What do you about WISQARS? What type of animal is this? What does it do?Where can you find it? Why do I need it? How can I use it?

Hopefully you can answer a few of these questions. If not maybe The Compliance Resource Center can help.

What is WISQARS?

WISQARS is Web-based Injury Statistics Query and Reporting System from the CDC (that’s a mouth full) that is an interactive, online database that provides fatal and nonfatal injury, violent death, and cost of injury data from a variety of trusted sources.

What does it do?

Users can search, sort, and view the injury data and create reports, charts, and maps based on the following:

• Intent of injury (unintentional injury, violence-related, homicide/assault, legal intervention, suicide/intentional self-harm)
• Mechanism (cause) of injury (e.g., fall, fire, firearm, motor vehicle crash, poisoning, suffocation)
• Body region (e.g., traumatic brain injury, spinal cord, torso, upper and lower extremities)
• Nature (type) of injury (e.g., fracture, dislocation, internal injury, open wound, amputation, and burn)
• Geographic location (national, regional, state) where the injury occurred
• Sex, race/ethnicity, and age of the injured person

Where can you find it?

At the CDC website  http://www.cdc.gov/injury/wisqars/facts.html

How can I use it?

• Show the size of the public health and economic impact of the injury problem
• Describe, compare, and monitor trends in unintentional and violence-related injuries
• Identify new or developing injury problems
• Identify persons at risk of injury
• Provide reliable surveillance data for program and policy decisions

Why do I need it?

What better way to sell safety programs than to show management how much an injury or death can cost a company. Using WISQARS you can calculate the cost of an incident and project how the impact will affect your company or organization.

We are always looking to tools to help increase our safety budget and have better programs. Now you can add WISQARS to your toolkit.

PEL and REL are acronyms used by the safety industry to define Permissible Exposure Limits (OSHA term) and Recommended Exposure Limits (NIOSH term).

In 1974, NIOSH joined OSHA in developing a series of occupational health standards for substances with existing PELs. OSHA sets enforceable permissible exposure limits (PELs) to protect workers against the health effects of exposure to hazardous substances. PELs are regulatory limits on the amount or concentration of a substance in the air. They may also contain a skin designation. OSHA PELs are based on an 8-hour time weighted average (TWA) exposure. Together NIOSH and OSHA set limits for 380 hazardous chemicals.

OSHA currently has about 500 permissible exposure limits (29 CFR part1910.1000), while NIOSH has about 700 RELs. NIOSH is able to evaluate them while OSHA PEL limits has not be updated since late 1960’s.

Acting under the authority of the Occupational Safety and Health Act of 1970 (29 USC Chapter 15) and the Federal Mine Safety and Health Act of 1977 (30 USC Chapter 22), NIOSH develops and periodically revises recommended exposure limits (RELs) for hazardous substances or conditions in the workplace. NIOSH also recommends appropriate preventive measures to reduce or eliminate the adverse health and safety effects of these hazards.

The NIOSH Web site features many different types of databases and information collections. The most popular databases include the International Chemical Safety Cards, NIOSH Pocket Guide to Chemical Hazards, and NIOSHTIC-2.

Chemical Databases:

· Immediately Dangerous to Life and Health (IDLH)
Provides the immediately dangerous to life or health air concentration values (IDLHs) for substances and the criteria and information sources that have been used to determine these values.

· International Chemical Safety Cards (WHO/IPCS/ILO)
ICSC cards summarize essential health and safety information on chemicals for their use at the “shop floor” level by workers and employers in factories, agriculture, construction and other work places.

· Manual of Analytical Methods (NMAM)
NMAM is a collection of methods for sampling and analysis of contaminants in workplace air, and in the blood and urine of workers who are occupationally exposed.

· NIOSH Pocket Guide to Chemical Hazards (NPG)
The NPG is intended as a source of general industrial hygiene information on several hundred chemicals/classes for workers, employers, and occupational health professionals.

·  The Emergency Response Safety and Health Database (ERSH-DB)
Developed by NIOSH for the emergency response community, The ERSH-DB contains accurate and concise information on high-priority chemical, biological and radiological agents that could be encountered by personnel responding to a terrorist event.

