Topics Healthcare

Legal Alert: OSHA Issues Guidance on Pandemic Preparation for Healthcare Workers and Employers

Date   May 30, 2007


While all employers should take the possibility of a flu pandemic into account when creating disaster preparedness plans, professionals working in the healthcare industry would face an especially daunting challenge during such a global outbreak.



While all employers should take the possibility of a flu pandemic into account when creating disaster preparedness plans, professionals working in the healthcare industry would face an especially daunting challenge during such a global outbreak. Since hospitals, emergency medical personnel, and other health professionals will be the first responders to a viral outbreak, healthcare employers should craft a preparedness plan designed to maximize both the safety of their own workers and the effectiveness of their response. Citing these needs, the Occupational Safety and Health Administration (OSHA) recently released a new guidance entitled "Pandemic Influenza Preparedness and Response Guidance for Healthcare Workers and Healthcare Employers." The 104-page manual, now available on OSHA’s official website,, provides a detailed plan for preparing for, and responding to, a potential influenza pandemic.

How Would an Influenza Pandemic Affect the Workplace?

Unlike the common seasonal flu, an influenza pandemic would constitute a worldwide outbreak of a new strain of the virus which could have a massive impact on the global economy, including travel, trade, financial markets, and the workplace. While such a pandemic could arise from strains of human influenza, a few highly pathogenic strains of avian influenza (commonly called "bird flu") have shown the ability to cross over from bird species and infect humans in direct contact. Scientists worry that a strain of avian influenza could eventually mutate and allow human-to-human transmission, which could spark a pandemic.

OSHA estimates that a pandemic could result in several waves of outbreaks, lasting between 6 and 8 weeks, and that such a pandemic could affect up to 40% of the workforce at its peak. The potential impact of a pandemic on the workplace -- including absenteeism, changes in customer habits, and supply interruptions -- means that all employers should always have a viable plan to combat such an outbreak. But employers and employees in the healthcare industry should take special precautions, since OSHA estimates that a pandemic would be capable of overwhelming the healthcare system at every level.

Adding Pandemic Preparedness to Existing Disaster Plans

OSHA's new guidance provides valuable advice for employers in the healthcare industry, including proposed methods of infection control and contact precautions for employees and patients, administrative controls, and several tactics designed to protect healthcare workers from infection when working on the front lines of a flu pandemic. The guidance also suggests that preparation for a pandemic is essential for healthcare employers. Thus, OSHA recommends that these employers address pandemics in their existing disaster preparedness plans. While most hospitals already have response plans that address bioterrorism and natural disasters, preparedness for large-scale pandemics often is insufficient. OSHA recommends that healthcare employers construct an algorithm that would group the influenza pandemic along with other threatening biological agents (such as smallpox, plague, and severe acute respiratory syndrome (SARS)).

Dealing with Resource Shortages

Hospitals should take into account that in the event of a pandemic, the resources available from other healthcare providers (and from federal and state authorities) will be severely limited or nonexistent. Additionally, since up to 40% of the workforce could be affected by a pandemic, hospitals must account for potentially huge numbers of patients as well as the possibility that many doctors, nurses, and other health professionals will themselves become infected. Thus, it is crucial that each healthcare provider create a specific preparedness plan that takes these potential resource shortages into account. And because a vaccine probably will not be available early in the pandemic, hospitals should plan to expect the unexpected, and have plans flexible enough to respond to changes in the situation.

Identifying Essential Staff and Functions

One of the most crucial steps for healthcare employers is to define the essential staff and functions of the facility. Accordingly, hospitals should consider cross training to ensure that the most vital processes of the facility – including trauma, intensive care, psychiatry, security, and food services – will continue with minimal interruption. OSHA suggests that hospitals form a multidisciplinary planning committee to create internal guidelines on how to respond to staff shortages and implement cross-training procedures. Since staff shortages are to be expected, hospitals should also identify available volunteer health and support professionals from the community and develop training exercises for those volunteers. Additionally, employers should address how to handle potential human resources issues caused by a pandemic, including an expected increase in workers’ compensation claims.

Keeping Lines of Communication Open

Since healthcare professionals play such a crucial role in responding to outbreaks, communication will remain an indispensable element of any disaster preparedness plan. Healthcare employers should work to create viable communication infrastructures that will allow them to keep in contact with the public and with employees, as well as with other healthcare organizations. A designated hotline or a website could become especially valuable as a tool to disseminate guidance to the public, identify misinformation, and provide a network for timely response.

Creating New Protocols

This need to bolster communications extends to the hospital’s role in combating the outbreak directly. Thus, healthcare professionals will need to work closely with one another (and with government agencies) in tracking infections and conducting epidemiology studies.

Establishing detailed protocols will be the cornerstone of a hospital’s pandemic preparedness plan. Employers should ensure they have procedures in place that cover occupational health services, proper screening and training for healthcare workers, and the maintenance of hospital security during an outbreak. OSHA’s guidance provides a step-by-step checklist to aid employers in creating protocols to best protect their employees and essential functions in the event of a pandemic.

The guidance also contains an extensive series of appendices that provide detailed instructions on pandemic preparedness and response, covering topics ranging from readiness plans for Epidemic Respiratory Infection to instructions on how to speak with journalists following a mass casualty event.

Every Employer Should Take Notice

OSHA recommends that all employers – not just those in the healthcare industry – add the issue of a potential flu pandemic to their existing disaster preparedness plans. Employers should always have a contingency plan for dealing with the tremendous economic and human impact of a pandemic, including procedures for protecting existing employees, preparations for how to respond to the concerns of affected customers, and contingency plans in the event that an employer's lines of supply are disrupted. A flu pandemic would affect practically every aspect of the workplace, and employers must take the initiative to ensure that, in the event of an outbreak, their employees and resources will be protected. For more information on planning for a potential pandemic, see our June 28, 2006 Legal Alert

Ford & Harrison attorneys and F&H Solutions Group consultants are available to assist you in preparing a plan that addresses your company's individual needs and concerns in the event of a pandemic. If you have any questions regarding the issues raised in this Alert or would like further information regarding emergency preparedness plans, please contact Pedro Forment,, 305-808-2104, or the Ford & Harrison attorney or F&H Solutions Group consultant with whom you usually work.