Workplace Safety & Health Issues - FAQs:

Do you have a sample policy statement for businesses who want to let folks know to stay home if they are sick?

You may want to consider using the type of message below.

In general, if you are sick with the flu, you should avoid contact with other people as much as possible to keep from spreading your illness. Persons who are infected influenza may be ill for a week or longer. With seasonal flu, people may be contagious from one day before they develop symptoms to up to 7 days after they get sick. Children, especially younger children, might potentially be contagious for longer periods.

With the exception of making trips to get medical care or for other necessities, you should stay home and keep away from others as much as possible. This includes avoiding travel and not going to work or school, for at least 24 hours after your fever is gone (Your fever should be gone without the use of fever-reducing medicine when returning to work.)

Always cover your coughs and sneezes with a tissue to avoid spreading droplets on others.

What can I do to make sure my workspace is free of flu and other viruses?

Influenza virus can survive for 24-48 hours or longer on nonporous (hard) surfaces and 8-12 hours on porous surfaces such as paper or cloth and can be transmitted to persons’ hands from these surfaces. Flu viruses may be spread when a person touches a hard surface (such as a desk or doorknob) or an object (such as a keyboard or pen) where the virus has landed and then touches his or her eyes, nose, or mouth. Routine cleaning of surfaces will help stop the virus from spreading in this way.

Routinely clean surfaces and items that are frequently touched by different people, such as doorknobs, faucets, and telephones. Wipe these surfaces with a household disinfectant, following the directions on the product label. Additional disinfection of these surfaces beyond routine cleaning is not recommended due to the hazards associated with chemical use.

For information on specific disinfectants, please refer to:

Antimicrobial Products Registered for Use Against Influenza A Virus on Hard Surfaces http://www.epa.gov/oppad001/influenza-a-product-list.pdf

Antimicrobial Products Registered for Use Against the H1N1 Flu and Other Influenza A Viruses on Hard Surfaces http://www.epa.gov/oppad001/influenza-disinfectants.html

May an ADA-covered employer send employees home if they display influenza-like symptoms during a pandemic?

Yes, the CDC states that employees who become ill with symptoms of influenza-like illness at work during a pandemic should leave the workplace. Advising such workers to go home is not a disability-related action if the illness is akin to the seasonal influenza virus. Additionally, the action would be permitted under the ADA if the illness were serious enough to pose a direct threat.

May an employer rescind a job offer made to an applicant based on the results of a post-offer medical examination, if it reveals that the applicant has a medical condition that puts him/her at increased risk of complications from the flu?

No, unless the applicant would pose a direct threat within the meaning of the ADA. A finding of “direct threat” must be based on reasonable medical judgment that relies on the most current medical knowledge and/or the best available evidence such as objective information from the CDC or state or local health authorities. The finding must be based on an individualized assessment of the individual’s present ability to safely perform the essential functions of the job, after considering, among other things, the imminence of the risk; the severity of the harm; and the availability of reasonable accommodations to reduce the risk. Before concluding that an individual poses a direct threat, the employer must determine whether a reasonable accommodation could reduce the risk below the direct threat level.

Example: The same international shipping employer offers a financial position at its U.S. headquarters to Steve. This position does not involve regular contact with flight crew or travel to the affected WHO region. Steve’s post-offer medical examination (which is the same examination given to all U.S. headquarters employees) reveals that Steve has a compromised immune system due to recent cancer treatments. Given the fact that the position does not involve regular contact with flight crew or travel, and that the influenza virus has not spread to North America, Steve would not face a significant risk of contracting the virus at work and does not pose a “direct threat” to himself or others in this position. Under the ADA, it would be discriminatory to rescind Steve’s job offer based on the possibility of an influenza pandemic.

May an employer covered by the ADA and Title VII of the Civil Rights Act of 1964 compel all of its employees to take the influenza vaccine regardless of their medical conditions or their religious beliefs during a pandemic?

No, an employee may be entitled to an exemption from a mandatory vaccination requirement based on an ADA disability that prevents him from taking the influenza vaccine. This would be a reasonable accommodation barring undue hardship (significant difficulty or expense).

