By refusing to require the use of proper equipment, Minnesota’s Department of Health may be putting nurses’ health at risk amidst a pandemic influenza outbreak, the Minnesota Nurses Association said Wednesday. The Minnesota Department of Health’s position on respiratory protection for health care workers exposed to confirmed or suspected cases of the H1N1 virus is counter to national guidelines issued by the Centers for Disease Control, the union said. MDH, along with a few other state health agencies, has taken the position that a surgical mask is sufficient respiratory protection unless the patient is undergoing an aerosol producing treatment.
Several times since October, MNA staff relayed the organization’s deep concerns to MDH officials regarding the state policy, but said they have met resistance and unwillingness to examine the facts.
The Centers for Disease Control has determined, and recently reaffirmed, that N95 respirators or Personal Air-Powered Respirators are the appropriate level of respiratory protection in exposure to H1N1. There is clear evidence that the H1N1 virus remains suspended in the air for 20 minutes, to a distance of six feet, after an infected patient coughs, the CDC said.
The same evidence indicates a nurse wearing a surgical mask has significant exposure to the virus, whereas a nurse wearing an N95 respirator has virtually none. If sufficient N95 respirators are not available, employers should be providing Personal Air-Powered Respirators (or other devices approved by the National Institute for Occupational Health and Safety) to protect workers, while also taking all necessary steps to implement other relevant CDC recommendations, the union said.
“We are dealing with a pandemic. This is not a state-by-state issue; it is a national issue which requires a consistent national approach,” said Bettye Shogren, RN, MNA Health and Safety Specialist, and nationally renowned expert in workplace safety. “It is a serious problem when standards for personal protective equipment are different from one part of this country to another.”
While exposure for all workers is a concern, many of them – such as pregnant nurses – also fall into high-risk groups, Shogren said. Because of delays in production and delivery of the H1N1 vaccine, many of these workers are not immunized.
On Tuesday, Shogren hand-delivered a letter to MDH Commissioner, Dr. Sanne Magnan, who has the final authority on the policy. The letter outlines the confusion the department’s position is creating for employers and how it places them in possible violation of federal workplace safety laws.
In the letter, Shogren notes that federal OSHA is “enforcing the CDC recommendations regarding respiratory protection.” Minnesota is one of several states that administers federal OSHA standards through its own state agency.
“As a waivered state, Minnesota OSHA must have a Respiratory Protection Standard at least as comprehensive as the federal OSHA does,” Shogren wrote. “I met with Minnesota OSHA Compliance on November 2, 2009, and was informed they will enforce the CDC Guidelines for H1N1. The Minnesota Department of Health’s position places employers in a position where following the Department of Health’s direction places them at risk of violation of OSHA Standards.
“On behalf of the 21,800 members of the Minnesota Nurses Association, I am requesting the Minnesota Department of Health to rescind its position related to respiratory protection, follow the CDC recommendations regarding respiratory protection for healthcare workers exposed to patients who have been confirmed or are suspected to have H1N1, and notify all healthcare employers of the change in position.”
Shogren said she has requested a meeting with Commissioner Magnan and other interested parties on the issue, but as of Wednesday afternoon had not received a response.
This article includes information from a news release by the Minnesota Nurses Association.
For more information
Read the text of the letter at the MNA website