Additional Resources

Entry Questions Poster

Tattooing Beyond Questions Poster

Additional Resources

Covid-19 Release Form Template

Covid-19 Tattoo Release Form Template

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Covid-19 Preparedness Plan


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Workstation Open/Close Checklist

Open/close checklist (click link to view)



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Covid-19 Minor Tattoo Release Form

Minor Tattoo Release From Covid-19

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Reopening Considerations

More information and guidance can be found in the CDC Reopening Guidance. –

Additional Resources

Cleaning and Disinfecting

CLEANING & DISINFECTING is a 2-step process.


In other words:               YOU CAN CLEAN WITHOUT DISINFECTING,



ALWAYS CLEAN BEFORE YOU DISINFECT.  Cleaning an item or surface first removes germs, dirt & impurities (otherwise known as “gross debris”).  This process does not necessarily kill germs, but by removing them, it lowers their numbers & the risk of spreading infection.


How a Disinfectant Works:  When applied to a CLEAN surface, a chemical disinfectant dissolves cell walls, essentially eliminating germs & bacteria, which are then wiped away.


Dirt & organic material (like blood) can reduce the germ-killing ability of some disinfectants, making them less effective.  Another important reason to ALWAYS CLEAN BEFORE YOU DISINFECT.


CLEANING & DISINFECTION OF OUR WORK AREAS will be accomplished by using the following intermediate-level disinfecting solution:  (INSERT NAME OF DISINFECTANT CLEANER HERE)


CLEANING & DISINFECTION OF OUR WORK AREAS is accomplished by wiping each surface with a pre-moistened disinfectant wipe, or a clean papertowel with adequate amount of disinfectant applied, using the following actions:






  • Wash hands & apply appropriate PPE.
  • Retrieve a clean, disposable paper towel & hold it down below your waist.
  • Spray (INSERT NAME OF DISINFECTANT CLEANER HERE) disinfectant into the clean, disposable paper towel.
    • – OR – Retrieve a pre-moistened (INSERT NAME OF DISINFECTANT CLEANER HERE) disinfectant wipe from the tub dispenser.

– OR –

  • Apply disinfectant wipe directly to the surface (or item).


  • Wipe in a circular motion, beginning at the centermost point of the surface (or item) & continue moving outward. (Think “SPIRAL OUT”)
    • NOTE: Disinfectants should never be sprayed directly onto any work surfaces in order to minimize the potential for aerosolization of chemicals, BLOODBORNE PATHOGENS, or OPIM.
  • Dispose of disinfectant wipe.




  • Retrieve a clean, disposable paper towel & hold it down below your waist.
  • Spray (INSERT NAME OF DISINFECTANT CLEANER HERE) disinfectant into the clean, disposable paper towel.
    • – OR – Retrieve a pre-moistened (INSERT NAME OF DISINFECTANT CLEANER HERE) disinfectant wipe from the tub dispenser.

– OR –


  • Apply disinfectant wipe directly to the surface (or item).


  • Wipe in a circular motion, beginning at the centermost point of the surface (or item) & continue moving outward. (Think “SPIRAL OUT”)
    • NOTE: Disinfectants should never be sprayed directly onto any work surfaces in order to minimize the potential for aerosolization of chemicals, BLOODBORNE PATHOGENS, or OPIM. 5) Dispose of disinfectant wipe
  • Dispose of gloves


  • Wash hands





  • After CLEANING & DISINFECTING the surface (or item) allow it to sit “undisturbed” for the amount of time indicated on the manufacturer’s instructions (INSERT AMOUNT OF TIME DISINFECTANT IS REQUIRED


« “Undisturbed” means: DO NOT ALLOW ANYTHING TO TOUCH THE SURFACE until the manufacturer’s recommended contact time has been met.

PPE Infromation

CDC Decontamination and Reuse of Filtering Facepiece Respirators


“Reusing disposable filtering facepiece respirators (FFRs) has been suggested as a crisis capacity strategy to conserve available supplies for healthcare environments during a pandemic. Strategies for FFR extended use and reuse (without decontamination of the respirator) are currently available from CDC’s National Institute for Occupational Safety and Health (NIOSH).

The surfaces of an FFR may become contaminated while filtering the inhalation air of the wearer during exposures to pathogen-laden aerosols. The pathogens on the filter materials of the FFR may be transferred to the wearer upon contact with the FFR during activities such as:

  • Adjusting the FFR
  • Doffing the FFR improperly
  • Performing a user-seal check when redoffing a previously worn FFR

A study evaluating the persistence of SARS-CoV-2 (the virus that causes COVID-19) on plastic, stainless steel, and carboard surfaces showed that the virus is able to survive for up to 72 hours [1]. One strategy to mitigate the contact transfer of pathogens from the FFR to the wearer during reuse is to issue five respirators to each healthcare worker who may care for patients with suspected or confirmed COVID-19. The healthcare worker will wear one respirator each day and store it in a breathable paper bag at the end of each shift. The order of FFR use should be repeated with a minimum of five days between each FFR use. This will result in each worker requiring a minimum of five FFRs, providing that they put on, take off, care for them, and store them properly each day. Healthcare workers should treat the FFRs as though they are still contaminated and follow the precautions outlined in our reuse recommendations. If supplies are even more constrained and five respirators are not available for each worker who needs them, FFR decontamination may be necessary.

