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Course 638 Preparing Workplaces for COVID-19

Safety guides and audits to make your job as a safety professional easier

Risk Levels and Respiratory Protection

Risk Pyramid.
Occupational Risk Pyramid for Infectious Disease
Click for more information.

Risk levels

Worker risk of occupational exposure to SARS-CoV-2, the virus that causes COVID-19, during an outbreak may vary from very high to high, medium, or lower (caution) risk. The level of risk depends in part on the:

  • occupations with each industry type
  • frequency of contact within 6 feet of people at work known to be, or suspected of being, infected with SARS-CoV-2
  • requirement for repeated or extended contact with persons at work known to be, or suspected of being, infected with SARS-CoV-2

To help employers determine appropriate precautions, OSHA has divided job tasks into four risk exposure levels: very high, high, medium, and lower risk. The Occupational Risk Pyramid shows the four exposure risk levels in the shape of a pyramid to represent probable distribution of risk. Most American workers will likely fall in the lower exposure risk (caution) or medium exposure risk levels.

1. The designation of an occupational risk level of exposure to the SARS-CoV-2 virus at work DOES NOT depend on _____.

a. the occupation within each industry type
b. the frequency of contact within 6 feet of suspect persons at work
c. the duration of nonoccupational contact with the general public
d. the requirement for repeated or extended contact with suspect persons at work

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Risk Levels (Continued)

Risk Pyramid.
Occupational Risk Pyramid for Infectious Disease
Click for more information.

Very High Exposure Risk

Very high exposure risk jobs are those with high potential for exposure to known or suspected sources of COVID-19 during specific medical, postmortem, or laboratory procedures. Click on the button to see the list of workers in this category.

High Exposure Risk

High exposure risk jobs are those with high potential for exposure to known or suspected sources of COVID-19. Click on the button to see the list of workers in this category.

Medium Exposure Risk

Medium exposure risk jobs include those that require frequent and/or close contact with (i.e., within 6 feet of) people who may be infected with SARS-CoV-2, but who are not known or suspected COVID-19 patients. Click on the button to see the list of workers in this category.

Lower Exposure Risk (Caution)

Lower exposure risk (caution) jobs are those that do not require contact with people known to be, or suspected of being, infected with SARS-CoV-2 nor frequent close contact with (i.e., within 6 feet of) the general public. Workers in this category have minimal occupational contact with the public and other coworkers.

Click on the buttons below to see the list of Very High, High, and Medium Risk jobs.

  • Healthcare workers (e.g., doctors, nurses, dentists, paramedics, emergency medical technicians) performing aerosol-generating procedures (e.g., intubation, cough induction procedures, bronchoscopies, some dental procedures and exams, or invasive specimen collection) on known or suspected COVID-19 patients.
  • Healthcare or laboratory personnel collecting or handling specimens from known or suspected COVID-19 patients (e.g., manipulating cultures from known or suspected COVID-19 patients).
  • Morgue workers performing autopsies, which generally involve aerosol-generating procedures, on the bodies of people who are known to have, or suspected of having, COVID-19 at the time of their death.

  • Healthcare delivery and support staff (e.g., doctors, nurses, and other hospital staff who must enter patients’ rooms) exposed to known or suspected COVID-19 patients. (Note: when such workers perform aerosol-generating procedures, their exposure risk level becomes very high.)
  • Medical transport workers (e.g., ambulance vehicle operators) moving known or suspected COVID-19 patients in enclosed vehicles.
  • Mortuary workers involved in preparing (e.g., for burial or cremation) the bodies of people who are known to have, or suspected of having, COVID-19 at the time of their death.

  • In areas without ongoing community transmission, workers in this risk group may have frequent contact with travelers who may return from international locations with widespread COVID-19 transmission.
  • In areas where there is ongoing community transmission, workers in this category may have contact be with the general public (e.g., in schools, high-population-density work environments, and some high-volume retail settings).

