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December 12, 2013
Occupational medicine expert gives tips for handling infectious disease in the workplace
By Emily Scace, Senior Editor, Safety

At the 2013 American Society of Safety Engineers (ASSE) New England Area Professional Development Conference on December 3 and 4, occupational medicine specialist Fred Kohanna, M.D., spoke to safety professionals about how to handle common infectious diseases in the workplace in a session titled “Ten Frequently Asked Workplace Infectious Disease Questions for Occupational Medicine Physicians.”

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Though OSHA does not have a specific standard that addresses infectious disease, preventing the spread of illness in the workplace is important for employers and employees alike. Employees who come to work while ill can infect others, and if the symptoms of an infectious disease cause an employee to become distracted or otherwise impaired, continuing to work while ill can compromise safety for everyone.

Kohanna spoke about several common infectious diseases, addressing questions such as whether it is safe for infected employees to be at work and the actions that employers should take to prevent the spread of infectious disease in the workplace.

Some infectious diseases, such as tuberculosis (TB), can be particularly alarming to employees who believe they may have been exposed at work. According to Kohanna, while there are cases that warrant specific steps to prevent the spread of an infectious disease in the workplace, in many situations employee education and reassurance are sufficient.

For example, while active TB is a serious disease that should be dealt with accordingly, 90 percent of individuals who are exposed to active TB never develop it themselves. Communicating this information, along with offering screening tests for exposed employees, provides both information about the risks employees face and concrete reassurance about their health status.

Across the board, Kohanna emphasized the importance of good hygiene. While symptoms and infection routes differ between diseases, the most important measures anyone can take are regular handwashing, cleaning and disinfecting the surfaces and objects where viruses and bacteria can linger, and avoiding the sharing of personal items such as razors, towels, and personal protective equipment (PPE).

Below are a few of Kohanna’s recommendations for three common infectious diseases:

Methicillin-resistant Staphylococcus aureus (MRSA)

  • MRSA is spread by direct close personal contact; therefore, coworkers are not typically at risk of catching the infection from one another.
  • To minimize the spread of MRSA, disinfect shared equipment and tools, wash hands frequently, and avoid sharing razors, towels, PPE, and uniforms.
  • As long as the infection site is covered with a dry, sterile dressing, employees with a MRSA infection do not need to be removed from the workplace.

Tuberculosis (TB)

  • In latent tuberculosis, TB bacteria are present in the body but do not cause illness. Latent TB has no symptoms and is not contagious.
  • In active tuberculosis, symptoms include fever, a productive cough, night sweats, and weight loss. Active TB is spread through the air from person to person when an infected person coughs, sneezes, or speaks and another person breathes in the bacteria.
  • For cases of active TB, public health authorities should be notified, and the individual should not continue to work until he or she has been treated and determined to be noncontagious. Individuals who have been exposed should receive baseline and follow-up TB tests.

Varicella (Chickenpox and Shingles)

  • Chickenpox and shingles are both caused by the varicella zoster virus (VZV). In a person who has had chickenpox, VZV can lie dormant in nerve cells and become reactivated later in life, causing shingles.
  • Shingles is characterized by a painful red rash with fluid-filled blisters. As long as the rash is covered and good hygiene practices are used, people with shingles can remain at work if they are not too uncomfortable or in too much pain.
  • The fluid in shingles blisters can cause chickenpox in people who have not had chickenpox or have not been immunized against it; however, the virus is not spread by sneezing, cough, or casual contact. Non-immune pregnant women and those with compromised immune systems are at increased risk.
  • Once the rash dries up and scabs over, shingles is no longer contagious.
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