How to Prevent Spread of Infectious Diseases in the Workplace

It may be obvious when people get injured at work, but it may not always be apparent when people acquire infections resulting from exposures at work.

The National Institute for Occupational Safety and Health (NIOSH) reviewed infectious disease investigations in workplaces across the U.S. to understand the range of cases, the risk factors for workers and ways to prevent infectious disease transmission. NIOSH researchers reviewed published scientific literature describing 66 U.S. workplaces from 2006 to 2015.

The need to identify at-risk populations at work, how diseases spread and how they can be prevented has been highlighted by experiences with anthrax, severe acute respiratory syndrome (SARS), influenza A (H1N1), the Ebola virus and several other clusters of infectious diseases in the workplace.

“The cases we reviewed allowed us to identify a range of diseases, specific settings and activities that are at an increased risk for certain infectious diseases, and employee and workplace factors that often facilitate transmission of the disease,” said Marie A. de Perio, MD, one of the lead authors of the study.

Researchers found reported cases appear to be concentrated in specific industries and occupations, especially the healthcare industry and among laboratory workers, animal workers and public service workers. These include those who come in contact with ill persons or with livestock, poultry or other animals as part of their job.

In addition to becoming infected themselves, some workers may serve as vectors that spread the disease. For example, workers in food preparation and serving-related occupations have been identified as sources of transmission in foodborne outbreaks.

NIOSH says considering occupational risk factors, strengthening biosafety programs and involving epidemiologists, physicians, industrial hygienists and engineers could help prevent spread of occupationally acquired infectious diseases to co-workers and the public.

“What is important to realize is that effective prevention and control measures begin with using the occupational health and safety hierarchy of controls as a framework, with the elimination of hazards being the most preferred occupational health and safety measure,” said Dr. de Perio. “Following the elimination of the hazard, the next best things are isolating workers from the hazard, changing the way people work, and personal protective equipment.”

Measures include improved ventilation systems in workplaces, vaccination of workers and personal protective equipment appropriate to the pathogen. “Although it is clear from the literature review that many groups of workers are at risk for infectious diseases, we may be missing some clusters in workplaces, given that surveillance of work-related infectious diseases is not done systematically,” said Sara Luckhaupt, MD, MPH, co-author of the study. “We also may be missing exposures, industries and occupations not readily identified as at risk.”