Every person (with or without symptoms) in the work place should be considered as a potential source of infection and a II planning has to be geared with this in mind. All the risks factors, including those associated with va rio us wor ksites and the tasks workers perform at those sites, must be taken into account. They include:
- Sources of infection at wor kplace, such as:
- The General public, customers, suppliers and workers etc.
- Sick individuals or those at pa rticula rly hig h risk of infection e.g. healthcare workers and travellers who have visited locations with widespread COVID -19 cases.
- Tasks performed by the employee.
- Non-occupational risk factors at home and in the community.
- Workers’ individual risk factors for serious disease as mentioned above.
- Worker’s mental welI-being.
Basic Infection Control Measures
Follow all Five Rules to Fight COVID-19
- Wear Masks
- Wash Hands Frequently
- Observe Repiratory Etiquette
- Maintain Social Distance
- Clean and Sanitize Workplace Frequently
Protection of Workers will depend on emphasizing and reinforcing basic measures to prevent infection with the help of talks, discussions, Q&As, posters, audio-visual aids, signs and visual cues etc. Basic infection control measures for COVID-19 include :
- As the disease spreads mainIy when a patient coughs, sneezes, talks or laughs, it is important for everyone to cover their mouth and nose with a mask in public. The mask has to be consistently worn and should be worn and taken off correctly.
- For the same reason respiratory etiquette should be practised. It includes covering coughs and sneezes with the arm or elbow or with tissue that should be disposed of in a closed bin.
- Frequent and thorough hand washing with soap and water for at least 40 seconds or with a sanitizer containing at least 60% ethyl alcohol or 70% isopropyl alcohol decreases the risk of getting the disease from contaminated surfaces. Hand washing with soap and water for at least 4O seconds is much better than using sanitizers.
- Social distancing of at least 2 meters between people is a potential ga me changer in limit ing the spread of COVI D-19. A distance of 2 meters between people minimizes the risk of spread of COVI D-19. WHO recommends at least 1O square meters of space around each worker.
- The virus may also be present on frequently used surfaces that have been contaminated by a person with COVI D-19. A worker may touch an infected surface and get infected. 1% freshly prepared Sodium Hypochlorite solution or a solution of more than 60% ethyl alcohol kills the virus.
- A single measure alone is not sufficient to keep people safe. Wearing masks, maintaining social distance, washing hands frequently and proper and frequent sanitization, when practised together, keep people safe.
Preventive Measures for Workplace Environment
There are advantages and disadvantages to each type of control measure when considering the ease of implementation, effectiveness, and cost. A combination of these measures will be necessary to protect workers. These are generic guidelines and they should be adapted to suit the nature of the business, its wor kplaces, it’s processes, it’s employees and the tasks they perform.
The following engineering solutions reduce the risk of spread of COVID-19 without relying on workers behaviour:
- Structural modifications in the workplace to maintain social distancing norms and ventilation
- Installation of physical barriers such as clear glass/Plexiglas/acrylic or any other suitable partition, wherever possible, between workstations, at the reception, between other work areas and where there is public interaction.
Workplace air: More Outdoor air ventilation
- Increasing outdoor air ventilation in airconditioners at workplace/shop floor by opening doors and windows or installing exhausts.
- Switching on exhausts/ventilation systems 2 hours prior to and 2 hours after the building usage time.
- Keeping toilet exhaust fans open 24/7.
- Avoiding the use of central air conditioning. Using individual room air conditioners with HEPA filters when absolutely necessary.
- Ensuring that ventilation systems operate properly and provide acceptable indoor air quality for the occupancy level for each space.
Consult detailed revised guidelines for HVAC issued by CPWD for making changes in air-conditioning and ventilation systems.
Administrative changes are relatively easier to implement and go a long way towards minimizing the risk of spread of COVID-19. Set up teams or identify individuals, if possible, for managing various tasks related to infection control:
- Discourage visitors. Allow visitors with prior appointments only. Whenever possible, their Aarogya Setu status should be checked before entry. No visitor should be allowed beyond the reception area.
- Do not use Biometric Attendance Systems. Discontinue frisking.