·Occupational Safety and Health Guidelines for Chemical Hazards
Summarizes information on permissible exposure limits, chemical and physical properties, and health hazards. It provides recommendations for medical surveillance, respiratory protection, and personal protection and sanitation practices for specific chemicals that have Federal occupational safety and health regulations.

· OSHA 1988 Permissible Exposure Limits (PELs)
PELs are OSHA comments from the January 19, 1989 Final Rule on Air Contaminants Project extracted from 54FR2332 et. seq. This rule was remanded by the U.S. Circuit Court of Appeals and the limits are not currently in force.

·Specific Medical Test Published in the Literature for OSHA Regulated Substances (MEDTEST)
The MEDTEST database lists the specific medical tests published in the literature for OSHA regulated substances. Updates of OSHA mandated tests (July 1, 2000) and NIOSH/OSHA recommendations are included.

Do you think a health hazard exists in your workplace? Do any of the following stories resemble situations at your workplace?

• A factory worker was feeling numbness and tingling in her fingers. She learned that three coworkers had the same problem, and two had headaches while at work but not over the weekend. Some workers said the air at work smelled bad. Their supervisor noticed the smell but didn’t think it was anything to worry about.
• A manager noticed that employees in one work area had more skin rashes in the past year than the year before. He wanted to know why, but didn’t know what to do.
• A work crew was putting cement tiles on a roof. They were working outside, but the air seemed dusty. The saws used to cut the tiles were noisy. Someone told them that this work was dangerous and they should have it checked out.

At no cost to employers or employees, or their representatives, the NIOSH Health Hazard Evaluation (HHE) program may be able to help with problems like these. This site lets you know about the program and how to ask for NIOSH help. It also has links to reports from thousands of HHEs done by NIOSH.

What is a Health Hazard Evaluation?

An HHE is a study of a workplace. It is done to learn whether workers are exposed to hazardous materials or harmful conditions. On the basis of the information you provide, NIOSH responds to an HHE request in one of the following ways:

• NIOSH staff responds in writing with helpful information or a referral to a more appropriate agency.
• NIOSH staff calls to discuss the problems and how they might be solved.

NIOSH staff visits the workplace. When this happens, they will meet with the employer and the employee representatives to discuss the issues. They will tour the workplace. They may review records about exposure and health, interview or survey employees, measure exposures, and do medical testing. These activities may happen during one or more visits. At the end of this evaluation, NIOSH will provide a written report to the employer and to the employee representatives. This can take from a few months to a few years, depending on the type of evaluation.

Who Can Request an HHE?

Private sector and Federal workplaces

An employee can request an HHE if he or she is currently an employee at the workplace of concern and has the signatures of two other employees. If the workplace has three or fewer employees, the signature of only one employee is enough.

An officer of a labor union that represents employees for collective bargaining can request an HHE.

Any management official may request an HHE on behalf of the employer.

For anyone who submits a request, NIOSH will not reveal to the employer the names of the persons who made the request if they indicate this on the request form

State or local government workplaces

When the workplace is part of a State or local government, NIOSH authority is more limited than for the private and Federal sectors. The cooperation of the employer may be necessary before NIOSH can do an evaluation.

Should you request an HHE?

When there is concern about a health hazard in a workplace, you can request an HHE, file a complaint with the Occupational Safety and Health Administration (OSHA), or request help from the OSHA Consultative Service. Some things to consider for each of these options are listed below.

1. When to request an HHE from NIOSH

You are an employee, employee representative, or employer and the following apply:

• Employees have an illness from an unknown cause.
• Employees are exposed to an agent or working condition that is not regulated by OSHA.
• Employees experience adverse health effects from exposure to a regulated or unregulated agent or working condition, even though the permissible exposure limit is not being exceeded.
• Medical or epidemiological investigations are needed to evaluate the hazard.
• The incidence of a particular disease or injury is higher than expected in a group of employees.
• The exposure is to a new or previously unrecognized hazard.
• The hazard seems to result from the combined effects of several agents.

2. When to request help from the OSHA Consultation Program (http://www.osha.gov/dcsp/smallbusiness/consult.html):

You are a small business owner and you want:

• assistance in recognizing hazards in your workplace.
• suggestions or options for correcting safety and health issues.
• assistance in developing or maintaining an effective safety and health program.
• to reduce workers compensation cost and improve employee morale..

