 

■ Absenteeism - A pandemic could affect as many as 40 percent

of the workforce during periods of peak influenza illness.

Employees could be absent because they are sick, must care

for sick family members or for children if schools or day care

centers are closed, are afraid to come to work, or the employer

might not be notified that the employee has died.

■ Change in patterns of commerce - During a pandemic, consumer

demand for items related to infection control is likely to increase

dramatically, while consumer interest in other goods may

decline. Consumers may also change the ways in which they

shop as a result of the pandemic. Consumers may try to shop

at off-peak hours to reduce contact with other people, show

increased interest in home delivery services, or prefer other

options, such as drive-through service, to reduce person-toperson contact. 

■ Interrupted supply/delivery - Shipments of items from those

geographic areas severely affected by the pandemic may be

delayed or cancelled. 

7
Who Should Plan for a Pandemic

To reduce the impact of a pandemic on your operations, employees,

customers and the general public, it is important for all businesses

and organizations to begin continuity planning for a pandemic now.

Lack of continuity planning can result in a cascade of failures as

employers attempt to address challenges of a pandemic with insufficient resources and employees who might not be adequately

trained in the jobs they will be asked to perform. Proper planning

will allow employers to better protect their employees and prepare

for changing patterns of commerce and potential disruptions in

supplies or services. Important tools for pandemic planning for

employers are located at www.pandemicflu.gov. 

The U.S. government has placed a special emphasis on

supporting pandemic influenza planning for public and private

sector businesses deemed to be critical industries and key resources

(CI/KR). Critical infrastructure are the thirteen sectors that provide

the production of essential goods and services, interconnectedness

and operability, public safety, and security that contribute to a

strong national defense and thriving economy. Key resources are

facilities, sites, and groups of organized people whose destruction

could cause large-scale injury, death, or destruction of property

and/or profoundly damage our national prestige and confidence.

With 85 percent of the nation’s critical infrastructure in the hands of

the private sector, the business community plays a vital role in ensuring national pandemic preparedness and response. Additional

guidance for CI/KR business is available at: www.pandemicflu.gov/

plan/pdf/CIKRpandemicInfluenzaGuide.pdf.

Critical Infrastructure and Key Resources

Key Resources

■ Government Facilities 

■ Dams 

■ Commercial Facilities 

■ Nuclear Power Plants

8
Critical Infrastructure 

■ Food and Agriculture 

■ Public Health and Healthcare

■ Banking and Finance 

■ Chemical and Hazardous Materials 

■ Defense Industrial Base 

■ Water 

■ Energy 

■ Emergency Services 

■ Information Technology 

■ Telecommunications 

■ Postal and Shipping 

■ Transportation 

■ National Monuments and Icons 

How Influenza Can Spread Between People

Influenza is thought to be primarily spread through large droplets

(droplet transmission) that directly contact the nose, mouth or

eyes. These droplets are produced when infected people cough,

sneeze or talk, sending the relatively large infectious droplets and

very small sprays (aerosols) into the nearby air and into contact

with other people. Large droplets can only travel a limited range;

therefore, people should limit close contact (within 6 feet) with

others when possible. To a lesser degree, human influenza is

spread by touching objects contaminated with influenza viruses

and then transferring the infected material from the hands to the

nose, mouth or eyes. Influenza may also be spread by very small

infectious particles (aerosols) traveling in the air. The contribution

of each route of exposure to influenza transmission is uncertain at

this time and may vary based upon the characteristics of the

influenza strain.

9
Classifying Employee Exposure to

Pandemic Influenza at Work

Employee risks of occupational exposure to influenza during a

pandemic may vary from very high to high, medium, or lower

(caution) risk. The level of risk depends in part on whether or not

jobs require close proximity to people potentially infected with the

pandemic influenza virus, or whether they are required to have

either repeated or extended contact with known or suspected

sources of pandemic influenza virus such as coworkers, the general

public, outpatients, school children or other such individuals or

groups. 

■ Very high exposure risk occupations are those with high

potential exposure to high concentrations of known or suspected

sources of pandemic influenza during specific medical or

laboratory procedures.

■ High exposure risk occupations are those with high potential for

exposure to known or suspected sources of pandemic influenza

virus. 

■ Medium exposure risk occupations include jobs that require

frequent, close contact (within 6 feet) exposures to known or

10 (continued on page 12)
11

Occupational Risk Pyramid for Pandemic Influenza

Very High Exposure Risk:

• Healthcare employees (for example, doctors, nurses, dentists)

performing aerosol-generating procedures on known or suspected

pandemic patients (for example, cough induction procedures, bronchoscopies, some dental procedures, or invasive specimen

collection).

• Healthcare or laboratory personnel collecting or handling specimens

from known or suspected pandemic patients (for example, manipulating cultures from known or suspected pandemic influenza

patients).

High Exposure Risk:

• Healthcare delivery and support staff exposed to known or

suspected pandemic patients (for example, doctors, nurses, and

other hospital staff that must enter patients’ rooms). 

• Medical transport of known or suspected pandemic patients in

enclosed vehicles (for example, emergency medical technicians).

• Performing autopsies on known or suspected pandemic patients (for

example, morgue and mortuary employees).

Medium Exposure Risk:

• Employees with high-frequency contact with the general population

(such as schools, high population density work environments, and

some high volume retail).

Lower Exposure Risk (Caution):

• Employees who have minimal occupational contact with the general

public and other coworkers (for example, office employees).

Very

High

High

Medium

Lower Risk (Caution)
suspected sources of pandemic influenza virus such as

coworkers, the general public, outpatients, school children or

other such individuals or groups.

■ Lower exposure risk (caution) occupations are those that do

not require contact with people known to be infected with the

pandemic virus, nor frequent close contact (within 6 feet) with

the public. Even at lower risk levels, however, employers should

be cautious and develop preparedness plans to minimize

employee infections.

Employers of critical infrastructure and key resource employees

(such as law enforcement, emergency response, or public utility

employees) may consider upgrading protective measures for these

employees beyond what would be suggested by their exposure

risk due to the necessity of such services for the functioning of

society as well as the potential difficulties in replacing them during

a pandemic (for example, due to extensive training or licensing

requirements).