Similarly, under Title VII of the Civil Rights Act of 1964, once an employer receives notice that an employee’s sincerely held religious belief, practice, or observance prevents him from taking the influenza vaccine, the employer must provide a reasonable accommodation unless it would pose an undue hardship as defined by Title VII (“more than de minimis cost” to the operation of the employer’s business, which is a lower standard than under the ADA).

Generally, ADA-covered employers should consider simply encouraging employees to get the influenza vaccine rather than requiring them to take it.

What measures can employers adopt during flu season to keep employees healthy?

The CDC recommends a yearly flu vaccine as the first and most important step in protecting against flu viruses. The two main strategies recommended to businesses this flu season are

host a flu vaccination clinic at the workplace, and
promote flu vaccination in the community.

The following link provides more information on these strategies: http://www.cdc.gov/flu/pdf/business/Recommended_Strategies.pdf

Employers can take additional steps by sharing information with employees to encourage flu vaccination. Consider posting a CDC flyer in the workplace (see link above), or copy and place in mailboxes or include in pay statements or newsletters. Also, employers should educate their workers about good hygiene and infection control practices and advise workers to stay home when sick.

Refer to the CDC’s recommendations for helpful guidance (http://www.cdc.gov/flu/business/). In addition, the Department of Labor's Occupational Safety and Health Administration has provided workplace safety and health guidance that will help employers protect workers during flu season. (See also: “What kinds of information should be conveyed to employees to prepare them for the issues that are likely to be of concern to them during flu season?"

Note: As an overall matter, employers should be guided in their relationship with their employees by federal, state, and local employment law, and by the company-specific application of these laws as reflected in employee handbooks, manuals, and contracts (including bargaining agreements).

Not all of the employment laws referenced apply to all employers or all employees, particularly state and local government agencies. For information on whether a particular employer or employee is covered by a law, please use the links provided for more detailed information. This information is not intended for federal agencies or federal employees -- they should contact the U.S. Office of Personnel Management (OPM) for guidance.

Are employers required to provide employees with infection control supplies and personal protective equipment (PPE) to prevent or slow the transmission of influenza?

Workplace safety law requires employers to provide a workplace free from hazards likely to cause death or physical harm. The Department of Labor’s Occupation Safety and Health Administration has provided detailed guidance on how to protect workers during flu season (Guidance on Preparing Workplaces for an Influenza Pandemic).

Employees who perform certain types of healthcare tasks for patients who may have the flu, may be at a higher risk of exposure to the seasonal flu virus at work. Precautions include using a combination of safe work practices and personal protective equipment (PPE) to reduce exposures to workers who are at high risk. Where the employer has evaluated the work site and determined that PPE is required to be worn by employees, it is the employer’s responsibility to assure that PPE is provided at that site. For guidance on selecting PPE, employers can consult the OSHA’s guidance referenced above.

There are various levels of control that can be used to protect employees who are at a higher risk of exposure including, engineering controls, work practices, administrative controls, and PPE. Some examples of these controls include: modifying patient intake, triage, and other service areas to increase space between workers, coworkers, and patients (e.g., installing sneeze guards or partitions), promoting personal hygiene measures, and use of gloves or other PPE. Employers will need to use a combination of these controls its protect employees. Signage in common areas around the workplace encouraging and explaining how to use these controls may increase awareness and good hygiene behavior.

Employers should also educate their workers about good hygiene and infection control practices.

May employers require employees to supply their own “safety equipment” (e.g., surgical masks or respirators, latex gloves, etc)?

Where the employer has evaluated the work and determined that personal protective equipment (PPE) is required to be worn by employees, it is the employer’s responsibility to assure that PPE is provided at that site.

Many OSHA standards, including the bloodborne pathogens standard, currently require employers to provide PPE at no cost to their employees. For those standards that do not specify payment, OSHA's Employer Payment for PPE, Final Rule (published November 15, 2007) requires, with very limited exceptions, payment for PPE.

Employers should also note that under the Americans with Disabilities Act, a qualified individual with a disability may be entitled to have certain safety equipment provided by his or her employer as a reasonable accommodation, absent an undue hardship. (See the U.S. Equal Employment Opportunity Commission’s Enforcement Guidance: Reasonable Accommodation and Undue Hardship under the Americans with Disabilities Act for additional information.)