Decontamination and subsequent reuse of FFRs should only be practiced where FFR shortages exist. At present, FFRs are considered one time use products and there are no manufacturer authorized methods for FFR decontamination before reuse. On March 29, 2020, the U.S. Food and Drug Administration (FDA) issued the first Emergency Use Authorization (EUA) for a decontamination process, and additional subsequent EUAs have been issued. The FDA Emergency Use Authorizations websiteexternal icon should be checked for the most up-to-date information. Only respirator manufacturers can reliably provide guidance on how to decontaminate their specific models of FFRs. In the absence of manufacturer’s recommendations, third parties may also provide guidance or procedures on how to decontaminate respirators without impacting respirator performance. Decontamination might cause poorer fit, filtration efficiency, and breathability of disposable FFRs as a result of changes to the filtering material, straps, nose bridge material, or strap attachments of the FFR. While decontamination and reuse of FFRs are not consistent with approved usage, this option may need to be considered when FFR shortages exist.

An effective FFR decontamination method should reduce the pathogen burden, maintain the function of the FFR, and present no residual chemical hazard. The filter media in NIOSH-approved respirators varies by manufacturer. The ability of the respirator filter media to withstand cleaning and disinfection are not NIOSH performance requirements. The NIOSH’s National Personal Protective Technology Laboratory (NPPTL) and other researchers have investigated the impact of various decontamination methods on filtration efficiency, facepiece fit of FFRs, and the ability to reduce viable virus or bacteria on the FFRs. This research is summarized below.”

PPE Infromation Uncategorized

How to Properly Seal a n95 Respirator


PPE Infromation Uncategorized

CDC Guidance on Reuse of n95 Respirators

Respirator Reuse Recommendations

There is no way of determining the maximum possible number of safe reuses for an N95 respirator as a generic number to be applied in all cases. Safe N95 reuse is affected by a number of variables that impact respirator function and contamination over time.(1819) However, manufacturers of N95 respirators may have specific guidance regarding reuse of their product.The recommendations below are designed to provide practical advice so that N95 respirators are discarded before they become a significant risk for contact transmission or their functionality is reduced.

If reuse of N95 respirators is permitted, respiratory protection program administrators should ensure adherence to administrative and engineering controls to limit potential N95 respirator surface contamination (e.g., use of barriers to prevent droplet spray contamination) and consider additional training and/or reminders (e.g., posters) for staff to reinforce the need to minimize unnecessary contact with the respirator surface, strict adherence to hand hygiene practices, and proper PPE donning and doffing technique, including physical inspection and performing a user seal check.(16) Healthcare facilities should develop clearly written procedures to advise staff to take the following steps to reduce contact transmission:

  • Discard N95 respirators following use during aerosol generating procedures.
  • Discard N95 respirators contaminated with blood, respiratory or nasal secretions, or other bodily fluids from patients.
  • Discard N95 respirators following close contact with any patient co-infected with an infectious disease requiring contact precautions.
  • Consider use of a cleanable face shield (preferred3) over an N95 respirator and/or other steps (e.g., masking patients, use of engineering controls), when feasible to reduce surface contamination of the respirator.
  • Hang used respirators in a designated storage area or keep them in a clean, breathable container such as a paper bag between uses. To minimize potential cross-contamination, store respirators so that they do not touch each other and the person using the respirator is clearly identified. Storage containers should be disposed of or cleaned regularly.
  • Clean hands with soap and water or an alcohol-based hand sanitizer before and after touching or adjusting the respirator (if necessary for comfort or to maintain fit).
  • Avoid touching the inside of the respirator. If inadvertent contact is made with the inside of the respirator, discard the respirator and perform hand hygiene as described above.
  • Use a pair of clean (non-sterile) gloves when donning a used N95 respirator and performing a user seal check. Discard gloves after the N95 respirator is donned and any adjustments are made to ensure the respirator is sitting comfortably on your face with a good seal.

To reduce the chances of decreased protection caused by a loss of respirator functionality, respiratory protection program managers should consult with the respirator manufacturer regarding the maximum number of donnings or uses they recommend for the N95 respirator model(s) used in that facility. If no manufacturer guidance is available, preliminary data(1920) suggests limiting the number of reuses to no more than five uses per device to ensure an adequate safety margin. Management should consider additional training and/or reminders for users to reinforce the need for proper respirator donning techniques including inspection of the device for physical damage (e.g., Are the straps stretched out so much that they no longer provide enough tension for the respirator to seal to the face?, Is the nosepiece or other fit enhancements broken?, etc.). Healthcare facilities should provide staff clearly written procedures to:

  • Follow the manufacturer’s user instructions, including conducting a user seal check.
  • Follow the employer’s maximum number of donnings (or up to five if the manufacturer does not provide a recommendation) and recommended inspection procedures.
  • Discard any respirator that is obviously damaged or becomes hard to breathe through.
  • Pack or store respirators between uses so that they do not become damaged or deformed.

