Personal Protective Equipment for Avian Influenza A Viruses in the Workplace

PPE for medium and high exposure settings and tasks

Engineering and administrative controls are not always sufficient for reducing exposures to confirmed or potentially infected animals and their secretions. PPE is needed in some cases to reduce the risk of exposures, especially for workers in direct contact with animals or their secretions.

Employers should provide appropriate PPE at no cost as well as training on its proper use. Putting on and removing PPE should occur during work hours.

Medium exposure settings

Recommended items:

• NIOSH Approved^® particulate respirator
• Safety goggles
• Disposable gloves with optional outer work gloves to protect the disposable gloves

High exposure settings

Recommended items:

• NIOSH Approved^® particulate respirator
• Fluid-resistant coveralls
• Safety goggles
• Boot covers or boots
• Head cover or hair cover
• Disposable gloves

Optional items:

• Waterproof apron over the top of coveralls to protect the coveralls and allow for easy removal of gross contamination during PPE removal
• Face shield over the top of goggles and respirator to protect against large amount of liquid splashing onto the filtering facepiece respirator
• Outer work gloves to protect the disposable gloves (for example, gloves for cold protection, manual shoveling, handling live poultry)

Milking parlor modification

In milking parlors where contamination from cows can only reach the worker from one side, a fluid-resistant coverall may be substituted with a fluid-resistant sleeved apron. This modification should not be used in milking parlors where cows line up on two or more sides that are relatively close together because splashes could come from behind. If used, it is important to train workers that this modification only provides partial body protection. It makes them more susceptible to transferring the virus from unprotected clothing through direct or indirect contact with their eyes, nose, or mouth, potentially causing an infection.

Training on PPE

Provide this training in a language that the worker understands. At the end of an effective training, workers will be able to demonstrate their understanding of these concepts.

Train workers on:

• When to use PPE
• What PPE is necessary
• How to properly put on, wear, and use respirators and other PPE
• Conducting a proper user seal check when putting on a respirator
• How and when to replace a respirator that is damaged, soiled, or causing noticeably increased breathing resistance
• Safe removal of respirators and other PPE
• Proper storage of respirators and other PPE
• How to dispose of PPE according to local and state regulations and authorities
• Cleaning and disinfection of, and recommended respirator change-out schedule for, reusable respirators
• How to maintain respirators and other PPE
• Limitations of respirators and other PPE
• Medical contraindications to respirator use
• Wearing PPE in hot and cold environments
• Use of only NIOSH Approved® respirators

Workers should continue to wear the PPE required for their normal duties and other hazards (for example, waterproof apron, hearing protection) and add PPE for avian influenza A virus exposure as appropriate. Appropriate PPE depends on a site-specific hazard assessment and the hazards identified.

PPE may be required by the Occupational Safety and Health Administration (OSHA) standards found at 29 CFR part 1910, Subpart I (Personal Protective Equipment) and 29 CFR 1910.134 (Respiratory Protection). Even when not required, following these standards will help protect workers from novel influenza A viruses.

Using PPE safely

Designate "clean" and "dirty" areas

Control flow of traffic between areas

Maintain clear separations between dirty and clean areas using physical barriers and signage.

Use clear signage to maintain flow of foot traffic in one direction, from clean to dirty when entering the worksite, and dirty to clean when exiting the worksite.

Reinforce protocols and procedures

Use a trained observer to supervise each step of workers putting on and removing PPE to ensure established PPE protocols are completed correctly.

Establish procedures and post signage reminding all workers that PPE should be removed before entering any clean areas, including restrooms, breakrooms, and administrative areas.

Remind workers to avoid touching themselves above their chest, especially eyes, mouth, or nose. This is especially important after touching any contaminated material.

Remind workers not to eat, drink, touch their phones, smoke, vape, chew gum, dip tobacco, or use the bathroom until PPE has been removed.

Minimize contamination

Cleaning reusable PPE

Provide appropriate facilities, equipment, and supplies to properly clean reusable PPE. All reusable PPE should be set aside, then cleaned and disinfected after every use.

Reusable PPE includes boot covers, boots, goggles, face shields, waterproof aprons, elastomeric half mask respirators, powered air purifying respirators, helmets, and hard hats.

To clean and disinfect reusable PPE:

1. Select an EPA registered disinfectant with label claims for avian influenza
2. Confirm disinfectant with PPE manufacturer to avoid damaging the PPE
3. Clean until visible dirt is removed then disinfect
   

Generally, it is recommended that reusable respirators be cleaned and disinfected immediately after removing. Elastomeric components vary among manufacturers and react differently to cleaning and disinfection solutions and procedures. The respirator facepiece components such as facepiece, valves, and straps require maintenance including cleaning, disinfection, and inspection prior to reuse.

Laundering washable PPE

Employers should launder washable PPE and other garments (for example, coveralls and clothing) onsite, following these instructions:

• Wash laundry onsite with standard laundry detergent, and completely machine-dry at the highest temperature suitable for the material
• Wear disposable gloves and protective outerwear when handling soiled laundry
• Use separate storage and transport bins for clean and dirty laundry

If no laundry facilities are onsite, clothing to be laundered at home should be transported in a plastic bag. It should be kept separate from household items, washed separately, and then thoroughly machine-dried at the highest temperature suitable for the material.

Hot working environments

Agricultural work is often carried out in hot and sometimes humid environments. Wearing PPE and certain clothing ensembles can increase the risk of heat-related injuries and illnesses. PPE can reduce the wearer's exposure to fresh, cooling air and limit evaporation from skin. It can also decrease a worker's ability to drink and rehydrate.

Actions to reduce heat stress

When work must be carried out in hot and/or humid environments, it is important to educate workers about symptoms of heat-related illnesses. Also consider implementing additional controls to protect workers.

Additionally, the OSHA-NIOSH Heat Safety Tool and AIHA Heat Stress App (Apple App Store and Google Play Store) are useful resources for planning outdoor work activities based on how hot it feels throughout the day.

Cold working environments

Using PPE in cold environments presents unique challenges. Cold environments may reduce lifespan for reusable PPE.

Often, wearers experience moisture build-up and stiffer PPE. This can then lead to additional issues.

Refer to the manufacturer's instructions for the range of temperatures where the PPE may be used and stored.

To address these challenges, employers can:

• Select fog-proof lenses or use a fog-proofing solution recommended by the manufacturer
• Store PPE in warm areas
• Consider shortening change-out schedules for reusable PPE

NIOSH Approved is a certification mark of the U.S. Department of Health and Human Services (HHS) registered in the United States and several international jurisdictions.