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Appendix F: Employee Health and Safety Practices for Pandemic Influenza



The safety and health recommendations below, and in Appendices G and H, will reduce the amount of infection that is spread during a pandemic.  In order to have an impact in this, it is critical that employee awareness/education campaigns and trainings begin well before the pandemic comes to the U.S. so that employees will have this knowledge, and know how to utilize it in protecting themselves, and their coworkers and family/friends.


General Recommendations for the DOI Employee Workforce:

It is key that employees learn infection control and disease mitigation strategies such as health habits, personal hygiene (emphasis on hand washing), cleaning and disinfecting work areas and equipment, use and limitations of PPE, strategies to minimize exposures when working with potentially infected animals, recognition of symptoms, actions to take if symptomatic at work.

Table F-1 provides helpful information to provide to and educate employees on related to infection control measures during a pandemic.

Table F-1. General Health and Safety Measures for Home and Work
Health and Safety Measures Proper Conduct Remarks

A.

Maintain good health habits

Eat a well-balanced diet and drink 6 - 8 glasses of water daily.

Exercise regularly.

Good health habits make your immune system stronger against common illness.

B.

Get immunized for seasonal influenza

See your doctor for immunization for you and your family.  Obtain vaccination for seasonal influenza.

The Advisory Committee on Immunization Practices (ACIP) recommendations for 2006 – 2007 regarding the seasonal influenza vaccine and antiviral agents are available at: www.cdc.gov/mmwr/preview/ mmwrhtml/rr5510a1.htm.

Employees who have, or are in contact with a person who has, high-risk medical conditions for influenza-related complications should especially consider vaccination.

The annual seasonal flu vaccine will not protect from the H5N1 strain of influenza, but it will provide protection from the flu viruses already circulating in the community.

This will also reduce the possibility of dual infection with avian and human influenza viruses. 

There is a small possibility that dual infection could occur and result in viral reassortment.

C.

Practice personal infectious disease control measures at home and in public to reduce spread of disease/ illnesses

Stock tissues and hand sanitizer in common areas (such as entrances, bathrooms and break rooms) at work and at home.

Set up prominent notices at all entry points to facility, advising staff and visitors not to enter if they have symptoms of influenza.

Post general infection control (basic hygiene and hand washing) notices at entrances, bulletin boards, meeting rooms, and restrooms.

There is a wealth of this type of educational information that is available on the internet, including CDC's "Cover your Cough" website at http://www.cdc.gov/flu/protect/ covercough.htm.

Carry around personal bottle of hand sanitizer and keep one on your desk at work.

Avoid touching common surfaces and objects unless your hands have been sanitized. Use personal hand sanitizer directly after using commonly touched objects, such as phone buttons, banking machines, door knobs, public washrooms, etc.

Carry your own commonly used items such as a pen (to sign receipts or credit card slips).
Avoid touching your eyes, nose or mouth unless you have just washed your hands. Use hand sanitizers if soap and water is not available. (Refer to Section E in this chart for proper hand washing/sanitizing technique.)

Use disposable single use tissues for wiping noses (NOT handkerchiefs, they harbor germs).

When coughing and sneezing, if tissues are not readily available, cough or sneeze into your upper sleeve/elbow (NOT your hands).

Always clean hands using hand sanitizer after coughing and sneezing.

Change toothbrush often or at least after cold or flu to prevent possible re-infection.

Limit non-essential travel to areas (refer to http://www.cdc.gov/travel for travel advisories and restrictions).

Transmission of influenza can occur by indirect contact from hands and articles freshly soiled with discharges of the nose and throat of an acutely ill individual.

D.

Practice social distancing

If possible, arrange for employees to work from home or work flexible / alternative hours / schedules to avoid crowding at the workplace.

For those employees who have to come into work, have 6 feet of separation between personnel, as much as possible, to reduce potential spread of infection.

Instead of face-to-face meetings, use methods such as telephone, video conferencing, and the internet to conduct business as much as possible, even when participants are in the same building.

Avoid any unnecessary travel and cancel or postpone non-essential meetings / workshops / training sessions.

