Ebola PPE selection matrix

OSHA recently published a Ebola PPE selection matrix covering employees who have varying degrees of contact with ebola.

Categories include:

• Casual contact
• Physical contact
• Medical Care
• Clinical and Laboratory
• Cleaning and disinfection
• Handling Dead Bodies
• Maintenance
• Transporting waste

CDC had updated donning and doffing procedures (08/31/2015)

MPCA/OSHA - Ebola Waste Handling Guidelines

For further information refer to: MPCA - Ebola Waste Handling Guidelines

Federal OSHA has also issued Ebola waste handling guidelines.

Ebola information resources

WHO (World Health Organization) Ebola information

Doctors Without Borders Ebola information

CDC (Centers for Disease Control)  Ebola information:                     

MDH (Minnesota Department of Health)  Ebola information:                    

CIDRAP - Center for Infectious Disease Research and Policy Ebola updates:              

Safe U Ebola information:                 

Ebola virus disinfection and cleaning

Links:

CDC recommendations for cleaning houses safely in West Africa

CDC guidelines for decontamination of US residence

EPA list L - Disinfectants for Use Against the Ebola Virus

OSHA - Cleaning and decontamination of Ebola on Surfaces

CDC videos on Donning and Doffing

The CDC has developed detailed training videos for Donning and Doffing PPE.  The videos are customized for N-95 or PAPR and gown or full suit.

UHS retreat - topic - Chasing Ice

On November 5, 2014, University Health and Safety retreat attendees viewed and discussed the documentary Chasing Ice. This award winning film shows retreat of glaciers at several locations around the globe using film and time lapse photography.  The film makes a powerful argument for humans causing a dramatic increase in the rate of glacier melting.

Official Trailer - 2min.

Large Glacier Calving - 5 min. 

The post film discussion focused on University of Minnesota Sustainability initiatives including efforts to reduce the energy use in labs, composting and increased energy efficiency from the new combined heat a power plant. We also discussed ideas for individuals to reduce energy use.  

In Daniel Goldman's book, Ecological Intelligence, he mentions Good Guide as an option for helping decide which products to purchase based on a sustainability rating.   

Happy Halloween from DEHS

DEHS staff - Halloween 2014 - click to enlarge

Dealing with the human remains of ebola patients

CDC guidance for Human Remains at Hospitals and Mortuaries.

PPE Medical Examiner

Virginia Department of Health Guidelines for Coroners.

A recent article from the CDC on  the Postmortem stability of  Ebola virus, and viral RNA suggests that humans who die of EVD can harbor active virus on the skin surface for 7 days, and viral RNA in the tissues for substantially longer (approx. 9 weeks). Additionally, it determined mucosal swabbing was equally as effective as tissue biopsies for sample testing. Blood continues to have the highest viral titer. - Thanks to Shawn Wilson -HCME for the information. 

http://www.bioseal.com/

Heat Sealed body bags are recommended.

Medical Examiners Guide for Bioterrorism and infectious agents - CDC

Ebola guidance for clinics and bleach dilution

Department of Health and Human Services has offered guidance for best practices for clinics and ambulatory care centers dealing with Ebola.

Several questions about the appropriate bleach dilution for cleaning up Ebola.  A 1:10 ratio of fresh bleach to water is the recommended dilution.  Do not mix in any other chemicals.  Use in a well ventilated area.  Bleach is an eye, skin and respirator irritant.

Canadian Guidelines:

SUSCEPTIBILITY TO DISINFECTANTS: Ebolavirus is susceptible to 3% acetic acid, 1% glutaraldehyde, alcohol-based products, and dilutions (1:10-1:100 for ≥10 minutes) of 5.25% household bleach (sodium hypochlorite), and calcium hypochlorite (bleach powder)^{Footnote48 Footnote49 Footnote50 Footnote62 Footnote63}. The WHO recommendations for cleaning up spills of blood or body fluids suggest flooding the area with a 1:10 dilutions of 5.25% household bleach for 10 minutes for surfaces that can tolerate stronger bleach solutions (e.g., cement, metal) ^Footnote62. For surfaces that may corrode or discolour, they recommend careful cleaning to remove visible stains followed by contact with a 1:100 dilution of 5.25% household bleach for more than 10 minutes.

