Selecting Controls for Minimizing SARS-CoV-2 Aerosol Transmission in Workplaces and Conserving Respiratory Protective Equipment Supplies

Office Workers' Views About the Uses, Concerns, and Acceptance of Hand Hygiene Data Collected From Smart Sanitizers: Exploratory Qualitative Interview Study

BACKGROUND

COVID-19 and the prospect of future pandemics have emphasized the need to reduce disease transmission in workplaces. Despite the well-established link between good hand hygiene (HH) and employee health, HH in nonclinical workplaces has received little attention. Smart sanitizers have been deployed in clinical settings to motivate and enforce HH. This study is part of a large project that explores the potential of smart sanitizers in office settings.

OBJECTIVE

Our previous study found that for office workers to accept the deployment of smart sanitizers, they would need to find the data generated as useful and actionable. The objectives of this study were to identify (1) the potential uses and actions that could be taken from HH data collected by smart sanitizers (2) the concerns of office workers for the identified uses and actions and (3) the circumstances in which office workers accept HH monitoring.

METHODS

An interview study was conducted with 18 office workers from various professions. Interview questions were developed using a framework from personal informatics. Transcripts were analyzed thematically.

RESULTS

A wide range of uses of smart sanitizer data was identified including managing hygiene resources and workflows, finding operating sanitizers, communicating the (high) standard of organizational hygiene, promoting and enforcing organizational hygiene policies, improving workers' own hygiene practices, executing more effective interventions, and identifying the causes of outbreaks. However, hygiene is mostly considered as a private matter, and it is also possible that no action would be taken. Office workers were also concerned about bullying, coercion, and use of hygiene data for unintended purposes. They were also worried that the data could be inaccurate or incomplete, leading to misrepresentation of hygiene practices. Office workers suggested that they would be more likely to accept monitoring in situations where hygiene is considered important, when there are clear benefits to data collection, if their privacy is respected, if they have some control over how their data are collected, and if the ways in which the data will be used are clearly communicated.

CONCLUSIONS

Smart sanitizers could have a valuable role in improving hygiene practices in offices and reducing disease transmission. Many actionable uses for data collected from smart systems were identified. However, office workers consider HH as a personal matter, and acceptance of smart systems is likely to be dynamic and will depend on the broad situation. Except when there are disease outbreaks, smart systems may need to be restricted to uses that do not require the sharing of personal data. Should organizations wish to implement smart sanitizers in offices, it would be advisable to consult widely with staff and develop systems that are customizable and personalizable.

Control Banding and the Global Rise of Qualitative Risk Assessment Strategies

PURPOSE OF REVIEW

Control banding (CB) is a risk assessment strategy that has been applied globally to a variety of occupational hazards. This article describes how this method can be applied, recent developments in the CB literature, an example of how it is utilized for a large, diverse worksite, and where the future of CB is headed.

RECENT FINDINGS

Over the past several years, the applications of CB have widened significantly and have accordingly helped bolster the public and occupational safety, health, and hygiene (OSHH) professionals' understanding of occupational exposure to various hazards. The fields of workplace chemicals, nanomaterials, and airborne pathogens (i.e., COVID-19), specifically have seen remarkable increases in the development of CB tools. Extensive CB tool validation efforts have also lent increasing credibility to this alternative approach. CB is a simplified strategy of assessing occupational exposures and providing commensurate controls and solutions to reduce workplace risks. CB can be used as a primary or tiered risk assessment and risk management approach which can be utilized by both OSHH professionals and nonexperts alike to identify solutions for reducing work-related exposures. The need for health and safety expertise will continue to grow as technological advancements, environmental changes, and economic forces increase workplace hazard complexity, and CB will continue to be a useful tool for those performing risk assessments.

