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Workplace Risk Pyramid - Anthrax

Red Zone
Workplaces Where Authorities Have Informed You That Contamination with Anthrax Spores Has Been Confirmed or Is Strongly Suspected

Red Zone Guidance Addresses Two Situations

  • The employer is notified by law enforcement or public health authorities that a facility is strongly suspected of or confirmed as having been contaminated with anthrax spores.
  • The employer is engaged in emergency response to and clean-up of bio-terrorist releases of anthrax spores.

Notification of an Exposure Incident by Authorities

Actions taken by an employer under these circumstances may vary depending on the specific facts and the nature of the incident. Employers should follow instructions given by law enforcement and public health agencies and convey appropriate information to employees.

Emergency Responders, Clean-up Personnel and Investigators

Recommended Work Practices
  • Emergency response to, and investigation and clean-up of sites contaminated through bio-terrorist acts is specialized work that must be performed by highly trained and qualified personnel.
  • OSHA's Hazardous Waste Operations and Emergency Response Standard, also known as HAZWOPER, (29 CFR 1910.120) applies to these operations. The HAZWOPER standard protects workers who respond to uncontrolled or emergency releases of hazardous substances and clean-up of sites contaminated with these substances. Under the standard, the definition of hazardous substances includes both chemicals and biological agents, and a bacterium like anthrax, which can cause disease and death, is covered under the definition.
  • The HAZWOPER standard provides protection through common sense requirements like emergency planning, training, exposure monitoring, and exposure control through protectivemeasures such as work practices and personal protective equipment (PPE).
  • HAZWOPER requirements are performance-oriented and are based on the risk an employer anticipates his/her employees will face. Each employer should review the requirements and choose the best way to apply them to specific emergency or clean-up operations.

Personal Protective Eqquipment (PPE)

Like the other requirements under HAZWOPER, the PPE requirements are performance-oriented. This means that the level of protection chosen, and the PPE used should be proportional to the risk anticipated for the task workers will do. OSHA provides the following recommendations, which are based on our recent experience with workplaces contaminated with anthrax spores. In most recent instances, exposure has generally resulted from contact with or dispersal of anthrax spores from a contaminated letter or package. As a result, many workers investigating suspected releases or cleaning up these types of releases may be able to respond in Modified Level C protection, outlined in Number 1 below. Terrorist releases of anthrax spores where there is no information about the potential source or dispersal method, or where the release is still occurring, will require that workers respond in higher levels of protection, as outlined in Numbers 2-3 below.

  1. Modified Level C protection should be adequate during the investigation and clean-up of a known anthrax release where the agent was dispersed from a letter or package that can be easily bagged and there is no potential for splashing potentially contaminated materials. Modified Level C cannot be used if anthrax spores were dispersed using an aerosol-generating device, like a garden duster, or there is no information about how anthrax spores were released. Modified Level C should be consistent with the description in HAZWOPER Appendix B, but employees should wear a tight-fitting, full-face Powered Air-Purifying Respirator (PAPR) and skin protection with an integral hood and booties. Note: Selection of respiratory protection should be consistent with OSHA's Respiratory Protection Standard (29 CFR 1910.134) and take into account the agents used for decontamination. If organic vapor cartridges are used, then a cartridge change schedule should be implemented.
  2. Level B protection should be adequate during response to or clean-up of a release where anthrax spores may have been dispersed with an aerosol-generating device but are no longer being released, or where there is a high potential for splashing potentially contaminated materials. Level B protection is a PPE ensemble that provides the highest level of respiratory protection, but a lesser level of skin protection than Level A. Level B protection should be consistent with the description in HAZWOPER Appendix B.
  3. Level A should be adequate for response to or clean-up of a release that involves an unknown dispersal method. Level A protection should also be adequate during response to or clean-up of a release that involves an aerosol-generating device and the release is still occurring, or the release has stopped but there is no information about the duration of the release or the airborne concentrations of anthrax spores. Level A protection is a PPE ensemble that provides the greatest level of skin, respiratory, and eye protection. Level A protection should be consistent with the description in HAZWOPER Appendix B.
  4. Personnel assisting in decontamination of emergency responders or clean-up personnel should be in PPE that is equivalent to one level below that required for the responder or clean-up personnel (e.g., if responder in Level A, then decontamination personnel in Level B).

Information Resources

Yellow Zone
Workplaces Where Contamination with Anthrax Spores Is Possible

This zone is where workplace contamination is possible. Risk factors that should be considered in this zone include handling bulk mail, handling mail from facilities that are known to be contaminated, working near equipment such as high-speed processors/sorters that could aerosolize anthrax spores; workplaces in close proximity to other workplaces known to be contaminated; or workplaces that may be targets of bio-terrorists.

Engineering controls are the most effective controls an employer can use to protect employees. The Centers for Disease Controls and Prevention (CDC) provide a list of suggested engineering controls in Recommendations for Protecting Workers from Exposure to Bacillus anthracis in Work Sites Where Mail Is Handled or Processed.

Prudent Work Practices

  • Follow OSHA's recommendations for green zone workplaces for workers who open mail or respond to suspicious envelopes or packages.
  • Develop strategies to limit the number of persons working at or near areas where airborne particles may be generated (e.g., mail-sorting machinery, places where mailbags are unloaded or emptied).
  • Restrict the number of non-essential personnel (e.g., contractors, visitors, etc.) entering areas where airborne particles may be generated.
  • Avoid practices that generate dust, such as dry sweeping, dusting, and using compressed air to clean machinery. Areas should be wet-cleaned or vacuumed with an industrial vacuum cleaner equipped with a high-efficiency particulate air (HEPA) filter. Conventional home or industrial vacuums should not be used since these vacuums may further disperse possible anthrax spores.
  • Instruct employees to wash hands regularly with soap and water. At a minimum, hands should be washed when gloves are removed, before eating, and at the end of a shift.
  • Establish procedures in the emergency plan for employees to report possible exposure and contact authorities:
    • Contact supervisor
    • Notify local police and local FBI
  • Give workers information and training on:
    • Modes of anthrax transmission;
    • Signs and symptoms of anthrax infection;
    • Emergency procedures to deal with possible contamination;
    • Protective clothing to minimize skin exposure;
    • Care for abrasions that might provide an infection route.

Personal Protective Equipment (Voluntary)

  • Impermeable gloves such as nitrile or vinyl.
  • Properly fitted, NIOSH-certified filtering facepiece (N95 or greater). See Appendix D of OSHA's Respiratory Protection standard for information about the use of respirators when such use is voluntary. 29 CFR 1910.134 Appendix D
  • Respirators equipped with P-type filters in areas where oil mist from machinery is present should be considered to ensure filter effectiveness.

Information Resources

Green Zone
Workplaces Where Contamination with Anthrax Spores Is Unlikely

This zone covers the vast majority of workplaces in the United States. Since October 2001, anthrax spores have only been discovered in a very limited number of workplaces.

Prudent Work Practices

Establish procedures for safe handling of mail and packages. Employees should:

  • Be on the lookout for suspicious envelopes or packages.
  • NOT open suspicious mail!
  • Open mail with a letter opener or another method that minimizes skin contact with the mail and is least likely to disturb contents.
  • Open mail with a minimum amount of movement.
  • Not blow into envelopes.
  • Keep hands away from nose and mouth while opening mail.
  • Turn off fans, portable heaters, and other equipment that may create air currents while opening mail.
  • Wash hands after handling mail.

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