Everyone deserves to go home from work safe and healthy. Sadly, during the current pandemic that will not be the case; some workers will die because they became infected with in their workplace. We expect that employers will take all reasonable steps to protect their workers but in truth we know very little about how these workers are exposed and what measures are effective in preventing infection. Governments need to put more research effort into evaluating how effective the current control measures are and in innovating new approaches to better protect workers.
We can become infected in a number of ways. The three most likely routes are from mucous droplets from coughs and sneezes that land directly on our faces; the transfer of virus particles from contaminated surfaces to our nose, mouth or eyes through hand-to-mouth contacts; and by inhaling very small droplets of contaminated mucus suspended in the air.
The most important route is via contaminated hands and this is why there is the ceaseless message from public health professionals to wash your hands frequently through the day, and to avoid touching your face. For most of us inhaling small droplets is an unlikely way to become infected and therefore those wearing facemasks in public are unlikely to see much benefit. However, this is not the case for workers in hospitals and other healthcare settings where there may be specific medical procedures such as intubation that generate high droplet concentrations in the air and efficient respirators and visors can offer important protection during these tasks.
Little is known about the presence of the virus contamination on surfaces in hospitals. We know even less about the concentration of virus in the air. We don’t really know which surfaces to disinfect or when the air concentrations require us to wear a facemask. This lack of evidence means we are using a precautionary approach which often results in our applying all available controls all the time. While this might seem like an effective strategy nobody can continuously maintain such a high level of protection over an extended period. It also means that resources are used unnecessarily, possibly leading to shortages for workers in particular environments where they could provide protection.
Occupational hygienists (also called Industrial hygienists in many countries) are an important public health profession that focuses on protecting workers’ from health hazards at work. Their work spans all hazards from chemicals, dusts, fibres through to physical agents such as noise and vibration, and other workplace hazards. Such people have considerable expertise in identifying hazards, evaluating workers’ exposure to those hazards and implementing effective control measures to reduce risks to health.
Understanding how workers are exposed to the virus will be essential to protect frontline healthcare staff and other at-risk workers such as shop staff, bus drivers and home health care workers. Occupational hygienists have, for many years, been studying the process of how contamination gets onto the skin and how workplace chemicals are ingested through hand-to-mouth contact. There is considerable research that looks at how factors relating to the work process, worker behaviour, and the use of protective equipment all influence the transfer of hazards to the skin and mouth. This work can provide valuable insights for those involved in infection control and developing new ways to protect workers from COVID-19 infection. For example, we know that workers wearing gloves are less likely to touch their face and so this could be a useful strategy for workers outside healthcare who do not normally wear protective gloves.
Occupational hygienists also have considerable experience in selecting suitable personal protective equipment and assessing its effectiveness. Respirators are an important protective measure for many frontline healthcare workers, but to provide reliable protection the masks must be closely fitted to the face or contaminated air will leak between the mask and the face, putting the wearer at risk.
Governments, however, need to promote research into better ways of protecting workers from the virus. In particular research should address:
- How important are respirators in protecting healthcare workers from infection?
- How can we treat or modify surfaces in workplaces to reduce transmission from hand-to-mouth actions?
- What simple behavioural changes in the workplace can be encouraged to reduce the risk of transmission?
There is a great deal of expertise in the occupational hygiene community that can contribute to a better understanding of the spread of this virus and help workers contain and delay community transmission.
Featured image credit: Tedward Quinn. Public Domain via Unsplash.