Bipolar ionization rapidly inactivates real-world, airborne concentrations of infective respiratory viruses

The SARS-CoV-2 (COVID-19) pandemic has highlighted the urgent need for strategies that rapidly inactivate airborne respiratory viruses and break the transmission cycle of indoor spaces. Air ions can reduce viable bacteria, mold, and virus counts, however, most studies use small test enclosures with target microbes and ion sources in close vicinity. To evaluate ion performance in real-world spaces, experiments were conducted in a large, room-size BSL-3 Chamber. Negative and positive ions were delivered simultaneously using a commercially available bipolar air ion device. The device housed Needle Point Bipolar ionization (NPBI) technology. Large chamber studies often use unrealistically high virus concentrations to ensure measurable virus is present at the trial end. However, excessively high viral concentrations bias air cleaning devices towards underperformance. Hence, devices that provide a substantial impact for protecting occupants in real-world spaces with real-world virus concentrations are often dismissed as poor performers. Herein, both real-world and excessive virus concentrations were studied using Influenza A and B, Human Respiratory Syncytial Virus (RSV), and the SARS-CoV-2 Alpha and Delta strains. The average ion concentrations ranged from 4,100 to 24,000 per polarity over 60-minute and 30-minute time trials. The reduction rate was considerably greater for trials that used real-world virus concentrations, reducing infectivity for Influenza A and B, RSV, and SARS-CoV-2 Delta by 88.3-99.98% in 30 minutes, whereas trials using in-excess concentrations showed 49.5-61.2% in 30 minutes. These findings strongly support the addition of NPBI ion technology to building management strategies aimed to protect occupants from contracting and spreading infective respiratory viruses indoors.

Health and Safety Regulations for COVID-19: A Policy Analysis

The COVID-19 pandemic spurred some regulators in the USA to require occupational health and safety programs to prevent COVID-19 transmission in workplaces. The objective of this study was to describe such state and federal regulations enacted between January 2020 and January 2022. Regulations, including emergency temporary standards (ETS) and permanent standards, were identified through a search of Nexis Uni and Bloomberg Law and review of US OSHA websites and the Federal Register. Full texts were reviewed for regulatory scope, hazard and exposure definitions, determination of exposure or risk levels, and control strategies. Four state (California, Michigan, Virginia, and Oregon) and two federal regulations were identified. All regulations described respiratory aerosols as the primary source of SARS-CoV-2 and recognized person-to-person transmission by droplet, airborne, and contact routes. Only the US OSHA ETS for healthcare explicitly stated that inhalation of respiratory particles was the most likely method of COVID-19 transmission. The Virginia, Michigan, and Oregon regulations described different categories of risk defined by exposure frequency and duration or specific workplace activities. California described exposure as places and times when employees come into contact or congregate with other people. The US OSHA ETS for healthcare described exposure as involving close contact with suspected or confirmed COVID-19 patients. While all of the state regulations required strategies from across the hierarchy, only the Virginia regulations specifically incorporated the hierarchy of controls. Only the California and Virginia regulations explicitly linked control strategies to the transmission route, while Virginia demarcated control strategies by risk level. Oregon linked risk level to occupancy levels and physical distancing requirements and referred to the use of a layered approach for transmission control. The US OSHA ETS for healthcare defined droplet and airborne precautions but made no mention of the hierarchy of controls or risk levels. Respirators were discussed in most of the regulations. The first Michigan regulation explicitly required respirators appropriate to exposure risk. The California regulations noted that respirators protect the wearer while face coverings protect people around the wearer. These regulations offer insights for a permanent US OSHA infectious disease regulation, such as the need to consider a range of transmission modes including near- and far-range aerosol inhalation, endemic and novel pathogens, workplaces beyond healthcare settings, factors that contribute to exposure and risk, the hierarchy of controls, the role of vaccination, and the importance of written exposure assessment and infection prevention plans.

Returning to Work after the COVID-19 Pandemic Earthquake: A Systematic Review

Background: The ongoing SARS-CoV-2 pandemic has disrupted life and work habits and has produced landmark changes worldwide. This systematic review aimed to analyse the management of Return to Work (RTW) by work organisations following the virus spread. Methods: A selection of 2477 papers, using string research on PubMed, Embase, Web of Science and Scopus from January 2020 to October 2021, were analysed. Results: Fifty-one articles were finally included, and the results obtained were discussed from three different points of view. Twenty articles concerning ‘Remodelling of Work Organization’ proposed some model strategies for resumption to work. Twenty-one papers, including ‘Clinical Evaluation of Workers’, mostly explored the psychosocial impact of returned workers. Finally, twelve articles explored the best ‘Testing Strategies related to RTW’. Despite the heterogeneity of included articles, several interesting approaches have emerged in managing RTW. Conclusions: The reported experiences could help to develop an RTW model for COVID-19 and future pandemics.

