thesynergist | NEWSWATCH
Office of Inspector General Recommends OSHA Action on COVID-19 Inspections
A surge of work site complaints to OSHA combined with reduced and mostly remote inspections have resulted in increased risk to U.S. workers’ safety, according to a report issued on Feb. 25 by the U.S. Department of Labor Office of Inspector General. OIG’s conclusions are based on an audit that examined plans and guidance developed by OSHA to address COVID-19 as well as the extent to which challenges created by the pandemic have affected the agency’s ability to protect the safety of workers. The OIG report highlights data provided by OSHA showing that the agency received 15 percent more complaints and conducted 50 percent fewer inspections between Feb. 1 and Oct. 26, 2020, compared to a similar period in 2019. Federal OSHA also issued fewer violations and performed a smaller number of COVID-19-related inspections compared to state workplace safety and health plans. According to the report, OSHA issued 295 violations for 176 inspections related to COVID-19, while state plans issued 1,679 violations for 756 inspections. Of the COVID-19 complaints received by OSHA throughout February–October 2020, 35 percent came from the healthcare and retail trade sectors. Twenty-four percent of all complaints related to COVID-19 came from just the healthcare industry, including workplaces such as hospitals, nursing homes, and residential care facilities. Restaurants and other eating places accounted for six percent of all COVID-19 complaints during that period, and together construction and general warehousing and storage represented five percent. The report also describes concerns about the lack of on-site inspections during the COVID-19 pandemic. A previous report (PDF) issued by OIG in 2017 found that for approximately one-third of the citations reviewed, employers abated the hazard during the OSHA inspection or within 24 hours of the agency identifying the hazard. “Without onsite observations, hazards or unsafe practices may not be identified or mitigated for longer periods, placing employees’ safety at greater risk,” OIG explains. “The lack of onsite inspections may impact OSHA’s ability to observe employer practices, quickly mitigate any potential hazards, and issue violations sooner to control the spread of the disease to other employees.” OIG urges OSHA to improve its inspection strategy by prioritizing high-risk employers for on-site inspections related to COVID-19. The report also recommends that OSHA compare COVID-19 inspections conducted remotely with those performed on site and examine the frequency and timeliness with which hazards are identified and abated. On March 12, OSHA updated its enforcement plan to limit remote inspections to certain circumstances with area directors’ approval and announced a new National Emphasis Program (NEP) that prioritizes workplaces at high risk for COVID-19 spread for enforcement efforts. The NEP and the updated enforcement guidance help address concerns brought up in the OIG report; more information about them can be found below. OSHA is also addressing another OIG recommendation to determine whether it is necessary to establish an emergency temporary standard (ETS) to help control occupational spread of COVID-19. As this issue of The Synergist went to press, OSHA had yet to issue an ETS. But in a press release published on April 28, OSHA announced that it had sent draft emergency temporary standards on COVID-19 to the Office of Management and Budget’s Office of Information and Regulatory Affairs for review. OSHA says that it worked with science-agency partners, economic agencies, and others in the U.S. government to “get the proposed emergency standard right.” An executive order issued by President Joe Biden during his first week in office directed OSHA to issue an ETS by March 15 if the agency determined it to be necessary. Earlier in April, Bloomberg Law reported that OSHA’s ETS was on hold at the request of the new Secretary of Labor, Marty Walsh. Bloomberg Law reported that a Labor Department spokesperson explained that Walsh “ordered a rapid update based on the Centers for Disease Control and Prevention analysis and the latest information regarding the state of vaccinations and the variants.” To learn more, view the full report (PDF) on OIG’s website.
Marty Walsh, Former Union Leader, Confirmed as Labor Secretary
On March 22, the Senate confirmed Marty Walsh, then mayor of Boston, as U.S. Secretary of Labor. Walsh was sworn in the following day. He is the first union member to serve as Labor secretary since the 1970s. Walsh was first elected as Boston’s mayor in 2013 and won reelection in 2017. Walsh was previously a member of the Massachusetts House of Representatives from 1997 through 2014. A member of the Laborers’ Union Local 223, Walsh served as the union’s president and as secretary- treasurer, general agent, and ultimately head of the Boston Metropolitan District Building Trades Council, an umbrella group of local construction unions. He resigned from his union leadership positions prior to his first mayoral campaign in 2013. More information about Walsh’s career can be found on the U.S. Department of Labor and City of Boston websites.