Secondary exposures can occur from respirator reuse if respirators are shared among users and at least one of the users is infectious (symptomatic or asymptomatic). Thus, N95 respirators must only be used by a single wearer. To prevent inadvertent sharing of respirators, healthcare facilities should develop clearly written procedures to inform users to:

  • Label containers used for storing respirators or label the respirator itself (e.g., on the straps(11)) between uses with the user’s name to reduce accidental usage of another person’s respirator.

Risks of Extended Use and Reuse of Respirators

Although extended use and reuse of respirators have the potential benefit of conserving limited supplies of disposable N95 respirators, concerns about these practices have been raised. Some devices have not been FDA-cleared for reuse(21). Some manufacturers’ product user instructions recommend discard after each use (i.e., “for single use only”), while others allow reuse if permitted by infection control policy of the facility.(19) The most significant risk is of contact transmission from touching the surface of the contaminated respirator. One study found that nurses averaged 25 touches per shift to their face, eyes, or N95 respirator during extended use.(15)Contact transmission occurs through direct contact with others as well as through indirect contact by touching and contaminating surfaces that are then touched by other people.

Respiratory pathogens on the respirator surface can potentially be transferred by touch to the wearer’s hands and thus risk causing infection through subsequent touching of the mucous membranes of the face (i.e., self-inoculation). While studies have shown that some respiratory pathogens (22-24) remain infectious on respirator surfaces for extended periods of time, in microbial transfer (25-27) and reaerosolization studies (28-32) more than ~99.8% have remained trapped on the respirator after handling or following simulated cough or sneeze.

Respirators might also become contaminated with other pathogens acquired from patients who are co-infected with common healthcare pathogens that have prolonged environmental survival (e.g., methicillin-resistant Staphylococcus aureas, vancomycin-resistant enterococci, Clostridium difficile, norovirus, etc.). These organisms could then contaminate the hands of the wearer, and in turn be transmitted via self-inoculation or to others via direct or indirect contact transmission.

The risks of contact transmission when implementing extended use and reuse can be affected by the types of medical procedures being performed and the use of effective engineering and administrative controls, which affect how much a respirator becomes contaminated by droplet sprays or deposition of aerosolized particles. For example, aerosol generating medical procedures such as bronchoscopies, sputum induction, or endotracheal intubation, are likely to cause higher levels of respirator surface contamination, while source control of patients (e.g. asking patients to wear facemasks), use of a face shield over the disposable N95 respirator, or use of engineering controls such as local exhaust ventilation are likely to reduce the levels of respirator surface contamination.(18)

While contact transmission caused by touching a contaminated respirator has been identified as the primary hazard of extended use and reuse of respirators, other concerns have been assessed, such as a reduction in the respirator’s ability to protect the wearer caused by rough handling or excessive reuse.(1920) Extended use can cause additional discomfort to wearers from wearing the respirator longer than usual.(1415) However, this practice should be tolerable and should not be a health risk to medically cleared respirator users.(19)


