Guidance on Requirements to Protect Health Care Workers from 2019 Novel Coronavirus

February 17, 2020
Cal/OSHA is issuing guidance on protecting health care workers from exposure to 2019 Novel Coronavirus (2019-nCoV). The guidance covers the safety requirements when providing care for suspected or confirmed patients of the respiratory disease or when handling pathogens in laboratory settings in California.
“It is vital that employers take the necessary steps to protect workers in health care settings where they may be at risk of exposure to 2019 Novel Coronavirus,” said Cal/OSHA Chief Doug Parker. “Cal/OSHA will provide guidance and resources on how to protect workers from this airborne infectious disease.”
The risk for infection is higher in health care settings such as hospitals and clinical laboratories. The U.S. Centers for Disease Control and Prevention (CDC) is providing updates and closely monitoring suspected cases of 2019-nCoV infection and transmission.
2019-nCoV is an airborne infectious disease covered by Cal/OSHA’s Aerosol Transmissible Diseases (ATD) standard, which requires employers to protect workers from diseases and pathogens transmitted by aerosols.
The ATD standard requires employers to have an ATD Exposure Control Plan with procedures to identify 2019-nCoV cases or suspected cases as soon as possible and protect employees from infection. 
The ATD standard further requires employers to provide training on the:
  • Signs and symptoms of 2019-nCoV.
  • Modes of transmission of the disease and source control procedures.
  • Tasks and activities that may expose the employee to 2019-nCoV.
  • Use and limitations of methods to prevent or reduce exposure to the disease including decontamination and disinfection procedures.
  • Selection of personal protective equipment, its uses and limitations, and the types, proper use, location, removal, handling, cleaning, decontamination and disposal of protective equipment. 
  • Proper use of respirators. 
  • Available vaccines, when they become available.
  • Employer's plan if an exposure incident occurs and surge plan, if applicable.
Employers must use feasible engineering and work practice controls to minimize employee exposure to 2019-nCoV. Examples of engineering controls include airborne infection isolation rooms or areas, exhaust ventilation, air filtration and air disinfection. Work practice controls include procedures for safely moving patients through the operation or facility, handwashing, personal protective equipment donning and doffing procedures, the use of anterooms, and cleaning and disinfecting contaminated surfaces, protective equipment, articles and linens.
Visit Cal/OSHA’s webpage for further interim guidance on 2019-nCoV exposure in health care settings. In order to help employers comply with the ATD standard, Cal/OSHA has posted several publications including The California Workplace Guide to Aerosol Transmissible Diseases and fillable ATD model exposure control and laboratory biosafety plans
Several occupational safety and health standards, including Cal/OSHA’s Bloodborne Pathogens Standard adopted in 1992 and the ATD Standard adopted in 2009, address worker protections when exposure to infectious diseases including coronavirus may occur in health care settings. The standards apply to hospital workers and emergency medical services, as well as workers in biological laboratories, decontamination workers, public health workers, or public safety employees who may be exposed to infectious disease hazards.
Cal/OSHA reminds all employers and workers that any suspected cases of 2019-nCoV must be promptly reported to the local public health department.
The California Department of Public Health has updated information on 2019-nCoV and reporting requirements. The Centers for Disease Control and Prevention has also posted specific information for health care workers and laboratory settings.
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Technical Regulatory Corrections Issued by OSHA
OSHA recently published technical corrections and amendments to 27 OSHA standards and regulations. This administrative rulemaking corrects minor misprints, omissions, outdated references, and tabular and graphic inaccuracies. The revisions apply to several industry sectors, including general industry, construction, shipyard employment and longshoring. Some revisions may reduce employer costs, and none expand employer obligations or impose new costs.
Pilot for Electronic Submission of Occupational Injuries
California’s Division of Workers’ Compensation (DWC) has launched an electronic filing pilot program for physicians to submit the Form 5021 Doctor’s First Report of Occupational Illness or Injury (DFR) online. The pilot is available on a voluntary basis for physicians who agree to send their reports to DWC electronically rather than filing paper forms. Large volume filers such as hospitals are also invited to participate through electronic data interchange (EDI) submission.
Physicians who treat an injured worker are required by the Labor Code to file, within five days after initial examination, a complete report of occupational injury or occupational illness with the employer's insurer or with the employer if self-insured. The forms are currently only available on paper.
As this is a pilot, physicians are not required to participate in the electronic filing program. DWC plans to draft regulations to require electronic reporting in the future with the goal of phasing out paper filing.