OSHA Establishes National Emphasis Program to Reduce Coronavirus Exposures
An OSHA directive (PDF) that went into effect on March 12 describes policies and procedures for implementing a new National Emphasis Program to reduce coronavirus exposures among workers at high risk of contracting SARS-CoV-2. The NEP targets workplaces where many workers are at significant risk of exposure and formalizes components for inspections in workplaces with prevalent hazards related to COVID-19. In addition to inspection targeting, the new program supports agency outreach to employers and compliance assistance. OSHA also intends to focus on protecting from retaliation workers who report unsafe or unhealthy conditions.
According to OSHA, the agency will continue to conduct unprogrammed inspections related to COVID-19 at workplaces where employees have a “high frequency of close-contact exposures.” OSHA expects that most of these inspections will occur in general industry, especially at healthcare work sites.
OSHA acknowledges that many state plans have already implemented similar enforcement programs. State plans are not required to adopt the new NEP, but OSHA “strongly encourages” that they do. According to the agency, state plans are required to notify federal OSHA within 60 days of the NEP’s issuance whether they already have a “substantially similar” policy in place, intend to adopt new policies based on the NEP, or do not intend to adopt the program. OSHA will summarize these responses on a webpage where it collects information related to state plan adoption of federal OSHA standards and directives.
Further details are available from OSHA’s press release.
ASHRAE Updates Building Reopening Guidance for HVAC Systems during COVID-19
New updates to ASHRAE’s “building readiness” document (PDF) address guidance for heating, ventilating, and air conditioning (HVAC) systems intended to help mitigate the transmission of SARS-CoV-2 as buildings reopen during the COVID-19 pandemic. The ASHRAE Epidemic Task Force has added information related to the pre- and post-flushing strategy that is meant to help reduce the time and energy needed to clear indoor spaces of contaminants between periods of occupancy. The updated guidance includes a link to a downloadable “Equivalent Outdoor Air Calculator,” (Google Spreadsheet) which can be used to determine the available equivalent outdoor air changes and time required for a pre- or post-occupancy flush. ASHRAE has also added data to consider for the heating of outdoor air and requirements for minimum outdoor air supply and filter efficiency.
Wade Conlan, the ASHRAE task force team lead, described the guidance as covering “the theory behind the use of equivalent outdoor air supply, method for calculating the performance of filters and air cleaners in series, and filter droplet nuclei efficiency that help evaluate the systems’ ability to flush the building” in a Feb. 2 press release.
Building owners and operators will also find guidance on developing a building readiness plan, increasing filtration, strategies for air-cleaning, domestic and plumbing water systems, and system improvements to mitigate virus transmission.
Other COVID-19 response resources from ASHRAE, the American Society of Heating, Refrigerating, and Air-Conditioning Engineers, are collected on the society’s website.
New NIOSH Topic Page Collects Resources on Worker Fatigue
NIOSH has published a new webpage for resources on work and fatigue. Associated with NIOSH’s Center for Work and Fatigue Research, the new topic page provides links to archived recordings of webinars on worker fatigue, an online training program, relevant research being conducted by NIOSH, and other resources, including a fact sheet helping employers to manage worker fatigue amid the COVID-19 pandemic.
According to NIOSH, worker fatigue is associated with nonstandard and extended working hours, stress, physically and mentally demanding tasks, and working in hot environments. Fatigue can result in slower reaction times, affect cognition, and contribute to numerous negative health effects, including cancer, cardiovascular disease, and psychological disorders. The NIOSH Center for Work and Fatigue Research was created to expand the existing literature on worker fatigue and develop practical solutions.
For more information, refer to the Center for Work and Fatigue Research webpage.
CDC Assesses Techniques to Improve Mask Fit
In CDC’s Feb. 19 Morbidity and Mortality Weekly Report (MMWR), the agency evaluates common methods used to improve the fits of cloth and medical procedure masks. These types of masks fit more loosely than respirator facepieces, and the effectiveness of these masks at protecting wearers from airborne viral particles may be improved by modifying them to fit more closely to the wearer’s face. Two common modifications made to medical procedure masks with the intention of improving fit are known as “double masking” and “knotting and tucking.”
The “double masking” method is the practice of wearing a cloth mask over a medical procedure mask. The “knotting and tucking” method requires tying off the ear loops of a medical procedure mask near the point where the loops connect to the mask and then tucking in the excess mask material so that the mask is worn flat against the face with minimal side gaps. CDC’s experiments examined these methods’ effectiveness in improving mask fit and therefore filtration compared to unmodified use of single cloth and medical procedure masks. The experiments used pliable elastomeric head forms to represent mask wearers, outfitted with mouthpieces that emitted potassium chloride aerosols (to simulate a cough) or with ventilators (to simulate breathing).