- Use calibrated, Infrared, no touch, thermometers at the entrances of the facility to measure temperature of all visitors and alI workers. Enquire a bout symptoms of COVID-19. All those with fever or symptoms shouId be asked to go back home and seek immediate medical attention. Maintain an entry and exit register. Allow entries and screenings at multiple places to avoid crowding.
- Encourage workers with symptoms of COVID-19 to inform their supervisor and stay at home and seek medical attention. Promote the message that workers should stay home even if they have mild sym ptoms. Allow workers to stay at home to look after family members with COVI D-19 and to self-monitor.
- Make sure that all workers and visitors sanitize their hands with an alcohol based sanitizer before entering.
Respiratory hygiene: Mask compulsory; respiratory etiquette essential
- Insist that workers and visitors wear a mask before entering and during their stay in the facility. Make it non-negotiable. Procure masks for workers or encourage them to sew three layered cloth masks that can be reused after washing with soap and water.
- Teach workers the correct technique of wearing and taking off a mask with the help of actual demonstration and with the help of posters and audio-visual aids.
- Encourage respiratory etiquette and demonstrate how to do it properly to workers. Provide tissues and covered waste bins at convenient locations.
Workplace hygiene: Frequent workplace sanitization and frequent hand washing; no sharing no touching
Maintain regular housekeeping practices, including cleaning and disinfecting of all floors, light switches, entrance gates, kitchen, washroom floors, counters, taps, sinks and toilet seats, machinery, doors and windows handles and knobs, staircase rails, work stations, tables and desks, chairs, vehicles (especially contact points) and objects like telephones and computer keyboards etc. and other elements of the work environment at least twice daily, once before each shift. High-touch surfaces should be identified for priority disinfection. Make sure that there is a gap of one hour between shifts to enable proper sanitization. 1% freshly prepared Sodium Hypochlorite solution may be used for the purpose. Alcohol based sanitizer can be used for those surfaces that can’t be cleaned with Sodium Hypochlorite. Provide materials to workers to clean their workplaces. Store and use disinfectants in a responsible and appropriate manner according to the label. Ensure good quality, Government approved materials.
Clean garbage bins and areas around them daily at the end of the day with soap solution and disinfect with 1% freshly made Sodium Hypochlorite solution. Ensure that all persons handling garbage wear gloves, masks, gowns and boots.
Insist on frequent cleaning of hands by workers and other visitors with soap and water or with a sanitizer. Ensure that hand sanitizers are placed at the entrance, near all touch points, in washrooms and in multiple easily accessible place and that they are regularly refilled. All employees must clean their hands before and after work shifts, before and after work breaks, after blowing their nose, coughing, or sneezing, after using the restroom, before eating or preparing food and after putting on, touching, or removing masks. Place posters that encourage hand hygiene.
Discourage people from touching common surfaces like gates, staircase banisters, walls, door handles with their hands and encourage them to use their elbows, shoulders or arms to open doors. Innovative messaging in the form of red paint and suitably placed signs should be placed for the purpose. Remove door handles and knows wherever possible. Dedicated personnel can also be deputed to open doors and operate lift, using gloves. Consider automatic doors and taps.
Remove newspapers, magazines, and other paper material which might come in contact amongst individuals.
Disallow workers from sharing pens, phones, desks, offices, computers or other work tools and equipment.
Create a place and a mechanism by which parcels and mail can be delivered to a single place without contact. take deliveries contact less.
Use packaged water and disposable cups for beverages.
Educate employees to make a habit of not touching their nose, mouth or eyes.
Spraying or logging is generally not recommended. Spraying of people with disinfectants (such as in a tunnel, cabinet, or chamber) is harmful and not recommended under any circumstances.
Workplace social distancing: Physical and functional changes; remote working and remote services
- Ensure a distance of 2 meters between tables and desks, and between various work areas and other spaces in the facility by modifying the work space if need be.Park areas around individual workspaces with visual indicators like barricade tape, floortape, cones etc. in order to limit encroachment by others.
- Reduce density of people in the building and ensure physical spacing in common spaces such as entrances/exits, lifts, pantries/cafeterias, stairs and lobbies etc.
