Cal/OSHA Releases Guidance for Protecting Health Care Workers from Ebola

Oakland-- Although widespread outbreak of Ebola in the United States is unlikely, Cal/OSHA has joined with other public health agencies in California to provide guidelines for preventing exposure to Ebola. They will be widely distributed starting today.

Federal officials have identified workers in certain professions to be at potential risk of exposure. Those workers include health care workers, emergency responders, laboratory staff, mortuary workers, airline flight crews and airport staff, and quarantine operations staff.

The Department of Industrial Relations (DIR) and its Division of Occupational Safety and Health, also known as Cal/OSHA, have coordinated with the California Department of Public Health (CDPH) to issue interim guidelines for workers in these occupations and their employers.

“California’s workplace safety and health standards go further than national standards in protecting workers from hazards such as Ebola,” said Juliann Sum, Acting Chief of Cal/OSHA. “We urge employers and their workers who may be at risk to pay careful attention to our guidance and check for updates as new information becomes available.”

In 2009, California adopted an occupational health regulation that specifically addresses infectious diseases like Ebola, which can spread by small liquid droplets that may come in contact with mucous membranes. This regulation, known as the Aerosol Transmissible Diseases Standard, helped inform the guidelines released today. Ebola is transmitted through direct contact with the blood or bodily fluids of an infected symptomatic person or through exposure to objects that have been contaminated.

“California’s workplace safety and health standards go further than national standards in protecting workers from hazards such as Ebola,”  
- Juliann Sum, Acting Chief of Cal/OSHA. 

The new guidance recommends that employers:

• Ensure that workers at risk of exposure to Ebola wear gloves, impermeable body coverings, face shields or other eye and face protection, and appropriate respiratory protection. All personal protective equipment (PPE) must be adequate to prevent the passage of bodily fluids to the employee’s clothing and skin. NIOSH-approved respirators must be used where infectious aerosols are likely to be present.
• Train employees in the use of all applicable protective equipment, including respirators. Employees must be clearly instructed on how to safely put on and take off equipment.
• Give employees opportunities to practice with the respirators and other equipment they will use.
• Provide dedicated, separate areas for the donning and removing of protective gear.
• Use either a buddy system or other means of assisting employees in donning and removing PPE. Employees who assist in removing contaminated equipment must also use PPE.
• Provide additional protective gear, such as double gloves and disposable shoe and leg coverings, in environments where copious amounts of blood, vomit, feces or other bodily fluids are present.
• Ensure that workers conducting aerosol-generating procedures such as intubation or bronchoscopy perform the procedures in an airborne infection isolation room, if feasible, or at least in a private room with the door closed. Employees exposed to these procedures must use NIOSH-approved respirators. 

Cal/OSHA reminds all employers and workers that any suspected cases of Ebola must be promptly reported to the local public health department.

The California Department of Public Health has a variety of updated information on Ebola and reporting requirements. The Centers for Disease Control and Prevention has also posted specific information for health care workers and settings.