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Home > Issue by Date > October 2006

Life Safety In The Workplace

Preventive safety measures are key to managing facilities during catastrophic health situations.

By Donald S. Jones, Sr., CSP, P.E., MBA

Whether toxic or tedious, the tiny microorganisms associated with previously undiagnosed health threats continue to cause problems in human populations. Despite major advancements in medicine and technology, including vaccines and preventive practices, rapidly spreading illnesses are a global concern—particularly in the workplace where populations are consolidated and exposure and infection can happen quickly and easily.

Currently, there is a health threat that has achieved global concern. H5N1, better known as bird flu, has grabbed the headlines with scattered reports of outbreaks around the world.

Despite the recent development and pending launch of a vaccine (possibly available as soon as 2007), H5N1 has demonstrated the tendency to mutate and evolve like other deadly viruses. The results have not been nearly as devastating as outbreaks in the past, but the chapter is not yet closed on this disturbing trend.

Historically, flu pandemics have occurred three to four times, on average, each century when new virus subtypes have emerged. In the 20th century, flu pandemics occurred from 1918 to 1919, causing an estimated 50 million deaths worldwide. This was followed by less serious outbreaks from 1957 to 1958 and 1968 to 1969.

Based on these patterns, it is likely that another pandemic may occur in the near future, especially since many flu strains that have the ability to mutate have existed for thousands of years. For instance, type A avian flu virus was first identified in Italy more than 100 years ago. In the past 10 years, this virus has reasserted itself, thus signaling the need for preventive safety measures—particularly in facilities inhabited by people who may come in contact with the flu.

Highly Infectious

The avian flu virus appears in both high and low pathogenic strains. It is the highly pathogenic or infectious strains that are of most concern. There are 15 subtypes of the flu that infect birds, and of all the subtypes to date, the subtypes H5 and H7 of the type A virus cause highly pathogenic outbreaks.

Recently, this strain of the flu has appeared in poultry across Asia, parts of Europe, the Near East, and Africa. The spread of the virus in birds, especially poultry, increases the chances for direct infection of humans.

There have been confirmed cases of the direct transmission of H5N1 virus from bird to human in Hong Kong, Thailand, Vietnam, and Indonesia. And since 2004, there have been more than 200 confirmed cases of humans infected with the H5N1 strain of avian flu virus; 50% of these infections have been fatal.

The H5N1 strain is of particular concern, because it mutates rapidly and has a tendency to acquire genes from viruses infecting other animal species, including humans. Though there are very few reported cases of human to human transmission, the virus’ capacity to evolve through exposure to new hosts makes each human infection dangerous, particularly if it comes in contact with human influenza.

Contact of this kind allows the virus to adapt and gain the ability to transmit easily from human to human. The more humans become infected, whether from birds, equipment, or from other humans, the more likely a new strain can develop that is highly pathogenic. This can lead to a widespread pandemic. The key to preventing a pandemic begins with limiting the spread of the virus in poultry.

Should an outbreak of avian flu occur, managers in high risk facilities must take great care in limiting worker exposure. At particular high risk are health care, food processing, agriculture, and warehouse/storage personnel.

Fighting Back

Given the right conditions, the virus can survive up to one week. And if an outbreak should occur, it is essential for both government and private industry to develop feasible and orderly contingency plans for containment.

Overall, the most essential component of an effective influenza contingency plan is communication. Facility managers must develop an effective network that includes governments, other industries, and facility workers.

The U.S. Centers for Disease Control and Prevention (CDC), the United States Department of Health and Human Services (DHHS), and the World Health Organization (WHO) all recommend several approaches to limit the risk of workers (particularly those in health care) who may encounter outbreaks.

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One of the first steps is to provide information on the risks—as well as the prevention—of the spread of infection. This means setting up training programs, distributing available literature, and providing worker education to anyone exposed to the illness.

It is also possible to prevent the spread of the virus simply through the reiteration of good hygiene practices. In other words, sick employees should be encouraged to stay home; personal protective equipment (PPE) should be used to minimize exposure to contaminated surfaces; employees at high risk of exposure to H5N1 should be treated with the current human influenza vaccine to prevent the mixture of human flu genes with bird flu genes; and anyone at risk of exposure should be given antiviral drugs.

Minimizing Exposure

Charged with coordinating efforts to maintain the daily functions of their facility, professionals also need to consider the possibility of high employee absenteeism in the event of an outbreak. For example, facility managers should work with human resources to develop a plan that encourages employees to work off-site in the event they develop flu-like symptoms (cough, eye infection, etc.) prior to any outbreak.

To limit the spread of flu, managers should ask employees to wait 24 hours after their fever subsides before returning to work. The goal is to keep the transition from low to high absenteeism seamless in the event of an outbreak.

Facility managers, especially those in charge of health facilities, need to enforce the use of PPE to limit the levels of exposure to any flu virus. For example, both the WHO and the CDC recommend the use of protective clothing, gloves, and boots or protective foot covers that can be discarded or disinfected when in contact with flu patients or infected birds.

Fit tested respirators, especially among health facility workers, should be part of a comprehensive respiratory protection program. Workers can also be given and encouraged to wear eye protection when within 3' of a patient to prevent exposure. Finally, health care facility managers should provide precautions against possible airborne exposure by creating airborne isolation rooms (AIR) for patients suffering from flu symptoms.

Fighting Fair

Studies have shown that the H5N1 subtype is immune to some antiviral medications (amantadine and rimantadine), but oseltamivir and zanamivir are still effective against this strain of flu. Health care and agricultural facility managers should provide these antiviral medications to employees who come in contact with birds, contaminated surfaces, or patients daily as a preventive safety measure. (Source: CDC.)

Facility managers can help prevent the spread of disease that so often surprises—and then kills—unsuspecting workers. Smart precautions can help food processing, health care, education, and other high risk facilities from a deadly outbreak, thus allowing managers to maintain day-to-day functions and safeguard co-workers.

Jones, Sr., CSP, P.E., MBA is president of the American Society of Safety Engineers (ASSE) and is a regulatory expertise leader for Dow Chemical Company. He is also an adjunct safety and health faculty member at Southeastern Louisiana University. For more information on ASSE, go to www.asse.org.

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