To help employers determine appropriate work practices and

precautions, OSHA has divided workplaces and work operations

into four risk zones, according to the likelihood of employees’

occupational exposure to pandemic influenza. We show these

zones in the shape of a pyramid to represent how the risk will

likely be distributed (see page 11). The vast majority of American

workplaces are likely to be in the medium exposure risk or lower

exposure risk (caution) groups.

How to Maintain Operations During 

a Pandemic

As an employer, you have an important role in protecting employee

health and safety, and limiting the impact of an influenza pandemic.

It is important to work with community planners to integrate your

pandemic plan into local and state planning, particularly if your

operations are part of the nation’s critical infrastructure or key

resources. Integration with local community planners will allow

12
you to access resources and information promptly to maintain

operations and keep your employees safe.

Develop a Disaster Plan

Develop a disaster plan that includes pandemic preparedness

(See www.pandemicflu.gov/plan/businesschecklist.html) and review

it and conduct drills regularly. 

■ Be aware of and review federal, state and local health

department pandemic influenza plans. Incorporate appropriate

actions from these plans into workplace disaster plans.

■ Prepare and plan for operations with a reduced workforce.

■ Work with your suppliers to ensure that you can continue to

operate and provide services.

■ Develop a sick leave policy that does not penalize sick employees,

thereby encouraging employees who have influenza-related

symptoms (e.g., fever, headache, cough, sore throat, runny or

stuffy nose, muscle aches, or upset stomach) to stay home so

that they do not infect other employees. Recognize that

employees with ill family members may need to stay home to

care for them.

■ Identify possible exposure and health risks to your employees.

Are employees potentially in contact with people with influenza

such as in a hospital or clinic? Are your employees expected to

have a lot of contact with the general public?

■ Minimize exposure to fellow employees or the public. For

example, will more of your employees work from home? This

may require enhancement of technology and communications

equipment. 

■ Identify business-essential positions and people required to

sustain business-necessary functions and operations. Prepare to

cross-train or develop ways to function in the absence of these

positions. It is recommended that employers train three or more

employees to be able to sustain business-necessary functions

and operations, and communicate the expectation for available

employees to perform these functions if needed during a

pandemic.

13
14

■ Plan for downsizing services but also anticipate any scenario

which may require a surge in your services. 

■ Recognize that, in the course of normal daily life, all employees

will have non-occupational risk factors at home and in community

settings that should be reduced to the extent possible. Some

employees will also have individual risk factors that should be

considered by employers as they plan how the organization will

respond to a potential pandemic (e.g., immuno-compromised

individuals and pregnant women).

■ Stockpile items such as soap, tissue, hand sanitizer, cleaning

supplies and recommended personal protective equipment.

When stockpiling items, be aware of each product’s shelf life

and storage conditions (e.g., avoid areas that are damp or have

temperature extremes) and incorporate product rotation (e.g.,

consume oldest supplies first) into your stockpile management

program.

Make sure that your disaster plan protects and supports your

employees, customers and the general public. Be aware of your

employees’ concerns about pay, leave, safety and health. Informed

employees who feel safe at work are less likely to be absent. 

■ Develop policies and practices that distance employees from

each other, customers and the general public. Consider practices

to minimize face-to-face contact between employees such as email, websites and teleconferences. Policies and practices that

allow employees to work from home or to stagger their work

shifts may be important as absenteeism rises.

■ Organize and identify a central team of people or focal point to

serve as a communication source so that your employees and

customers can have accurate information during the crisis. 

■ Work with your employees and their union(s) to address leave,

pay, transportation, travel, childcare, absence and other human

resource issues. 

■ Provide your employees and customers in your workplace with

easy access to infection control supplies, such as soap, hand

sanitizers, personal protective equipment (such as gloves or

surgical masks), tissues, and office cleaning supplies.
■ Provide training, education and informational material about

business-essential job functions and employee health and

safety, including proper hygiene practices and the use of any

personal protective equipment to be used in the workplace. Be

sure that informational material is available in a usable format

for individuals with sensory disabilities and/or limited English

proficiency. Encourage employees to take care of their health

by eating right, getting plenty of rest and getting a seasonal flu

vaccination.

■ Work with your insurance companies, and state and local health

agencies to provide information to employees and customers

about medical care in the event of a pandemic.

■ Assist employees in managing additional stressors related to the

pandemic. These are likely to include distress related to personal

or family illness, life disruption, grief related to loss of family,

friends or coworkers, loss of routine support systems, and

similar challenges. Assuring timely and accurate communication

will also be important throughout the duration of the pandemic

in decreasing fear or worry. Employers should provide opportunities for support, counseling, and mental health assessment

and referral should these be necessary. If present, Employee

Assistance Programs can offer training and provide resources

and other guidance on mental health and resiliency before and

during a pandemic.

Protect Employees and Customers

Educate and train employees in proper hand hygiene, cough

etiquette and social distancing techniques. Understand and develop

work practice and engineering controls that could provide additional

protection to your employees and customers, such as: drive-through

service windows, clear plastic sneeze barriers, ventilation, and

the proper selection, use and disposal of personal protective

equipment. 

These are not comprehensive recommendations. The most

important part of pandemic planning is to work with your

employees, local and state agencies and other employers to

develop cooperative pandemic plans to maintain your operations

15
and keep your employees and the public safe. Share what you

know, be open to ideas from your employees, then identify and

share effective health practices with other employers in your

community and with your local chamber of commerce. 

How Organizations Can Protect Their

Employees

For most employers, protecting their employees will depend on

emphasizing proper hygiene (disinfecting hands and surfaces) and

practicing social distancing (see page 26 for more information).

Social distancing means reducing the frequency, proximity, and

duration of contact between people (both employees and customers)

to reduce the chances of spreading pandemic influenza from

person-to-person. All employers should implement good hygiene

and infection control practices. 

Occupational safety and health professionals use a framework

called the “hierarchy of controls” to select ways of dealing with

workplace hazards. The hierarchy of controls prioritizes intervention

strategies based on the premise that the best way to control a

hazard is to systematically remove it from the workplace, rather

than relying on employees to reduce their exposure. In the setting

of a pandemic, this hierarchy should be used in concert with current

public health recommendations. The types of measures that may be

used to protect yourself, your employees, and your customers

(listed from most effective to least effective) are: engineering

controls, administrative controls, work practices, and personal

protective equipment (PPE). Most employers will use a combination

of control methods. There are advantages and disadvantages to

each type of control measure when considering the ease of implementation, effectiveness, and cost. For example, hygiene and social

distancing can be implemented relatively easily and with little

expense, but this control method requires employees to modify

and maintain their behavior, which may be difficult to sustain. On

the other hand, installing clear plastic barriers or a drive-through

window will be more expensive and take a longer time to implement,

16
although in the long run may be more effective at preventing

transmission during a pandemic. Employers must evaluate their

particular workplace to develop a plan for protecting their employees

that may combine both immediate actions as well as longer term

solutions. 

