Containing Contagions in Close Quarters

Pandemic preparation is nothing new. In fact, I have been telling employers since the 1980s that a pandemic plan is one of the business/safety mechanisms they should have in place. It’s just good practice to address and interrupt a contagion that could potentially immobilize the employer’s workforce.

The United States has been researching pandemic responses since a swine flu outbreak in 1976, but few if any publications back then addressed workforce contagions. The earliest literature on organized pandemic responses appeared around 1976 when the U.S. government established formal research panels to develop a nationwide response to a pandemic threat. The panels performed research and modeling activities and revised and expanded both research and national immunization programs in response to new threats, such as the avian flu in 1997, anthrax in 2001 and SARS in 2003. Even though U.S. government literature mentioned bioterror as a concern following the avian flu outbreak, the anthrax event was a homegrown bioterror event that raised the stakes.

OSHA was still in its infancy in the mid-1970s and operated around the fringes of the government’s pandemic plans. Those plans in the 1970s and 1980s still did not even mention using employers and workplaces as part of the systematic controls to limit contagions – even though the swine flu originated at Fort Dix, New Jersey, infecting 230 soldiers. In 1994 and 1998, the Centers for Disease Control and Prevention published recommendations for a coordinated response to nationwide and international pandemic events. OSHA’s COVID guidance for employers in 2020 was still only ordered for health-care and health-care-related exposures. In fact, the only OSHA rules for communicable disease reporting originated in the rules for temporary camps in 1974, where they still reside today (see 29 CFR 1910.142(l)).

Segue to storm season and crews in close quarters. Occasionally, in very hard-hit areas, crews end up in temporary camps. Typically, these are portable sleeping quarters with room to sleep six to eight people. Few of these portable sleeping quarters meet the space and configuration requirements of the OSHA standard for temporary camps. I believe OSHA would view the portable trailers used by lineworkers in storm restoration as different than what the 1910.142 standard was created for: labor camps for transient agricultural workers. Even if crews end up in hotels, they frequently share a dining area, especially in the first weeks after a bad storm. The dining areas often are contracted and pick up local workers supervised by employees of the contract service. I have seen this dozens of times in my nearly 50 years in the industry, and often the dining areas are the source of contagions that typically spread flus and colds. Of course, now we have to add COVID to the list, which by many accounts is worse than the flu. For our purposes, it doesn’t matter which is worse – they can both cripple a storm response and they can both be prevented with the same cleaning and hygiene techniques.

During flu seasons in particular, temporary camps must take extra steps to minimize the spread of the influenza virus. These steps are also effective for preventing the spread of the common cold as well as other potential contagions, such as Zika virus and Legionnaires’ disease, that are not uncommon in closed, high-occupancy living facilities. The most effective strategy for preventing the spread of contagions among encamped workers is to focus on identifying and eliminating points of multiple touch in public access areas, particularly mess halls. I have surveyed several temporary camps and mess halls over the years, so here are some recommendations for protecting your visiting workforce.

Contract Kitchen Services
I wish I could tell you that a contract kitchen’s staff will be properly trained and equipped to provide sanitation services, but that is not always the case. In fact, they seldom arrive with a trained crew, and many services necessary to run a camp kitchen are handled by locals often hired after the kitchen arrives. Food and housekeeping handlers need to be clearly advised on how vinyl gloves work as well as how they must be donned, doffed and disposed of. They must also be trained on when to change gloves and understand that using the same pair for all activities transmits contagions. This is the same for cleaning supplies, especially rags. Many crews opt for the convenience of spray bottles and paper towels that do a pretty poor job of sanitizing.

Table Surfaces
Tables should be cleaned with detergent and then wetted with a disinfectant. Detergents remove viral contaminants but do not destroy them. Those viral contaminants are simply transferred to the towel and can later be spread to other surfaces with the towel. Disinfectants such as Lysol kill viral contaminants but are not an effective cleanser.

The CDC does not recommend bleach solutions as anti-viral agents for decontaminating surfaces. Bleach can be effective in decontamination, but it is not as reliable as a surface disinfectant as commercial disinfecting products like Lysol. And while a spray bottle for cleaning is convenient, it is not as effective as towels and buckets with a cleansing solution. A tabletop cleansing solution of water and dish soap, with a half-cup of household bleach per gallon added to the mix, will permit using cloth towels for cleansing and ensure the cloth towels in the solution will not harbor and transfer viral contaminants.

After cleanser is used, the tabletop should be disinfected with Lysol. Allow the disinfectant to remain wet for at least 30 seconds before being wiped. Wiping dry the disinfectant can be done with cloth towels since disinfectants will kill viral contamination on cloth towels.

