Prompted by increased concerns of an influenza pandemic and the need to protect healthcare workers and facilities as the first line of defense, the Occupational Safety and Health Administration ("OSHA") recently issued its "Pandemic Influenza Preparedness and Response Guidance for Healthcare Workers and Healthcare Employers." This guidance provides a comprehensive resource for health care facilities and employers and builds upon its earlier publication, "Preparing Workplaces for an Influenza Pandemic," which offers general guidance for all types of workplaces and identifies health care facilities and workers as at the highest occupational risk for pandemic influenza. 

Each of these publications was created in cooperation with the U.S. Department of Health and Human Services and in response to President Bush's National Strategy for Pandemic Influenza Implementation Plan. The goal of the most recent guidance is to assist employers in assessing risk and developing policies and practices customized to the unique aspects of the health care setting. A recent study suggests that a pandemic flu affecting 15 percent to 35 percent of the United States would result in unprecedented hospitalizations and outpatient visits, thus requiring a large-scale and sustained response from health care facilities and professionals. These facilities and professionals must be able to resist infection at the highest level in order to sustain the response level necessary to meet expected demands.

The guidance is arranged into four sections: (1) clinical and historical information on influenza and influenza pandemics; (2) infection control for facilities management and individual workers; (3) pandemic influenza preparedness (such as planning tools, allocation of responsibilities and communication methods); and (4) OSHA standards of special importance (e.g., personal protective equipment, respiratory protection and blood-borne pathogens). It also includes several appendices containing sample infection-control plans, supply checklists and other technical information.

The fundamental purpose of OSHA's actions in issuing the guidance is to advise employers that preparation is key. A severe pandemic could lead to high levels of illness, death and socioeconomic disruptions, which can only be mitigated through effective planning. Should a pandemic occur, OSHA will furnish up-to-date information and guidance to the public through the website.

In the meantime, employers are responsible for providing a safe and healthful workplace for their employees. As such, OSHA may be inclined to use this guidance to issue citations under 5(a)(1) of the OSHA Act, General Duty Clause (similar to what has been done with ergonomics hazards), if it believes an employer has knowledge of a flu hazard and takes no action to protect workers.

If you have questions or seek additional information on this subject, please contact Jill Lashay at 717-237-4856 or