For spills with more organic matter DEHS has consistantly recommended a contact time of 30 minutes.

Videos on donning and doffing from Emory University

USA Today article

Emory University Website:  Login and acceptance of Disclaimer is required.  The Emory Healthcare Ebola Preparedness Protocols full site/materials Disclaimer is available at at www.emoryhealthcare.org/ebolaprep.

Donning PPE procedure 10/21/2014

New CDC guidelines on Ebola PPE procedures

NY Times PPE comparison

1. Original PPE recommendations from CDC
2. New Minimum PPE (level-2) N-95, tyvek jump suit, water resistant gown, booties at calf height, double gloves, detachable hood, face shield.  Croc footwear optional 
3. Full PPE (level -3)  Water Impermeable, tear resistant suit - HEPA PAPR, taped durable gloves, suit and booties.

CDC combined the best practices from hospitals successfully treating patients at Emory, Nebraska and NIH with the protocols used by Doctors without Boarders. 

Key points via
John Hick, MD 
Emergency Medicine MC 825
Hennepin County Medical Center

1. simple masks no longer recommended - N95 or PAPR only (so this does require fit-testing unless PAPR is used - this is probably the biggest surprise of the document though a good move - but for public safety agencies may be an issue)
2. all skin covered
3. hood to cover head (but not hood integrated into suit due to issues with traction from suit that can cause gapping at forehead apparently)
4. aprons to be worn when dealing with significant body fluids
5. emphasis on monitoring of PPE process - note that monitor is also to be in PPE (minus respiratory protection)
6. gowns must cover to calf
7. note footwear issues - some have recommended crocs for comfort and ease of cleaning as opposed to boots.  

CDC guideline summary

NY Times summary of updated PPE procedures

CBS News Comparison of PPE levels - This was done prior to the CDC revision.





PPE procedure for  Medical workers in Abola treatment areas - WSJ  approx. 2 min.

Safe U - Ebola Virus and additional resources.

Ebola Signs and Symptoms:  Asia One News

Ebola Virus and the University of Minnesota - Safe U site on Ebola  -

CDC will be updating guidelines for PPE and care and treatment of Ebola Patients soon.

Signs and symptoms - Global Nation

Ebola: Donning and Doffing - U of Nebraska

The University of Nebraska - ebola information has developed a more comprehensive donning and doffing procedure than the preliminary CDC guidelines.  So far none of their medical personnel has come down with any Ebola symptoms while treating an infected patient who survived.

Donning PPE for Ebola Patients - U of Nebraska

Nice additions- More comfortable respirators, Booties, Neck covering.
Removing jewelry- wearing washable shoes. Making sure to hydrate prior to entering.

Doffing PPE for Ebola Patients - U of Nebraska

Nice additions: Using multiple gloves for removing PPE.  Supplying a disposable mat for standing.
Bleach wiping crock footwear.  Shower after doing the work.  Do vitals and hydrate.

Report on U of Nebraska Ebola treatment ward.  - Lincoln Journal Star.  August 6, 2014.

Emory University Video - Donning and Doffing

The Emory University procedure is different than the U of Nebraska protocol.  Doffing occurs in the patient room.  There is a buddy system to help with removal of the outer apron.  The decontamination and doffing procedure for the assistant is not shown.   

Ebola information

WCCO Ebola photo - CDC

Link to John's Hopkins Ebola Forum archived webcast 10/14/2014 (3 hours).

Link to Agenda and speakers at the Forum

CIDRAP links on Ebola - Center for Infectious Disease Research and Policy - U of MN

1.       The Centers for Disease Control and Prevention “Interim

Guidance for Emergency Medical Services (EMS) Systems and 9-1-1 Public
Safety Answering Points (PSAPs) for Management of Patients with Known
or Suspected Ebola Virus Disease in the United States”
http://www.cdc.gov/vhf/ebola/hcp/interim-guidance-emergency-medical-services-systems-911-public-safety-answering-points-management-patients-known-suspected-united-states.html

A number of people have asked MDH about whether PSAPs should do
screening of callers. The guidance listed above addresses this issue
under the “Key Points” section.

