Interim Guidance for Employers to Reduce Exposure to Novel Influenza A (Such as H5N1 Bird Flu) for People Working with or Exposed to Animals | Bird Flu | CDC

This updated interim guidance identifies work tasks that may pose an increased risk of worker exposure to novel influenza A viruses associated with disease in humans and provides recommended controls for each level. Specific recommendations for these work tasks may be updated as CDC learns more during this evolving situation.

Human infections with novel influenza A viruses (such as H5N1 Bird Flu) can happen when enough virus gets into a person's eyes, nose, or mouth, or is inhaled. This can happen when virus is in the air (in droplets, small aerosol particles, or possibly dust) and deposits on the mucus membranes of the eyes, nose, and mouth. It can also happen when a person breathes the virus in, or possibly when a person touches something contaminated by viruses and then touches their mouth, eyes, or nose.

Employers should take steps to reduce workers' exposure to novel influenza A viruses from sick animals or contaminated environments. Workers may be exposed when working with animals confirmed or potentially infected with novel influenza A viruses. They may also be exposed when working with materials, including raw milk, that are confirmed or potentially contaminated with novel influenza A viruses. Examples of related workers include:

To protect workers who might be exposed, employers should update or develop a workplace health and safety plan. Employers are encouraged to use a health and safety committee that includes representatives from both management and workers to develop the plan. Helpful guidance and consultation on developing a workplace health and safety plan is available from the Occupational Safety and Health Administration (OSHA) and through your local agriculture extension office. Employers in a state regulated by a state OSHA plan should familiarize themselves with any additional requirements that may apply to them. Employers should conduct a site-specific hazard assessment to identify potential exposures based on work tasks and locations and use the hierarchy of controls to identify controls to reduce or eliminate hazards including exposure to novel influenza A viruses. The Hazard Assessment Worksheet for Dairy Facilities can help identify dairy workplace hazards and prioritize controls including personal protective equipment (PPE) needed for protection. Protecting Poultry Workers from Avian Influenza (Bird Flu) can help identify poultry workplace hazards and prioritize controls. CDC provides separate recommendations to prevent the spread of flu between pigs and people.

The hierarchy of controls identifies a preferred order of actions to best control hazardous workplace exposures. Engineering controls are more effective than administrative controls or PPE because they control exposures without requiring significant and ongoing efforts by workers and their supervisors. The following table identifies the type of controls that should be used based on our current understanding of the exposure risk associated with different work tasks and settings.

Contact with raw milk, other secretions, udders, or viscera from a farm with confirmed or potentially infected animals (e.g., work in milking parlor, raw milk processing, some slaughter house work)

Contact with animals from a farm without confirmed or potentially infected animals, but when there are confirmed or potentially infected animals in the region‡

No contact with animals or animal secretions, regardless of cases on the farm or regional cases

*This is in addition to standard operating procedures for these settings

†Once a positive test result is detected on a poultry farm, all the birds on that farm are considered potentially infected

‡CDC recommends using the USDA-defined control area (10 km or ~6.21 mile radius around a farm) as the region. Factors that may justify widening a region include: (1) worker commute distances greater than 10 km from their home or other workplaces, especially other farms, (2) joint services that serve the farm (such as veterinary services, milk haulers, feed supply, and transport companies), (3) other considerations in the USDA Highly Pathogenic Avian Influenza Response Plan (The Red Book)

To help employers implement the guidance, CDC is providing the following resources:

Engineering controls are methods to reduce or remove the hazard at the source or place a barrier between the worker and the hazard.

Proper ventilation in dairy and poultry barns depends on factors such as the size of the barn, the number of animals, and local climate, among other factors. Poor ventilation can lead to the buildup of harmful gases, excessive heat and humidity, and the accumulation of airborne pathogens (bacteria and viruses). Circulating fresh air helps dilute and disperse potential pathogens and can help control the temperature and humidity.

In high and medium exposure settings, employers can implement the following engineering controls to reduce the spread of novel influenza A viruses:

Administrative controls are policies and work practices that reduce workers' exposure to hazards. In all exposure settings, employers can implement the following policies and work practices:

Engineering and administrative controls are not always sufficient for reducing exposures to confirmed or potentially infected animals and their secretions. Therefore, 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.

Keep Reading: Wear Personal Protect Equipment – High Exposure

Keep Reading: Wear Personal Protect Equipment – High Exposure - Spanish

Keep Reading: Put On Personal Protective Equipment Safely – High Exposure

Keep Reading: Put On Personal Protective Equipment Safely – High Exposure - Spanish

Keep Reading: Remove Personal Protective Equipment Safely – High Exposure

Keep Reading: Remove Personal Protective Equipment Safely – High Exposure - Spanish

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.

Keep Reading: Wear Personal Protect Equipment – High Exposure for Milking Parlor

Keep Reading: Wear Personal Protect Equipment – High Exposure for Milking Parlor - Spanish

Keep Reading: Put On Personal Protective Equipment Safely – High Exposure for Milking Parlor

Keep Reading: Put On Personal Protective Equipment Safely – High Exposure for Milking Parlor - Spanish

Keep Reading: Remove Personal Protective Equipment Safely – High Exposure for Milking Parlor

Keep Reading: Remove Personal Protective Equipment Safely – High Exposure for Milking Parlor - Spanish

Keep Reading: Put On and Remove Personal Protective Equipment Safely – Medium Exposure