The OSHA On-site Consultation Program:

• is a free service.
• is delivered by state (and territorial) governments using well-trained safety and health professionals.
• is separate from enforcement.
• is confidential. The company’s name, and any other identifying information provided about the workplace, plus any unsafe or unhealthful working conditions that the consultant uncovers, will not routinely be reported to OSHA enforcement personnel.
• does not issue and citations, penalties, or fines.
• will provide you a confidential, written report that summarizes the consultant’s findings.
• requires the correction of hazards identified by the consultant(s).
• under specific circumstances, employers with exemplary safety and health programs can be recommend for recognition and provided with an exclusion from general schedule inspections.

3. When to file a complaint with OSHA (www.osha.gov/as/opa/worker/index.html):

You are an employee and the following situations apply*:

• Immediate enforcement by a regulatory agency is needed.
• Employees want the employer to comply with existing health and safety standards.
• The hazard is well recognized.
• An OSHA standard is known to adequately protect employees from the hazard.

* [Employers in the Federal sector may wish to explore the services available through the Division of Federal Occupational Health (DFOH), which maintains an office in each Federal region. State and local government employers may be eligible for help under the OSHA Consultation Program operating in their State. The State or local health department may also be able to help with occupational safety and health issues.]

How Does NIOSH Respond to an HHE Request?

NIOSH logs in each request for an HHE and generally sends a letter to the person making the request. Most often this happens within a few weeks.When NIOSH decides to send information or make a referral to another agency, usually a letter is sent within 4–6 weeks.

When NIOSH decides that telephone consultation or a workplace visit is needed, a project officer is assigned. Usually, within 4–6 weeks, the project officer contacts the person who sent in the request. When the request is made by an employee or union, NIOSH also contacts the employer to let them know about the request and to arrange for a site visit. Typically, NIOSH does not conduct surprise visits.

What protections are provided for employees who request and participate in HHE investigations?

Confidentiality

If desired and noted on the HHE request form, NIOSH will not reveal to the employer the names of the persons who made the request. Personal information from records, questionnaires, interviews with NIOSH investigators, and individual medical results will be safeguarded in accordance with provisions of the Privacy Act.

Anti-discrimination Provisions

The Occupational Safety and Health Act and the Federal Mine Safety and Health Act forbid employers from retaliating or punishing employees for making HHE requests or cooperating with NIOSH investigators (see Section 11(c) of the Occupational Safety and Health Act or Section 105(c) of the Mine Safety and Health Act). The enforcement of these anti-discrimination provisions is the responsibility of the U.S. Department of Labor. If discrimination is suspected, contact the nearest OSHA or MSHA office immediately.

Procedural Rights of NIOSH and Employee or Employee Representatives

There are 7 legal rights of NIOSH and employees or employee representatives that NIOSH considers non-negotiable:

• NIOSH and its representatives have the right to enter the workplace to conduct HHE investigations.
• NIOSH and its representatives have the right to access information and records maintained by the employer that are pertinent to the HHE investigation.
• NIOSH and employees (including management employees) have the right to private and confidential interviews.
• Employee representatives, including an employee requestor and a representative of any union representing the affected employees, have the right to accompany NIOSH investigators during the initial inspection of any workplace to be evaluated.(NIOSH investigators may have additional employee representatives accompany them if necessary to aid in the investigation.)
• Employee representatives have the right to participate in an opening and closing conference with NIOSH investigators at the start and conclusion of a NIOSH investigation at the workplace.
• Employees have the right to wear NIOSH sampling devices and participate in medical tests when offered or requested by NIOSH. (This also applies to management employees.)
• Employees have the right to read or obtain copies of all HHE interim and final reports. (The employer is required to post the final report in the workplace for 30 days, or supply a list of names and addresses of affected employees so that NIOSH can mail the report directly to them.)

