Communicable & infectious diseases on the rise in the U.S.
Biohazards warrant priority attention
Biohazards are microorganisms – including bacteria, viruses, mold, and fungi -- capable of causing communicable and infectious diseases. OHS pros in healthcare and related occupations know they can’t relax biohazard control efforts. Pros in general industry, construction and the like should place biohazards higher on the priority pole. Biohazards, with their opportunist diseases, have become particularly troublesome.
Biohazards can cause communicable or infectious disease. These terms are not synonymous. All communicable diseases are infectious, but not all infections are communicable. An employee who steps on a rusty nail at work may develop a tetanus infection. Tetanus, however, is not communicable to other workers. People may carry an infectious or communicable disease and show no symptoms of illness.
- Measles were eradicated in the United States in 2010. If outbreak trends hold throughout 2019, put measles back onto the U.S.’s infectious diseases list.
- Cases of Hepatitis A, B and C, after years of decline, are showing rapid growth across all U.S. regions.
- U.S. tick and mosquito transmitted diseases, such a Lyme Disease and West Nile, respectively, hit record highs in 2017-18.
- “Flu Severity” for adults, as classified by the CDC, reached “High” in 2018, a first-time event since records were established nearly 15 years ago. Flu-related medical visits, hospitalizations, and deaths in the U.S. reached record highs during 2017-2018.
Communicable and infectious diseases are on the rise in the U.S for many reasons:
- Growing anti-vaxxers movement. Flu vaccination among US adults in 2018 was 37.1%, a decrease of 6.2% from 2017, per the CDC. The U.S .measles outbreak in 2019 has been among unvaccinated people.
- Opioid epidemic. The rise of Hepatitis A, B and C strongly correlates with the U.S.’s opioid epidemic.
- Record unemployment levels. “At risk” populations for communicable disease are entering the workforce.
- Global warming. Man-made or not, global warming has pushed tick and mosquito populations into colder regions of the U.S. Biohazards thrive in warmer environments.
- Deteriorating U.S. infrastructure. Legionnaires’ and other water-borne diseases – the Flint, MI water crisis for example -- are on the rise due to outdated practices and poor maintenance of the U.S.’s infrastructure.
- Weak immune systems. The average American’s immune system has grown weaker due to unintended consequences, including “clean” lifestyles and misuse of disinfectants that help microorganisms develop drug resistance. Antimicrobial resistance could kill 10 million people by 2050, according to a recent announcement from the United Nations.
- Urbanization. Growing urbanization in the U.S. has brought wild critters, with their own health problems such as deer with chronic wasting disease aka “zombie deer,” in close habitation with humans, facilitating disease transmission.
OSHA’s bloodborne pathogens standard (1910.1030) is effective for workers with a “duty to respond” where blood and some other body fluids, e.g. saliva in dental procedures, may be encountered. The standard does not cover body fluids such as urine, feces, nasal secretions, sputum, vomit, breast milk, and saliva not in dental procedures.
The standard has no enforcement for worker vaccinations for biohazard diseases such as influenza (seasonal and pandemic); measles, mumps and rubella (MMR); tetanus, diphtheria and pertussis (Tdap); varicella; and others such as vaccine for meningococcal diseases. TB, SARS, MRSA, Zika, Norovirus – vaccines for biohazard diseases are continually being explored by the medical community; success often comes slowly.
“How clean is clean?” is not defined in OSHA’s sanitation standard (1910.141). Legionnaires’ in chiller water? Pathogens in metalworking fluids? OSHA has no standards for these and many other biohazards but may enforce as an employer’s “General Duty” on case-by-case basis.
How does an OHS pro sell management on a biohazards control program without an OSHA hammer? A business continuity plan, as provided at www.ready.gov, is perhaps the best-selling point.
Biohazard diseases can severely disrupt business as usual. The OHS pro should research and present management with control options best suited for the workplace. With biohazards there is not a one-size-fits-all strategy.
A basic control option is to ensure key members of the management team have all necessary vaccinations, many described above. Even though most managers are smart, it may be necessary for the OHS pro to explain how vaccines work and confront anti-vaxxer arguments. Slightly over one-third of Americans got a flu vaccination in 2018; 100% of key managers should get vaccinated for the upcoming flu season.
In many workplaces the human resources pro has taken the lead on basic biohazard control, since most of the control is “beyond OSHA.” But the HR pro’s knowledge and awareness of workplace biohazard controls may be no stronger than the general public. OHS pros should insert their technical superiority in the matter, and take on greater business management decisions on the topic – recognizing they must manage the team dynamic.
HR’s role is critical considering that some biohazard controls may appear to infringe on perceived “employee rights.” Audits of employee food storage and consumption, for example, is a necessary biohazard control. If foods such as meat and eggs are not stored cold or hot, they shouldn’t be consumed at the workplace. Potluck and pass-around foods, often with shared utensils, particularly following hunting seasons such as deer, must be done wisely. Enforcement of proper actions, such how to wash hands (most people get this wrong), must follow good education.
For workplaces using N95 respirators, stockpiling these respirators may be wise. The public and other businesses may make a run on inventories if an airborne biohazard disease, such as the flu, becomes pandemic.
Successful workplace health and safety requires anticipation, recognition, evaluation and control of various hazards. Biohazard control must be a greater priority at all workplaces.