Control and Prevention

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• Workplace Hazard Assessments
• Workplace Prevention Plans

Workplace Hazard Assessments

All employers should consider conducting a workplace hazard assessment to evaluate workers' risk of exposure to respiratory viruses. Employers should consider if, when, and for how long workers may be exposed to someone who may be infected with a respiratory virus. Specific work tasks and duties may pose additional hazards. For example, physical trainers have a heightened risk of being exposed to respiratory viruses during their workday to the extent they have direct personal contact with clients who have a respiratory illness. Other workers with a high potential for exposure to people who may transmit respiratory illnesses and surfaces that may be contaminated with IRPs include but are not limited to:

• Teachers, administrators, janitors, and other school staff.
• Cashiers, stockers, and other retail staff who interact with the public.
• Transport industry workers (drivers, conductors, security, etc.) who frequently carry or interact with people in enclosed vehicles.
• Cleaning industry workers, especially in congregate settings.
• Entertainment industry workers who have contact with crowds of people.

Employers should keep in mind that actions to prevent respiratory illnesses among staff may change as work environments change and as adjustments are made to employees' job duties or tasks. Since respiratory illnesses can be spread from person to person through the air by ensuring adequate ventilation throughout the work environment, with outside air or filtering, can help promote a safe and healthy workplace. Employers should consider working with a qualified heating, ventilation, and air conditioning (HVAC) professional to determine steps necessary to optimize building ventilation. In addition to ventilation, other elements that influence the likelihood of exposure in the workplace include:

• Occupancy, or how many coworkers and clients occupy the workspace.
• Distance, or the space between people.
• Interaction, or whether and how people communicate.
• Protection, or whether people wear source control to prevent themselves from spreading infection through exhalation or adequate protection to prevent inhalation of droplets and virus particles.

Because respiratory illnesses are often transmitted in healthcare settings, the CDC has published guidance to help healthcare employers recognize and mitigate the risks associated with employee exposure to respiratory illnesses. See the CDC's Infection Control Guidance: Respiratory Viruses and Preventing Transmission of Viral Respiratory Pathogens in Healthcare Settings.

For more information about workplace hazard assessments, see OSHA's Recommended Practices for Safety and Health Programs

Workplace Prevention Plans

Employers can use hazard assessments to develop workplace respiratory virus control and prevention plans that are tailored to prevent respiratory illnesses among their employees. It is recommended that employers' respiratory illness control and prevention plans utilize the hierarchy of controls, which generally prioritizes controls in the following order, from most to least effective: elimination/substitution, engineering controls, administrative controls and safe work practices, and Personal Protective Equipment (PPE). Effective plans will identify and describe how the employer will implement mitigation strategies, in accordance with the hierarchy of controls.

For example, where an employee is not otherwise exposed to other people, videoconferencing can be used as an elimination control for in-person meetings and will be more effective than the use of PPE to prevent transmissions. Video conferencing may also be used to support a policy of staying home when ill and reducing the likelihood of disease transmission to coworkers.

It is important to note that workplace risk factors that increase the likelihood of respiratory virus exposure are compounded; each additional risk factor identified further increases the risk of exposure and virus transmission. For example, a transportation worker may be exposed to a respiratory virus when assisting a client with respiratory illness to board the vehicle. In addition, if the transportation vehicle is small, enclosed, and has poor ventilation, the risk that the respiratory virus can be transmitted to the worker increases. The risk of exposure increases with the distance the client is transported, because of the corresponding increase in driving time. Because layering controls typically increases their effectiveness, the transportation worker in the example above can reduce the risk of exposure by increasing the ventilation in the vehicle, either through its internal HVAC system, or by opening a window(s). In addition to improving ventilation (an engineering control), wearing a face mask (PPE) can add an additional level of protection against exposure and transmission of respiratory viruses.

For more information about layered controls to prevent transmission of respiratory illnesses in vehicles, see the University of California, Davis website Design Strategies in Shared Vehicles to Prevent Disease Transmission.

As illustrated in the example above of a transportation worker, employers can protect workers by developing and implementing a tailored respiratory virus control and prevention plan using layered controls to reduce the risk of exposure from airborne droplets and viral particles. The employer may also use administrative controls such as standard operating procedures that require personnel to use protective controls during outbreaks within a workplace or when seasonal respiratory illness is known to be spreading in the community.

Finally, employers who develop respiratory illness control and prevention plans should engage workers and their representatives throughout the process of the plan's development and implementation. Employee engagement improves attitudes about safety procedures and builds a culture of safety in the workplace.