Questions

If you have questions about the issues raised in this newsletter, or any health, safety or wellness issue, please contact Mark Grabas at 604.730.4509 or markg@bcpsea.bc.ca

H1N1, Undue Hazard and Refusal of Unsafe Work

As you may have heard, in at least one district, some pregnant teachers have walked away from their classrooms asserting that it is unsafe for them to be in the workplace due to the potential for H1N1.

A worker can only refuse unsafe work when that person has reasonable cause to believe that to carry out their work would create an undue hazard to the health and safety of any person.

With specific reference to H1N1, where a school has an effective Exposure Control Plan (ECP), it is unlikely that an undue hazard would exist. In fact, compared with the community at large, a school with an ECP is likely safer. WorkSafeBC's position is that a broadly communicated and effective ECP based on risk assessment as required by the Occupational Health and Safety Regulation provides the strongest protection for workers. 

For an ECP to be considered effective:

• The ECP must be written and available for review;
• The ECP must be distributed to all staff;
• The ECP must be communicated to all staff;
• Staff must be trained on the requirements and procedures of the ECP; and
• The employer must ensure the ECP is functioning as intended.

An updated ECP template is included below.

Right to Refuse Unsafe Work

WorkSafeBC is currently accepting the medical perspective of the Public Health Agency of Canada (PHAC) and the BC Ministry of Health, including:

“It's important that people continue their daily lives during the pandemic. PHAC doesn't recommend that anyone avoid going to work or community social events if they are healthy.”

With regard to the right to refuse unsafe work, there is a process that must be followed when Section 3.12 of the Regulation is invoked. WorkSafeBC does not become part of the process until the steps defined in the Regulation have been followed and exhausted. Each refusal is assessed on a case by case basis.

The general principle for a 3.12 being upheld by a Prevention Officer would be the worker in question being exposed to an “undue hazard.” However, given that the current Influenza H1N1 is primarily a community-acquired infection and teaching staff are at no greater risk of contracting the infection than others in the community, determining that the workplace represents an undue risk of exposure to the current Influenza H1N1 pandemic would prove challenging.

Updated Exposure Control Plan

Following is an updated template for an ECP. The plan has been updated to reflect the current understanding of H1N1 and recommendations by WorkSafeBC. Please take this opportunity to review your current ECP and modify it as required.

Purpose

The district is committed to providing a safe and healthy workplace for all of our staff and students. A combination of measures will be used to minimize staff and student exposure to the H1N1 Influenza. Our work procedures will protect not only our staff, but all staff and students who enter our facilities. All staff must follow the procedures outlined in this plan in order to prevent or reduce exposure to the H1N1 Influenza.

Facts About H1N1 Influenza

Symptoms
Seasonal flu affects people to varying degrees, with symptoms including headache, fever, fatigue, sore throat, and runny nose. In some cases, secondary infections such as pneumonia may develop. Symptoms of H1N1 influenza are likely to include high fever (higher than 38°C) and a cough.

Transmission

The BC Centre for Disease Control advises that influenza is communicable for 24 hours before the onset of symptoms and 3–5 days afterward (this may be longer in some children and some adults). H1N1 influenza is spread in the same way that seasonal influenza is spread. Exposure to the virus may occur in a variety of ways, including the following:

• Shaking hands with an infected person or touching a surface contaminated with the virus, followed by touching one’s eyes, nose, or mouth
• Infectious droplets (from a coughing or sneezing person) landing in the eye or onto the mucosa (moist inner surfaces) of the nose or mouth
• Breathing infectious airborne droplets or particles (from coughing, sneezing, or aerosol-generating medical procedures on infected patients)
• Sharing food items or utensils with an infected person.

Responsibilities

Administrators and Supervisors

1. Contact has been made with the [Insert Your Health Authority] to seek advice on what to communicate to parents and staff regarding the current H1N1 Influenza situation. We will keep in regular contact with [Insert Your Health Authority] and follow any “directives” provided by the Provincial Health Officer. 
2. The school district Superintendent will work closely and directly with their regional medical health officers and the Provincial Health Officer in each instance where a school closure is being considered.

Staff and Students

Influenza is caused by viruses, and is generally spread when an infected person coughs or sneezes. Here are six simple precautions:

1. Stay home when you’re sick or have influenza symptoms. Get plenty of rest and check with a health care provider as needed.
2. Avoid close contact with people who are sick. If you are sick, keep your distance from others to protect them from getting sick.
3. Cover your mouth and nose with a tissue when coughing or sneezing, and throw the tissue away immediately. It may prevent those around you from getting sick.
4. Wash your hands. Washing your hands often will help protect you from getting sick. When soap and water are not available, use alcohol-based disposable hand wipes or gel sanitizers.
5. Avoid touching your eyes, nose or mouth. You can become ill by touching a surface contaminated with germs and then touching your eyes, nose or mouth.
6. Practice other good health habits. Get plenty of sleep, be physically active, manage stress, drink plenty of fluids, eat nutritious foods, and avoid smoking, which may increase the risk of serious consequences if you do contract the flu.

