乐动平台-首页OSHA已在疗养院和长期护理设施（统称“ LTCF”）中发布了个人保护设备（“ PPE”）和呼吸保护使用指南，以防止Covid-19。在它的recently issued guidance，O乐动平台-首页SHA介绍了有关LTCF在保护员工免受Covid-19时应考虑的策略的其他详细信息。作为初步提醒，尽管OSHA发布的指导文件，但该指南文件并未经过《行政程序法》规定的严格规则制定程序，而只是作为有关行业的指导。乐动平台-首页
In the latest issued LTCF guidance OSHA follows its usual hazard assessment and hierarchy of control framework provided in the PPE Standard (29 C.F.R. § 1910.134), stating that LTCFs should first conduct a risk assessment to identify which workers are at risk of exposure to any airborne hazards, which includes (per OSHA’s definition) COVID-19, as a result of their job duties. After a thorough risk assessment is completed, the LTCF must determine how to protect employees from the identified hazards pursuant to OSHA’s long-established hierarchy of controls. The LTCF must engage in engineering controls (e.g. ventilation) to reduce the hazard wherever possible. Next, the LTCF must apply administrative controls (i.e. hand hygiene, physical distancing, and cleaning and disinfection protocols). As a third step of hazard prevention, LTCFs should determine appropriate PPE and make sure it is available to each employee who needs it.
乐动平台-首页OSHA表明呼吸保护,等an N-95 respirator, may be appropriate for any individual who provides patient care while working within six feet of individuals who are a suspected or confirmed positive for COVID-19. This includes while performing tasks such as bathing, dressing, and toileting, in addition to clinical care. However, for each of the examples mentioned, it is unlikely that the employer could be using a form of source control, such as requiring the patient to wear a mask, or be behind a protective barrier. As a result, respirators may not be needed in these situations when other engineering or administrative controls are being used effectively. This is further complimented by the fact that guidance from the Centers for Disease Control and Prevention (“CDC”) requires only surgical masks for direct care of patients with confirmed or suspected COVID-19, unless the care provided involves aerosol generating procedures or surgeries with risk of transmission through infectious material splashes or sprays. Any LTCF engaging in a hazard assessment should document its decision-making, following the best and most up-to-date infectious disease guidelines, industry best practices, and recommendations from the CDC, and guidance from state and local health departments.
请注意，每当LTCF确实进行危险评估并确定过滤面部呼吸器（例如N-95s）是必要的PPE时，OSHA的呼吸保护标准（29 C.F.R.§1910.134，“ RPP”）将适用。乐动平台-首页乐动平台-首页OSHA的RPP法规需要长期的书面工作危害分析和使用呼吸器的任务危害分析；一个冗长的书面呼吸器计划，为每个单独的位置，工作或任务提供详细的个性化程序（取决于危害分析所需的内容）；选择具有特定职责的计划管理员；医学评估；初始使用，然后进行年度调查；冗长的存储，清洁和掩模替换程序；和其他详细要求。
OSHA’s guidance further details various “source control” measures, in categories recommended as follows:
- Cloth face coverings – to be worn by patients and visitors but not by healthcare providers if protection against exposure to splashes and sprays, or respiratory protection against airborne hazards is needed. All patients and visitors should be offered a surgical mask, face mask, or cloth face covering by the LTCF if they do not provide their own, and if supplies allow.
- Facemasks – these include KN95 respirators with ear loops instead of head straps, as well as other masks that do not provide fluid resistance.
- FDA-cleared or authorized surgical masks – these masks, authorized for emergency use by the FDA, are regulated by OSHA under the PPE standard (at 29 CFR 1910.132) or the Bloodborne Pathogens standard (29 CFR 1910.1030). OSHA prefers that healthcare providers use these rather than face masks or cloth face coverings, as they provide source control和protection for the wearer against splashes and sprays. As they are loose-fitting and do not provide a seal for the user, these masks are not effective at protecting against potential airborne hazards.
- Respirators (including FDA-cleared or authorized surgical N95 FFRs), which must be subject to fit-testing, medical evaluations, employee training, specific cleaning and storage procedures, and all of the other myriad requirements under OSHA’s RPP standard at 29 C.F.R. § 1910.134. OSHA also refers employers to the CDC guidelines for extending the use of N95s as necessary during the shortages presented by the pandemic, and cautions against accidental purchase of counterfeit N95s. N95 FFRs remain in short supply, as are most alternative respirators, including P100s and N99s, reusable rubber respirators, and powered air purifying respirators (“PAPRs”).
OSHA reminds employers that employees wearing N95s must be sure that any additional required PPE, such as eye or face protection, will fit with the N95 so that all pieces can safely be worn together.
If you have questions or need assistance in managing your response to OSHA’s guidance here or the pandemic in general, please reach out to the Jackson Lewis attorney with whom you often work, or any member of our Workplace Safety and Health Team.