2. Which of the following workers is categorized as experiencing a Very High Exposure Risk of exposure to SARS-CoV-2?

a. Workers with contact with travelers returning from international locations
b. Mortuary workers preparing bodies for burial
c. Doctors, nurses, dentists, paramedics, emergency medical technicians
d. Workers with ongoing contact with the general public in schools

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Isolation room.
Isolation rooms are effective in limiting exposure.

How to Protect Workers

High and Very High Risk

Jobs Classified at High or Very High Exposure Risk: What to do to protect workers in workplaces where workers have high or very high exposure risk, employers should follow guidance and implement control measures described in this section.

Click on the buttons to see the various control methods used to protect workers in these classifications.

Engineering Controls

  • Ensure appropriate air-handling systems are installed and maintained in healthcare facilities. See "Guidelines for Environmental Infection Control in Healthcare Facilities" for more recommendations on air handling systems.
  • CDC recommends that patients with known or suspected COVID-19 (i.e., person under investigation) should be placed in an airborne infection isolation room (AIIR), if available.
  • Use isolation rooms when available for performing aerosol-generating procedures on patients with known or suspected COVID-19. For postmortem activities, use autopsy suites or other similar isolation facilities when performing aerosol-generating procedures on the bodies of people who are known to have, or suspected of having, COVID-19 at the time of their death. See the CDC postmortem guidance. OSHA also provides guidance for postmortem activities on its COVID-19 webpage.
  • Use special precautions associated with Biosafety Level 3 when handling specimens from known or suspected COVID-19 patients. For more information about biosafety levels, consult the U.S. Department of Health and Human Services (HHS) "Biosafety in Microbiological and Biomedical Laboratories."

Administrative Controls

If working in a healthcare facility, follow existing guidelines and facility standards of practice for identifying and isolating infected individuals and for protecting workers.

  • Develop and implement policies that reduce exposure, such as cohorting (i.e., grouping) COVID-19 patients when single rooms are not available.
  • Post signs requesting patients and family members to immediately report symptoms of respiratory illness on arrival at the healthcare facility and use disposable face masks.
  • Consider offering enhanced medical monitoring of workers during COVID-19 outbreaks.
  • Provide all workers with job-specific education and training on preventing transmission of COVID-19, including initial and routine/refresher training.
  • Ensure that psychological and behavioral support is available to address employee stress.

Safe Work Practices

If working in a healthcare facility, follow existing guidelines and facility standards of practice for identifying and isolating infected individuals and for protecting workers.

  • Provide emergency responders and other essential personnel who may be exposed while working away from fixed facilities with alcohol-based hand rubs containing at least 60% alcohol for decontamination in the field.

Personal Protective Equipment

Most workers at high or very high exposure risk likely need to wear gloves, a gown, a face shield or goggles, and either a face mask or a respirator, depending on their job tasks and exposure risks.

  • Those who work closely with (either in contact with or within 6 feet of) patients known to be, or suspected of being, infected with SARS-CoV-2, the virus that causes COVID-19, should wear respirators. In these instances, see the PPE section beginning on page 14 of this booklet, which provides more details about respirators.
  • PPE ensembles may vary, especially for workers in laboratories or morgue/mortuary facilities who may need additional protection against blood, body fluids, chemicals, and other materials to which they may be exposed. Additional PPE may include medical/surgical gowns, fluid-resistant coveralls, aprons, or other disposable or reusable protective clothing. Gowns should be large enough to cover the areas requiring protection.

NOTE: Workers who dispose of PPE and other infectious waste must also be trained and provided with appropriate PPE.

3. Which of the following is an example of an effective engineering control for high and very high risk exposure situations?

a. Using alcohol-based hand rubs
b. Ensure psychological support
c. Posting warning signs
d. Isolation rooms

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Workers Living Abroad or Traveling Internationally

Isolation room.
Travel will never be the same.

Employers with workers living abroad or traveling on international business should consult:

Employers should communicate to workers that the Department of State (DOS) cannot provide Americans traveling or living abroad with medications or supplies, even in the event of a COVID-19 outbreak.

