For the past month or so, the lead story in every radio newscast and online report has involved the potential threat from the Ebola virus in the United States. Multiple states have both foreign visitors and residents who either traveled or worked in West Africa; they have people who had “close personal contact” with such persons in quarantine either at hospitals or in “self-isolation” in their homes. Two American healthcare workers contracted Ebola while treating a visitor who later died; both of them were able to recover.
Semi-successful urging of the federal government to take greater steps to prevent the spread from foreign travelers and healthcare workers helped prompt New Jersey and New York to announced more stringent quarantine plans; however, they rescinded them.
While the risk to most Americans living and working in the U.S. is likely to be low, Ebola will not be leaving the headlines anytime soon. Meanwhile, the Occupational Safety & Health Administration (OSHA) has gotten into the act and provided information to employers on management of Ebola threats in the workplace. Failure to follow OSHA’s recommended protective actions could lead to sanctions (citations and civil penalties) under the agency’s “General Duty Clause,” Section 5(a)(1) of the OSH Act, which requires employers to keep workplaces free from “recognized hazards” that could cause death or serious bodily harm, as well as other standards discussed below.
EBOLA AND HOW IT’S CONTRACTED
Ebola is a hemorrhagic fever caused by a virus and transmitted by contact with blood, sweat, semen, vomit, diarrhea, and other bodily fluids. The virus can live on surfaces for a period of time, and is fatal in 50-90 percent of cases, although some novel treatments used on the infected American nurses proved effective.
One concerning development is that both U.S. nurses who contracted Ebola from a Texas patient used personal protective equipment and yet still got infected. The reasons are still under review. A doctor now hospitalized in New York City with Ebola reports that he traveled on subways and in rental vehicles, dined out, and went bowling shortly before developing a fever and testing positive for the disease. While his close contacts are now in quarantine, it is uncertain whether any other individuals may have contracted the illness through surface contact during his recreational activities.
EBOLA IN CONSTRUCTION
While the construction industry is not at especially high risk for individuals with Ebola, employers should still be aware of safe work practices. It is not uncommon for first aid to be provided to injured workers at construction sites, and if such a worker were to carry Ebola, it could readily be transmitted if proper precautions are not followed. Although few construction workers would be expected to have traveled recently to West Africa, they could have close, personal contact with those in the healthcare community or emergency responders who transport or treat such individuals, or could have traveled in proximity to those infected on planes, trains, buses, subways, or used improperly cleaned utensils in restaurants.
On October 20, 2014, Richard Trumka, president of the AFL-CIO, sent letters to President Barack Obama and key Senate leaders noting that “there are hundreds of thousands of workers potentially at risk of Ebola exposure” and calling for executive action to protect workers and the public by:
- Mandating uniform enforceable national standards to provide optimal protections to healthcare workers, and standards to provide appropriate protections for other workers who are at increased risk of exposure.
- Prohibiting retaliation against or discipline of workers who raise safety and health concerns, and any workers who contract the Ebola virus or are restricted or placed under quarantine.
- Providing for maintenance of wages and benefits for any workers who are removed from their jobs due to Ebola exposure.
- Directing CDC, OSHA, and other government agencies to seek input from workers and unions in the development of these standards and to establish ongoing communication to provide and exchange timely information on the latest developments related to Ebola exposure, transmission, and control.
OSHA RECOMMENDATIONS ON FACING EBOLA
In its current guidance, OSHA points to the need for hazard recognition. While the spread of Ebola is not generally through casual contact, appearances of symptoms can be abrupt, within 2-21 days after exposure to the virus. Therefore, supervisors should be familiar with the symptoms and be prepared to take action by isolating workers and notifying authorities if someone has a high fever or other symptoms consistent with Ebola. OSHA’s Bloodborne Pathogens (BBP) standard (29 CFR 1910.1030) covers exposure to Ebola, as well as other communicable diseases.
Anyone in the workplace designated to provide first aid or medical treatment should train on the BBP “universal precautions.” Proper BBP protective equipment should be available at the worksite. Employers can also be cited under OSHA’s Respiratory Protection standard (1910.134) and the Personal Protective Equipment standard (1910.132) if they fail to have proper PPE on site and neglect to do a written PPE hazard assessment. Of course, any chemicals (e.g., bleach) that are used in cleaning up potentially infected waste are subject to the requirements of OSHA’s Hazard Communication Standard (1910.1200), and workers handling them must be trained on the hazards and mandatory PPE, as indicated on the label or safety data sheet.
OSHA’s guidance also focuses on control and prevention. This means that employers must follow generally accepted good infection control practices, ensure that workers dealing with infectious fluids wear gloves and wash with soap and water once they have removed gloves and dispose of contaminated gloves in proper containers. Among other guidance that OSHA has issued is a guide to cleaning and decontaminating Ebola on surfaces in non-healthcare settings. www.osha.gov/Publications/OSHA_FS-3756.pdf
KNOWLEDGE IS POWER
Finally, OSHA expects that employers will train workers about the sources of Ebola exposure and appropriate precautions. Such training should be documented, and should cover the use of PPE, when and how it must be used, how to dispose of the equipment, and also any engineering controls or work practices that supplement the use of PPE.
OSHA also stresses the worker rights aspect, and employers must educate workers about the hazards to which they are exposed.
While the prospect of an Ebola epidemic in this country is frightening, officials are aggressively working to limit the spread within the U.S. Meanwhile, as the old saying goes, “An ounce of prevention is worth a pound of cure.” ■
About The Author
Adele L. Abrams, Esq., CMSP, is an attorney and safety professional who is president of the Law Office of Adele L. Abrams PC, a ten-attorney firm that represents employees in OSHA and MSHA matters nationwide. The firm also provides occupational safety and health consultation, training, and auditing services. For more information, visit www.safety-law.com.
Modern Contractor Solutions, November 2014
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