DWC has posted a web page with more information on the pilot program. To participate in EDI filing, contact
New Potential Cause of Minamata Mercury Poisoning
“By using state-of-the-art techniques to re-investigate a historic animal brain tissue sample, our research helps to shed new light on this tragic mass poisoning,” said USask professor Ingrid Pickering, Canada Research Chair in Molecular Environmental Science. “Mercury persists for a long time in nature and travels long distances. Our research helps with understanding how mercury acts in the environment and how it affects people.”
The study examining which mercury species could be responsible for the Minamata poisoning was published Feb. 12 in the journal Environmental Science & Technology. It is expected to prompt a wider re-assessment of the species of mercury responsible for not only the Minamata tragedy but perhaps also of other organic mercury poisoning incidents, such as in Grassy Narrows, Ont.
Mercury-containing industrial waste from the Chisso Corporation’s chemical factory continued to be dumped in Minamata Bay up to 1968. Thousands of people who ingested the mercury by eating local fish and shellfish died, and many more displayed symptoms of mercury poisoning, including convulsions and paralysis.
“Something that was unknown at that time was that unborn children would also suffer the devastating effects of mercury poisoning, with many being born with severe neurological conditions,” said USask PhD toxicology student Ashley James, the first author of the paper. “A mother may be essentially unaffected by the poisoning because the mercury within her body was absorbed by the unborn child.”
The Minamata poisoning has been considered a textbook example of how inorganic mercury turns into organic mercury, and how a toxic substance propagates up the food chain to humans. For decades, it has been assumed that micro-organisms in the muds and sediments of Minamata Bay had converted the toxic inorganic mercury from the factory wastewater into a much more lethal organic form called methyl mercury, which targets the brain and other nervous tissue. This compound was thought to spread to humans from eating contaminated seafood.

Recent studies have suggested that methyl mercury itself may have been discharged directly from the Minamata plant. But USask research—involving 60-year-old Minamata feline tissue samples—has found these assumptions may be misplaced.
Using a new type of spectroscopy and sophisticated computational methods, the USask researchers have found that the cat brain tissue contained predominantly organic mercury, contradicting previous findings and assumptions. The team’s computer modelling was also able to predict which kinds of mercury waste compounds the chemical plant would be likely to produce.
“The most probable neurotoxic chemical form of mercury discharged from the factory was neither methyl mercury nor inorganic mercury,” said professor Graham George, Canada Research Chair in X-ray Absorption Spectroscopy, and an expert in spectroscopy of toxic heavy elements at USask’s Toxicology Centre and geological sciences department. “We think that it was caused by an entirely different type of organic mercury discharged directly from the Chisso factory at Minamata in an already deadly chemical form.”
The cat brain samples from the USask study come from an experiment conducted by the Chisso company doctor in 1959 to determine the causes of the sickness, which was not at first connected to the industrial dumping. The doctor fed cats the industrial waste and they soon showed symptoms similar to the sick villagers. While the doctor was ordered to stop his experiments, he kept samples of brain tissue from one of the cats. 
The USask team has found that the likely culprit of the poisoning is alpha-mercuri-acetaldehyde, a mercury waste product from aldehyde production not previously identified.
“It was this species that very likely contaminated Minamata Bay and subsequently gave rise to the tragedy of Minamata disease. We think that this was the dominant mercury species in the acetaldehyde plant waste. More work is needed to explore the molecular toxicology of these compounds, to understand the ways they could be toxic to humans, animals and the environment,” said George.
The 12-member research team included researchers from USask, Stanford Synchrotron Radiation Lightsource at the SLAC National Accelerator Laboratory, Japanese National Institute for Minamata Disease and the environmental medicine department of the University of Rochester. 
While USask is home to the Canadian Light Source synchrotron, there are only two synchrotrons in the world set up with the specialized equipment needed for the advanced work that the team does with these precious samples—one in Grenoble, France, and the other at Stanford.
The USask research was funded by the Natural Sciences and Engineering Research Council, the Canadian Institutes of Health Research, and the Canada Foundation for Innovation.
The new findings coincide with renewed public interest in the tragedy due to the much-anticipated premiere on Feb. 21 at the Berlin International Film Festival of a new movie Minamata, which stars Johnny Depp as photojournalist W. Eugene Smith whose work publicized the devastating effects of the mercury poisoning. 
Cookie Manufacturer Cited for Exposing Employees to Falls and Other Hazards
OSHA has cited Nonni’s Foods LLC for exposing employees to falls and other hazards at the Ferndale, New York, facility. The manufacturer of premium cookies faces $221,257 in penalties.