During an flu pandemic, can a healthy employee refuse to come to work, travel, or perform other job duties because of a belief that by doing so, he or she would be at an increased risk of catching the flu?

The circumstances under which employees have a right to refuse to work are very limited. Refusing to do a job because of potentially unsafe workplace conditions is not ordinarily an employee right under the Occupational Safety and Health Act (OSH Act). (A union contract or state law may, however, provide for such rights.) Employees may refuse an assignment only if:

(1) they reasonably believe that doing the work would put them in serious and immediate danger;

(2) they have asked their employer to fix the hazard;

(3) there is no time to call the Department of Labor’s Occupational Safety and Health Administration (OSHA); and

(4) there is no other way to do the job safely. Employees are not protected for simply walking off the job.

An employer can impose disciplinary action for refusing to work. However, employees do have the right to refuse to do a job if they believe in good faith that they are exposed to an imminent danger. "Good faith" means that even if an imminent danger is not found to exist, the worker had reasonable grounds to believe that it did exist.

In addition, employers should be aware that an employee’s inability to attend work or perform certain duties could be related to a disability. In this instance, the employer may need to consider the implications of its actions under the Americans with Disabilities Act¹ before proceeding. For example, if an employee with a disability could safely perform the essential functions of the job with a reasonable accommodation (e.g., telework, changes in shift times), then an employer would need to provide the accommodation, in lieu of termination, unless it would pose an undue hardship. (See the U.S. Equal Employment Opportunity Commission’s Enforcement Guidance: Reasonable Accommodation and Undue Hardship under the Americans with Disabilities Act for additional information.)

We would encourage employers to prepare a plan of action specific to your workplace. As a practical matter, employers will likely want to be flexible regarding attendance during a pandemic. It would also be prudent to notify employees and, if applicable, their bargaining unit representatives about decisions made at the earliest feasible time.

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¹The EEOC enforces Title I of the ADA. The ADA’s provisions in regards to disability-related inquiries, medical examinations, and confidentiality apply to all applicants and employees of covered employers, regardless of whether those individuals have disabilities, as defined by the ADA. By contrast, other ADA requirements apply only if an applicant or an employee is an individual with a disability under the ADA.

It cannot be definitively established in advance, however, whether a future pandemic influenza would rise to the level of a disability under the ADA. Therefore, this answer provides guidance for employers that would comport with the ADA even if a future pandemic illness was found to be an ADA disability.

Must an employer grant leave to an employee who is sick or who is caring for a family member that is sick?

An employee who is sick or whose family members are sick may be entitled to leave under the Family and Medical Leave Act (FMLA) under certain circumstances. The FMLA entitles eligible employees of covered employers to take up to 12 weeks of unpaid, job-protected leave in a designated 12-month leave year for specified family and medical reasons which may include the flu where complications arise that create a “serious health condition” as defined by the FMLA. Employees on FMLA leave are entitled to the continuation of group health insurance coverage under the same conditions as coverage would have been provided if the employee had been continuously employed during the leave period.

Workers who are ill with pandemic influenza or have a family member with influenza are urged to stay home to minimize the spread of the pandemic. Employers are encouraged to support these and other community mitigation strategies and should consider flexible leave policies for their employees. (See Community Strategy for Pandemic Influenza Mitigation.)

The U. S. Department of Labor and other federal agencies are currently reviewing federal statutes and regulations that may affect employers and employees during the unique circumstance where the U.S. experiences a severe influenza pandemic. Decisions have not yet been made as to whether any changes are needed. Answers to questions such as this one are based on current laws and regulations.

Not all of the employment laws referenced apply to all employers or all employees, particularly state and local government agencies. For information on whether a particular employer or employee is covered by a law, please use the links provided for more detailed information. This information is not intended for federal agencies or federal employees -- they should contact the U.S. Office of Personnel Management (OPM) for guidance.

Where can I find a comprehensive set of questions and answers about workplace policies and practices during a flu outbreak?

Flu.gov has a comprehensive list of questions and answers prepared by the US Department of Labor at http://answers.flu.gov/categories/284.

The workplace topics cover:

What steps can businesses take to keep employees from getting sick, especially during flu season?