If you have an influenza-like illness, stay home from work or school and limit contact with others to keep from infecting them. See a health care provider if your symptoms become worse but call ahead of time to let them know you have an influenza-like illness.

Education and Training

Workers will receive training in the following:

1. The risk of exposure to H1N1 influenza and the signs and symptoms of the disease.
2. Safe work procedures to be followed, including hand washing and cough/sneeze etiquette.
3. Location of washing facilities, including dispensing stations for alcohol-based hand rubs.
4. How to report an exposure to or symptoms of the H1N1 influenza.

Washing your hands often will help protect you from germs. Wash with soap and water or clean with alcohol-based hand cleaner. When you wash your hands — with soap and warm water — wash for 15 to 20 seconds. When soap and water are not available, non-alcohol-based disposable hand wipes or gel sanitizers may be used. If using gel, rub your hands until the gel is dry. The gel doesn't need water to work.
Wash your hands immediately:

• Before leaving a work area
• After handling materials that may be contaminated
• Before eating, drinking, smoking, handling contact lenses, or applying makeup.

Cough/Sneeze Etiquette

All staff and students are expected to follow cough/sneeze etiquette, which is a combination of measures that minimizes the transmission of diseases via droplet or airborne routes.
Cough/sneeze etiquette includes the following:

• Educate workers in control measures, including hand washing.
• Post signs at entry points to instruct everyone about control measures.
• Cover your mouth and nose with a sleeve or tissue when coughing or sneezing.
• Use tissues to contain secretions, and dispose of them promptly in a waste container.
• Turn your head away from others when coughing or sneezing.
• Wash hands regularly.

If Staff or Students Show Symptoms of Influenza
If staff or students are ill with influenza, they should stay home. If they develop symptoms of influenza while at school or work, they should leave the school or workplace. Schools should promptly isolate students or staff who become ill with symptoms of influenza while in school in a room/area separate from others with adequate supervision until they can go home. To help prevent transmission, good respiratory and hand hygiene practices are recommended as well as, to the extent possible, having the ill children stay two metres away from others. If people are not typically trained in the proper use of masks and considering the potential risk of infection associated with improper mask use, the use of masks in the school/daycare setting is not recommended. If trained, during isolation a surgical mask may be used as described in the section “Use of surgical masks.”

Schools will follow the protocols in place to notify parents/guardians if their child becomes ill with influenza while at school.

Children who become ill with influenza while at school will be sent home with their parent or guardian and not travel on school buses. If there is no other option and the child must ride a school bus, it is recommended that staff ensure the child sits on a seat by themselves and is able to cover their mouth and nose with a tissue.

Staff and students should only return to school or the workplace once they have recovered from influenza and no longer show symptoms. Staff should inform their manager or supervisor if they are ill with influenza.

Use of surgical masks

A surgical mask is a protective barrier that is worn on the face, covers at least the nose and mouth, and is used to contain large droplets generated during coughing and sneezing by the person using the mask.
Surgical masks help minimize the spread of potentially infected material from the wearer to other people. Under some circumstances (for example, when a student is ill with influenza and isolated prior to being picked up by their parents), some staff may be required to work with someone who shows signs of influenza. These staff should either:

• Wear surgical masks and reinforce that the student practice cough/sneeze etiquette to avoid infecting other workers and students; or
• Have the student wear a surgical mask and practice cough/sneeze etiquette to avoid infecting other workers and students.

Health Monitoring

Staff will promptly report any symptoms of the H1N1 influenza to their manager/supervisor and the first aid attendant.

Record Keeping

The district will keep records of instruction and training provided to workers regarding the H1N1 influenza, as well as reports of exposure and first aid records.

Latest Updates

Updates on the impact of the outbreak in BC are being provided regularly by the Ministry of Healthy Living and Sport and the Ministry of Health Services; this information is also available on the Ministry of Education website. Please visit these websites for the most current and factual information about the swine flu outbreak.
If you have questions about the health situation in your district, you can call HealthLink BC at 8-1-1, 24 hours a day/seven days a week. Additional information on the swine influenza outbreak is also available through HealthLink BC.

Annual Review

This Exposure Control Plan will be reviewed at least annually and updated as new and updated information is made available.

Exposure Control Plan Review History

BC Public School Employers' Association
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