Procedural Rights of the Employer

Regardless of who submitted the request for an HHE, employers have the following rights during HHE investigations:

• To obtain a copy of the HHE request (excluding the identity of confidential requestors and any accompanying information of a personal nature.)
• To obtain verbal accounts from NIOSH investigators concerning plans, procedures, and findings at conferences at the beginning and conclusion of NIOSH visits to the workplace.
• To accompany NIOSH investigators during the initial inspection of the workplace to be investigated.
• To observe NIOSH investigative procedures during the HHE, except for certain confidential NIOSH-employee interactions, such as private interviews and medical test procedures.
• To identify, at the start of the investigation, information that is considered trade secret, and to have that information safeguarded by NIOSH unless NIOSH follows procedures outlined in 42 CFR 85.7(b) to remove the trade secret designation from such information. (These procedures provide an opportunity for the employer to defend the trade secret designation.)
• To require that NIOSH officers comply with all safety and health rules in the workplace, and conduct the investigations in a manner that does not unreasonably disrupt operations.

Role of the Employee Representative

The local, national, or international union may submit an HHE request on behalf of employees it represents. Two employees may authorize a third employee to submit an HHE request on their behalf.

The employee representative has the following rights:

• To accompany NIOSH investigators on the initial inspection of the workplace.
• To convey to the NIOSH investigators, privately if requested, additional information related to the HHE request.
• To participate in the opening and closing conferences.
• To receive copies of all interim and final reports

How Are HHE Results Reported?

NIOSH reports its findings and recommendations to employers, employees, and employee representatives. Verbal reports are normally provided to employer and employee representatives during a closing conference at the conclusion of a site visit, and by telephone. Often, results are only preliminary or incomplete at that time. Written interim reports are sometimes provided while an investigation is still in progress.

When all the information and data have been analyzed, NIOSH issues a report of its final determination, giving findings and recommendations. Copies of this report are sent to the requestor, the employer, employee representatives, OSHA, and other appropriate agencies.

The employer is required to post the final report in a place accessible to employees from all areas evaluated (alternatively, the employer may give NIOSH names and addresses of affected employees to permit NIOSH to mail the report to each affected employee.) Although NIOSH has no authority to force the employer to adopt its recommendations, experience has shown that most employers attempt to address any problems identified in the HHE report.

By What Authority Does NIOSH Conduct HHEs?

In private sector workplaces, NIOSH is supported by the following:

• The Law

Section 20(a)(6) of the Occupational Safety and Health Act (Public Law 91-596, 91st Congress, S.2193, December 29, 1970), 29 USC 669 (a)(6), authorizes the Secretary of Health and Human Services (delegated to NIOSH), “following a written request by any employer or authorized representative of employees, to determine whether any substance normally found in the place of employment has potentially toxic effects in such concentrations as used or found.” Section 501(a) of the Federal Mine Safety Act of 1977 authorizes NIOSH, “upon the written request of any mine operator or authorized representative of miners, to evaluate potentially hazardous or toxic effects of substances, physical agents, or equipment found or used in mines.”

• Federal Regulations

The regulations governing NIOSH procedures for conducting HHEs are published in Title 42, Code of Federal Regulations, Part 85; Requests for Health Hazard Evaluations (42 CFR 85).

In Federal agency workplaces, NIOSH is supported by the following:

• The Law

Section 19 of the Occupational Safety and Health Act (29 USC 668) requires the head of each Federal agency to “establish and maintain an effective and comprehensive occupational safety and health program.”

• Executive Order

Executive Order 12196 of February 26, 1980, “Occupational Safety and Health Programs for Federal Employees.”

• Federal Regulations

Title 29, Code of Federal Regulations, Part 1960; Basic Program Elements for Federal Employees Occupational Safety and Health

Programs and Related Matters (29 CFR 1960). Section 1960.35 of these regulations describes the procedures for requesting HHEs in Federal agency workplaces.  NIOSH follows the procedures outlined in the regulations governing HHEs (42 CFR 85) when evaluating Federal agency workplaces.

In other government agency workplaces, NIOSH is supported by the following:

• The Law

Section 18 of the Occupational Safety and Health Act (29 USC 667) permits OSHA to approve a plan under which the State assumes responsibility for developing and enforcing occupational safety and health standards. Section 18(c)(6) requires that such a plan, to be approved, must contain satisfactory assurances that the State will “establish and maintain an effective and comprehensive occupational safety and health program applicable to all employees of public agencies of the State and its political subdivisions.” Although approved State plans do not ordinarily extend the right to request HHEs to State employees and employers, the State agency charged with carrying out this plan has right-of-access to State and local government workplaces, and could request technical assistance from NIOSH in evaluating the workplaces.