Here is a description of each type of control:

Work Practice and Engineering Controls - Historically, infection

control professionals have relied on personal protective equipment

(for example, surgical masks and gloves) to serve as a physical

barrier in order to prevent the transmission of an infectious disease

from one person to another. This reflects the fact that close interactions with infectious patients is an unavoidable part of many

healthcare occupations. The principles of industrial hygiene

demonstrate that work practice controls and engineering controls

can also serve as barriers to transmission and are less reliant on

employee behavior to provide protection. Work practice controls

are procedures for safe and proper work that are used to reduce

the duration, frequency or intensity of exposure to a hazard. When

defining safe work practice controls, it is a good idea to ask your

employees for their suggestions, since they have firsthand experience

with the tasks. These controls should be understood and followed

by managers, supervisors and employees. When work practice

controls are insufficient to protect employees, some employers

may also need engineering controls. 

Engineering controls involve making changes to the work

environment to reduce work-related hazards. These types of controls

are preferred over all others because they make permanent changes

that reduce exposure to hazards and do not rely on employee

or customer behavior. By reducing a hazard in the workplace,

engineering controls can be the most cost-effective solutions for

employers to implement.

During a pandemic, engineering controls may be effective in

reducing exposure to some sources of pandemic influenza and not

others. For example, installing sneeze guards between customers

and employees would provide a barrier to transmission. The use of

barrier protections, such as sneeze guards, is common practice for

both infection control and industrial hygiene. However, while the

17
18

installation of sneeze guards may reduce or prevent transmission

between customers and employees, transmission may still occur

between coworkers. Therefore, administrative controls and public

health measures should be implemented along with engineering

controls.

Examples of work practice controls include:

■ Providing resources and a work

environment that promotes

personal hygiene. For example,

provide tissues, no-touch trash

cans, hand soap, hand sanitizer,

disinfectants and disposable towels

for employees to clean their work

surfaces.

■ Encouraging employees to obtain a

seasonal influenza vaccine (this helps to

prevent illness from seasonal influenza

strains that may continue to circulate).

■ Providing employees with up-to-date

education and training on influenza risk

factors, protective behaviors, and

instruction on proper behaviors (for

example, cough ettiquette and care of personal protective

equipment). 

■ Developing policies to minimize contacts between employees

and between employees and clients or customers.

More information about protecting yourself, your coworkers and

employees, and your family can be found at www.pandemicflu.gov.
19

Examples of engineering controls include:

■ Installing physical

barriers, such as clear

plastic sneeze guards.

■ Installing a drivethrough window for

customer service.

■ In some limited

healthcare settings, for

aerosol generating

procedures, specialized

negative pressure ventilation may be indicated.

Administrative Controls - Administrative controls include controlling

employees' exposure by scheduling their work tasks in ways that

minimize their exposure levels. Examples of administrative controls

include:

■ Developing policies that encourage ill employees to stay at

home without fear of any reprisals.

■ The discontinuation of unessential travel to locations with high

illness transmission rates. 

■ Consider practices to minimize face-to-face contact between

employees such as e-mail, websites and teleconferences. Where

possible, encourage flexible work arrangements such as

telecommuting or flexible work hours to reduce the number of

your employees who must be at work at one time or in one

specific location. 

■ Consider home delivery of goods and services to reduce the

number of clients or customers who must visit your workplace.

■ Developing emergency communications plans. Maintain a

forum for answering employees’ concerns. Develop internetbased communications if feasible.

Personal Protective Equipment (PPE) - While administrative and

engineering controls and proper work practices are considered to

be more effective in minimizing exposure to the influenza virus, the

use of PPE may also be indicated during certain exposures. If used

correctly, PPE can help prevent some exposures; however, they

This photo shows a clear plastic barrier between

employees and customers that can reduce occupational exposure to the general public. 
should not take the place of other prevention interventions, such as

engineering controls, cough etiquette, and hand hygiene (see

www.cdc.gov/flu/protect/stopgerms.htm). Examples of personal

protective equipment are gloves, goggles, face shields, surgical

masks, and respirators (for example, N-95). It is important that

personal protective equipment be:

■ Selected based upon the hazard to the employee;

■ Properly fitted and some must be periodically refitted (e.g.,

respirators);

■ Conscientiously and properly worn;

■ Regularly maintained and replaced, as necessary;

■ Properly removed and disposed of to avoid contamination of

self, others or the environment.

Employers are obligated to provide their employees with

protective gear needed to keep them safe while performing their

jobs. The types of PPE recommended for pandemic influenza will

be based on the risk of contracting influenza while working and the

availability of PPE. Check the www.pandemicflu.gov website for

the latest guidance.

The Difference Between a Surgical Mask

and a Respirator

It is important that employers and employees understand the

significant differences between these types of personal protective

equipment. The decision on whether or not to require employees to

use either surgical/procedure masks or respirators must be based

upon a hazard analysis of the employees’ specific work environment

and the differing protective properties of each type of personal

protective equipment. The use of surgical masks or respirators is

one component of infection control practices that may reduce transmission between infected and non-infected persons. 

It should be noted that there is limited information on the use of

surgical masks for the control of a pandemic in settings where there

is no identified source of infection. There is no information on

20
respirator use in such scenarios since modern respirators did not

exist during the last pandemic. However, respirators are now

routinely used to protect employees against occupational hazards,

including biological hazards such as tuberculosis, anthrax, and

hantavirus. The effectiveness of surgical masks and respirators has

been inferred on the basis of the mode of influenza transmission,

particle size, and professional judgment. 

To offer protection, both surgical masks and respirators must be

worn correctly and consistently throughout the time they are being

used. If used properly, surgical masks and respirators both have a

role in preventing different types of exposures. During an influenza

pandemic, surgical masks and respirators should be used in

conjunction with interventions that are known to prevent the spread

of infection, such as respiratory etiquette, hand hygiene, and

avoidance of large gatherings.