  1. Murray, M., J. Grant, E. Bryce, P. Chilton, and L. Forrester: Facial protective equipment, personnel, and pandemics: impact of the pandemic (H1N1) 2009 virus on personnel and use of facial protective equipment. Infection Control and Hospital Epidemiology 31(10): 1011-1016 (2010).
  2. Beckman, S., B. Materna, S. Goldmacher, J. Zipprich, M. D’Alessandro, D. Novak et al.: Evaluation of respiratory protection programs and practices in California hospitals during the 2009-2010 H1N1 influenza pandemic. American Journal of Infection Control 41(11): 1024-1031 (2013).
  3. Hines, L., E. Rees, and N. Pavelchak: Respiratory protection policies and practices among the health care workforce exposed to influenza in New York State: Evaluating emergency preparedness for the next pandemic. American Journal of Infection Control (2014).
  4. Srinivasan, A., D.B. Jernign, L. Liedtke, and L. Strausbaugh: Hospital preparedness for severe acute respiratory syndrome in the United States: views from a national survey of infectious diseases consultants. Clinical Infectious Diseases 39(2): 272-274 (2004).
  5. OSHA: “Enforcement procedures and scheduling for occupational exposure to tuberculosis.” [Online] Available at icon, 1996).
  6. Siegel, J.D., E. Rhinehart, M. Jackson, and L. Chiarello: “2007 Guideline for isolation precautions: preventing transmission of infectious agents in health care settings.” [Online] Available at icon, 2007).
  7. CDC: “Guidelines for preventing the transmission of Mycobacterium tuberculosis in health care facilities.” [Online] Available at icon, 1994).
  8. Bollinger, N., J. Bryant, W. Ruch, J. Flesch, E. Petsonk, T. Hodous et al.: “TB Respiratory Protection Program in Health Care Facilities, Administrator’s Guide.” [Online] Available at, 1999).
  9. Jensen, P., L. Lambert, M. Iademarco, and R. Ridzon: “Guidelines for preventing the transmission of Mycobacterium tuberculosis in health-care settings, 2005.” [Online] Available at, 2005).
  10. CDC: “Questions and Answers Regarding Respiratory Protection For Preventing 2009 H1N1 Influenza Among Healthcare Personnel” [Online] Available at, 2010).
  11. Rebmann, T., S. Alexander, T. Cain, B. Citarella, M. Cloughessy, and B. Coll “APIC position paper: extending the use and/or reusing respiratory protection in healthcare settings during disasters.” [Online] Available at iconexternal icon, 2009).
  12. IOM: Reusability of facemasks during an influenza pandemic: facing the flu. Washington, D.C.: National Academies Press, 2006.
  13. Lin, C.S.: “FDA Regulation of Surgical Masks and Respirators.” [Online] Available at Files/PublicHealth/ReusableFluMasks/FDApresentation12306.ashxexternal icon, 2006).
  14. Radonovich Jr, L.J., J. Cheng, B.V. Shenal, M. Hodgson, and B.S. Bender: Respirator tolerance in health care workers. JAMA: The Journal of the American Medical Association 301(1): 36-38 (2009).
  15. Rebmann, T., R. Carrico, and J. Wang: Physiologic and other effects and compliance with long-term respirator use among medical intensive care unit nurses. American Journal of Infection Control 41(12): 1218-1223 (2013).
  16. CDC: “Sequence for donning personal protective equipment PPE/Sequence for removing personal protective equipment.” [Online] Available at icon
  17. Roberge, R.J.: Effect of surgical masks worn concurrently over N95 filtering facepiece respirators: extended service life versus increased user burden. Journal of Public Health Management and Practice : JPHMP 14(2): E19-26 (2008).
  18. Fisher, E.M., J.D. Noti, W.G. Lindsley, F.M. Blachere, and R.E. Shaffer: Validation and Application of Models to Predict Facemask Influenza Contamination in Healthcare Settings. Risk Analysis in press(2014).
  19. Fisher, E.M., and R.E. Shaffer: Considerations for Recommending Extended Use and Limited Reuse of Filtering Facepiece Respirators in Healthcare Settings Journal of Occupational and Environmental Hygiene: (in press) (2014).
  20. Bergman, M.S., D.J. Viscusi, Z. Zhuang, A.J. Palmiero, J.B. Powell, and R.E. Shaffer: Impact of multiple consecutive donnings on filtering facepiece respirator fit. American Journal of Infection Control 40(4): 375-380 (2012).
  21. FDA: “510(k) Premarket Notification.” [Online] Available at icon, 2014).
  22. Casanova, L., W.A. Rutala, D.J. Weber, and M.D. Sobsey: Coronavirus survival on healthcare personal protective equipment. Infection Control and Hospital Epidemiology 31(5): 560-561 (2010).
  23. Coulliette, A., K. Perry, J. Edwards, and J. Noble-Wang: Persistence of the 2009 Pandemic Influenza A (H1N1) Virus on N95 Respirators. Applied and Environmental Microbiology 79(7): 2148-2155 (2013).
  24. Fisher, E.M., and R.E. Shaffer: Survival of bacteriophage MS2 on filtering facepiece respirator coupons. Applied Biosafety: Journal of the American Biological Safety Association 15(2): 71 (2010).
  25. Lopez, G.U., C.P. Gerba, A.H. Tamimi, M. Kitajima, S.L. Maxwell, and J.B. Rose: Transfer Efficiency of Bacteria and Viruses from Porous and Nonporous Fomites to Fingers under Different Relative Humidity Conditions. Applied and Environmental Microbiology 79(18): 5728-5734 (2013).
  26. Fisher, E.M., C.M. Ylitalo, N. Stepanova, and R.E. Shaffer: Assessing Filtering Facepiece Respirator Contamination During Patient Care in Flu Season: Experimental and Modeling Approaches. In ISRP — Sixteenth International Conference:A Global View on Respiratory Protection. Boston, 2012.
  27. Rusin, P., S. Maxwell, and C. Gerba: Comparative surface-to-hand and fingertip-to-mouth transfer efficiency of gram-positive bacteria, gram-negative bacteria, and phage. Journal of Applied Microbiology 93(4): 585-592 (2002).
  28. Fisher, E.M., A.W. Richardson, S.D. Harpest, K.C. Hofacre, and R.E. Shaffer: Reaerosolization of MS2 bacteriophage from an N95 filtering facepiece respirator by simulated coughing. Annals of Occupational Hygiene 56(3): 315-325 (2012).
  29. Birkner, J.S., D. Fung, W.C. Hinds, and N.J. Kennedy: Particle release from respirators, part I: determination of the effect of particle size, drop height, and load. Journal of Occupational and Environmental Hygiene 8(1): 1-9 (2011).
  30. Kennedy, N.J., and W.C. Hinds: Release of simulated anthrax particles from disposable respirators. Journal of Occupational and Environmental Hygiene1(1): 7-10 (2004).
  31. Qian, Y., K. Willeke, S.A. Grinshpun, and J. Donnelly: Performance of N95 respirators: reaerosolization of bacteria and solid particles. American Industrial Hygiene Association Journal 58(12): 876-880 (1997).
  32. Willeke, K., and Y. Qian: Tuberculosis control through respirator wear: performance of National Institute for Occupational Safety and Health-regulated respirators. American Journal of Infection Control 26(2): 139-142 (1998).

