Health Care Worker Safety During a Pandemic

Scientific Publications | Suggestions

Health care workers will be on the front lines during an influenza pandemic. In a recent survey in New York City (Quereshi et al., 2005), 48% of health care workers indicated that they would be unwilling to work during a SARS outbeak. Similar numbers might be expected to be unwilling to work during an influenza pandemic if the mortality rate is similar to SARS. The major concern is personal safety and the safety of family members. More recent data on a pandemic and workforce attitudes in Maryland (Balicer, et.al.) can be found here. There are several methods health care workers may use to protect themselves during an influenza pandemic including:

  • Hand Hygeine
  • Personal Protective Equipment (PPE)
    • N95 disposable respirators (masks). Although not guaranteed to prevent influenza infection, N95 masks may significantly reduce the odds of infection among health care workers in general. However, N95 masks may not be sufficient for health care workers involved in open airway procedures.
      • N95 disposable respirators from the Minnesota Department of Health
      • NIOSH-Approved N95 Disposable Particulate Respirators
      • A NIOSH approval is issued to a respirator only after it has been evaluated in the laboratory and found to comply with all the requirements of Title 42, Code of Federal Regulations, Part 84, including a review of the manufacturer’s quality plan. The Nano Guard N95 Particulate Respirator is not certified and approved by NIOSH.
    • Powered Air-Purifying Respirators (PAPRs). Offers a higher level of protection than N95 masks. May be preferred for open airway procedures.
      • Powered Air Purifying Respirator (PAPR) from the Minnesota Department of Health
    • Gloves - double-gloving recommended
    • Gowns - double-gowning recommended
    • Full head and shoe covering recommended
    • Face shield or Goggles.
  • Vaccine - uncertain whether this will be available in all regions during a pandemic
    • see Vaccine for bird flu tests well, but making enough may be problem
    International Herald Tribune, August 8, 2005
  • Prophylactic oseltamivir therapy
    • Supplies are limited. May not be available during a pandemic for many Health Care Workers.

Scientific publications:

  • Review of Aerosol Transmission of Influenza A Virus
    From CDC’s Emerging Infectious Diseases, November 2006
  • Local public health workers’ perceptions toward responding to an influenza pandemic .pdf format, BMC Public Health, April 2006
  • Prioritization of Healthcare Worker Vaccination
    PowerPoint presentation by the Pandemic Influenza Working Group on June 15, 2005
  • Health care workers’ ability and willingness to report to duty during catastrophic disasters
Qureshi, et al., Journal of Urban Health: Bulletin of the New York Academy of Medicine, July 6, 2005
  • Avian Influenza H5N1 and Healthcare Workers
Schultsz, et al., Emerging Infectious Diseases, July, 2005
  • Outbreaks of Avian Influenza A (H5N1) in Asia and Interim Recommendations for Evaluation and Reporting of Suspected Cases - United States, 2004
CDC, MMWR, February, 2004
Includes Interim recommended infection-control precautions for influenza A, H5N1
  • SARS among Critical Care Nurses, Toronto
Loeb, et al., Emerging Infectious Diseases, February, 2004
“Risk was lower with consistent use of a N95 mask than with consistent use of a surgical mask. We conclude that activities related to intubation increase SARS risk and use of a mask (particularly a N95 mask) is protective.”
  • The changing face of healthcare worker perceptions on powered air-purifying respirators during the SARS outbreak
Khoo, et al., Respirology, January, 2005
  • Early containment of severe acute respiratory syndrome (SARS); experience from Bamrasnaradura Institute, Thailand
Chaovavanich, et al., J. Med. Assoc. Thai, October, 2004
  • Guidelines for Preventing Health-Care—Associated Pneumonia
Recommendations of CDC and the Healthcare Infection Control Practices Advisory Committee, 2003
  • Singapore Medical Association article about masks and other Personal Protective Equipment (PPE), pdf

Suggestions to reduce and protect against unnecesary respiratory contact

  • Use phone, interphone, and email (perhaps through a proxy-person) as much as possible.
  • Use plastic sheets or window between health-care provider and patient. This applies to clerical workers in health care centers too.
  • Contacts could be made in the open if the weather is good.
Page last modified on July 19, 2007, at 03:20 PM by Bronco Bill