Avoid mass gatherings of people, including using mass transportation, and recreational or other activities where contact could occur with infectious people.

Do not sit near someone who is sneezing or coughing unless you are protected (see Section H of this chart).

For additional guidance, refer to Section 5 (specifically 5.4.1 Social Distancing) of this Plan, and Section 5.4.6.2 for COOP-related social distancing issues that need to be considered and addressed.

 

E.

Maintain good hand hygiene

Hands should be washed after contact with contaminated surfaces, removing gloves, sneezing, using the bathroom, handling garbage, contact with wildlife or soils, and other similar activities, and before preparing or eating food, smoking, drinking, applying cosmetics, lip balm, or lotions.

Insist that all family members, especially children, follow strict hand washing practices. Have everyone practice hand washing. This will help prevent the spread of virus at work, at play, and at home.

Post signs in restrooms during WHO Pandemic Phase 4 (confirmed human outbreak overseas) / FGRS 4 to increase awareness and emphasize hand washing.

  • Proper hand washing with water and soap:
    • Remove jewelry
    • Wet hands with warm water
    • Apply soap. (Water alone is not sufficient for proper hand washing.)
    • Vigorously scrub with soap all over your hands and under nails for at least 30 seconds
    • Rinse hands for at least 10 seconds under warm water
    • Dry hands completely with paper towel
    • Turn off tap with paper towel to avoid hands getting dirty again
    • Throw towel in waste basket
  • Proper use of alcohol-based hand sanitizer:
    • Wet hands with sanitizer
    • Rub hands until alcohol is dried.

The influenza virus is readily inactivated by soap and water.

Hand sanitizers can be used as an alternative to hand washing, and are especially useful when access to sinks or warm running water is limited.

F.

Implement measures to prevent spreading illness to others

If you are sick, stay at home. Do not allow ill children to attend school or daycare.

Do not return to work (or allow children to return to school or daycare) until symptoms do not appear for a period of time determined by the CDC (the incubation period for the specific virus), or your doctor says you are no longer contagious.

Inform your doctor of your symptoms. The doctor may not want to see you in his office to prevent spread of infection, especially during a pandemic.

Your doctor may prescribe an anti-viral drug to reduce the amount of time you are sick and reduce your symptoms.

Keep anyone who is sick at least 6 feet away from others, especially children (social distancing).

Cover your mouth and nose with a tissue when you cough and sneeze.

Dispose of these tissues safely, as they are contaminated.

Regularly clean/disinfect surfaces at home and at work as outlined in Section H of this chart.

Practice other personal infectious disease control measures to reduce spread of disease/illnesses as described in Sections C and D of this chart.

 

G.

Management of employees with symptoms in the workplace

If a person feels ill, or if someone observes that another person is exhibiting symptoms of influenza at work, he/she should notify his/her supervisor, and the sick employee should be instructed to leave work and contact their medical provider.

The individual should limit contact with others and not use public transport if at all possible.

If the employee cannot leave the workplace immediately, have the symptomatic individual wear surgical mask or filtering facepiece respirators to reduce the risk of spreading infection.

People who have been in close contact with the symptomatic employee should be informed. Advise these employees to teleworking from home for the duration of the incubation period of the disease.

Advise the ill staff member, and those employees in close contact with him/her, on how long to stay away from work. (CDC will advise on this once the characteristics of the pandemic are known).

The suspected ill employee’s work station should be cleaned and disinfected using the method described in Section H of this chart.

 

H.

Regularly clean / disinfect surfaces and shared items and disinfect / decon potentially contaminated items

HVAC system should be cleaned and maintained in optimal operating condition.

Regularly clean/disinfect frequently touched surfaces and objects such as toys, shared items, equipment, desks, phones, door knobs.

Disinfectant solutions should also be applied to all common areas such as counters, railing, washbasins, toilets, urinals daily.