Businesses should take the steps below to keep employees from getting sick with flu.

Promote vaccination. Encourage all employees to get vaccinated for seasonal flu. Review the health benefits you offer your employees and consider including flu vaccination. If possible, you should offer seasonal flu vaccination opportunities at the worksite.
Advise all employees to stay home if they are sick until at least 24 hours after they no longer have a fever (100 degrees Fahrenheit or 38 degrees Celsius) or signs of a fever (have chills, feel very warm, has a flushed appearance, or is sweating). This should be determined without the use of fever-reducing medicines (any medicine that contains ibuprofen or acetaminophen). They should stay home until at least 24 hours after they no longer have a fever, even if they are using antiviral medicines. Businesses should review their policies and practices to consider ways to allow flexibility for employees to stay home when they are sick.
Encourage hand cleanlinessby providing
- education and reminders about washing their hands, and
- easy access to running water and soap or alcohol-based hand cleaners.

See the CDC handwashing video.

Encourage "respiratory etiquette"by providing
- education and reminders about covering coughs and sneezes with tissues, and
- easy access to tissues and trash cans.
Routinely clean surfaces and items that are more likely to have frequent hand contact with cleaning agents that are usually used in these areas. Additional disinfection beyond routine cleaning is not recommended.
Address travel concerns. Provide information to employees overseas about what to do if they become sick.

What additional steps should businesses and employees take if the flu becomes more severe?

In addition to the steps that businesses should be taking all the time to prevent flu, businesses and employees may consider the steps below if flu conditions become more severe.

Educate employees to recognize the symptoms of influenza. Symptoms of flu include fever or chills and cough or sore throat. In addition, symptoms of flu can include runny nose, body aches, headache, tiredness, diarrhea, or vomiting. Workers who have flu-like symptoms should be asked to go home. Continue to advise workers to check for any signs of illness before coming to work each day.
Prepare for employees to stay home from work and extend the time sick employees stay home to at least 7 days. People who are still sick after 7 days should continue to stay home until at least 24 hours after symptoms have gone away, even if they feel better sooner. Employees may stay home because they are sick, are at higher risk for complications, need to care for sick household members, or because schools have been dismissed or childcare centers have closed and they need to care for their children. Review sick-leave policies and consider making them flexible and consistent with public health recommendations.
Promote flu vaccination in the community. Make sure your employees know where they and their family can get seasonal flu vaccination in the community. Find out about health providers, pharmacies or clinics that offer seasonal flu vaccinations in your community. Partner with a pharmacy or provider to get your employees vaccinated

From a business standpoint if there is a confirmed case of the flu in the home is it still safe to allow that employee to come to work if he/she is not sick? What are the chances of it being transferred to family members?

An employee with an ill household member may go to work. But it is especially important that these employees monitor themselves for illness.

Employees with school-aged children may need to stay home to care for their children. Employers should review leave policies for the flexibility to allow employees to stay home if they need to care for their children or other household members. If flu conditions are more severe, CDC guidance for school-aged children is that they should stay home for 5 days from the time someone in their home became sick. However, this guidance does not apply to adults.

People infected with seasonal influenza (flu) shed virus and may be able to infect others from 1 day before getting sick to 5 to 7 days after. This can be longer in some people, especially:

Children;
People with weakened immune (body defense) systems; and
People infected with the 2009 H1N1 virus.

Many people with flu illness will continue shedding the flu virus 24 hours after their fevers go away, but at lower levels than during their fever. In some cases, shedding of the flu virus can be detected for 10 days or more by reverse-transcription polymerase chain reaction (RT-PCR). So, when people who have had flu-like illness return to work, school, or other community settings, they should:

Continue to practice good respiratory etiquette and hand hygiene; and
Avoid close contact with people they know to be at increased risk of flu-related complications.

Because some people may shed flu virus before they feel ill, and because some people with flu will not have a fever, it's important that all people:

Cover their cough; and
Wash their hands often.

I have a disability -- can my employer require me take a flu vaccine?

Generally, ADA-covered employers should consider simply encouraging employees to get the influenza vaccine rather than requiring them to take it.

For more workplace questions and answers, go to:

http://answers.flu.gov/search/results?q=workplace

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