In 2009, California adopted an occupational health regulation that specifically addresses infectious diseases like Ebola. This regulation, known as the Aerosol Transmissible Diseases Standard, served as the foundation for the new guidelines, which recommend that employers:
- Ensure that workers at risk of exposure to Ebola wear gloves, impermeable body coverings, face shields or other eye and face protection, and appropriate respiratory protection. All PPE must be adequate to prevent the passage of bodily fluids to the employee's clothing and skin. NIOSH-approved respirators must be used where infectious aerosols are likely to be present.
- Train employees in the use of all applicable protective equipment, including respirators. Employees must be clearly instructed on how to safely put on and take off equipment.
- Give employees opportunities to practice with the respirators and other equipment they will use.
- Provide dedicated, separate areas for the donning and removing of protective gear.
- Use either a buddy system or other means of assisting employees in donning and removing PPE. Employees who assist in removing contaminated equipment must also use PPE.
- Provide additional protective gear, such as double gloves and disposable shoe and leg coverings, in environments where copious amounts of blood, vomit, feces or other bodily fluids are present.
- Ensure that workers conducting aerosol-generating procedures such as intubation or bronchoscopy perform the procedures in an airborne infection isolation room, if feasible, or at least in a private room with the door closed. Employees exposed to these procedures must use NIOSH-approved respirators.