CDC H1N1 Flu | General Business and Workplace Guidance for the Prevention of Novel Influenza A (H1N1) Flu in Workers

General Business and Workplace Guidance for the Prevention of Novel Influenza A (H1N1) Flu in Workers
June 25, 2009, 2:15 PM ET

Symptoms of Novel Influenza A (H1N1) Flu
Prevention of Illness in Well Employees
Management of Employee Exposure in the Workplace after a Confirmed Case
How Businesses Can Respond to the Impact on their Operations and Employees
This guidance is to help employers with employees in OSHA's Lower Risk (Caution) Zone*: those employees who have minimal occupational contact with the general public and other coworkers (for example, office employees).

Note: This guidance as been updated as of Jun 25, 2009 to state that a worker who has been exposed to a person with pandemic influenza A (H1N1) may continue to go to work unless he/she becomes ill.

A pandemic influenza A (H1N1) virus has infected humans in the United States as well as multiple other countries, and the spread of this virus continues. Businesses and employers, in general, play a key role in protecting employees' health and safety, as well as in limiting the negative impact of the outbreak on the individual, the community, and the nation’s economy. This interim guidance is meant to inform and educate management, unions, and employees about appropriate precautions and work practices to minimize the risk of potential employee exposure, illness, and the spread of pandemic influenza A (H1N1) flu in the workplace through general prevention and preparedness strategies and in the event that a worker becomes ill.

The guidance in this document may change as additional information about pandemic influenza A (H1N1) becomes known. Please check the website periodically for updated guidance.

Symptoms of Novel Influenza A (H1N1) Flu
The symptoms of this pandemic influenza A (H1N1) flu virus in people are similar to the symptoms of seasonal flu and include fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills and fatigue. A significant number of people who have been infected with this virus also have reported diarrhea and vomiting. Also, as with seasonal flu, severe illnesses and death have occurred as a result of illness associated with this virus.

Prevention of Illness in Well Employees
Spread of this pandemic influenza A (H1N1) virus is thought to be happening in the same way that seasonal flu spreads. Flu viruses are spread mainly from person to person through coughing or sneezing by people with influenza. Sometimes people may become infected by touching something with flu viruses on it and then touching their eyes, mouth, or nose.

What can employers do to protect employees?
Encourage sick workers to stay home and away from the workplace, and provide flexible leave policies.
Encourage infection control practices in the workplace by displaying posters that address and remind workers about proper hand washing, respiratory hygiene, and cough etiquette. These posters can be found on the Germ Stopper: Posters and Other Materials page.
Provide written guidance (email, etc.) on pandemic influenza A (H1N1) flu appropriate for the language and literacy levels of everyone in the workplace. Employers should work closely with local and state public health officials to ensure they are providing the most appropriate and up-to-date information (e.g., the CDC H1N1 Flu website).
Provide sufficient facilities for hand washing and alcohol-based (at least 60%) hand sanitizers (or wipes) in common workplace areas such as lobbies, corridors, and restrooms.
Provide tissues, disinfectants, and disposable towels for employees to clean their work surfaces, as well as appropriate disposal receptacles for use by employees.
One study showed that influenza virus can survive on environmental surfaces and can infect a person for up to 2-8 hours after being deposited on the surface. To reduce the chance of spread of the pandemic influenza A (H1N1) virus, disinfect commonly-touched hard surfaces in the workplace, such as work stations, counter tops, door knobs, and bathroom surfaces by wiping them down with a household disinfectant according to directions on the product label.
What can employees do to reduce the spread of novel influenza A (H1N1) flu in the workplace?
Stay home if you are sick. If you have symptoms of influenza-like illness, stay home for 7 days after symptoms begin or until you have been symptom-free for 24 hours, whichever is longer. Following these recommendations will help keep you from infecting others and spreading the virus.
Employees who are well but who have an ill family member at home with pandemic H1N1 flu can go to work as usual. These employees should monitor their health every day, notify their supervisor and stay home if they become ill. Employees who have an underlying medical condition or who are pregnant should call their health care provider for advice, because they might need to receive influenza antiviral drugs to prevent illness.
Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it.
Wash your hands often with soap and water, especially after you cough or sneeze. Alcohol-based hand sanitizers can be used if soap and water are not available.
Avoid touching your eyes, nose, or mouth. Germs spread this way.
Avoid close contact with sick people. If an employee suspects that they have been exposed to a sick person with pandemic H1N1 influenza they may continue to go to work as usual. These employees should monitor their health every day and should notify their supervisor and stay home if they become ill
Management of Employee Exposure in the Workplace after a Confirmed Case of Novel Influenza A (H1N1) Flu
What to do when an employee comes to work with influenza-like illness symptoms in a community where novel influenza A (H1N1) virus is circulating
Notify appropriate health center or first aid personnel.
Place the employee in a room by him- or herself.
If the employee needs to go into a common area, he or she should cover coughs/sneezes with a tissue or wear a facemask if available and tolerable.
Notify the employee’s supervisor or employer.
Send the employee home as soon as possible.
Call for emergency medical services if the ill person develops any of the emergency warning signs. See What to Do If You Get Flu-Like Symptoms to review emergency warning signs and for more information on what employees should do if they become sick.
Ensure the ill employee stays home for 7 days after symptom onset or until symptom-free for 24 hours, whichever is longer.
For recommendations on facemask and respirator use for the person assisting the ill employee see Interim Recommendations for Facemask and Respirator Use to Reduce Novel Influenza A (H1N1) Virus Transmission.
What to do for co-workers of an employee who is a suspected or confirmed case of novel influenza A (H1N1) flu
Inform the employees of their exposure to a co-worker with confirmed, probable, or suspected pandemic H1N1 flu during the ill person’s infectious period.
Have the employees monitor themselves for symptoms.
Advise employees to check with their health care provider about any special care they might need if they are pregnant or have a chronic health condition such as diabetes, heart disease, asthma, or emphysema.
What to do for an employee with confirmed novel influenza A (H1N1) flu while he or she is on travel status
Notify his or her supervisor or employer if an employee becomes ill on travel or temporary assignment.
If outside the U.S., contact medical provider or overseas medical assistance companies to assist in finding an appropriate medical provider in that country, if needed. A U.S. consular officer can help locate medical services. Take note that U.S. embassies, consulates, and military facilities do not have the legal authority, capability, and resources to evacuate or to give medications, vaccines, or medical care to private U.S. citizens overseas.
See Novel H1N1 Flu and Travel for more information for travelers.
Considerations for Pregnant Employees with Suspected Novel Influenza A (H1N1) Flu
Pregnant women are known to be at higher risk for seasonal influenza complications. They might also be at higher risk for pandemic H1N1 influenza complications. Pregnant women with flu-like symptoms should contact their health care provider. For more information, please visit What Pregnant Women Should Know About H1N1 Virus

