SARS: Protecting WorkersSARS: Protecting Workers

OSHA Guidance for Employers on OSHA Guidance for Employers on Severe Acute Respiratory Severe Acute Respiratory

Syndrome Syndrome (SARS)(SARS)

• Potentially deadly respiratory diseasePotentially deadly respiratory disease

• Coronavirus—leading suspected Coronavirus—leading suspected causative agentcausative agent

• Most U.S. cases contracted by those Most U.S. cases contracted by those who’ve traveled to ASIA, more who’ve traveled to ASIA, more recently also Toronto recently also Toronto

• Spread primarily by close person-to-Spread primarily by close person-to-person contact person contact

• Healthcare workers face greatest risk Healthcare workers face greatest risk of workplace transmissionof workplace transmission

SARS: Possible SymptomsSARS: Possible Symptoms

• ChillsChills

• Muscle achesMuscle aches

• Dry coughDry cough

• DizzinessDizziness

Suspect Cases of SARSSuspect Cases of SARS

• Fever of at least 100.4 degrees FFever of at least 100.4 degrees F

• Respiratory illness—cough, shortness Respiratory illness—cough, shortness of breath, difficulty breathing of breath, difficulty breathing

• Onset within 10 days foreign travel Onset within 10 days foreign travel or close contact with someone or close contact with someone with SARS with SARS

SARS: Clinical EvidenceSARS: Clinical Evidence

• Incubation period: 2-7 days, Incubation period: 2-7 days, maybe up to 14 daysmaybe up to 14 days

• Decreased white blood cell countDecreased white blood cell count

• Below normal blood platelet countBelow normal blood platelet count

• Liver enzyme increaseLiver enzyme increase

• Electrolyte disturbancesElectrolyte disturbances

SARS: Potential High Risk PopulationSARS: Potential High Risk Population

• Age 40 or older; especially those Age 40 or older; especially those over 65over 65

• Have other medical conditions Have other medical conditions (heart/liver disease)(heart/liver disease)

• Hospital worker or family member Hospital worker or family member of victimof victim

• Liver enzyme Liver enzyme increaseincrease

SARS: TransmissionSARS: Transmission

• Spread through airborne Spread through airborne droplets released when infected droplets released when infected person coughs or sneezesperson coughs or sneezes

• Or through contact with Or through contact with body fluidsbody fluids

• Not likely to be transmitted in Not likely to be transmitted in offices or on public transportation offices or on public transportation

SARS: Treatment SARS: Treatment

• Antibiotics inappropriate since Antibiotics inappropriate since SARS is viral rather than bacterialSARS is viral rather than bacterial

• Steroids may helpSteroids may help

• 80-90% get better in a week80-90% get better in a week

• 10-20% get worse, may need 10-20% get worse, may need mechanical ventilators to breathemechanical ventilators to breathe

• Death rate estimated at 15%; Death rate estimated at 15%; higher for those over 60higher for those over 60

SARS: Precautions for SARS: Precautions for WorkplacesWorkplaces

Centers for Disease Control documentsCenters for Disease Control documents provide most up-to-date information atprovide most up-to-date information at www.cdc.gov/ncidod/sarswww.cdc.gov/ncidod/sars

See also the World Health OrganizationSee also the World Health Organization SARS webpage atSARS webpage at www.who.int/csr/sars/en/www.who.int/csr/sars/en/

SARS: OSHA RecommendationsSARS: OSHA Recommendations

See OSHA suggested practices at See OSHA suggested practices at

www.osha.gov/dep/sars/index.html www.osha.gov/dep/sars/index.html

Precautions for Healthcare Precautions for Healthcare FacilitiesFacilities

• Standard precautions Standard precautions

• PPE: gowns, gloves, N95 PPE: gowns, gloves, N95 respirators, eye protection respirators, eye protection

• Appropriate ventilationAppropriate ventilation

• Isolation rooms for Isolation rooms for suspected SARS casessuspected SARS cases

• Low or Intermediate level Low or Intermediate level disinfectantsdisinfectants

Precautions for LaboratoriesPrecautions for Laboratories

• PPE: disposable gloves, gowns, PPE: disposable gloves, gowns, eye protection and respiratory eye protection and respiratory protection—N95, N100 or PAPRS protection—N95, N100 or PAPRS with HEPA filterswith HEPA filters

• Manipulation/testing of Manipulation/testing of specimens—certified biological specimens—certified biological safety cabinetsafety cabinet

• Low or intermediate level Low or intermediate level disinfectantsdisinfectants

Precautions for Airline Precautions for Airline Flight Crews/Airport PersonnelFlight Crews/Airport Personnel

• PPE not recommended by CDC PPE not recommended by CDC for airline crewsfor airline crews

• Airline cleaning crews, INS, TSA Airline cleaning crews, INS, TSA workers should wear glovesworkers should wear gloves

• All workers should use good All workers should use good hygiene practices including hygiene practices including frequent hand washingfrequent hand washing

Precautions for Airplane Cleaning Precautions for Airplane Cleaning CrewsCrews

• Wear disposable gloves Wear disposable gloves • Do not use compressed air Do not use compressed air

for cleaningfor cleaning• Discard gloves after cleaningDiscard gloves after cleaning• Use soap and water to wash Use soap and water to wash

hands after cleaning hands after cleaning • If soap and water are not available, use If soap and water are not available, use

alcohol-based hand washalcohol-based hand wash• Wipe down frequently touched Wipe down frequently touched

surfaces in the passenger cabin with low surfaces in the passenger cabin with low or intermediate level disinfectantor intermediate level disinfectant

Precautions for Air Medical Precautions for Air Medical Transport of SARS PatientsTransport of SARS Patients

• Use respiratory protection (N95)Use respiratory protection (N95)

• Wear protective clothing if there is Wear protective clothing if there is potential for exposure to blood or potential for exposure to blood or body fluids body fluids

• Follow standard hygiene practicesFollow standard hygiene practices

Precautions for Handling Human Precautions for Handling Human Remains of SARS PatientsRemains of SARS Patients

• Use N95 or higher respirators Use N95 or higher respirators

• Wear surgical scrub suit, surgical Wear surgical scrub suit, surgical cap, gown or apron, eye protection, cap, gown or apron, eye protection, shoe covers, double glovesshoe covers, double gloves

• Use good hygiene practices Use good hygiene practices

Employee Training Employee Training

• All employees with potential exposure All employees with potential exposure should receive training should receive training

• Training should cover hazards and Training should cover hazards and protocols at worksite to reduce protocols at worksite to reduce exposures and isolate and report exposures and isolate and report SARS casesSARS cases

• Workers who experience SARS Workers who experience SARS symptoms should be excluded symptoms should be excluded from duty from duty

CDC Suggestions for Family CDC Suggestions for Family Members Caring for SARS Members Caring for SARS

Patients at Home Patients at Home

• Detailed guidance for family Detailed guidance for family members of SARS patients members of SARS patients available from CDC: available from CDC: www.cdc.gov/ncidod/sars/www.cdc.gov/ncidod/sars/factsheetcc.htmfactsheetcc.htm