Condiment Dispensers
Commercial bottles of popular condiments are shaped, grooved and otherwise decorated as an advertising and sales tool, which makes them hard to clean and disinfect. Individual packets of condiments are considered a best practice. However, sourcing, managing and using individual packets becomes tedious, not to mention that how you distribute individual packets can lead to contagion just through handling. An alternative is to pour condiments into plastic squeeze dispenser bottles, which lack bottle contours, knurled or textured tops, and moisture-harboring labels that cannot be readily disinfected. Plastic bottles are designed to be readily wiped and disinfected. People filling the bottles should be trained just like those cleaning the tables. Bottle filling should be performed by masked workers wearing gloves.

Common Area Refrigerators and Coolers
In auditing mess halls in the past, I have frequently found refrigerator and cooler doors to be overlooked as a contamination source. They are handled by everybody and, gloves or not, each time they are handled, the user picks up and leaves behind contaminants. It is recommended that refrigerator and cooler doors and handles be decontaminated after each meal and periodically during the meals. Touch surfaces on refrigerators and coolers should be cleaned and decontaminated in the same manner as tabletops.

Drink Dispensers
Five- and 8-gallon dispensers as well as pitchers are often used to serve drinks. These are very hard to wipe or clean during use. The best prevention of viral contaminant transfer when serving drinks is to provide all liquids in single-serving, individually sealed units. If drink dispensers are to be used, the dispensing mechanism should be the cup-press-activated type as opposed to a lever pressed by hand. Signage requesting use of a clean cup for each drink dispensed is appropriate.

Portable Coolers and Ice Kegs
Coolers and kegs should be dumped out daily. Before dumping, a half-cup of bleach per gallon of water in the container should be added. The contents should remain or be lightly swirled for 30 seconds to disinfect the interior surfaces of the cooler or keg walls. Portable coolers should be restricted to cooling single-serving containers; the contents should not be used as drinking water.

Hand-Washing Facilities
Cleaning of hand-washing facilities should be the same as surface decontamination of tabletops. A thorough cleaning with the water/dish soap/bleach solution should be carried out, followed by a 30-second wetting of the surfaces with Lysol.

Portable Lavatories
The vendor should be disinfecting the interior of the facilities during pump-outs. Ensure that the facilities are pumped and disinfected on a regular schedule. During flu season, a pump-out is recommended daily.

Don’t Ignore Bedbugs
Even if you want to ignore them, they will not let you. Bedbugs are not associated with any country or social stratum, affecting rich and poor alike. And there are numerous states with poorly controlled bedbug infestations, making it a realistic likelihood that bedbugs may be introduced to common sleeping quarters. Lineworkers travel from across the U.S. during storm restoration events, and many may stop overnight at inexpensive motels (though even the priciest hotels are not immune), so bedbugs can be expected in temporary camps. I’m even aware of a case in Puerto Rico where a sleeper trailer came with bedbugs already infested. Those trailers originated in Ohio – they didn’t get contaminated in Puerto Rico.

There are insecticides that kill bedbugs, but pre-treating is not an effective measure for prevention. Early detection and control are effective measures. Once bedbugs are established, it will take several treatments and isolation periods of all room contents to get rid of them.

CDC recommendations include detection kits that will attract and trap bedbugs before they have a chance to multiply and establish colonies. Two documents that provide good information on prevention and control can be found at https://vtechworks.lib.vt.edu/bitstream/handle/10919/55985/VCE2014e_bed_bug_treatment.pdf?sequence=1 and https://cchealth.org/bedbugs/pdf/2016-Non-Chemical-Bed-Bug-Management.pdf.

Another CDC recommendation is to install at least one detector system in each bunk trailer that is checked daily by housekeeping staff. If bedbugs are detected, the contents should be removed immediately and sealed, and pest control should be applied. Pest control will kill active bedbugs, but a reapplication every two weeks for one to two months is required to kill hatching eggs. Prevention is the best way to stop colonization, so quick action is the best practice. Eggs laid will hatch in two weeks. A hatchling takes about five weeks to reach reproductive maturity. Females can lay one to five eggs a day. Infestation can get out of control in a matter of days if not treated.

Finally, I also recommend mattress seals be installed on mattresses to protect against bedbugs inhabiting the mattress’ packing and padding, making pesticides ineffective.

About the Author: After 25 years as a transmission-distribution lineman and foreman, Jim Vaughn, CUSP, has devoted the last 22 years to safety and training. A noted author, trainer and lecturer, he is a senior consultant for the Institute for Safety in Powerline Construction. He can be reached at jim@ispconline.com.