Surgical Masks - Surgical masks are used as a physical barrier to

protect employees from hazards such as splashes of large droplets

of blood or body fluids. Surgical masks also prevent contamination

by trapping large particles of body fluids that may contain bacteria

or viruses when they are expelled by the wearer, thus protecting

other people against infection from the person wearing the surgical

mask. 

Surgical/procedure masks are used for several different purposes,

including the following:

■ Placed on sick people to limit the spread of infectious respiratory

secretions to others.

■ Worn by healthcare providers to prevent accidental contamination of patients’ wounds by the organisms normally present in

mucus and saliva.

■ Worn by employees to protect themselves from splashes or

sprays of blood or body fluids; they may also have the effect of

keeping contaminated fingers/hands away from the mouth and

nose.

Surgical masks are not designed or certified to prevent the

inhalation of small airborne contaminants. These small airborne

contaminants are too little to see with the naked eye but may still

be capable of causing infection. Surgical/procedure masks are not

21
designed to seal tightly against the user’s face. During inhalation,

much of the potentially contaminated air passes through gaps

between the face and the surgical mask, thus avoiding being pulled

through the material of the mask and losing any filtration that it

may provide. Their ability to filter small particles varies significantly based upon the type of material used to make the surgical mask,

and so they cannot be relied upon to protect employees against

airborne infectious agents. Only surgical masks that are cleared by

the U.S. Food and Drug Administration and legally marketed in the

United States have been tested for their ability to resist blood and

body fluids. 

Respirators - Respirators are designed to reduce an employee’s

exposure to airborne contaminants. Respirators are designed to fit

the face and to provide a tight seal between the respirator’s edge

and the face. A proper seal between the user’s face and the respirator

forces inhaled air to be pulled through the respirator’s filter material

and not through gaps between the face and respirator. Respirators

must be used in the context of a comprehensive respiratory

protection program, (see OSHA standard 29 CFR 1910.134, or

www.osha.gov/SLTC/respiratoryprotection/index.html). It is

important to medically evaluate employees to assure that they can

perform work tasks while wearing a respirator. Medical evaluation

can be as simple as a questionnaire (found in Appendix C of OSHA’s

Respiratory Protection standard, 29 CFR 1910.134). Employers who

have never before needed to consider a respiratory protection plan

should note that it can take time to choose a respirator to provide

to employees and to arrange for a qualified trainer and provide

training, fit testing, and medical evaluation for their employees. If

employers wait until an influenza pandemic actually arrives, they

may be unable to provide an adequate respiratory protection

program in a timely manner.

Types of Respirators

Respirators can be air supplying (e.g., the self-contained breathing

apparatus worn by firefighters) or air purifying (e.g., a gas mask

that filters hazards from the air). Most employees affected by

pandemic influenza who are deemed to need a respirator to

minimize the likelihood of exposure to the pandemic influenza virus

22
in the workplace will use some type of air purifying respirator. They

are also known as “particulate respirators” because they protect by

filtering particles out of the air as you breathe. These respirators

protect only against particles—not gases or vapors. Since airborne

biological agents such as bacteria or viruses are particles, they can

be filtered by particulate respirators. 

Air purifying respirators can be divided into several types:

■ Disposable or filtering facepiece respirators, where the entire

respirator facepiece is comprised of filter material. This type of

respirator is also commonly referred to as an “N95” respirator.

It is discarded when it becomes unsuitable for further use due

to excessive breathing resistance (e.g., particulate clogging the

filter), unacceptable contamination/soiling, or physical damage.

• Surgical respirators are a type of respiratory protection that

offers the combined protective properties of both a filtering

facepiece respirator and a surgical mask. Surgical N95

respirators are certified by NIOSH as respirators and also

cleared by FDA as medical devices which have been designed

and tested and shown to be equivalent to surgical masks in

certain performance characteristics (resistance to blood

penetration, biocompatibility) which are not examined by

NIOSH during its certification of N95 respirators.

■ Reusable or elastomeric respirators, where the facepiece can

be cleaned, repaired and reused, but the filter cartridges are

discarded and replaced when they become unsuitable for further

use. These respirators come in half-mask (covering the mouth

and nose) and full-mask (covering mouth, nose, and eyes)

types. These respirators can be used with a variety of different

cartridges to protect against different hazards. These respirators

can also be used with canisters or cartridges that will filter out

gases and vapors.

■ Powered air purifying respirators, (PAPRs) where a batterypowered blower pulls contaminated air through filters, then

moves the filtered air to the wearer’s facepiece. PAPRs are significantly more expensive than other air purifying respirators but

they provide higher levels of protection and may also increase

the comfort for some users by reducing the physiologic burden

23
associated with negative pressure respirators and providing a

constant flow of air on the face. These respirators can also be

used with canisters or cartridges that will filter out gases and

vapors. It should also be noted that there are hooded PAPRs that

do not require employees to be fit tested in order to use them.

All respirators used in the workplace are required to be tested

and certified by the National Institute for Occupational Safety and

Health (NIOSH). NIOSH-approved respirators are marked with the

manufacturer’s name, the part number, the protection provided by

the filter (e.g., N95), and “NIOSH.” This information is printed on

the facepiece, exhalation valve cover, or head straps. If a respirator

does not have these markings it has not been certified by NIOSH.

Those respirators that are surgical N95 respirators are also cleared

by the FDA and, therefore, are appropriate for circumstances in

which protection from airborne and body fluid contaminants is

needed.

When choosing between disposable and reusable respirators,

employers should consider their work environment, the nature of

pandemics, and the potential for supply chain disruptions. Each

pandemic influenza outbreak could last from 6 to 8 weeks and waves

of outbreaks may occur over a year or more. While disposable

respirators may be more convenient and cheaper on a per unit

basis, a reusable respirator may be more economical on a longterm basis and reduce the impact of disruption in supply chains or

shortages of respirators.

Classifying Particulate Respirators and Particulate Filters

An N95 respirator is one of nine types of particulate respirators.

Respirator filters that remove at least 95 percent of airborne

particles during “worst case” testing using the “most-penetrating”

size of particle are given a 95 rating. Those that filter out at least 99

percent of the particles under the same conditions receive a 99

rating, and those that filter at least 99.97 percent (essentially 100

percent) receive a 100 rating.