- Make sure that everyone understands that they must ensure a distance of at least 2 meters from each other at all times. Use signs, colour marks, or other visual cues such as coloured tape on the floor placed 2 meters apart to indicate where to stand when physical barriers are not possible. Use verbal announcements, signage, and visual cues to promote social distancing.
- Limit access to common areas like cafeterias, changing and locker rooms, washrooms etc.
- Suspend recreational activities.
- Prohibit touching, handshaking and hugging.
- Prohibit unnecessary movement by workers.
- Deliver services remotely (e.g. by phone, video, or web) where possible. Use contact less/cashless payment systems. Move the elect ronic payment terminal/credit card reader farther away from the cashier.
- Replace face to face meetings with virtual meetings. Cancel all non-essential meetings. Avoid huddles and other gatherings; address workers, if needed, by PA system. In case a meeting is unavoidable, minimize the number of people. Advise participants not to attend if they feel unwell. If possible, hold meetings in open spaces. Provide masks, tissues and sanitizers and ensure social distancing and frequent hand sanitization.
- Flexible worksites, e.g. work from home, tele-working and flexible work hours like staggered shifts, split teams, alternate day working or extra shifts, help to reduce the number of employees reporting at the same time. This will not only increase the physical distance among employees but between employees and others.
- For jobs requiring collaboration that would interfere with social distancing, redesign the production flow. Make small teams of workers and keep the membership of the team fixed. Minimize contact between workers of different teams.
- Make all documentation and processes like communications, bills, invoices, job cards, filings, trainings etc. online/paperless.
- Stairs should be preferred over lifts. The number of people should be restricted in lifts. Users should face the walls on clearly marked out places at least three feet away from each other. Sanitize all lifts twice daily.
- Reception and dispatch of supplies and material should be staggered and done during off hours. Limit the number of workers involved and make safety protocols for loading and unloading so as to maintain social distancing. All involved persons shouId wear masks and wash hands before and after loading/unloading. Discourage outside workers from entering your facility. If possible, disinfect materials before using them. Sanitize trucks before loading and after unloading.
Travel Advisory : Only unavoidable travel; basic infection control measures while travelling
- Discontinue nonessential travel.
- Do not al low employees who are at hig h risk of serious illness to t ravel.
- Provide the employee with a small bottle of hand sanitizer when he/she goes out. take sure he/she will wear a mask and take all basic infection control measures mentioned above and avoid loitering, avoid touching surfaces as much as possible and avoid crowded places.
- Ensure that employees who become sick while travelling or on temporary assignment understand that they should notify their supervisor and promptly call a healthcare provider for advice if needed.
Cafeterias: Social distancing and hygiene measures
- Ideally, cafeterias should be discontinued and packed lunches should be made available or employees should be encouraged to carry their own food and eat at their desks.
- If it’s not possible, discontinue self-service.
- Use disposable cutlery and crockery, if possible. If utensils are reused, ask workers to wash their utensils.
- Stagger meal times and ensure physical distancing between workers and tables.
- Prohibit eating in groups and sharing of food and utensils.
- Cafeteria food handlers should frequently sanitize their hands and must wear masks.
- Keep the dining area clean and sanitize it at least twice daily.
Workers accomodation and transportation: close by housing; safe transportation
- Wherever possible, make arrangements for the workers to stay in the factory campus or close by.
- Arrange transportation of employees from home to work, if possible.
- Drivers should wear masks and should be checked for symptoms.
- Social distancing norms must be followed in the vehicle.
- Encourage workers to avoid public transport and walk or cycle to work.
- Educate workers to wear a mask when using public transport and sanitize their hands before boarding and after alighting.
- Discourage car pools and chauffeurs. Discourage workers from going out during breaks.
Human resource: Accomodative policy; workers’ safety and education primary concern
- Take changes in the HR policies to reflect the core concern for safety for all. Provide health cover for all, be it ESIC cover or private Mediclaim policy.
- Tie up with a nearby Medical Practitioner or hospital.
- Develop a special leave policy, with respect to Covid -19.
- Wherever possible, install CCTV cameras on the shop floors and other areas to observe the behaviour of employees. Check those who are lax or careless. Repeated non-adherence to social distancing and hygiene practices, despite warnings, by any employee should reflect in his/her annual appraisals.