  • To properly disinfect surfaces:
    • Wear gloves.
    • Use disinfectant solution or 70% alcohol.
      • Disinfectants may include 1% solution of household bleach (1.25 oz or about 8 teaspoons of 5.25% sodium hypochlorite solution in water) for hard, non-porous surfaces; 5% solution of household bleach for porous surfaces; 5% hospital grade Lysol™; or other EPA approved disinfectant.
      • Addition of chlorine bleach provides an extra margin of safety.
    • Apply on surfaces.
    • Rinse, if chlorine was used or let air dry, if alcohol was used.
    • Dispose of disposable cloth wipes after use.
    • After removing gloves, thoroughly wash hands with soap and water.
  • For guidance on cleaning / disinfecting and decontaminating surfaces, equipment, etc (potentially) contaminated by H5N1, refer to Sections 4, 6, and 7 of chart in Appendix H.

Wash linens on a regular basis, and between use by others, especially children’s linens.

A hot water temperature of at least 71°C (160°F) for a minimum 25 minutes is recommended.
 

I.

Use of protective personal equipment (PPE) when providing direct care to a sick person or handling potentially infected wildlife

At this time, CDC does not recommend the routine use of masks or other PPE by well persons in the general population.

Whenever possible, rather than relying on the use of facemasks or respirators, close contact and crowded conditions should be avoided during an influenza pandemic.

Facemasks should be considered for use by individuals who enter crowded settings, both to protect their nose and mouth from other people's coughs and to reduce the wearers' likelihood of coughing on others. The time spent in crowded settings should be as short as possible.

Respirators should be considered for use by individuals for whom close contact with an infectious person is unavoidable. This can include selected individuals who must take care of a sick person at home or as part of their job.

For those providing direct care to infected/symptomatic persons and those handling birds or other wildlife suspected of being infected with H5N1or other potential pandemic causing organism (this category could include emergency and law enforcement personnel):

Wear a minimum of N-95 filtering facepiece respirator, goggles, and gloves to prevent contact with infectious agent.

For additional, more specific information on proper PPE for these scenarios, refer to Appendix H.

PPE use and training for DOI employees is done in accordance with 29 CFR 1910.132 – 134.

Facemasks and respirators should be used in combination with other preventive measures, such as hand hygiene and social distancing, to help reduce the risk for influenza infection during a pandemic. This interim guidance will be updated as new information becomes available.

 

J.

Develop a personal / family prepared-ness plan

Stockpile bottled water, non-perishable food, and other emergency supplies at home.

Refer to the American Red Cross for specifics on what to stockpile, and how much - www.redcross.org/news/ds/panflu/planahead.html

In addition, refer to the Individuals / Families pandemic influenza planning checklist in Appendix O.

The supply chain may be interrupted and stores may have reduced stock of items for sale.

These items can also be used during other types of emergencies.

K.

Educate family members

Teach your family on the personal hygiene and infection control measures that are outlined throughout this chart, as well as the family preparedness plan.

Practice these measures and implementing the preparedness plan.

 

Vaccination and Anti-Viral Medications

CDC is developing guidance on anti-viral medication and vaccine distribution and use during an influenza pandemic.  DOI’s interim prioritization scheme is located in Appendix G.  Those DOI personnel supporting COOP and other Mission Essential Functions, as well as those performing emergency services, critical infrastructure, and critical homeland and nation security services are among those included in the priority groups for receiving pandemic vaccination.  When vaccine is available, COOP team members will be required to be vaccinated in order to gain access to the Departmental alternate sites. 

In addition, employees should receive the current season’s influenza vaccine. This will reduce the possibility of dual infection with avian and human influenza viruses that could occur and result in viral reassortment (mixing of genes from human and avian viruses to form a new, mutated form of the influenza virus).


Additional Precautions for Mission-Critical Personnel

In addition to the general precautions listed above, such as ensuring good personal hygiene, social distancing, and frequent hand washing, for those who must report to work to ensure the continuity of operations and Mission Essential Functions for the Department, refer to the guidance provided in Sections 5.4.6 (Continuity Planning for Pandemic Influenza) and 5.4.6.2 (Special Provisions for COOP Team Members during a Pandemic) of this Plan.