In a recently published Interim Guidance regarding the control and prevention of Ebola, OSHA has provided interim general requirements and recommendations for workers whose duties are performed in circumstances that are known or reasonably suspected to be contaminated with the Ebola virus (e.g., due to contamination with blood or other potentially infectious material). OSHA differentiated such workers from those who have direct contact with persons with Ebola Hemorrhagic Fever.
Non-Direct Contact Workers
Employers should follow recognized and accepted good infection control practices, and are obligated to meet the requirements for the Personal Protective Equipment standard and the Respiratory Protection standard set forth in the applicable regulations (29 C.F.R. § 1910.132 and 29 C.F.R. § 1910.134, respectively). Workers must use personal protective equipment and good hand hygiene protocols to avoid exposure to infected and/or contaminated fluids and objects. These employees should wear gloves, wash their hands with soap and water after they have removed the gloves, and discard such gloves in properly labeled waste receptacles.
Face and eye protection must be worn by workers who may be splashed or sprayed with blood or bodily fluids from environmental surfaces where Ebola virus contamination is a possibility. Such protective gear may include a full-face shield or surgical masks with goggles. To avoid workers’ clothing from being contaminated with infected materials, employees must wear aprons or other fluid-resistant protective clothing.
Employers are charged with the responsibility of ensuring that workers are properly protected from Ebola exposure and are not exposed to harmful levels of cleaning and disinfectant chemicals. OSHA has prepared a Fact Sheet regarding Cleaning and Decontamination of Ebola on Surfaces to assist employers in carrying out this responsibility, and the CDC has issued specific guidance for workers who clean and disinfect possibly contaminated surfaces.
Employers are also mandated to train their workers about the sources of Ebola exposure and appropriate precautions, including the use and disposal of personal protective equipment. In situations where workers are exposed to blood or other possibly infectious matters, employers must train employees as required by the Bloodborne Pathogens standard.
Direct Contact Workers
In the same Guidance, OSHA has also identified workers in certain fields as being at increased risk of Ebola exposure, including healthcare workers; airline and travel industry personnel; mortuary and death care workers; laboratory workers; border, customs, and quarantine workers; emergency responders; and workers in critical sectors, such as transportation and pharmacy. OSHA has stated that the precautionary measures depend on the type of work. OSHA’s Guidance with respect to two of these groups is summarized below.
Healthcare workers should follow Centers for Disease Control and Prevention (“CDC”) guidance and recommendations, including the Infection Prevention and Control Recommendations for Hospitalized Patients with Known or Suspected Ebola Hemorrhagic Fever in U.S. Hospitals. They should also be aware of the U.S. Department of Health and Human Service’s Guidelines for Evaluation of U.S. Patients Suspected of Having Ebola Virus Disease.
In addition, employers must require healthcare workers to use proper personal protective equipment. When caring for patients infected with Ebola, the CDC has issued recommendations for the appropriate personal protective equipment, which includes fluid-resistant garments, dedicated washable footwear, double gloves, respirator, full-face shield, and surgical hood that covers the head and neck completely. In addition to providing the necessary personal protective equipment, employers should train their health care workers on proper donning, doffing, and disposal procedures. Employers in the healthcare industry should also review OSHA standards for personal protective equipment (e.g., 29 C.F.R. § 1910.132), respirator use (e.g., 29 C.F.R. § 1910.134), and Bloodborne Pathogens (e.g., 29 C.F.R. § 1910.1030), and revise protocols to comply with these standards.
Airline and Travel Industry Personnel
Airline workers and those involved in airport service operations (including cleaning staff, cargo staff, and cab drivers who pick-up passengers from airports) may be exposed to Ebola from affected airline passengers who are traveling from West Africa, and any other locations where an outbreak may occur. The CDC has prepared interim guidance for airline flight crews, cleaning personnel, and cargo operations workers.
The CDC recommends that airline and other travel industry workers consider providing surgical masks for sick travelers, and suggests disinfecting lavatory surfaces and frequently touched surfaces. In the event that a passenger becomes ill, airline personnel are instructed to assess the risk of Ebola by asking the passenger if he or she was in a country with an Ebola outbreak and asking about Ebola symptoms. If an ill passenger was in Guinea, Liberia, or Sierra Leone in the last 21 days and is experiencing any Ebola symptoms, the airline crew is to make an immediate report to the CDC before arrival.
The CDC further instructs travel industry personnel to treat all bodily fluids as though they are infectious. In addition, employers must provide protective clothing and equipment for employees who are tasked with cleaning up bodily fluids from a sick passenger. OSHA has issued a Fact Sheet on Cleaning and Decontamination of Ebola on Surfaces. According to OSHA, “[e]mployers are responsible for ensuring that workers are protected from exposure to Ebola and that workers are not exposed to harmful levels of chemicals used for cleaning and disinfection.” The Fact Sheet provides guidance on how to clean and disinfect areas of suspected contamination and explains what personal protective equipment employers should provide to protect employees who are cleaning contaminated areas. In addition to the standards identified for healthcare workers, OSHA notes that employers whose workers may need to clean Ebola-infected areas should also review OSHA standards for Hazard Communication related to potentially hazardous chemicals (29 C.F.R. § 1910.1200).