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SEASONAL INFLUENZA (FLU) IN THE WORKPLACE

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NIOSH Activities: 2009 H1N1 Influenza-related Health Hazard Evaluations

The 2009-2010 influenza season saw the emergence of the 2009 H1N1 influenza virus (previously called "novel H1N1, pH1N1, or swine flu"). This virus caused the first influenza pandemic (global outbreak of disease caused by a new flu virus) in more than 40 years. During this period NIOSH conducted several health hazard evaluations. These reports helped identify ways of reducing risks to workers during the 2009-2010 influenza pandemic. Their applicability to workplaces during the current influenza season may vary.

NIOSH Investigation of N95 Filtering Facepiece Respirators from the California Department of Public Health Stockpile for Defects; NIOSH Health Hazard Evaluation 2010-0044-3109; May 2010

General Description: NIOSH provided technical assistance to the California Occupational Safety and Health Administration. The concern that prompted this evaluation was if there were any defects in the N95 NIOSH certified respirators obtained from the California Department of Public Health respirator stockpile. The concern arose following N95 respiratory fit testing failures identified for 60 to 100% of the healthcare workers fit tested by a large healthcare organization. NIOSH did not include efforts to evaluate the California healthcare organization’s fit testing program or to conduct additional fit testing on the actual healthcare workers who failed the California fit tests.

Relevance to worker safety and health: The purpose of this evaluation was to determine if the fit test pass rate reported by a California healthcare organization’s facilities was due to defects. The evaluation aimed to determine if this resulted in non-compliance with the NIOSH requirements for air filtration and airflow (breathing) resistance. The performance tests and review of manufacturing quality assurance records and inspections revealed compliance with applicable approval requirements for the N95 respirators. The evaluation did not identify a need for any further actions. A description of the five-part assessment and the complete findings are presented in the final report available below.

Status: This NIOSH HHE final report was published in May 2010. A complete copy of the final report may be obtained at http://www.cdc.gov/niosh/hhe/reports/pdfs/2010-0044-3109.pdf Adobe PDF file [PDF - 3.8 MB]

Point of Contact: NIOSH INFO cbd1@cdc.gov

An Investigation of Two Fatalities Among Teachers Attributable to H1N1 Infection: NIOSH Health Hazard Evaluation 2010-0056; September, 2010

General Description: In September 2009, two school teachers from two different Georgia primary schools died as a result of laboratory-confirmed pandemic 2009 H1N1 influenza virus infection. Later that year, the Georgia Department of Education (DOE) and the Georgia Department of Community Health (DCH) requested that NIOSH conduct an HHE to look into possible work-related factors that may have predisposed to occupational exposure and infection. It was hoped that the results of this investigation could lead to protective recommendations for other teachers in the state of Georgia. The investigation consisted of discussions with DOE staff to obtain information about the two teachers, discussions with DCH staff to obtain information regarding influenza activity in Georgia schools during the fall of 2009, a review of absenteeism data from schools in Georgia in that area during the fall (obtained from DCH), and a review of medical records of the deceased.

Relevance to Worker Safety and Health: This NIOSH HHE presented an opportunity to understand the transmission of pandemic influenza in the education sector. The closeout letter for the evaluation contains recommendations for reducing influenza transmission in the school setting.

Status: This NIOSH HHE was published as a closeout letter Adobe PDF file [PDF -207 KB] in September 2010.

Point of Contact: NIOSH-INFO cbd1@cdc.gov

Evaluation of 2009 Pandemic Influenza A (pH1N1) Virus Exposure Among Internal Medicine Housestaff and Fellows: NIOSH Health Hazard Evaluation 2009-0206-3117; 2010

General Description: During the summer of 2009, NIOSH investigators evaluated internal medicine housestaff and fellow exposure to 2009 H1N1 influenza virus at four medical centers in Utah. NIOSH investigators identified 13 cases of influenza-like illness (ILI) among this group. Lapses in administrative controls and PPE were also identified.

Relevance to Worker Safety and Health: Measures that can be implemented to correct identified problems are listed in the final report of the evaluation.

Status: This NIOSH HHE final report was published in October 2010. A complete copy of the final report  may be obtained at: http://www.cdc.gov/niosh/hhe/reports/pdfs/2009-0206-3117.pdf Adobe PDF file .