• Federal Regulations

In cases where NIOSH responds to requests to evaluate State or local government workplaces, the procedures outlined in 42 CFR 85 are followed.

Occupational Medicine Rotation Program

The NIOSH Health Hazard Evaluation and Technical Assistance Branch provides hands-on, one- and two-month workplace training opportunities to Medical Residents. Residents join staff on a combination of workplace and epidemiologic investigations, public inquiries, health and safety assessments on today’s health and safety topics and learn to plan and conduct worksite health evaluations. Residents gain understanding of the role and function of CDC/NIOSH regarding occupational health research and service.

OSHA recently solidified leadership for the agency and has provided a clearer picture of the regulatory horizon.

Hepatitis B Vaccination and Post-Exposure Follow-Up Procedures

Q. Who must be offered the hepatitis B vaccination?

A. The hepatitis B vaccination series must be made available to all employees who have occupational exposure. The employer does not have to make the hepatitis B vaccination available to employees who have previously received the vaccination series, who are already immune as their antibody tests reveal, or who are prohibited from receiving the vaccine for medical reasons.

Q. When should the hepatitis B vaccination be offered to employees?

A. The hepatitis B vaccination must be made available within 10 working days of initial assignment, after appropriate training has been completed. This includes arranging for the administration of the first dose of the series. In addition, see page 17 for vaccination of designated first aiders.

Q. Can pre-screening be required for hepatitis B titer? Post-screening?

A. No. The employer cannot require an employee to take a pre-screening or post-vaccination serological test. An employer may, however, decide to make pre-screening available at no cost to the employee. Routine post-vaccination serological testing is not currently recommended by the CDC unless an employee has had an exposure incident, and then it is also to be offered at no cost to the employee.

Q. If an employee declines the hepatitis B vaccination, can the employer make up a declination form?

A. If an employee declines the hepatitis B vaccination, the employer must ensure that the employee signs a hepatitis B vaccination declination. The declination’s wording must be identical to that found in Appendix A of the standard. A photocopy of the Appendix may be used as a declination form, or the words can be typed or written onto a separate document.

Q. Can employees refuse the vaccination?

A. Employees have the right to refuse the hepatitis B vaccine and/or any post-exposure evaluation and follow-up. Is important to note, however, that the employee needs to be properly informed of the benefits of the vaccination and post-exposure evaluation through training. The employee also has the right to decide to take the vaccination at a later date if he or she so chooses. The employer must make the vaccination available at that time.

Q. Can the hepatitis B vaccination be made a condition of employment?

A. OSHA does not have jurisdiction over the issue.

Q. Is a routine booster does of hepatitis B vaccine required?

A. Because the U.S. Public Health Service (USPHS) does not recommend routine booster doses of hepatitis B vaccine, they are not required at this time. However, if a routine booster dose of hepatitis B vaccine is recommended by the USPHS at a future date, such booster doses must be made available at no cost to those eligible employees with occupational exposure.

Q. Whose responsibility is it to pay for the hepatitis B vaccine?

A. The responsibility lies with the employer to make the hepatitis B vaccine and vaccination, including post-exposure evaluation and follow-up, available at no cost to the employees.

Q. What information must the employer provide to the healthcare professional following an exposure incident?

A. The healthcare professional must be provided with a copy of the standard, as well as the following information:

•A description of the employee’s duties as they relate to the exposure incident;

•Documentation of the route(s) and circumstances of the exposure;

•The results of the source individual’s blood testing, if available; and

•All medical records relevant to the appropriate treatment of the employee, including vaccination status, which are the employer’s responsibility to maintain.

Q. What serological testing must be done on the source individual?

A. The employer must identify and document the source individual if know, unless the employer can establish that identification is not feasible or is prohibited by state or local law. The source individual’s blood must be tested as soon as feasible, after consent is obtained, in order to determine HIV and HBV infectivity. The information on the source individual’s HIV and HBV testing must be provided to the evaluating healthcare professional. Also, the results of the testing must be provided to the exposed employee. The exposed employee must be informed of applicable laws and regulations concerning disclosure of the identity and infectious status of the source individual.