2.       Because we have received many questions about procedures and
products for cleaning and disinfection, we are including the
Occupational Safety and Health Administration fact sheet on  “Cleaning
and Decontamination of Ebola on Surfaces”
https://www.osha.gov/Publications/OSHA_FS-3756.pdf  This fact sheet
includes a link to the listing of EPA-Registered Disinfectants
http://www.epa.gov/oppad001/chemregindex.htm ; select List G
(Norovirus) for products that are effective against Ebola.

3.       The Centers for Disease Control and Prevention/Assistant
Secretary for Preparedness and Response “Detailed Emergency Medical
Services (EMS) Checklist for Ebola Preparedness”
http://www.cdc.gov/vhf/ebola/pdf/ems-checklist-ebola-preparedness.pdf

We also encourage you to check the CDC and MDH Ebola websites
frequently for updated information:

http://www.cdc.gov/vhf/ebola/

http://www.health.state.mn.us/divs/idepc/diseases/vhf/index.html

NY times How hospital workers are supposed to treat an Ebola Patient Safely.

Ken Kerns appointed to Assistant Vice President, UHS at the University of Minnesota

Ken Kerns has been appointed to the position of Assistant Vice President, University Health and Safety (UHS).  Ken will begin in his new role on November 24, 2014.

The AVP is responsible for the development, implementation, administration, facilitation, and monitoring of health, safety, and preparedness policies and programs for the University of Minnesota system.  The position works collaboratively with faculty, academic administrators, and staff to support academic and research excellence while developing and sustaining a culture of safety and compliance.  University Health and Safety was recently expanded, and now includes the Department of Environmental Health and Safety, the Office of Occupational Health and Safety, Facilities Management Safety, the Department of Emergency Management, and the Building Code Division.

Ken comes to us from Tulane University, where he has served for the past three years as the Assistant Vice President for Environmental Health and Safety.  During his tenure, he has successfully strengthened partnerships with the academic community and has guided his team toward a more effective organization with a focus on excellence and service.  Prior to Tulane, he served at Iowa State University for sixteen years as the Associate Director of Environmental Health and Safety, specializing in radiation safety, emergency management, and physical safety.  He also continues to consult on a periodic basis for the International Atomic Energy Agency, a role he has maintained since 1997.  He received his B.S. in Zoology from Weber State College, and his M.S. in Zoology from Iowa State.

Assistant Vice President for Health and Safety position (Now filled)

The job posting for the Assistant Vice President for Health and Safety at the University of Minnesota is now open.

Minimum Qualifications:

The Assistant Vice President for University Health & Safety will possess solid credentials in public health and safety administration and should be recognized as an expert in their field. 

Minimum qualifications include: 
* A master's degree from an accredited institution; 
* At least 7 years of experience leading chemical hygiene, biosafety, radiation safety, occupational health & safety, environmental protection, research safety, emergency management, or other health & safety activities, of which 3 years must have been at an upper management level in a large complex organization. 
* Successful experience in supervising professional managers and technical staff. 
* Possession of one or more of the following professional certifications is preferred: 
* Certified Industrial Hygienist (CIH) - American Board of Industrial Hygiene (ABIH) 
* Certified Safety Professional (CSP) - Board of Certified Safety Professionals 
* Certified Health Physicist (CHP) - American Board of Health Physics 
* Certified Hazardous Materials Manager (CHMM) - Institute of Certified Hazardous Materials Managers 
* Certified Emergency Manager 
* Successful candidates must be eligible to successfully complete a security risk assessment conducted by the U.S. Attorney General/FBI in accordance with CDC/USDA Select Agent Regulations. 