A peer-reviewed journal article from this evaluation is available: Evaluation of 2009 pandemic influenza a (h1n1) exposures and illness among physicians-in-training. AJIC 40(7):617-621

Point of Contact: NIOSH-INFO cbd1@cdc.gov

Review of Employer Program to Reduce Occupational Exposure Risk to Novel Influenza A (H1N1) for Transportation Security Administration Employees (TSA): NIOSH Health Hazard Evaluation 2009-0213; 2010

General Description: In August 2009, NIOSH received a request for assistance in classifying and managing the occupational exposure risk of transportation security employees to 2009 H1N1 influenza. The investigation consisted of a written program review and interviews with agency occupational safety and health management. The medium exposure risk category (i.e., employees with high-frequency contact with the general population) previously identified by TSA and the selected PPE made available to the employees were determined to be appropriate. Actions taken by TSA for the medium risk category agreed with current Department of Homeland Security (DHS), Centers for Disease Control and Prevention (CDC), and OSHA pandemic influenza guidance.

Relevance to Worker Safety and Health: This NIOSH HHE addressed the appropriateness of the risk category identified by the agency for its transportation security employees using the Occupational Safety and Health Administration’s "Occupational Risk Pyramid for Pandemic Influenza" [OSHA 2009].

Status: This NIOSH HHE was closed in January 2010 with an informational letter Adobe PDF file [PDF - 806 KB]./p>

Link: Guidance on Preparing Workplaces for an Influenza Pandemic  Adobe PDF fileExternal Web Site Icon OSHA [2009].

Point of Contact: NIOSH-INFO cbd1@cdc.gov

NIOSH Technical Assistance Examining Vaccination Rates for Seasonal and H1N1 Influenza; Assessing Knowledge and Attitudes Toward Vaccination Among Child Care Center Employees: NIOSH Health Hazard Evaluation 2010-0025

General Description: NIOSH provided technical assistance evaluating vaccination rates for seasonal and 2009 H1N1 influenza among workers at child care centers in an Ohio county. NIOSH also evaluated the knowledge and attitudes of these workers regarding influenza vaccination.

Relevance to worker safety and health: This NIOSH HHE concerns the extent to which child care workers are knowledgeable and capable of protecting themselves from seasonal and 2009 H1N1 influenza infections in the daycare setting. Measures that can be implemented to correct identified problems are listed in the final report of the evaluation.

Status: This NIOSH HHE final report was published in February 2011. A complete copy of the final report may be obtained at: http://www.cdc.gov/niosh/hhe/reports/pdfs/2010-0025-3121.pdf Adobe PDF file

A peer-reviewed journal article from this evaluation is available: Low influenza vaccination rates among child care workers in the United States: assessing knowledge, attitudes, and behaviors. J Community Health 2012 Apr; 37(2):272-281.

Point of Contact: NIOSH-INFO cbd1@cdc.gov

Environmental Assessment for the Presence of Influenza Viruses (2009 Pandemic Influenza A H1N1 and Seasonal) in Dental Offices–Ohio: NIOSH Health Hazard Evaluation 2010-0019 & 0021

General Description: NIOSH received requests for health hazard evaluations at two separate dental offices in a metropolitan area of Ohio. Management at each dental office was concerned about transmission of 2009 H1N1 influenza virus to dental staff. Both offices wanted to participate in a workplace exposure assessment of influenza virus transmission.

Relevance to worker safety and health: This NIOSH HHE represents an opportunity to characterize the exposure of dental staff to 2009 H1N1 influenza virus. Dental staff may be at increased risk of exposure to influenza virus through their close work with the public.

Status: Field work for this HHE is complete. This NIOSH HHE final report was published in January 2011. A complete copy of the final report may be obtained at: http://www.cdc.gov/niosh/hhe/reports/pdfs/2010-0019-0021-3120.pdf Adobe PDF file

Point of Contact: NIOSH-INFO cbd1@cdc.gov

NIOSH Health Hazard Evaluation (HHE) Program Technical Assistance Response Concerning an Attendance Policy Instituted for Hospital Employees: NIOSH Health Hazard Evaluation 2010-0003; 2010

General Description: NIOSH received a request from employees of a hospital in Alaska concerning an attendance policy instituted in November 2008. The employees believed that the leave policy encourages employees to come to work when they are ill and remain at work when they are experiencing symptoms. They were specifically concerned about the employee leave policy conflicting with CDC guidelines concerning 2009 H1N1 influenza and sick leave [http://www.cdc.gov/h1n1flu/business/guidance/ Note: This website is now an archival page, no longer maintained. Reader is referred to: http://www.cdc.gov/flu/].

Relevance to Worker Safety and Health: To reduce the likelihood that employees avoid bringing illness into the workplace and are able to attend appropriately to their illness, employers should establish non-punitive workplace policies regarding reporting of illness and sick leave.

Status: This NIOSH HHE was closed with an informational letter available at http://www.cdc.gov/niosh/hhe/pdfs/2009-0003CloseOutLttr.pdf Adobe PDF file.

Point of Contact: NIOSH-INFO cbd1@cdc.gov

 
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  • Page last reviewed: June 4, 2012
  • Page last updated: December 4, 2012
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