Preventing Occupational Exposures to Infectious Disease in Health Care

plan.  It describes important employee vaccination and immunization plans. The concepts of the industrial hygiene hierarchy of controls are introduced. The hierarchy is an evidence-based method to help readers build, design, and evaluate preventive strategies that provide the highest and most productive levels of protection. It also provides information on workers' rights, whistleblowing, and personnel-based opportunities for change.
4.MicrobiologyChapter 4 provides a background on the most epidemiologically important microbes likely to be an occupational exposure risk -- serving as a Microbiology 101 for non-microbiologists. It can be incorporated into new employee onboarding or annual refresher training. It describes how microorganisms propagate and transmit and why some microorganisms cause disease (are pathogenic). It provides control strategies to mitigate exposure risk for personnel, leadership, and the communities they serve. It also highlights the critical elements of Post-Exposure Prophylaxis and Antimicrobial Stewardship Plans.
5.Regulatory Compliance; OSHA StandardsThere are surprisingly few regulatory standards or laws that apply to occupational infection prevention and control. The bulk of the standards are promulgated by the Occupational Safety and Health Administration (OSHA). This chapter provides in-depth information on the elements of OSHA Standards applicable to infectious disease in health care, including the Bloodborne Pathogens, Respiratory Protection, and Personal Protective Equipment Standards. It describes the essential components for compliance with OSHA standards and provides a foundation for complying with OSHA standards as it relates to inspections, citations, and fines. This chapter details how to comply and what resources to use for compliance assistance. It serves as the roadmap to professionals responsible for regulatory compliance on behalf of their employers.
6.Other Regulatory Requirements, National Standards, and AccreditationChapter 6 has comprehensive lists of other relevant Federal Agencies and Accreditation Bodies that provide requirements and recommendations for exposure to infectious disease beyond OSHA. These include the Department of Transportation, Environmental Protection Agency, the Joint Commission, and more. It describes, in detail, the essential components for compliance with standards and guidance and delivers tools, checklists, and program ideas for readers to use immediately. Since many different types of healthcare facilities (acute care, long-term care, behavioral health, outpatient, etc.) adhere to different licensing and accreditation bodies, it provides references and resources to set professionals on the right path.
7.Hazard AssessmentThe hazard assessment chapter offers readers strategies to identify critical elements needed to perform an occupational hazard assessment. It provides lists for considerations to include in job hazard analyses. There are many tools and resources including outlines and sample plans for requirements of an Exposure Control Plan. It also provides instruction and guidance on how to perform task assessments and audits, along with sample plans and questionnaires.
8.Institutional ControlsIn safety and health professions, we typically address safety controls in the context of what risk can be physically "engineered" out. In other words, how do we physically make a workplace safer? This chapter describes how individualized health beliefs can drive safer occupational outcomes. It provides readers with the confidence to be able to discuss the differences between Safety Culture & Safety Climate with leadership and personnel. It illustrates ways to identify cues to action for safe work practices. It also provides unique examples of opportunities to "teach up" to leadership and tools to establish strategies for communicating cost and value of programs.
9.Engineering ControlsIn Chapter 9, readers gain an understanding of how to identify the role of engineering controls in the industrial hygiene hierarchy of controls. Using the hierarchy provides readers with the ability to introduce the role that adjunct or adjuvant technologies can play in reducing environmental pathogens in their facilities. In addition, it summarizes resources to identify available engineering controls for safer options for medical devices, textiles, and antimicrobial technologies.
10.Personal Protective Equipment (PPE)This section provides a background on the position of PPE in the hierarchy of controls. Readers will be able to identify the role of PPE in health care and barriers to use. Since so much of health care has relied on this less desirable method of occupational prevention, the section builds knowledge around why considerations for protection that are higher in the hierarchy of controls may be more effective and appropriate. It describes standards and specifications for PPE and their application in health care and provides information on selection of each PPE type. This includes the provision of lists of tools and resources that can be put into action immediately.
11.Making It All WorkChapter 11 pulls everything together into a comprehensive summary resource. It summarizes key motivations for building safer occupational infection prevention programs and then provides the subsequent tools, resources, and checklists for professionals to move those programs forward. It includes sample cost-benefit analyses, lists of standards to consider for compliance, required precautions practices, and more.
12.References ^^
13.Appendices (tools, charts, campaigns, etc.)This can be a stand-alone section with all subsequent tools, charts, checklists, campaign poster ideas, and more. Or it can be incorporated into each applicable section. Marketability may be in both places.

COVID-19.  She is also Adjunct Faculty at the University of Maryland School of Medicine, Department of Occupational and Environmental Medicine.