How Businesses Can Respond to the Impact that Novel Influenza A (H1N1) Flu May Have on their Operations and Employees
What businesses can do to anticipate and respond to the impact of novel influenza A (H1N1) flu on operations
Identify a workplace coordinator who will be responsible for dealing with pandemic influenza A (H1N1) flu issues and impact at the workplace, including contacting local health department and health care providers in advance and developing and implementing protocols for response to ill individuals.
Determine who will be responsible for responding to ill individuals in the workplace, either through an established health clinic or as a first aid duty.
Share your plans with employees and clearly communicate expectations.
Review interim recommendations for facemask and respirator use in non-health care settings.
Identify essential employees, essential business functions, and other critical inputs (e.g. raw materials, suppliers, subcontractor services/products, and logistics) required to maintain business operations by location and function should there be disruptions during the pandemic influenza A (H1N1) flu outbreak.
Implement business continuity plans if there is significant absenteeism in the workplace during this outbreak.
Review your plan with regard to increases or decreases in demand for your products and/or services during the outbreak (e.g., the need for hygiene supplies).
Review the CDC travel-related websites for up-to-date information and communicate these recommendations to employees who may have upcoming business-related travel.
Establish an emergency communications plan. This plan includes identification of key contacts (with back-ups), chain of communications (including suppliers and customers), and processes for tracking and communicating business and employee status.
Develop platforms (e.g., hotlines, dedicated websites) for communicating pandemic influenza A (H1N1) flu status and actions to employees, vendors, suppliers, and customers inside and outside the worksite in a consistent and timely way, including redundancies in the emergency contact system.
What businesses can do to anticipate and respond to the impact of novel influenza A (H1N1) on employees

Examine policies for leave and employee compensation and review with managers, supervisors, and employees so they are up-to-date on sick leave policies, leave donation, and employee assistance services that are covered under the different employee-sponsored health plans. Leave policies should be flexible and non-punitive.
Plan for the possibility of unscheduled leave that encourages employees who are sick to stay at home to care for themselves and others who are ill with the flu or children dismissed from school.
Establish policies for flexible worksite (e.g., telecommuting) and flexible work hours (e.g., staggered shifts), if needed.
Communicate policies for employee access to, and availability of, health care, mental health, and social services including corporate and community resources.

Footnotes:

*See the Risk Pyramid on page 11 of the OSHA Guidance on Preparing Workplaces for an Influenza Pandemic (PDF, 615 KB, 46 pages)
Occupational Safety and Health Administration, 2009

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