In addition, filters in this family are given a designation of N, R,

or P to convey their ability to function in the presence of oils that

are found in some work environments. 

24
“N” if they are Not resistant to oil. (e.g., N95, N99, N100)

“R” if they are somewhat Resistant to oil. (e.g., R95, R99, R100)

“P” if they are strongly resistant (i.e., oil Proof). (e.g., P95, P99,

P100)

This rating is important in work settings where oils may be present

because some industrial oils can degrade the filter performance to

the point that it does not filter adequately. Thus, the three filter efficiencies combined with the three oil designations lead to nine types

of particulate respirator filter materials. It should be noted that any

of the various types of filters listed here would be acceptable for

protection against pandemic influenza in workplaces that do not

contain oils, particularly if the N95 filter type was unavailable due to

shortages.

Replacing Disposable Respirators

Disposable respirators are designed to be used once and are then

to be properly disposed of. Once worn in the presence of an

infectious patient, the respirator should be considered potentially

contaminated with infectious material, and touching the outside of

the device should be avoided to prevent self-inoculation (touching

the contaminated respirator and then touching one’s eyes, nose, or

mouth). It should be noted that a once-worn respirator will also be

contaminated on its inner surface by the microorganisms present in

the exhaled air and oral secretions of the wearer.

If a sufficient supply of respirators is not available during a

pandemic, employers and employees may consider reuse as long as

the device has not been obviously soiled or damaged (e.g., creased

or torn), and it retains its ability to function properly. This practice is

not acceptable under normal circumstances and should only be

considered under the most dire of conditions. Data on decontamination

and/or reuse of respirators for infectious diseases are not available.

Reuse may increase the potential for contamination; however, this

risk must be balanced against the need to provide respiratory

protection. When preparing for a pandemic, employers who

anticipate providing respiratory protection to employees for the

duration of the pandemic should consider using reusable or elastomeric

respirators that are designed to be cleaned, repaired and reused.

25
Dust or Comfort Masks

Employers and employees should be aware that there are “dust” or

“comfort” masks sold at home improvement stores that look very

similar to respirators. Some dust masks may even be made by a

manufacturer that also produces NIOSH-certified respirators.

Unless a mask has been tested and certified by NIOSH, employers

do not know if the device will filter very small airborne particles.

The occupational use of respirators, including those purchased at

home improvement or convenience stores, are still covered by

OSHA’s Respiratory Protection standard. 

Note: Some respirators have an exhalation valve to make it

easier for the wearer to breathe. While these respirators provide the

same level of particle filtration protection to the wearer, they should

not be used by healthcare providers who are concerned about

contaminating a sterile field, or provided to known or suspected

pandemic patients as a means of limiting the spread of their body

fluids to others.

Note: Additional respirator and surgical mask guidance for

healthcare workers has been developed and is available at

www.pandemicflu.gov/plan/healthcare/maskguidancehc.html. This

document, “Interim Guidance on Planning for the Use of Surgical

Masks and Respirators in Health Care Settings during an Influenza

Pandemic,” provides details on the differences between a surgical

mask and a respirator, the state of science regarding influenza

transmission, and the rationale for determining the appropriate

protective device.

Steps Every Employer Can Take to Reduce

the Risk of Exposure to Pandemic Influenza

in Their Workplace

The best strategy to reduce the risk of becoming infected with

influenza during a pandemic is to avoid crowded settings and other

situations that increase the risk of exposure to someone who may

be infected. If it is absolutely necessary to be in a crowded setting,

26
the time spent in a crowd should be as short as possible. Some

basic hygiene (see www.cdc.gov/flu/protct/stopgerms.htm) and

social distancing precautions that can be implemented in every

workplace include the following:

■ Encourage sick employees to stay at home. 

■ Encourage your employees to wash their hands frequently with

soap and water or with hand sanitizer if there is no soap or

water available. Also, encourage your

employees to avoid touching their

noses, mouths, and eyes.

■ Encourage your employees to cover

their coughs and sneezes with a

tissue, or to cough and sneeze into

their upper sleeves if tissues are not

available. All employees should wash

their hands or use a hand sanitizer

after they cough, sneeze or blow their

noses. 

■ Employees should avoid close contact with their coworkers and

customers (maintain a separation of at least 6 feet). They should

avoid shaking hands and always wash their hands after contact

with others. Even if employees wear gloves, they should wash

their hands upon removal of the gloves in case their hand(s)

became contaminated during the removal process.

■ Provide customers and the public with tissues and trash

receptacles, and with a place to wash or disinfect their hands.

■ Keep work surfaces, telephones, computer equipment and other

frequently touched surfaces and office equipment clean. Be sure

that any cleaner used is safe and will not harm your employees

or your office equipment. Use only disinfectants registered by

the U.S. Environmental Protection Agency (EPA), and follow

all directions and safety precautions indicated on the label.

■ Discourage your employees from using other employees’

phones, desks, offices or other work tools and equipment. 

■ Minimize situations where groups of people are crowded

together, such as in a meeting. Use e-mail, phones and text

messages to communicate with each other. When meetings are

27
necessary, avoid close contact by keeping a separation of at

least 6 feet, where possible, and assure that there is proper

ventilation in the meeting room. 

■ Reducing or eliminating unnecessary social interactions can be

very effective in controlling the spread of infectious diseases.

Reconsider all situations that permit or require employees,

customers, and visitors (including family members) to enter the

workplace. Workplaces which permit family visitors on site

should consider restricting/eliminating that option during an

influenza pandemic. Work sites with on-site day care should

consider in advance whether these facilities will remain open or

will be closed, and the impact of such decisions on employees

and the business.

■ Promote healthy lifestyles, including good nutrition, exercise,

and smoking cessation. A person’s overall health impacts their

body’s immune system and can affect their ability to fight off, or

recover from, an infectious disease.

Workplaces Classified at Lower Exposure

Risk (Caution) for Pandemic Influenza:

What to Do to Protect Employees

If your workplace does not require employees to have frequent

contact with the general public, basic personal hygiene practices

and social distancing can help protect employees at work. Follow

the general hygiene and social distancing practices previously

recommended for all workplaces (see page 26). Also, try the

following: 

■ Communicate to employees what options may be available to

them for working from home. 