The first CDC experiment tested how effectively these mask modification methods contained the aerosols emitted by a wearer during a simulated cough. The results demonstrated that the use of a single unmodified medical procedure mask blocked 56.1 percent of aerosol particles from the cough. The use of a single cloth mask blocked 51.4 percent, the use of the double mask technique blocked 85.4 percent, and use of the knotted and tucked medical procedural mask blocked 77.0 percent.
The second CDC experiment assessed the effectiveness of the two techniques in reducing wearers’ exposures to aerosols emitted by an aerosol-emitting source throughout a 15-minute period of simulated breathing. The results showed that double masking the source reduced aerosol exposure to the unmasked receiver by 82.2 percent. A knotted and tucked mask-wearing source reduced another unmasked receiver’s exposure by 62.9 percent. An unmasked source and a double masked or knotted and tucked receiver saw the receiver’s exposure reduced by 83 percent and 64.5 percent, respectively. When the source and receiver both were double masked or knotted and tucked, the receiver’s exposure was reduced by 96.4 and 95.9 percent, respectively.
For a full discussion of the experiments and their findings, refer to the report on CDC's website.
MSHA Guidance Aims to Protect Miners from COVID-19
Guidance issued by MSHA on March 10 is intended to help mine operators and workers mitigate and prevent the spread of COVID-19 in coal, metal, and nonmetal mines. According to MSHA, the updated recommendations will help miners and mine operators identify and control SARS-CoV-2 exposure risks.
MSHA’s new guidance stresses the importance of implementing COVID-19 prevention programs at each mine. The guidance calls on mine operators to conduct hazard assessments, identify control measures that limit COVID-19 spread, ensure that measures are in place to separate and send home potentially infected miners, and implement protections from retaliation for workers who raise concerns related to COVID-19. According to MSHA, these prevention programs are most effective when employers engage miners and their representatives throughout the programs’ development and implementation.
MSHA’s guidance also discusses ventilation improvements, the use of face coverings, and the use of personal protective equipment as additional measures that can help limit COVID-19 spread in mines.
The new guidance is not a standard or regulation. For more information, refer to the full guidance or the press release announcing its availability. Further details about MSHA’s response to COVID-19 can be found on the agency’s website.
Congressional Leaders Urge Updates to COVID-19 Guidance
A group of congressional leaders wrote a letter dated March 1 (PDF) urging the Biden administration to address the aerosol transmission of COVID-19, in keeping with findings by infectious disease, aerosol science, and occupational health experts. The letter expresses concern that CDC’s existing guidance does not reflect experts’ current understanding of transmission and therefore does not adequately protect workers from exposure.
The letter from congressional leaders referred to an earlier letter (PDF) to the administration from 13 health experts, which also called for CDC guidelines to recognize aerosol transmission, an OSHA emergency standard on COVID-19, and the use of the Defense Production Act to increase production of N95 filtering facepiece respirators. In their own letter, the members of Congress noted that many studies demonstrate aerosol COVID-19 transmission and recommended that, unless CDC scientists had persuasive contradictory evidence, CDC and OSHA should follow the recommendations listed in the experts’ letter. More information can be found in the news release by the House Education and Labor Committee. The Synergist covered the experts’ letter in further detail in a Feb. 18 article.
Updated Enforcement Policy Prioritizes On-Site OSHA Inspections
An updated interim enforcement response plan issued by OSHA on March 12 prioritizes the agency’s use of on-site workplace inspections during the ongoing COVID-19 pandemic. A combination of on-site and remote methods may be used for programmed inspections, inspections related to fatalities potentially related to COVID-19, and inspections following formal complaints of hazardous conditions in workplaces where employees face frequent close-contact exposures. OSHA’s updated strategy replaces previous enforcement guidance, which allowed inspections to be initiated remotely when resources did not permit for onsite inspections in areas with sustained elevated community transmission of COVID-19 or experiencing a resurgence in community spread. Under OSHA’s new guidance, area directors will approve remote-only inspections under limited circumstances in which onsite inspections cannot be performed safely. The new guidance will remain in effect until further notice.
OSHA’s updated enforcement policy was issued on the same day as the agency released its new National Emphasis Program. In keeping with the NEP, OSHA’s new enforcement policy prioritizes inspections that involve deaths or multiple hospitalizations due to occupational exposures to COVID-19. This prioritization of high-risk work sites also addresses the concerns of the U.S. Department of Labor’s Feb. 25 report, which found that increased pandemic-related work site complaints to OSHA combined with reduced, mostly remote inspections have negatively impacted workers’ safety.