- Provide workers with up-to-date education and training on COVID-19 symptoms, risk factors and protective behaviours. Training material should be easy to understand and available in vernacular language. Posters, talks, presentations and audio-visuals aids can be used to spread Covid-19 literacy. Reinforce them regularly with repeated announcement over P.A. systems, by holding regular drills and interactive training sessions. Display Government Helpline numbers and address and contact numbers of nearest government/private clinics and hospitals.
- COVID-19 is associated with a range of concerns, such as fear of falling ill and dying, of being socially excluded, of losing a livelihood, domestic issues or bereavement. There is also the overwhelming, potentially depressing information overload from the audio-visual and social media. Anxiety and depression are therefore common. Psychosocial support should be made available to all workers. Set a culture of an open, communicative and compassionate leadership and facilitate medical attention where needed. Urge workers to limit media consumption.
- Ask all workers to make a contact log of the workers or people he/she meets during the day and give it to the supervisor at the end of the day. This will help in contact tracing in case of sickness.
- take a list of workers at high risk of severe COVID-19 (refer to ‘About COVID-19’ a bove), expecting mothers and mothers with small children. Ensure that they are following all precautions. Monitor them closely. Offer flexible work options to them, wherever possible. Devise processes and duties for them in such a way that they avoid meeting people. Be especially flexible about their attendance.
- Ban the use of Gutka, tobacco, Paan Masala and cigarettes at the workplace. Ban spitting as it may increase disease transmission. Prohibit any cigarette breaks as they are social-distancing disruptors.
- Over time, with the excessive media coverage of this disease and the display of daily death counts, an apprehension has a risen among people about catching the infection and its consequences. This has resuIted in people with Covid-19 being stigmatized in the community. AII educational and training programmes must especially emphasize the need for these patients to be treated with empathy and the need for society to help them in whatever way possible.
- Over a period of time during pandemics, there is a tendency to de-risk the situation by people. Guard against that and reinforce the message of infection control by frequent training programmes.
- Make the use of Aarogya Setu application mandatory.
- take communication between workers, supervisors and managers easier with the help of telephones or internet applications which can also be used to report sickness or to notify employees of exposures and closures.
Personal Protective Equipment (PPE)
While engineering and administrative controls are considered more effective in minimizing exposure to SARS-CoV-2, the corona virus that causes COVID-19, PPE may also be needed to prevent certain exposures. While correctly using PPE can help prevent some exposures, it should not take the place of other prevention strategies outlined a bove. Employers are obligated to provide their workers with PPEneeded to keep them safe while performing their jobs. Examples of PPE include gloves, goggles, face shields, gowns, surgical (three ply) masks, and respirators like N95, FFP2, KN95. Check the websites of Ministry of Health and Family Welfare, State government, ASSOCH AT, FICCI, CII, PHDCCI and NASSCOM etc. regularly for updates a bout recommended PPE. All types of PPEmust be:
- selected based upon the hazard to the worker.
- consistently worn.
- regularly inspected, maintained, and replaced, as necessary.
- properly worn, removed, sanitized and stored/disposed of as per protocol in order to avoid the spread of disease.
The types of PPE required will be based on the risk of being infected with the virus while working and tasks that may lead to exposure.
Assessment fo Risk
Risk Assessment of Workplace Environment to Effectively Combat the Virus.
Employers and managers, in consultation with workers, should carry out and regularly update the risk assessment for work-related exposure to COVID-19 and classify workers depending on their risk of exposure.
Low Exposure Risk : There is low risk of exposure in jobs that do not require frequent, close contact with other co-workers, clients, contractors, suppliers and the public etc. Examples include remote workers (i.e. working from home) and workers providing tele-services or those whose jobs require minimal contact.
Medium Exposure Risk : This risk level may apply to workers who have frequent and close contact with co-workers or with clients, contractors and the public etc. or where physical distancing of at least 2 meters may be difficult to observe at the workplace. These also include jobs in markets, bus stations, public transport, schools, construction, hotels and restaurants, police and security etc.