■ Communicate the office leave policies, policies for getting paid,

transportation issues, and day care concerns. 

■ Make sure that your employees know where supplies for hand

hygiene are located. 

28
■ Monitor public health communications about pandemic flu

recommendations and ensure that your employees also have

access to that information. 

■ Work with your employees to designate a person(s), website,

bulletin board or other means of communicating important

pandemic flu information. 

More information about protecting employees and their families

can be found at: www.pandemicflu.gov.

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, drivethrough 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. 

29
■ 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

30
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

31
but will not protect against airborne transmission, to the extent that

the disease may be spread in that manner. Each employer should

select the combination of PPE that protects employees in their

particular workplace. It should also be noted that wearing PPE may

be physically burdensome to employees, particularly when the use

of PPE is not common practice for the work task.

Educate and train employees about the protective clothing and

equipment appropriate to their current duties and the duties which

they may be asked to assume when others are absent. Employees

may need to be fit tested and trained in the proper use and care of

a respirator. Also, it is important to train employees to put on (don)

and take off (doff) PPE in the proper order to avoid inadvertent

self-contamination (www.osha.gov/SLTC/respiratoryprotection/

index.html). During a pandemic, recommendations for PPE use in

particular occupations may change, depending on geographic

proximity to active cases, updated risk assessments for particular

employees, and information on PPE effectiveness in preventing the

spread of influenza. 

Workplaces Classified at Very High or High

Exposure Risk for Pandemic Influenza:

What to Do to Protect Employees

If your workplace requires your employees to have contact with

people that are known or suspected to be infected with the

pandemic virus, there are many practices that can be used to reduce

the risk of infection and to protect your employees. Additional

guidance for very high and high exposure risk workplaces, such as

health care facilities, can be found at: www.pandemicflu.gov and

www.osha.gov.

Very high and high exposure risk occupations require employers

to address enhanced safety and health precautions in addition to

the basic work practices that every workplace should adopt (see

page 26). Employers should also be aware that working in a high

32
risk occupation can be stressful to both employees and their families.

Employees in high risk occupations may have heightened concern

about their own safety and possible implications for their family.

Such workplaces may experience greater employee absenteeism

than other lower risk workplaces. Talk to your employees about

resources that can help them in the event of a pandemic crisis.

Keeping the workplace safe is everyone’s priority. More information

about protecting employees and their families can be found at:

www.pandemicflu.gov.

Work Practice and Engineering Controls

Employers should ensure that employees have adequate training

and supplies to practice proper hygiene. Emergency responders

and other essential personnel who may be exposed while working

away from fixed facilities should be provided with hand sanitizers

that do not require water so that they can decontaminate themselves

in the field. Employers should work with employees to identify ways

to modify work practices to promote social distancing and prevent

close contact (within 6 feet), where possible. Employers should also

consider offering enhanced medical monitoring of employees in

very high and high risk work environments.

In certain limited circumstances ventilation is recommended for

high and very high risk work environments. While proper ventilation

can reduce the risk of transmission for healthcare workers in the

same room as infectious patients, it cannot be relied upon as the

sole protective measure. Thus, a combination of engineering

controls and personal protective equipment will be needed.

■ When possible, health care facilities equipped with isolation rooms

should use them when performing aerosol generating procedures

for patients with known or suspected pandemic influenza. 

■ Laboratory facilities that handle specimens for known or suspected

pandemic patients will also require special precautions associated

with a Bio-Safety Level 3 facility. Some recommendations can be

found at: www.cdc.gov/flu/h2n2bs13.htm.

Employers should also consider installing physical barriers, such

as clear plastic sneeze guards, to protect employees where possible

(for example, reception or intake areas). The use of barrier protections,

33
such as sneeze guards, is common practice for both infection control

and industrial hygiene.

Administrative Controls (Isolation Precautions)

If working in a health care facility, follow existing guidelines and

facility standards of practice for identifying and isolating infected

individuals and for protecting employees. See the U.S. Department

of Health and Human Services’ pandemic influenza plan for health

care facilities at: www.hhs.gov/pandemicflu/plan/sup4.html.

Personal Protective Equipment (PPE)

Those who work closely with (either in contact with or within 6

feet) people known or suspected to be infected with pandemic

influenza should wear:

■ Respiratory protection for protection against small droplets from

talking, coughing or sneezing and also from small airborne

particles of infectious material.

• N95 or higher rated filter for most situations.

• Supplied air respirator (SAR) or powered air purifying respirator

(PAPR) for certain high risk medical or dental procedures likely

to generate bioaerosols.

• Use a surgical respirator when both respiratory protection and

resistance to blood and body fluids is necessary.

■ Face shields may also be worn on top of a respirator to prevent

bulk contamination of the respirator. Certain respirator designs

with forward protrusions (duckbill style) may be difficult to

properly wear under a face shield. Ensure that the face shield

does not prevent airflow through the respirator.

■ Medical/surgical gowns or other disposable/decontaminable

protective clothing.

■ Gloves to reduce transfer of infectious material from one patient

to another.

■ Eye protection if splashes are anticipated.

The appropriate form of respirator will depend on the type of

exposure and on the transmission pattern of the particular strain of

34
influenza. See the National Institute for Occupational Safety and

Health (NIOSH) Respirator Selection Logic at: www.cdc.gov/niosh/

docs/2005-100.

Educate and train employees about the protective clothing and

equipment appropriate to their current duties and the duties which

they may be asked to assume when others are absent. Education

and training material should be easy to understand and available in

the appropriate language and literacy level for all employees.

Employees need to be fit tested and trained in the proper use and

care of a respirator. It is also important to train employees to put on

(don) and take off (doff) PPE in the proper order to avoid inadvertent

self-contamination (www.osha.gov/SLTC/respiratoryprotection/

index.html). Employees who dispose of PPE and other infectious

waste must also be trained and provided with appropriate PPE.

During a pandemic, recommendations for PPE use in particular

occupations may change depending on geographic location,

updated risk assessments for particular employees, and information

on PPE effectiveness in preventing the spread of influenza.

Additional respirator and surgical mask guidance for healthcare

workers has been developed and is available at www.pandemicflu.

gov/plan/healthcare/maskguidancehc.html. This document,

Interim Guidance on Planning for the Use of Surgical Masks and

Respirators in Health Care Settings during an Influenza Pandemic,

provides details on the differences between a surgical mask and a

respirator, the state of science regarding influenza transmission,

and the rationale for determining the appropriate protective device.

