Avoiding H1N1: OSHA Offers Recommendations for Healthcare Personnel

More than most, you're at risk of exposure to H1N1. To help protect healthcare providers and those working in medical settings, the Occupational Safety and Health Administration (OSHA) has released specific guidelines that go beyond its recommendations for the general public.

Employers in the healthcare fields should use workplace controls, safe work practices and personal protective equipment to reduce their personnel's likelihood of exposure, OSHA says. Workplace controls may include:

• Modifying patient intake, triage and other service areas and procedures to increase space between workers, coworkers and patients;
• Transporting H1N1 patients in ambulances with separate ventilation systems for the driver and patient compartments, or increasing ventilation by operating systems in nonrecirculation mode and letting in as much outdoor air as possible;
• Using closed suctioning systems to suction patients' airways, and using high-quality filters on ventilator expiratory ports;
• Isolating and grouping H1N1 patients;
• Using airborne infection isolation rooms for aerosol-generating procedures and limiting the number of people present during such procedures;
• Handling H1N1 flu specimens in biosafety Level 2 equipment.

Under safe work practices, OSHA recommends:

• Screening incoming patients and separating those with respiratory illnesses;
• Using proper respiratory and cough etiquette (cover coughs and sneezes with a tissue or upper sleeve; discard tissues in "no-touch" receptacles; clean hands after coughing, sneezing or nose-blowing; avoid touching your mouth, nose and eyes) and encouraging hand washing;
• Washing hands with soap and water for 20 seconds before and after contact with patients, after using PPE and after touching contaminated surfaces. Rub soapy hands together for at least 20 seconds, rinse with water and dry completely. If soap and water are not available, use an alcohol-based hand rub;
• Following routine cleaning and disinfection strategies;
• Keeping frequently touched common surfaces (e.g., telephones, computer equipment) clean;
• Limiting transportation of H1N1 patients within facilities--use mobile diagnostic equipment and collect specimens in patient rooms instead;
• Having only staff necessary for patient care enter patient and airborne infection isolation rooms;
• Restricting visits for patients in isolation;
• Checking yourself for symptoms of respiratory illness.

For PPE:

• Use a fit-tested N95 disposable respirator or better when you come in contact with a patient who has or may have H1N1;
• Use a fit-tested N95 disposable respirator or better during aerosol-generating procedures;
• Use gloves, gowns and eye protection for any tasks that might cause contamination or create splashes.

OSHA notes that demand for disposable respirators may exceed current supplies.

Additional pointers include taking advantage of any training your employer offers and being ready, if you have kids, for school or daycare closures.

Should the severity of the H1N1 outbreak increase this winter, employers should also take measures to reduce close contact among employees in the workplace. Techniques may include minimizing face-to-face meetings in favor of virtual meetings or teleconferences, and discouraging hand-shaking.

Beyond the healthcare fields, recommendations for all workers remain in place: Stay home if you're sick, keep frequently touched surfaces clean, don't use colleagues' equipment, get the H1N1 and regular flu vaccines, and, for those in high-risk categories (pregnant, asthmatic, etc.), investigate alternative work assignments. For more information, see OSHA's Pandemic Influenza Preparedness and Response Guidance for Healthcare Workers and Healthcare Employers, available at www.osha.gov. OSHA also has a dedicated H1N1 site at www.osha.gov/h1n1. The CDC also offers Interim Guidance on Infection Control Measures for 2009 H1N1 Influenza in Healthcare Settings, Including Protection of Healthcare Personnel.