Knowledge, Skills, and Abilities: 
* Strong interpersonal skills with a demonstrated record of establishing effective working relationships with diverse populations and functions, both internal and external to the organization. A demonstrated ability to work with campus stakeholders to create a culture of safety while accomplishing academic, research, and outreach missions is preferred. 
* Demonstrated ability to work closely with local, state, and federal regulatory agencies, in addition to advisory boards, committees, and other policy formulating or recommending groups; evidence of positive performance with regard to responses to inquiries from these agencies. 
* Strategic management skills with demonstrated experience formulating and implementing preventative and remedial strategies for a variety of safety, health, and environmental issues as well as emergency management. 
* Ability to communicate effectively and articulately in both oral and written communication and have command of enough logic to be able to effectively form a position on an issue, while taking into account multiple perspectives and competing interests. 
* Ability to develop professional skills of staff. 
* Ability to work cooperatively with faculty, academic administrators and staff to develop new programs consistent with the needs of the institution, including education, record keeping, public relations, and related functions. 
* Strong problem solving, analytical, and organizational skills, with the ability to prioritize in a rapidly changing environment. 
* Demonstrated understanding of the nature and purpose of health and safety functions within a higher education institution, including building code compliance, occupational health and emergency management, and the inter-relationship of the environment, safety and health in the workplace, laboratories and general campus environment. 
* Demonstrated leadership in implementing technology to support organizational strategies within a large and complex organization. 
* Personal characteristics which distinguish the incumbent as being an effective leader: team builder, customer-oriented, decisive and result-oriented, and committed to improvement. A management style that entrusts decision-making into the organization with minimal intervention. Possesses both the wisdom and the political savvy to determine which initiatives are important enough to champion and which ones to relinquish.  

Duties and Responsibilities:

This position reports to the Vice President for University Services and works collaboratively with faculty, academic administrators, and staff to support excellence while developing and sustaining a culture of safety in compliance with applicable federal, state, and local statutes and regulations/ordinances. The position is responsible for the development, implementation, administration, facilitation, and monitoring of health, safety, and preparedness policies and programs for the University of Minnesota system. It oversees Environmental Health and Safety, Building Code Division, Office of Occupational Health and Safety, Emergency Management.

Responsibilities: 
*Directs department resources to mitigate risks and serve the critical safety interests of the University of Minnesota. Has fiscal responsibility for program operating budgets of approximately $10 million dollars and leadership responsibility for 70 positions. In partnership with University administrators and their departments, develops a customer-focused service environment. 

*Directs and supports a high-impact and metric-based environmental health and safety program and ensure that it is communicated, embraced, and enforced. Develops and maintains active partnerships with academic and administrative departments across the University system to ensure that the institution's safety and regulatory compliance requirements are met. Ensures access to health and safety resources, timely consultative assistance, management of hazardous substances, and facilitation of prevention efforts. 

*Directs and supports the work of the University Building Official and the Building Code Division office. Ensures the administration of the Minnesota State Building Code (MSBC) is integrated with University design and construction standards and the operation and maintenance of University facilities and physical assets in the built environment. Promote the Building Code Division in the delivery of inspection services and business processes on all University campuses. 

*Directs and supports the work of the Department of Emergency Management in the development and implementation of emergency preparedness, response, recovery and mitigation efforts. Evaluates and ensures an All-Hazards 24/7 response to emergencies and large scale events between emergency management, environmental health and safety and public safety partners. Ensures system-wide support for emergency management and advises University leadership on emergency preparedness, crisis management, and business continuity and safety. 

*Directs and supports the work of the Office of Occupational Health and Safety to promote and protect the health and safety of all employees, students, volunteers, and visitors who participate in activities related to the University's missions of teaching, research, and service. Provides leadership to align the goals and objectives of the Office of Occupational Health and Safety with University policies and procedures in support of University Services strategic plan and the University's mission. 

*Serves as the University's responsible official and primary interface with local, state, and federal regulatory agencies. 

*Creates a positive work environment, incorporating the University's commitment to equal opportunity and diversity recruitment, retention and promotion of employees, empowering employees to use their full range of talents and abilities. Ensures that annual performance appraisals are completed for all staff in University Health & Safety. 

*Serves as a member of the University Services Leadership Team. Contributes to the overall strategic direction of University Services and advises on University-wide strategy as necessary. Leads the formulation and execution of the Department of University Health & Safety strategic work plan in coordination with other University Services units.  

Summer Construction Projects at U of MN East and West Bank 2014

Construction Projects Spring trough Summer 2014

Click on picture to enlarge