Q. What if consent cannot be obtained from the source individual?

A. If consent cannot be obtained and is required by state law, the employer must document in writing that consent cannot be obtained. When the source individual’s consent is not required by law, the source individual’s blood if available shall be tested and the results documented.

Q. When is the exposed employee’s blood tested?

A. After consent is obtained, the exposed employee’s blood is collected and tested as soon as feasible for HIV and HBV serological status. If the employee consents to the follow-up evaluation after an exposure incident, but does not give consent for HIV serological testing, the blood sample must be preserved for 90 days. If, within 90 days of the exposure incident, the employee elects to have the baseline sample tested for HIV, testing must be done as soon as feasible.

Q. What information does the healthcare professional provide to the employer following an exposure incident?

A. The employer must obtain and provide to the employee a copy of the evaluating healthcare professional’s written opinion within 15 days of completion of the evaluation. The healthcare professional’s written opinion for hepatitis B is limited to whether hepatitis B vaccination is indicated and if the employee received the vaccination. The written opinion for post-exposure evaluation must include information that the employee has been informed of the results of the evaluation and told about any medical conditions resulting from exposure that may further require evaluation and treatment. All other findings or diagnoses must be kept confidential and not included in the written report.

Q. What type of counseling is required following an exposure incident?

A. The standard requires that post-exposure counseling be given to employees following an exposure incident. Counseling should include USPHS recommendations for prevention of HIV. These recommendations include refraining from blood, semen, or organ donation; abstaining from sexual intercourse or using measures to prevent HIV transmission during sexual intercourse; and refraining from breast feeding infants during the follow-up period. In addition, counseling must be made available regardless of the employee’s decision to accept serological testing.

Q. What information about exposure incidents is recorded on the OSHA 300 Log?

Revision 10/02 A. All work-related needlestick injuries and cuts from sharp objects that are contaminated with another person’s blood or other potentially infectious materials must be recorded. Enter the case on the 300 Log as an injury. To protect the employee’s privacy, do not enter the employee’s name. Enter the case on the sharps injury log or enter comparable data on the OSHA 300 Log.

The risk of influenza to healthcare workers is not a new concern, but the ongoing experience with novel influenza A (nH1N1) makes this issue even more urgent. Among the many considerations for the health and well-being of healthcare workers is the question about what types of personal protective equipment (PPE) (respiratory protection, gloves, gowns, eye protection, and other equipment) are needed to protect these frontline workers. PPE needs to be regarded one part of a set of infection control strategies to reduce the potential for infection in healthcare workers. At the request of the Centers for Disease Control and Prevention (CDC) and the Occupational Safety and Health Administration (OSHA) the Institute of Medicine convened the Committee on Respiratory Protection for Healthcare Workers in the Workplace Against Novel H1N1 Influenza A to provide recommendations regarding the necessary respiratory protection for healthcare workers in their workplace against novel H1N1 influenza A.

RESPIRATORY PROTECTION

The committee focused solely on the scientific and empirical evidence regarding the efficacy of various types of personal respiratory protective equipment (e.g., medical masks and respirators). Studies on influenza transmission show that airborne (inhalation) transmission is one of the potential routes of transmission. N95 respirators are documented to filter out 95 to 99 percent of relevant particles and have maximum effectiveness when properly fitted to the face of users. Research results on the filtration and fit of medical masks show wide variation in penetration of aerosol particles and inadequate fit suggesting that the use of medical masks is unlikely to be effective against airborne transmission.

Recommendationation 1: Use Fit -Teste d N95 Respirators espirators

Healthcare workers (including those in non-hospital settings) who are in close contact with individuals with nH1N1 influenza or influenza-like illnesses should use fit-tested N95 respirators or respirators that are demonstrably more effective as one measure in the continuum of safety and infection control efforts to reduce the risk of infection.

• The committee endorses the current CDC guidelines and recommends that these guidelines should be continued until or unless further evidence can be provided to the effect that other forms of protection or other guidelines are equally or more effective.

• Employers should ensure that the use and fit testing of N95 respirators be conducted in accordance with OSHA regulations, and healthcare workers should use the equipment as required by regulations and employer policies.

