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Updated Recommendations and Guidance for Influenza Prevention in Health Care Settings (11.5.10)

Note: This guidance supersedes “GUIDANCE FOR INFECTION CONTROL FOR 2009 H1N1 INFLUENZA IN HEALTH CARE” released on 2.4.10)

On November 5, the California Department of Public Health (CDPHi) issued guidance on influenza prevention in health care settings, and Cal/OSHA issued guidance on the application of the aerosol transmissible diseases standards for the 2010-11 influenza season.

The CDPH standards are based on the September 2010 Centers for Disease Control and Prevention (CDC) publication Prevention Strategies for Seasonal Influenza in Healthcare Settings, which supersedes CDC guidance for 2009 H1N1 and seasonal flu. Cal/OSHA concurs with the CDPH guidance, which emphasizes the need for specific precautions for activities that increase the risk of transmissions.

Hospital personnel responsible for activities related to the prevention of influenza in health care settings should thoroughly read the five-page CDPH guidance and the four-page Cal/OSHA guidance. The CDPH Guidance for Influenza Prevention in Health Care Settings and the Cal/OSHA Guidance for the 2010-2011 Influenza Season Regarding the Application of the Aerosol Transmissible Diseases Standards are posted here.

  • While CDC recommends that health care personnel (HCP) don a face mask (i.e., surgical mask), CDPH and Cal/OSHA believe health care employers should consider allowing HCP to use respiratory protection, at least as effective as fitted N95 respirators, during influenza patient care, based on an individual employee’s preference for added protection. Cal/OSHA views this as a best practice that a number of hospitals have been promoting for some time. Cal/OSHA will not issue citations for non-compliance.
  • Based on the recommendations of CDC and CDPH, Cal/OSHA will enforce the use of airborne-infection isolation procedures as described by CDC and CDPH when employees perform high-hazard (i.e., aerosol-generating) procedures on patients who have or are suspected to have influenza. These procedures include the use of airborne-infection isolation rooms when feasible, and the use of respiratory protection, at least as effective as an N95 respirator. Cal/OSHA will issue citations for non-compliance.
  • CDC recommends that health care personnel not redon filtering face-piece respirators or use them for an extended period of time. CDPH and Cal/OSHA support this position. Cal/OSHA will issue citations for non-compliance.