1 The term “reuse” is used in a variety of settings in healthcare. For example, FDA defines 3 kinds of reuse: (1) between patients with adequate reprocessing (e.g., as with an endoscope), (2) reuse by the same person with adequate reprocessing/decontamination (e.g., as with contact lenses), and (3) repeated use by the same person over a period of time with or without reprocessing.(12, 13)

2 Functional means that the N95 respirator has maintained its physical integrity and when used properly provides protection (exposure reduction) consistent with the assigned protection factor for this class of respirator.

3 Use of a cleanable face shield is strongly preferred to a surgical mask to reduce N95 respirator contamination. Concerns have been raised that supplies of surgical masks may also be in limited supply during a public health emergency and that the use of a surgical mask could affect the function of the N95 respirator.(17)

Additional Resources

Covid-19 Tattoo Release Form Template

release form covid-19

Additional Resources

Alliance of Professional Tattooist Covid-19 Plan

Additional Resources

Body Art Education Alliance Covid-19 Reopen Plan

PPE Infromation

CDC Factors Required for a Respirator to be Effective

Three Key Factors Required for a Respirator to be Effective Infographic
PPE Infromation

CDC Facial Hairstyles for Respirators

Infographic – Facial Hairstyles and Filtering Facepiece Respirators
PPE Infromation

CDC N95 Concideration Chart

PPE Infromation

CDC N95 Myths

Covid-19 Transmission

CDC Information on Floor and Corvid-19

Aerosol and Surface Distribution of Severe Acute Respiratory Syndrome Coronavirus 2 in Hospital Wards, Wuhan, China, 2020

Suggested citation for this article: Guo Z-D, Wang Z-Y, Zhang S-F, Li X, Li L, Li C, et al. Aerosol and surface distribution of severe acute respiratory syndrome coronavirus 2 in hospital wards, Wuhan, China, 2020. Emerg Infect Dis. 2020 Jul [date cited].

DOI: 10.3201/eid2607.200885

Original Publication Date: 4/10/2020

1These authors contributed equally to this article.


To determine distribution of severe acute respiratory syndrome coronavirus 2 in hospital wards in Wuhan, China, we tested air and surface samples. Contamination was greater in intensive care units than general wards. Virus was widely distributed on floors, computer mice, trash cans, and sickbed handrails and was detected in air ≈4 m from patients.

Full Article


PPE Infromation



PPE Infromation

CDC Guidance on the Type of Masks (Respirators)

Understanding the Difference (surgical masks, N95 FFRs, and Elastomerics)

Additional Resources

OSHA Covid-19 Control and Prevention

Control and Prevention

Measures for protecting workers from exposure to, and infection with, SARS-CoV-2, the virus that causes Coronavirus Disease 2019 (COVID-19), depend on the type of work being performed and exposure risk, including potential for interaction with people with suspected or confirmed COVID-19 and contamination of the work environment. Employers should adapt infection control strategies based on a thorough hazard assessment, using appropriate combinations of engineering and administrative controls, safe work practices, and personal protective equipment (PPE) to prevent worker exposures. Some OSHA standards that apply to preventing occupational exposure to SARS-CoV-2 also require employers to train workers on elements of infection prevention, including PPE.

OSHA has developed this interim guidance to help prevent worker exposure to SARS-CoV-2. The general guidance below applies to all U.S. workers and employers. Depending on where their operations fall in OSHA’s exposure risk pyramid (Spanish), workers and employers should also consult additional, specific guidance for those at increased risk of exposure in the course of their job duties broken down by exposure risk level.

hands under water | Photo Credit: U.S. Department of Defense

U.S. Department of Defense

Regardless of specific exposure risks, following good hand hygiene practices can help workers stay healthy year round.