OSHA opened an inspection on Aug. 22, 2019, after learning that an employee fell on Aug. 7, 2019, and was hospitalized. Inspectors discovered that the employer instructed employees to retrieve stored material by standing on the forks of a forklift that elevated them to a storage area atop a break room. The storage area lacked guardrails to prevent falls. Both conditions exposed employees to falls.
Nonni’s Foods LLC also failed to re-train operators on appropriate use of a forklift, and did not report the employee’s injury to OSHA within 24 hours as required. Additionally, two rotating bearings on a conveyor lacked guarding to protect employees against caught-by injuries.
“Employers must provide training, and utilize appropriate equipment and work practices to protect workers from falls and amputations,” said OSHA Albany Area Director Amy B. Phillips.
OSHA’s Fall Protection in General Industry fact sheet summarizes employee fall protection measures and the Powered Industrial Trucks page provides detailed information on hazards, safeguards, training and safe operation of forklifts. OSHA’s Safeguarding Equipment and Protecting Workers from Amputations booklet provide information on identifying and managing common amputation hazards when operating and using stationary equipment.
Nonni’s Foods LLC has 15 business days from receipt of the citations and penalties to comply, request an informal conference with OSHA’s area director or contest the findings before the independent Occupational Safety and Health Review Commission.
Fatal Boom Lift Accident at Music Festival
Oregon OSHA has issued $31,000 in fines against two companies for safety violations following an investigation of a boom lift accident that killed two workers at the site of the Pickathon Music Festival in Happy Valley.
The division’s investigation of the Aug. 8, 2019, accident found Pickathon LLC and GuildWorks LLC – a subcontractor to Pickathon LLC – failed to follow safety rules governing the operation of a boom lift. Those rules included keeping safety alarm devices activated and heeding the manufacturer’s operating and maintenance instructions for the machine.
“It is an employer’s responsibility to make sure that safety rules are followed for the very purpose of protecting workers from such tragedies,” said Michael Wood, administrator for Oregon OSHA. “This is a time to pause and remember that two people died, leaving behind family and friends. And it is a time to remind ourselves that this accident was entirely preventable.”
The two workers – positioned in the platform of a boom lift raised about 40 feet high – were performing tasks after the music festival had ended. They were dismantling event-related hardware and ropes attached to trees when the boom lift tipped over, crashing to the ground and killing them.
Oregon OSHA cited both Pickathon and GuildWorks for a serious violation because two alarm devices on the boom lift had been disabled. One device would sound an alarm warning against operating the machine on uneven terrain. The other device would stop the upward motion of the platform if an employee became pinned between an overhead obstruction and the platform’s railing and controls.
That serious violation carries a $12,500 penalty for each of the companies.
Additionally, Oregon OSHA fined GuildWorks $6,000 for another serious violation: failing to follow the boom lift manufacturer’s operating and maintenance instructions.
Those instructions included not raising the boom while on an uneven surface; maintaining a firm footing on the platform’s floor at all times; not moving the machine while the boom was extended and while the machine was stationed on a sloped surface; and not putting the boom in a raised position while the counterweight – which acts as a balance – is located on the downward side of a slope.
Using its discretionary penalty authority, Oregon OSHA determined that the companies will not receive the normal reduction in the penalty granted to small employers. This decision is based on the particular facts uncovered by the division’s investigation, which revealed a history of failing to follow proper safety procedures. 
Lowes Fans Recalled Because Ejecting Blades Hit Consumers
Lowes Harbor Breeze 48-inch Santa Ana Ceiling Fans after the company received 210 reports of the fan blade breaking or ejecting from the fan, including 10 reports of a fan blade hitting consumers.
The recall involves model LP8294LBN, UPC code 840506599178.  The model number can be on the fan motor as well as on the inside of the battery compartment cover of the included handheld remote control.  The recalled fan has two dark walnut fan blades, brushed nickel blade arm holders and a frosted white glass globe containing a light bulb.
The fans were imported by LG Sourcing, Inc. of Mooresville, N.C. and manufactured in China by Fanim Industries, of Zionsville, Ind.
If you have the recalled fans, you should immediately stop using the recalled ceiling fan and contact Fanim Industries toll-free at 888-434-3797 from 8 am to 5 pm ET Monday through Friday, or email for instructions. Or go to and click on Recalls for more information and to submit your request for replacement blade arm holders online.