COVID-19 in the working environment and its consequences on the health of workers

ABSTRACT This study showed the consequences of the new Coronavirus in the working environment and its effects on workers’ health. SARS-CoV-2 has a high transmission level through exhaled droplets, affecting organs such as the lungs, heart, liver, kidneys, and brain. Productive and social activities were interrupted, but many continued to operate due to market pressure. Health professionals are among the most exposed, but activities requiring many people in the same environment are at substantial risk of exposure to Coronavirus. Work can favor and accelerate the destruction caused by the virus. Inadequate economic and social policies contributed to the deterioration of the health crisis, increasing the economic and social crisis, marked by the loss of jobs and increased work instability. Control and prevention measures are required to reduce risk, but they should consider the nature of relationships in the work and social environment. Social isolation, hand hygiene, and masks are recommended measures, besides Personal Protective Equipment and collective measures for workers. The impact of the pandemic marks every worker involved. Several stressors arise or deteriorate, psychologically affecting many employees. Returning to work with adequate planning requires safety to minimize risks and protect workers.

Covid-19 no ambiente de trabalho e suas consequências à saúde dos trabalhadores

RESUMO Este trabalho apresentou as consequências do novo coronavírus no ambiente de trabalho e reflexos na saúde do trabalhador. O Sars-CoV-2 possui elevado nível de transmissão pelas gotículas exaladas, afetando órgãos como pulmões, coração, fígado, rins e cérebro. Atividades produtivas e sociais foram interrompidas, mas muitas seguiram operando por pressão do mercado. Profissionais da saúde estão entre os mais expostos, porém atividades que exigem grande número de pessoas no mesmo ambiente se encontram sob risco elevado de exposição ao novo coronavírus. O trabalho pode favorecer e acelerar a destruição causada pelo vírus. Políticas econômicas e sociais inadequadas contribuíram para agravamento da crise sanitária, aumentando a crise econômica e social, marcada pela perda de postos de trabalho e aumento da precarização do trabalho. Controles e medidas de prevenção são necessários para a redução de risco, mas precisam contemplar a natureza das relações no ambiente de trabalho e sociais. Isolamento social, higienização das mãos e uso de máscaras são providências recomendadas, além de Equipamentos de Proteção Individual e medidas coletivas para trabalhadores. O impacto da pandemia marca cada trabalhador envolvido, diversos estressores surgem ou se agravam, afetando psicologicamente muitos funcionários. O retorno ao trabalho com planejamento adequado requer segurança para minimizar riscos e proteger os trabalhadores.

The Development of a Covid-19 Control Measures Risk Matrix for Occupational Hygiene Protective Measures

The British Occupational Hygiene Society (BOHS) Covid-19 Working Group developed a control banding matrix to provide guidance for employers and others to help assess the risks of Covid-19 infection during the pandemic. The matrix was based on occupational hygiene principles and the judgement of the occupational health practitioners involved; since objective data on workers’ exposure were unavailable. Users of the matrix identify one of five exposure categories based on generic job descriptions and example occupations, and these categories are linked to generic guidance on interventions at source, on the exposure pathway and for individual workers. The risk matrix was published on the BOHS website and the guidance has been downloaded more than 2000 times. The matrix has had limited evaluation for reliability, but the data suggest that the highest exposure ranked jobs were associated with higher age-standardized mortality in Britain during the pandemic. However, there was considerable variability in exposure assignments between assessors, which underlines the need for the control guidance to be precautionary. The BOHS calls on academic researchers to undertake further work to validate the reliability of the tool.

An Analysis of K-12 School Reopening and Its' Impact on Teachers

Teachers are vulnerable non-essential workers that continue to have significant misgivings about in-person school reopening. Dialogue around pandemic management has relatively neglected these concerns so far. This perspective offers a broad framework for risk assessment related to COVID-19 and in-person instruction. The accumulated general body of knowledge related to COVID-19 is particularized to the special dynamics of education. We highlight the impact of historic investments and underinvestment in education on the viability of adapting best practices to mitigate risk. Gaps in public health planning to supply educators with needed personal protective equipment and vaccination are explored. The challenges for low-income and minority-predominant districts receive special attention. We place these problems within the broader context of socioeconomic disparities and the societal consequences of the pandemic. The local level of community transmission, resources, and circumstances should dictate reopening dates. Without effective infection control, teachers are justified to fear infection. The transparency and scientific rigor that would allow teachers to assess their personal health risk and characterize the process for decision-making has been largely absent.