General Guidance for All Workers and Employers

For all workers, regardless of specific exposure risks, it is always a good practice to:

  • Frequently wash your hands with soap and water for at least 20 seconds. When soap and running water are unavailable, use an alcohol-based hand rub with at least 60% alcohol. Always wash hands that are visibly soiled.
  • Avoid touching your eyes, nose, or mouth with unwashed hands.
  • Practice good respiratory etiquette, including covering coughs and sneezes.
  • Avoid close contact with people who are sick.
  • Stay home if sick.
  • Recognize personal risk factors. According to U.S. Centers for Disease Control and Prevention (CDC), certain people, including older adults and those with underlying conditions such as heart or lung disease or diabetes, are at higher risk for developing more serious complications from COVID-19.

OSHA and the U.S. Department of Health and Human Services (HHS) provide joint guidance for all employers on preparing workplaces for COVID-19 (Spanish).

The CDC has also developed interim guidance for businesses and employers to plan for and respond to COVID-19. The interim guidance is intended to help prevent workplace exposure to acute respiratory illnesses, including COVID-19. The guidance also addresses considerations that may help employers as community transmission of COVID-19 evolves. The guidance is intended for non-healthcare settings; healthcare workers and employers should consult guidance specific to them, including the information below and on the CDC coronavirus webpage.

Interim Guidance for Workers and Employers of Workers at Lower Risk of Exposure

For most types of workers, the risk of infection with SARS-CoV-2 is similar to that of the general American public. Workers whose jobs do not require contact with people known to be, or suspected of being, infected with SARS-CoV-2, nor frequent close contact with (i.e., within 6 feet of) the general public are at lower risk of occupational exposure.

worker in gown, gloves | Photo Credit: CDC/Kimberly Smith, Christine Ford

CDC/Kimberly Smith, Christine Ford

OSHA’s infection prevention recommendations follow the hierarchy of controls, including using engineering and administrative controls and safe work practices to protect workers from exposure to COVID-19. Depending on work tasks and potential exposures, appropriate PPE for protecting workers from the virus may include gloves, gowns, masks, goggles or face shields, and/or respirators.

As the Hazard Recognition page explains, workers’ job duties affect their level of occupational risk, and such risk may change as workers take on different tasks within their positions.

Employers and workers in operations where there is no specific exposure hazard should remain aware of the evolving community transmission. Changes in community transmission may warrant additional precautions in some workplaces or for some workers not currently highlighted in this guidance.

Employers should monitor public health communications about COVID-19 recommendations, ensure that workers have access to that information, and collaborate with workers to designate effective means of communicating important COVID-19 information. Frequently check the OSHA and CDC COVID-19 websites for updates.

Interim Guidance for Workers and Employers of Workers at Increased Risk of Occupational Exposure

Certain workers are likely to perform job duties that involve medium, high, or very high occupational exposure risks. Many critical sectors depend on these workers to continue their operations. Examples of workers in these exposure risk groups include but are not limited to, those in healthcare, emergency response, meat and poultry processing, retail stores (e.g., grocery stores, pharmacies), and other critical infrastructure operations. These workers and their employers should remain aware of the evolving community transmission risk.

As discussed on the Hazard Recognition page explains, workers’ job duties affect their level of occupational risk. Employers should assess the hazards to which their workers may be exposed; evaluate the risk of exposure; and, select, implement, and ensure workers use controls to prevent exposure. Control measures may include a combination of engineering and administrative controls, safe work practices, and PPE.

Identify and Isolate Suspected Cases
  • In workplaces where exposure to COVID-19 may occur, prompt identification and isolation of potentially infectious individuals is a critical first step in protecting workers, visitors, and others at the work site.
  • Wherever feasible, immediately isolate individuals suspected of having COVID-19. For example, move potentially infectious individuals to isolation rooms. On an aircraft, if possible and without compromising aviation safety, move potentially infectious individuals to seats away from passengers and crew. In other work sites, move potentially infectious individuals to a location away from workers, customers, and other visitors and with a closed door, if possible.
  • Take steps to limit the spread of the individual’s infectious respiratory secretions, including by providing them a facemask and asking them to wear it, if they can tolerate doing so. Note: A surgical mask on a patient or other sick person should not be confused with PPE for a worker; the surgical mask acts to contain potentially infectious respiratory secretions at the source (i.e., the person’s nose and mouth).
  • After isolation, the next steps depend on the type of workplace. For example:
    • In most types of workplaces (i.e., those outside of healthcare):
      • Isolated individuals should leave the work site as soon as possible. Depending on the severity of the isolated individual’s illness, he or she might be able to return home or seek medical care on his or her own, but some individuals may need emergency medical services.
    • In healthcare workplaces:
      • If possible, isolate patients suspected of having COVID-19 separately from those with confirmed cases of the virus to prevent further transmission, including in screening, triage, or healthcare facilities.
      • Restrict the number of personnel entering isolation areas, including the room of a patient with suspected or confirmed COVID-19.
      • Protect workers in close contact* with the sick person by using additional engineering and administrative controls, safe work practices, and PPE.
      • Sick workers should leave the work site as soon as possible. Depending on the severity of the isolated worker’s illness, he or she might be able to return home or seek medical care on his or her own, but some individuals may need emergency medical services.