High Exposure Risk : High risk is associated onIy where there is close contact with people who have or are likely to have COVID-19, as well as contact with possibly contaminated objects and surfaces. Examples include healthcare, medical laboratory and morgue workers, those workers transporting people suspected to have or have COVID-19 as also those providing services to them, like domestic workers, personal transport and home delivery providers and plumbers, carpenters and electricians etc. who have to provide services in the homes of people with COVID-19.
Action Points for Risk Mitigation
Low Exposure Risk : Additional PPE is not recommended for workers in the low exposure risk group. These workers should continue to use face masks and follow general guidelines and basic infection control methods.
Medium Exposure Risk : Consider suspending any activity where physical distancing of at least 2 metres cannot be implemented. If that’s not possible, limit/restrict access to the areas, stagger activities, minimize face-to-face and skin to skin contact, place workers side-by-side or facing away from each other, assign the same staff to the same shift teams, install PlexigIas/cIea r plastic barriers (provide reusable face shields where that is not feasible) as sneeze guards at all points of regular interaction and sanitize them regularly with 60% ethyl alcohol. Increase ventilation through natural aeration or mechanical ventilation without recirculation of air. These workers should continue to use face masks and follow all basic infection control methods with enhanced reg ular hand hygiene, especiall y before entering and after leaving enclosed machinery, vehicles, confined spaces, and before putting on and after taking off PPE. Workers with medium exposure risk may need to wear some combination of gloves, gown, face mask, face shield or goggles, depending on the hazard assessment and the type of exposure. Workers must be trained to use the PPEas per protocols.
Workplaces for jobs at medium risk require at least twice daily cleaning and disinfection of all rooms, washrooms, objects and surfaces that are used regular Iy. Staff should be trained to wear appropriate face masks, goggles, g loves and work clothes during cleaning procedures. If possible, organize changing and washing of work clothes at the workplace.
High Exposure Risk : This is a special category of workers who work in hospitals, morgues, medical laboratories, ambulances and Hearse vans etc. They should continue following general guidelines and basic infection control methods as elucidated above. However, these workplaces require special engineering and administrative controls and those working in them need to use adequate PPE depending on their site and nature of work. Those guidelines are outside the scope of this document. Guidelines for the same are available at mohfw.gov.in.
Domestic workers, personal transport and home delivery providers and plumbers and electricians etc. who have to provide services in the homes of people with COVID-19 will need to wear correctly a three ply (triple layer) surgical mask/ N95respirator, ploves, face shield/goggles or gown (depending on duration and closeness of contact with the patient) at work and follow basic infection control methods.
Avoid assigning tasks with high risk to workers who are at high risk of severe disease.
Management of Sickness at the Workplace
The employer/supervisor/co-workers must promptly identify and isolate workers with symptoms of COVID-19 at the workplace. In case he/she is not wearing a mask, the same should be provided immediately. An isolation facility like a small, well ventilated room with a closable door can be created to isolate such a worker till he/she is sent for medical attention. Otherwise the worker should be moved immediately to an open area away from others.
In most cases, there is no need to shut down the facility. Close off any areas used for prolonged periods of time by the sick person after opening its windows and doors. Wait 24 hours before cleaning and disinfecting.
- Clean dirty surfaces with soap and water before disinfecting them.
- Use freshly made 1% Sodium Hypochlorite or 60% Ethyl alcohol solution, whichever is appropriate, for surfaces and objects.
- Mask, gloves, goggles/face shield, gown and boots must be worn by the person who is cleaning and disinfecting.
Determine which other employees may have been exposed and may need to take additional precautions.
- Inform employees of their possible exposure to COVID-19 in the workplace but maintain confidentiality.
- Instruct all employees not wearing a face mask and in prolonged/repeated close contact (i.e. within 2 meters) with such a person to quarantine at home for 14 days, tele-work if possible, self-monitor for symptoms and report sickness and follow the MOHFW/State government guidelines.
- Other employees can continue working and asked to closely monitor and report any symptoms.
- Employers also have an obligation to manage potentially exposed workers’ return to work in ways that best protect the health of those workers, their co-workers, and the general public.
For latest SOP on Preventive measures to contain spread of COVID-19, visit https://www.mohfw.gov.in/.
Source : Employee's State Insurance Corporation