It is important to note that controversy exists regarding clinical guideline decision making as many factors besides efficacy may affect policy decisions for PPE guidance including economics, equipment supplies, vaccine availability, immunization status, extent of worker compliance, and logistical considerations in the implementation of such guidance. The committee was not charged to address these other issues.

AUGUST 19, 2009

CDC is releasing new guidance that recommends actions that non-healthcare employers should take now to decrease the spread of seasonal flu and 2009 H1N1 flu in the workplace and to help maintain business continuity during the 2009–2010 flu season. The guidance includes additional strategies to use if flu conditions become more severe and some new recommendations regarding when a worker who is ill with influenza may return to work. The guidance in this document may change as additional information about the severity of the 2009-2010 influenza season and the impact of 2009 H1N1 influenza become known. Please check www.flu.gov periodically for updated guidance

Introduction

The U.S. Department of Health and Human Services’ (HHS) Centers for Disease Control and Prevention (CDC), with input from the U.S. Department of Homeland Security (DHS), has developed updated guidance for employers of all sizes to use as they develop or review and update plans to respond to 2009 H1N1 influenza now and during the upcoming fall and winter influenza season. Businesses and employers, in general, play a key role in protecting employees’ health and safety, as well as in limiting the negative impact of influenza outbreaks on the individual, the community, and the nation’s economy. Employers who have developed pandemic plans should review and revise their plans in light of the current 2009 H1N1 influenza outbreak to take into account the extent and severity of disease in their community as outlined in this guidance.

Planning for Fall and Winter Influenza Season

Businesses may have already been impacted by the spring and summer outbreaks of 2009 H1N1 influenza affecting their employees. CDC anticipates that more communities may be affected than were in the spring/summer 2009, and/or more severely affected reflecting wider transmission and possibly greater impact. In addition, seasonal influenza viruses may cause illness at the same time as 2009 H1N1 this fall and winter. In response to the anticipated spread of 2009 H1N1 influenza, the CDC has revised its recommendations to assist businesses and other employers of all sizes.

The severity of illness that 2009 H1N1 influenza flu will cause (including hospitalizations and deaths) or the amount of illness that may occur as a result of seasonal influenza during the 2009–2010 influenza season cannot be predicted with a high degree of certainty. Therefore, employers should plan to be able to respond in a flexible way to varying levels of severity and be prepared to refine their pandemic influenza response plans if a potentially more serious outbreak of influenza evolves during the fall and winter. More people and communities are likely to be affected as influenza is more widely transmitted. The CDC and its partners will continuously monitor national and international data on the severity of illness caused by influenza, will disseminate the results of these ongoing surveillance and will make additional recommendations as needed.

FOR THE COMPLETE GUIDE GO TO http://www.flu.gov/plan/workplaceplanning/guidance.html

In 2006 an article was published on pandemic awareness:

Many organizations have planned for disasters, some with an impressive array of activities including practice drills, tabletop exercises, and extensive implementation plans. While all of these activities are essential to minimizing the impact and costs of natural disasters for terrorist activities, they will prove inadequate for pandemic events such as an outbreak of a new strain of influenza.

Experts say a pandemic will feel more like a war or a severe economic crisis than an earthquake, hurricane, or act of terrorism. As a result, a pandemic threat requires a unique approach to planning and a different set of skills and preparation than traditional disaster preparedness activities.
 
“Organizations that depend upon existing, on-the-shelf disaster plans will pay a heavy price during a pandemic event,” said Bob Blitzer, an ICF International vice president in emergency management. “Within a few days, the organization will realize that it is unprepared to respond to the needs of its employees, its customers, and its community.”

U.S. federal officials who have been planning for potential pandemic events have made it very clear that this is a unique threat, unlike any natural or man-made disaster.

“The pandemic threat is different…the significant mobility of human populations means that every corner of the globe and every element of society are likely to be touched. This widespread effect has ramifications not only for the health and well being of populations, but for the national and economic security of the nations, and the functioning of society. Once this fundamental premise is recognized, the scope and scale of the measures necessary to prepare for a pandemic become apparent.”1

It also is apparent to the experts involved in planning for a pandemic event that relying solely on the health and medical communities to respond to this kind of a crisis is unrealistic and potentially dangerous. Officials point out that the vast majority of the actions that will be taken will occur from nontraditional sources. Federal support will be substantially less than in the case of traditional disasters, and because of the scope of the problem, traditional “mutual assistance” agreements with neighboring communities and states will be virtually useless.