*CDC defines close contact as being within about 6 feet of an infected person while not wearing recommended PPE. Close contact also includes instances where there is direct contact with infectious secretions while not wearing recommended PPE. Close contact generally does not include brief interactions, such as walking past a person.

Environmental Cleaning and Decontamination

When people touch a surface or object contaminated with SARS-CoV-2, the virus that causes COVID-19, and then touch their own eyes, noses, or mouths, they may expose themselves to the virus.

Early information from the CDC, the National Institutes of Health, and other study partners suggests that SARS-CoV-2 can survive on certain types of surfaces, such as plastic and stainless steel, for 2-3 days. However, because the transmissibility of SARS-CoV-2 from contaminated environmental surfaces and objects is still not fully understood, employers should carefully evaluate whether or not work areas occupied by people suspected to have the virus may have been contaminated and whether or not they need to be decontaminated in response.

The CDC provides instructions for environmental cleaning and disinfection for various types of workplaces, including:

Employers operating workplaces during the COVID-19 pandemic should continue routine cleaning and other housekeeping practices in any facilities that remain open to workers or others. Employers who need to clean and disinfect environments potentially contaminated with SARS-CoV-2 should use EPA-registered disinfectants with label claims to be effective against SARS-CoV-2. Routine cleaning and disinfection procedures (e.g., using cleaners and water to pre-clean surfaces before applying an EPA-registered disinfectant to frequently touched surfaces or objects for appropriate contact times as indicated on the product’s label) are appropriate for SARS-CoV-2, including in patient care areas in healthcare settings in which aerosol-generating procedures are performed.

Workers who conduct cleaning tasks must be protected from exposure to hazardous chemicals used in these tasks. In these cases, the PPE (29 CFR 1910 Subpart I) and Hazard Communication (29 CFR 1910.1200) standards may apply, and workers may need appropriate PPE to prevent exposure to the chemicals. If workers need respirators, they must be used in the context of a comprehensive respiratory protection program that meets the requirements of OSHA’s Respiratory Protection standard (29 CFR 1910.134) and includes medical exams, fit testing, and training.

Cleaning chemicals’ Safety Data Sheets and other manufacturer instructions can provide additional guidance about what PPE workers need to use the chemicals safely.

Do not use compressed air or water sprays to clean potentially contaminated surfaces, as these techniques may aerosolize infectious material. More information about protecting environmental services workers is included in the worker-specific section, below.

See the interim guidance for specific worker groups and their employers, below, for further information.

Worker Training

Train all workers with reasonably anticipated occupational exposure to SARS-CoV-2 (as described in this document) about the sources of exposure to the virus, the hazards associated with that exposure, and appropriate workplace protocols in place to prevent or reduce the likelihood of exposure. Training should include information about how to isolate individuals with suspected or confirmed COVID-19 or other infectious diseases, and how to report possible cases. Training must be offered during scheduled work times and at no cost to the employee.

Workers required to use PPE must be trained. This training includes when to use PPE; what PPE is necessary; how to properly don (put on), use, and doff (take off) PPE; how to properly dispose of or disinfect, inspect for damage, and maintain PPE; and the limitations of PPE. Applicable standards include the PPE (29 CFR 1910.132), Eye and Face Protection (29 CFR 1910.133), Hand Protection (29 CFR 1910.138), and Respiratory Protection (29 CFR 1910.134) standards. The OSHA website offers a variety of training videos about respiratory protection.

When the potential exists for exposure to human blood, certain body fluids, or other potentially infectious materials, workers must receive the training required by the Bloodborne Pathogens (BBP) standard (29 CFR 1910.1030), including information about how to recognize tasks that may involve exposure and the methods, such as engineering controls, work practices, and PPE, to reduce exposure. Further information on OSHA’s BBP training regulations and policies is available for employers and workers on the OSHA Bloodborne Pathogens and Needlestick Prevention Safety and Health Topics page.

OSHA’s Training and Reference Materials Library contains training and reference materials developed by the OSHA Directorate of Training and Education as well as links to other related sites. The materials listed for Bloodborne Pathogens, PPE, Respiratory Protection, and SARS may provide additional material for employers to use in preparing training for their workers.

OSHA’s Personal Protective Equipment Safety and Health Topics page also provides information on training in the use of PPE.

Workers with Increased Susceptibility for SARS-CoV-2 Infection or Complications

Identify workers who may be at increased susceptibility for SARS-CoV-2 infection or complications from COVID-19 and consider adjusting their work responsibilities or locations to minimize exposure. Other flexibilities, if feasible, can help prevent potential exposures among workers who have diabetes, heart or lung issues, or other immunocompromising health conditions.

Personal Protective Equipment Considerations

Respiratory Protection Flexibilities

Under specific circumstances in which National Institute for Occupational Safety and Health (NIOSH)-certified N95 filtering facepiece respirators (FFRs) are unavailable, and employers follow guidelines to conserve respirators, OSHA’s temporary enforcement discretion permits employers to use:

These alternative respirators are expected to provide better protection against SARS-CoV-2 compared to face masks, homemade or improvised equipment, or no respiratory protection at all.