The DOL report and the NEP are covered on pages 20 and 21 of The Synergist. OSHA will also follow DOL’s COVID-19 Workplace Safety Plan (PDF) to reduce COVID-19 transmission during inspections.
National Academies Offers Emergency Response Guidance for COVID-19 Era
The Societal Experts Action Network (SEAN), a project of the National Academies of Sciences, Engineering, and Medicine, has released guidance on evacuation planning, sheltering operations, and risk communication strategies for public officials confronting hazards and disasters during the COVID-19 pandemic. Titled Emergency Evacuation and Sheltering During the COVID-19 Pandemic, this document is an aid for updating disaster response plans regarding the ongoing, widespread public health hazard of the COVID-19 pandemic. According to the document, strategies for evacuation and related activities must account for the risk that evacuees from disasters such as floods, hurricanes, wildfires, and industrial accidents may inadvertently transmit or become exposed to SARS-CoV-2 until vaccination becomes more widespread.
“To prepare for emergency events requiring evacuation, it is necessary to revise shelter planning and mass care operations, shelter staffing, and shelter design and operations with a focus on reducing virus transmission and ensuring safety,” the document states. “Developing effective public messaging is also critical during the pandemic and requires advance planning and familiarity with the needs and characteristics of the communities being served.”
The National Academies released an online interactive report overview, which helps users understand the document’s strategies for evacuation planning, sheltering and mass care operations, and risk communication during COVID-19.
Emergency Evacuation and Sheltering During the COVID-19 Pandemic is available as a free download from the National Academies’ website. Additional information can be found in the National Academies’ press release.
Committee Seeks Improved Preparedness and Response for Pandemic, Influenza
An international committee established by the National Academy of Medicine is part of a global initiative to advance pandemic and seasonal influenza preparedness and response. NAM intends to examine aspects of the response to COVID-19 to determine how lessons learned could inform future preparedness efforts for pandemics and seasonal influenza. According to NAM’s concept paper (PDF) for the project, the committee will assess capabilities, technologies, processes, and policies developed for the COVID-19 pandemic, focusing on vaccine development. The committee’s objective is to “provide recommendations to improve the global design, composition, clinical trials, production, scale-up, regulatory approval, distribution of influenza vaccines, and post-approval surveillance for adverse events,” the paper explains.
The project will develop recommendations in four focus areas: vaccine research and development; vaccine distribution and supply chains; public health interventions and countermeasures, such as non-pharmaceutical interventions, diagnostics, and treatment strategies; and global coordination, partnerships, and financing for preparedness and response. Recommendations for vaccines will concentrate on optimizing research and development and strengthening distribution and supply chains for future seasonal and pandemic influenza events. The project will also identify best practices for implementing public health measures, diagnostics, and therapeutics to mitigate the spread of influenza; and recommend ways to strengthen global collaborations, regulations, and financing structures related to influenza vaccination.
The NAM international committee was established in coordination with the U.S. Health and Human Services Office of Global Affairs. Further details on the committee’s efforts and the ongoing consensus studies are available from NAM’s website.
Research Raises Concerns About Essential Workers’ Access to Healthcare
In a study published March 9 in the online journal Public Health Reports, NIOSH researchers identify several occupations considered “essential” during the COVID-19 pandemic that lacked regular access to healthcare services in the years 2017–2018. Researchers analyzed workers aged 18–64 in 31 U.S. states according to four metrics: health insurance status, ability to afford to see a doctor when needed, access to a personal care provider, and having received a routine checkup within the previous year.
Of all occupations studied, workers in farming, fishing, and forestry were most likely to lack health insurance; personal care aides were least likely to be able to see a doctor when needed due to cost; and construction workers were least likely to have a personal healthcare provider or to have had a routine physical checkup within the past year. Workers in food preparation and serving, building and grounds cleaning and maintenance, and construction trades had significantly lower levels of healthcare access compared to the general working population.
The occupations and groups discussed in the study were labeled “essential” when the COVID-19 pandemic reached the U.S. and were required to continue reporting to the workplace and interact closely with patients, the public, or coworkers. The study provides a baseline to understand what healthcare was accessible for these workers.
For more information, refer to NIOSH’s news release covering the study or read the study’s abstract in Public Health Reports.
The article “Virtual Once More: A Preview of AIHce EXP 2021” on page 14 in the April print issue misidentified the author of “Moving to an All-Virtual AIHce” on page 8 in the same issue. The author is AIHA President Lindsay Cook. The digital version of the magazine has been updated.