“They all think the cavalry is going to arrive and do all the ‘heavy lifting,’” said Anita Tallarico, an ICF senior vice president describing state and local agencies and the business community. “However, government officials emphasize that local communities must prepare to be able to help themselves for at least three days.”

The President’s Implementation Plan clearly states that the primary burden of responding will fall on nongovernmental institutions. “More than 85 percent of critical infrastructure is owned and operated by the private sector. Therefore, sustaining the operations of critical infrastructure under conditions of pandemic influenza will depend largely on each organization’s development and implementation of plans for business continuity while facing staffing shortages and the need to protect the health of its workforce.”2

This will require a major “shift in thinking” for businesses that are not accustomed to taking care of health needs for employees while simultaneously trying to sustain business operations with limited staff and absence of other normal support services for an extended period of time.

“When we go in and work with a client on a training exercise and help with planning,” said Blitzer—who formerly headed up the Weapons of Mass Destruction response operations at the Federal Bureau of Investigation—“the client quickly realizes that its traditional way of thinking about disaster planning is completely inadequate. Once stakeholders realize how quickly a pandemic outbreak occurs, and the fact that it is inevitable that another one will occur in our lifetime, their thinking changes.”

Here are just a few of the assumptions federal officials make as they plan for a pandemic event. These assumptions also must be incorporated into planning efforts in the private sector and by state and local agencies.

• Susceptibility will be universal.
• Civil disturbances and breakdowns in the public order may occur.
• Typically, illness rates will be highest among school-aged children (about 40 percent) and decline with age. Among working adults, an average of 20 percent will become ill during a community outbreak. Actual illness rates by age, however, will depend on the characteristics of the new virus and may vary from these rates.
• Risk groups for severe and fatal infection cannot be predicted with certainty, but are likely to include infants, the elderly, pregnant women, and persons with chronic or immunosuppressive medical conditions.
• In a severe pandemic, absenteeism rates of 40 percent or higher may result from individual illness, the need to care for ill family members, and fear of infection.
• Typically, the risk of transmission (viral shedding) will be greatest during the first two days of illness. Children will play a major role in spreading the disease.
• On average, infected persons will transmit infection to approximately two other people.
• Isolation and quarantine measures are likely, as are mandatory restrictions on domestic and international travel.
• Epidemics will last six to eight weeks in affected communities.
• Multiple waves of illness are likely to occur, with each wave lasting two to three months.

Things are now closer than anyone ever thought it would happen.  On 23 rd April 2009 the world began to become aware of a very strange new version of swine flu H1N1 in Mexico with limited cases in Texas and California. By the morning of the 24th of April, we began hear that there were hundreds of sick and 20 or so dead. By late in the day, we have learned that over 1,000 are now reported ill and over 60 are reported dead. There are solid reasons to suspect that this new Mexican Swine Flu is NOT a naturally occurring event but instead is an Advanced Biological Warfare recombination DNA genetically engineered virus.

Here is what we know of the virus so far. This virus has already gone international having crossed the border from Mexico to America. All schools in Mexico City have been canceled, millions of students told to stay home due to Mexican Swine Flu. Sick victims of this strange new virus are currently reported in California and Texas. Over 60 deaths reported in Mexico (could be substantially higher considering the state of Mexican health care and reporting).

Young healthy adults seem to be the most at risk. This is similar to the deadest killer flu in history, Spanish Flu in 1918. Most if not all nations with advanced biological warfare programs have been interested in recreating the Spanish Flu DNA sequence and several are reported to have done so.

The new Mexican Swine Flu has elements of DNA from the following: avian flu, human flu Type A, human flu Type B, Asian swine flu, and European swine flu. A strange combination never seen before and having less than 1/10% chance of being a natural event. Human and animal viruses from four or more continents suddenly recombine in a new flu during a non-flu season that spreads from human-to-human with a 10% fatality rating.