What Employees Living Abroad or Who

Travel Internationally for Work Should Know

Employees living abroad and international business travelers should

note that other geographic areas have different influenza seasons

and will likely be affected by a pandemic at different times than the

United States. The U.S. Department of State emphasizes that, in the

event of a pandemic, its ability to assist Americans traveling and

35
residing abroad may be severely limited by restrictions on local and

international movement imposed for public health reasons, either

by foreign governments and/or the United States. Furthermore,

American citizens should take note that the Department of State

cannot provide Americans traveling or living abroad with medications

or supplies even in the event of a pandemic.

In addition, the Department of State has asked its embassies and

consulates to consider preparedness measures that take into consideration the fact that travel into or out of a country may not be

possible, safe, or medically advisable during a pandemic. Guidance

on how private citizens can prepare to shelter in place, including

stocking food, water, and medical supplies, is available at the

www.pandemicflu.gov website. Embassy stocks cannot be made

available to private American citizens abroad, therefore, employers

and employees are encouraged to prepare appropriately. It is also

likely that governments will respond to a pandemic by imposing

public health measures that restrict domestic and international

movement, further limiting the U.S. government's ability to assist

Americans in these countries. As it is possible that these measures

may be implemented very quickly, it is important that employers

and employees plan appropriately.

More information on pandemic influenza planning for employees

living and traveling abroad can be found at: 

www.pandemicflu.gov/travel/index.html 

www.cdc.gov/travel

www.state.gov/travelandbusiness

36
For More Information

Federal, state and local government agencies are your best source

of information should an influenza pandemic take place. It is

important to stay informed about the latest developments and recommendations since specific guidance may change based upon the

characteristics of the eventual pandemic influenza strain, (for example,

severity of disease, importance of various modes of transmission). 

Below are several recommended websites that you can rely on

for the most current and accurate information:

www.pandemicflu.gov 

(Managed by the Department of Health and Human Services;

offers one-stop access, including toll-free phone numbers, to U.S.

government avian and pandemic flu information.)

www.osha.gov 

(Occupational Safety and Health Administration website)

www.cdc.gov/niosh 

(National Institute for Occupational Safety and Health website)

www.cdc.gov 

(Centers for Disease Control and Prevention website)

www.fda.gov/cdrh/ppe/fluoutbreaks.html 

(U.S. Food and Drug Administration website)

37
OSHA Assistance

OSHA can provide extensive help through a variety of programs,

including technical assistance about effective safety and health

programs, state plans, workplace consultations, voluntary protection programs, strategic partnerships, training and education,

and more. An overall commitment to workplace safety and health

can add value to your business, to your workplace and to your life.

Safety and Health Program Management Guidelines

Effective management of employee safety and health protection is

a decisive factor in reducing the extent and severity of workrelated injuries and illnesses and their related costs. In fact, an

effective safety and health program forms the basis of good

employee protection and can save time and money (about $4 for

every dollar spent) and increase productivity and reduce employee

injuries, illnesses and related workers’ compensation costs.

To assist employers and employees in developing effective

safety and health programs, OSHA published recommended Safety

and Health Program Management Guidelines (54 Federal Register

(16): 3904-3916, January 26, 1989). These voluntary guidelines

apply to all places of employment covered by OSHA.

The guidelines identify four general elements critical to the

development of a successful safety and health management

program:

■ Management leadership and employee involvement.

■ Work analysis.

■ Hazard prevention and control.

■ Safety and health training.

The guidelines recommend specific actions, under each of 

these general elements, to achieve an effective safety and health

program. The Federal Register notice is available online at

www.osha.gov. 

State Programs

The Occupational Safety and Health Act of 1970 (OSH Act) encourages states to develop and operate their own job safety and

38
39

health plans. OSHA approves and monitors these plans. Twentyfour states, Puerto Rico and the Virgin Islands currently operate

approved state plans: 22 cover both private and public (state and

local government) employment; Connecticut, New Jersey, New

York and the Virgin Islands cover the public sector only. States and

territories with their own OSHA-approved occupational safety and

health plans must adopt standards identical to, or at least as

effective as, the Federal standards. 

Consultation Services

Consultation assistance is available on request to employers who

want help in establishing and maintaining a safe and healthful

workplace. Largely funded by OSHA, the service is provided at no

cost to the employer. Primarily developed for smaller employers

with more hazardous operations, the consultation service is delivered by state governments employing professional safety and

health consultants. Comprehensive assistance includes an appraisal

of all mechanical systems, work practices and occupational safety

and health hazards of the workplace and all aspects of the employer’s present job safety and health program. In addition, the

service offers assistance to employers in developing and implementing an effective safety and health program. No penalties are

proposed or citations issued for hazards identified by the consultant. OSHA provides consultation assistance to the employer

with the assurance that his or her name and firm and any information about the workplace will not be routinely reported to OSHA

enforcement staff.

Under the consultation program, certain exemplary employers

may request participation in OSHA’s Safety and Health

Achievement Recognition Program (SHARP). Eligibility for participation in SHARP includes receiving a comprehensive consultation

visit, demonstrating exemplary achievements in workplace safety

and health by abating all identified hazards and developing an

excellent safety and health program.

Employers accepted into SHARP may receive an exemption

from programmed inspections (not complaint or accident investigation inspections) for a period of one year. For more information

concerning consultation assistance, see the OSHA website at

www.osha.gov.
Voluntary Protection Programs (VPP)

Voluntary Protection Programs and on-site consultation services,

when coupled with an effective enforcement program, expand

employee protection to help meet the goals of the OSH Act. The 

three levels of VPP are Star, Merit, and Star Demonstration designed

to recognize outstanding achievements by companies that have

successfully incorporated comprehensive safety and health

programs into their total management system. The VPPs motivate

others to achieve excellent safety and health results in the same

outstanding way as they establish a cooperative relationship

between employers, employees and OSHA.

For additional information on VPP and how to apply, contact the

OSHA regional offices listed at the end of this publication.

Strategic Partnership Program

OSHA’s Strategic Partnership Program, the newest member of

OSHA’s cooperative programs, helps encourage, assist and

recognize the efforts of partners to eliminate serious workplace

hazards and achieve a high level of employee safety and health.