As COVID-19 outbreak conditions change, travel into or out of a country may not be possible, safe, or medically advisable. It is also likely that governments will respond to a COVID-19 outbreak by imposing public health measures that restrict domestic and international movement, further limiting the U.S. government’s ability to assist Americans in these countries. It is important that employers and workers plan appropriately, as it is possible that these measures will be implemented very quickly in the event of worsening outbreak conditions in certain areas.

Click on the button below to see a short video on what travel will look like post-covid.

4. Where can you find the latest information on international business travelers?

a. Major news networks
b. OSHA's COVID-19 webpage
c. YouTube advisory pages
d. Local radio news stat

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Follow Existing OSHA Standards

Grinding paint.
Many requirements are covered under OSHA's General Duty Clause.
Click to enlarge.

Existing OSHA standards may apply to protecting workers from exposure to infectious diseases.

While there is no specific OSHA standard covering COVID-19 exposure, some OSHA requirements may apply to preventing occupational exposure to infectious diseases. Among the most relevant are:

  • OSHA's Personal Protective Equipment (PPE) standards (in general industry, 29 CFR 1910.132, PPE General Requirements), which require using gloves, eye and face protection, and respiratory protection.
  • When respirators are necessary to protect workers or where employers require respirator use, employers must implement a comprehensive respiratory protection program in accordance with the Respiratory Protection standard (29 CFR 1910.134). OSHA has issued temporary guidance related to enforcement of respirator annual fit-testing requirements for healthcare.
  • The General Duty Clause, Section 5(a)(1) of the Occupational Safety and Health (OSH) Act of 1970, 29 USC 654(a)(1), which requires employers to furnish to each worker "employment and a place of employment, which are free from recognized hazards that are causing or are likely to cause death or serious physical harm."

Visit OSHA's COVID-19 Frequently Asked Questions for more information. This page includes frequently asked questions (FAQs) and answers related to the coronavirus disease 2019 (COVID-19) pandemic.

5. If specific OSHA standards do not cover requirements, employers may still be responsible under _____.

a. the OSH Act General Duty Clause, Sec. 5
b. 1910.1200, Hazard Communication
c. OSHA's vertical and horizontal standards
d. 1910.132, General Requirements

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Information and Training

Training
Education includes instruction, training, and evaluation.
Click to enlarge.

Educating employees about exposure to infectious diseases and the IDPR Plan is accomplished using three primary strategies: instruction, training, and evaluation. These strategies ensure employees have the necessary knowledge, skills, and abilities (KSAs) required to work safe on the job.

  1. Instruction: Employees must be instructed on OSHA regulations, hazards of exposure, components of the IDPR Plan, and related company safety policies, programs, and procedures.
  2. Training: Employees must receive training that includes hands-on demonstration and an opportunity to practice performing procedures and using tools and equipment.
  3. Evaluation: Employee abilities to perform their responsibilities on the job must be evaluated by a competent person, formally certified to train, and designated as qualified to use PPE, equipment, and perform response procedures.

Employer Responsibilities

Many OSHA regulations require employers to develop and deploy a suitable safety training program. Note: It's important to know that OSHA will ALWAYS inspect the safety training program during an OSHA inspection.

Click on the button below to see a list of specific employer training responsibilities.

Your employer is required to provide an information and training program for all employees exposed to hazards in the workplace.

Information and training must inform employees of the specific hazards associated with their work environment, protective measures which can be taken, and their rights under the standard.

The employer may be required to distribute and make relevant materials provided by OSHA available to employees.

For more information on OSHA training requirements see OSHA Pub 2254, Training Requirements in OSHA Standards, and OSHAcademy Course 703, Introduction to OSHA Training.

6. The three primary components of effective safety education include each of the following EXCEPT _____.

a. instruction
b. discipline
c. training
d. evaluation

Check Your Work

Read the material in each section to find the correct answer to each quiz question. After answering all the questions, click on the "Check Quiz Answers" button to grade your quiz and see your score. You will receive a message if you forgot to answer one of the questions. After clicking the button, the questions you missed will be listed below. You can correct any missed questions and check your answers again.

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