In Focus: Ebola

Currently, most workers in the U.S. are unlikely to encounter Ebola virus or individuals with Ebola Hemorrhagic Fever (EHF). However, exposure to the virus or someone with EHF may be more likely in certain sectors, including the healthcare, mortuary/death care, and airline servicing industries. Workers who interact with people, animals, goods, and equipment arriving in the U.S. from foreign countries with current EHF outbreaks are at the greatest risk for exposure.


Precautionary measures for preventing exposure to the Ebola virus depend on the type of work, potential for Ebola-virus contamination of the work environment, and what is known about other potential exposure hazards. Infection control strategies may have to be modified to include additional selections of personal protective equipment (PPE), administrative controls, and/or safe work practices. OSHA has developed interim guidance to help prevent worker exposure to Ebola virus and individuals with EHF.

 

Interim general guidance for workers

The following are OSHA’s requirements and recommendations for protecting workers whose work activities are conducted in an environment that is known or reasonably suspected to be contaminated with Ebola virus (e.g., due to contamination with blood or other potentially infectious material). These general guidelines are not intended to cover workers who have direct contact with individuals with EHF.

  • Employers should follow recognized and generally accepted good infection control practices, and must meet applicable requirements in the Personal Protective Equipment standard (29 CFR 1910.132, general requirements) and the Respiratory Protection standard (29 CFR 1910.134).
  • Use proper personal protective equipment (PPE) and good hand hygiene protocols to avoid exposure to infected blood and body fluids, contaminated objects, or other contaminated environmental surfaces.
  • Wear gloves, wash hands with soap and water after removing gloves, and discard used gloves in properly labeled waste containers.
  • Workers who may be splashed, sprayed, or spattered with blood or body fluids from environmental surfaces where Ebola virus contamination is possible must wear face and eye protection, such as a full-face shield or surgical masks with goggles. Aprons or other fluid-resistant protective clothing must also be worn in these situations to prevent the worker's clothes from being soiled with infectious material.
  • Workers tasked with cleaning surfaces that may be contaminated with Ebola virus must be protected from exposure. Employers are responsible for ensuring that workers are protected from exposure to Ebola and that workers are not exposed to harmful levels of chemicals used for cleaning and disinfection. OSHA’s Cleaning and Decontamination of Ebola on Surfaces (PDF) Fact Sheet provides guidance on protecting workers in non-healthcare/non-laboratory settings from exposure to Ebola and cleaning and disinfection chemicals. CDC also offers specific guidance for workers cleaning and disinfecting surfaces that have been in contact with blood or body fluids from a traveler known to have or suspected of having EHF.
  • Employers must train workers about the sources of Ebola exposure and appropriate precautions. Employers must train workers required to use personal protective equipment on what equipment is necessary, when and how they must use it, and how to dispose of the equipment. In addition where workers are exposed to blood or other potentially infectious materials, employers must provide the training required by the Bloodborne Pathogens standard, including information about how to recognize tasks that may involve exposure and the methods to reduce exposure, including engineering controls, work practices, and personal protective equipment.

OSHA's "Protecting Workers during a Pandemic" (PDF) Fact Sheet provides general guidance about principles of worker protection that may be useful during a wide-spread disease outbreak.


The National Institute for Occupational Safety and Health (NIOSH) Ebola page also provides guidance for protecting workers. 

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Correct Donning and Removal of Personal Protective Equipment (PPE) for Ebola

For most work tasks requiring PPE to protect a worker from exposure to Ebola virus, put on personal protective equipment in the following order:

  1. Gown (if using double gloves, put on first pair before gown)
  2. Mask (or respirator, when appropriate)
  3. Face shield or goggles
  4. Gloves

Remove PPE in a way to avoid self-contamination. This may include removing outer gloves simultaneously with the gown, decontaminating PPE between removal steps, or other measures. The order of PPE removal may vary depending on the type of PPE a worker uses, the nature of the work tasks being performed, and which devices or garments are contaminated, among other factors.

 

After use, remove and place gowns, gloves, and disposable masks in a labeled waste container, as appropriate. Wash hands with soap and water, or use an alcohol-based hand gel if soap and water are not available. Reusable goggles, face shields, respirators, and other equipment must be decontaminated before re-use.

 

CDC has tightened previous infection control guidance for healthcare workers caring for patients with EHF, to ensure there is no ambiguity in its recommended sequence for donning and removal of PPE:

  1. Guidance on Personal Protective Equipment To Be Used by Healthcare Workers During Management of Patients with Ebola Virus Disease in U.S. Hospitals, Including Procedures for Putting On (Donning) and Removing (Doffing)
  2. Tightened Guidance for U.S. Healthcare Workers on Personal Protective Equipment for Ebola Fact Sheet

 

**This information is from OSHA's web site and is current as of December 1, 2014 

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