Whereas OSHA’s Consultation Program and VPP entail one-on-one

relationships between OSHA and individual worksites, most

strategic partnerships seek to have a broader impact by building

cooperative relationships with groups of employers and employees. These partnerships are voluntary, cooperative relationships between OSHA, employers, employee representatives and

others (e.g., trade unions, trade and professional associations, 

universities and other government agencies). 

For more information on this and other cooperative programs,

contact your nearest OSHA office, or visit OSHA’s website at

www.osha.gov.

Alliance Programs

The Alliance Program enables organizations committed to

workplace safety and health to collaborate with OSHA to prevent

injuries and illnesses in the workplace. OSHA and the Alliance 

participants work together to reach out to, educate and lead the

nation’s employers and their employees in improving and advancing workplace safety and health. 

40
41

Groups that can form an Alliance with OSHA include employers,

labor unions, trade or professional groups, educational institutions

and government agencies. In some cases, organizations may be

building on existing relationships with OSHA that were developed

through other cooperative programs. 

There are few formal program requirements for Alliances and

the agreements do not include an enforcement component. However, OSHA and the participating organizations must define, implement and meet a set of short- and long-term goals that fall into

three categories: training and education; outreach and communication; and promoting the national dialogue on workplace safety and

health. 

OSHA Training and Education

OSHA area offices offer a variety of information services, such as

compliance assistance, technical advice, publications, audiovisual

aids and speakers for special engagements. OSHA’s Training

Institute in Arlington Heights, IL, provides basic and advanced

courses in safety and health for Federal and state compliance

officers, state consultants, Federal agency personnel, and private

sector employers, employees and their representatives.

The OSHA Training Institute also has established OSHA Training

Institute Education Centers to address the increased demand for its

courses from the private sector and from other Federal agencies.

These centers are nonprofit colleges, universities and other organizations that have been selected after a competition for participation

in the program.

OSHA also provides funds to nonprofit organizations, through

grants, to conduct workplace training and education in subjects

where OSHA believes there is a lack of workplace training. Grants

are awarded annually. Grant recipients are expected to contribute

20 percent of the total grant cost.

For more information on grants, training and education, contact

the OSHA Training Institute, Office of Training and Education, 2020

South Arlington Heights Road, Arlington Heights, IL 60005, (847)

297-4810 or see “Outreach” on OSHA’s website at www.osha.gov.

For further information on any OSHA program, contact your

nearest OSHA area or regional office listed at the end of this

publication.
Information Available Electronically

OSHA has a variety of materials and tools available on its website

at www.osha.gov. These include eTools such as Expert Advisors,

Electronic Compliance Assistance Tools (e-cats), Technical Links;

regulations, directives and publications; videos and other

information for employers and employees. OSHA’s software programs and compliance assistance tools walk you through challenging safety and health issues and common problems to find the best

solutions for your workplace.

A wide variety of OSHA materials, including standards, interpretations, directives, and more, can be purchased on CD-ROM from

the U.S. Government Printing Office, Superintendent of Documents,

phone toll-free (866) 512-1800.

OSHA Publications

OSHA has an extensive publications program. For a listing of free

or sales items, visit OSHA’s website at www.osha.gov or contact the

OSHA Publications Office, U.S. Department of Labor, 200

Constitution Avenue, NW, N-3101, Washington, DC 20210.

Telephone (202) 693-1888 or fax to (202) 693-2498. 

Contacting OSHA

To report an emergency, file a complaint, or seek OSHA advice,

assistance, or products, call (800) 321-OSHA or contact your nearest

OSHA Regional or Area office listed at the end of this publication.

The teletypewriter (TTY) number is (877) 889-5627.

Written correspondence can be mailed to the nearest OSHA

Regional or Area Office listed at the end of this publication or to

OSHA’s national office at: U.S. Department of Labor, Occupational

Safety and Health Administration, 200 Constitution Avenue, N.W.,

Washington, DC 20210.

By visiting OSHA’s website at www.osha.gov, you can also:

• file a complaint online,

• submit general inquiries about workplace safety and health electronically, and

• find more information about OSHA and occupational safety and

health.

42
43

OSHA Regional Offices

* These states and territories operate their own OSHA-approved job

safety and health programs (Connecticut, New Jersey, New York and the

Virgin Islands plans cover public employees only). States with approved

programs must adopt standards identical to, or at least as effective as, the

Federal standards.

Note: To get contact information for OSHA Area Offices, OSHAapproved State Plans and OSHA Consultation Projects, please visit us

online at www.osha.gov or call us at 1-800-321-OSHA.

Region I

(CT,* ME, MA, NH, RI, VT*) 

JFK Federal Building, Room E340

Boston, MA 02203

(617) 565-9860

Region II

(NJ,* NY,* PR,* VI*)

201 Varick Street, Room 670

New York, NY 10014

(212) 337-2378

Region III

(DE, DC, MD,* PA, VA,* WV)

The Curtis Center

170 S. Independence Mall West

Suite 740 West

Philadelphia, PA 19106-3309

(215) 861-4900

Region IV 

(AL, FL, GA, KY,* MS, NC,* SC,* TN*)

61 Forsyth Street, SW

Atlanta, GA 30303

(404) 562-2300

Region V

(IL, IN,* MI,* MN,* OH, WI)

230 South Dearborn Street 

Room 3244

Chicago, IL 60604

(312) 353-2220

Region VI

(AR, LA, NM,* OK, TX)

525 Griffin Street, Room 602

Dallas, TX 75202

(214) 767-4731 or 4736 x224

Region VII

(IA,* KS, MO, NE)

City Center Square

1100 Main Street, Suite 800

Kansas City, MO 64105

(816) 426-5861

Region VIII

(CO, MT, ND, SD, UT,* WY*)

1999 Broadway, Suite 1690

PO Box 46550

Denver, CO 80202-5716

(720) 264-6550

Region IX 

(American Samoa, AZ,* CA,* HI,* NV,*

Northern Mariana Islands)

71 Stevenson Street, Room 420

San Francisco, CA 94105

(415) 975-4310

Region X

(AK,* ID, OR,* WA*)

1111 Third Avenue, Suite 715

Seattle, WA 98101-3212

(206) 553-5930

www.osha.gov