Cal/OSHA Releases Ebola Protection Guidelines Advocacy groups urge federal OSHA to expedite stalled infection control rule

By Roy Maurer Oct 20, 2014
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Although widespread outbreak of the Ebola virus in the United States is unlikely, California’s worker protection and public health agencies announced on Oct. 15, 2014, interim guidelines for preventing occupational exposure to the deadly disease.

The Division of Occupational Safety and Health, also known as Cal/OSHA, has coordinated with the California Department of Public Health (CDPH) to issue interim guidelines for workers and employers in professions identified as at potential risk of exposure. These include health care workers, emergency responders, laboratory staff, mortuary workers, airline flight crews and airport staff, and quarantine operations staff.

A 2009 state regulation known as the Aerosol Transmissible Diseases Standard specifically addresses infectious diseases like Ebola, and helped inform the guidelines, the agency said.

Ebola is transmitted through direct contact with the blood or bodily fluids of an infected symptomatic person or through exposure to objects that have been contaminated.

“California’s workplace safety and health standards go further than national standards in protecting workers from hazards such as Ebola,” said Juliann Sum, acting chief of Cal/OSHA, in a statement. “We urge employers and their workers who may be at risk to pay careful attention to our guidance and check for updates as new information becomes available.”

The new guidance recommends that employers:

  • Ensure that workers at risk of exposure to Ebola wear gloves, impermeable body coverings, face shields or other eye and face protection, and appropriate respiratory protection. All personal protective equipment (PPE) must be adequate to prevent the passage of bodily fluids to the employee’s clothing and skin. Federally approved respirators must be used where infectious aerosols are likely to be present.
  • Train employees in the use of all applicable protective equipment, including respirators. Employees must be clearly instructed on how to safely put on and take off equipment.
  • Give employees opportunities to practice with the respirators and other equipment they will use.
  • Provide dedicated, separate areas for the donning and removing of protective gear.
  • Use either a buddy system or other means of assisting employees in donning and removing PPE. Employees who assist in removing contaminated equipment must also use PPE.
  • Provide additional protective gear, such as double gloves and disposable shoe and leg coverings, in environments where copious amounts of blood, vomit, feces or other bodily fluids are present.
  • Ensure that workers conducting aerosol-generating procedures such as intubation or bronchoscopy perform the procedures in an airborne infection isolation room, if feasible, or at least in a private room with the door closed. Employees exposed to these procedures must use approved respirators.

The agency reminds all employers and workers that any suspected cases of Ebola must be promptly reported to the local public health department.

Nurses Say Not Good Enough

Representatives from National Nurses United (NNU), the largest union of registered nurses in the country, have thus far been highly critical of the government’s and hospitals’ response to the Ebola threat.

The union said in a statement that it is “deeply concerned” that Cal/OSHA’s interim guidance on Ebola consists of “essentially the protocols that were in place” in Dallas and that the guidelines “are simply preparing for this as if it’s a contact droplet disease” like the flu.

Gov. Jerry Brown announced Oct. 17, 2014, that the interim guidelines are only a first step and that the state’s public health department is meeting with NNU reps to create strengthened protections for health care workers.

OSHA Lagging Behind?

Spurred by the heightened coverage of the Ebola outbreak, safety advocacy groups have been more vocal in calling for the federal Occupational Safety and Health Administration (OSHA) to move forward its infectious-disease rule, first mentioned in a 2010 request for information.

Current OSHA disease-specific requirements to protect health care workers focus on blood-borne pathogens, protective equipment and hazard communication.

“We’re working closely with the [Centers for Disease Control and Prevention] on Ebola,” said David Michaels, assistant secretary of labor for occupational safety and health. “Coincidentally, we began the small business review of the [infectious diseases] standard just last week,” Michaels told SHRM Online.

The American Industrial Hygiene Association is one group that has called on the agency to “quickly move forward” with the delayed rule. “This rule would provide increased protections and recommendations for America’s health care workers. The rule is an absolute necessity to assist in controlling this virus,” said the group’s executive director, Peter O’Neil.

Government agencies continue to compile resources on Ebola control and prevention, including:

*The California Department of Public Health.

*The Centers for Disease Control and Prevention.

*The Occupational Safety and Health Administration.

Roy Maurer is an online editor/manager for SHRM.

Follow him @SHRMRoy

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