OSHA is also providing enforcement discretion for annual fit-testing requirements of the Respiratory Protection standard (29 CFR 1910.134) to help reduce the rate at which respirators—specifically disposable models—are used and discarded.

See the Enforcement Memoranda section of the Standards page for further information.

The interim guidance for specific worker groups and their employers includes recommended PPE ensembles for various types of activities that workers will perform. In general:

  • PPE should be selected based on the results of an employer’s hazard assessment and workers specific job duties.
  • When disposable gloves are used, workers should typically use a single pair of nitrile exam gloves. Change gloves if they become torn or visibly contaminated with blood or body fluids.
  • When eye protection is needed, use goggles or face shields. Personal eyeglasses are not considered adequate eye protection.
  • If workers need respirators, they must be used in the context of a comprehensive respiratory protection program that meets the requirements of OSHA’s Respiratory Protection standard (29 CFR 1910.134) and includes medical exams, fit testing, and training.
    • Surgical masks are not respirators and do not provide the same level of protection to workers as properly-fitted respirators.
  • If there are shortages of PPE items, such as respirators or gowns, they should be prioritized for high-hazard activities.
    • Workers need respiratory protection when performing or while present for aerosol-generating procedures, including cardiopulmonary resuscitation (CPR) and intubation.
    • Workers must be protected against exposure to human blood, body fluids, other potentially infectious materials, and hazardous chemicals, and contaminated environmental surfaces.
  • CDC provides strategies for optimizing the supply of PPE, including guidance on extended use and limited reuse of N95 filtering facepiece respirators (FFRs) and methods for decontaminating and reusing disposable filtering facepiece respirators during crises.
    • These guidelines are intended for use in healthcare but may help employers in other sectors optimize their PPE supplies, as well.
  • After removing PPE, always wash hands with soap and water for at least 20 seconds, if available. Ensure that hand hygiene facilities (e.g., sink or alcohol-based hand rub) are readily available at the point of use (e.g., at or adjacent to the PPE removal area).
  • Employers should establish, and ensure workers follow, standard operating procedures for cleaning (including laundering) PPE and items such as uniforms or laboratory coats intended to function as PPE, as well as for maintaining, storing, and disposing of PPE. When PPE is contaminated with human blood, body fluids, or other potentially infectious materials, employers must follow applicable requirements of the Bloodborne Pathogens standard (29 CFR 1910.1030) with respect to laundering. OSHA’s Enforcement Procedures for the Occupational Exposure to Bloodborne Pathogens (CPL 02-02-069) provide additional information.

Employers in all sectors may experience shortages of PPE, including gowns, face shields, face masks, and respirators, as a result of the COVID-19 pandemic. These shortages critically impact the ability of the U.S. healthcare system to provide care for the most seriously ill COVID-19 patients. However, employers outside of healthcare also may experience the effects of shortages as PPE supplies are diverted to healthcare facilities where they are most needed.

Although employers are always responsible for complying with OSHA’s PPE standards (29 CFR 1910 Subpart I), including the Respiratory Protection standard (29 CFR 1910.134), whenever they apply, OSHA is providing temporary enforcement flexibility for certain requirements under these and other health standards.

Interim guidance for specific worker groups and their employers

This section provides information for specific worker groups and their employers who may have potential exposures to SARS-CoV-2. Guidance for each worker group generally follows the hierarchy of controls, including engineering controls, administrative controls, safe work practices, and PPE. However, not all types of controls are provided in each section; in those cases, employers and workers should consult the interim general guidance for U.S. workers and employers of workers with potential occupational exposures to SARS-CoV-2, above.

Additional Resources

OSHA COVID-19 Hazard Recognition

Hazard Recognition

Construction workers | Photo Credit: U.S. Department of Defense/Seaman Rob Aylward (U.S. Navy)

U.S. Department of Defense/Seaman Rob Aylward (U.S. Navy)

Many workers, even those who do not encounter infectious people in the course of their job duties, have similar exposure risks as the general American public during a pandemic. Other workers, including some covered on this webpage provides, are at increased risk of exposure to SARS-CoV-2 while on the job.

What is the risk to workers in the United States?

The risks from SARS-CoV-2, the virus that causes Coronavirus Disease 2019 (COVID-19), for workers depends on how extensively the virus spreads between people; the severity of resulting illness; pre-existing medical conditions workers may have; and the medical or other measures available to control the impact of the virus and the relative success of these measures. The U.S. Centers for Disease Control and Prevention (CDC) provides detailed information about this topic.

According to the CDC, certain people, including older adults and those with underlying conditions such as heart or lung disease or diabetes, are at higher risk for developing more serious complications from COVID-19.

Classifying Risk of Worker Exposure to SARS-CoV-2

Worker risk of occupational exposure to SARS-CoV-2 during a pandemic may depend in part on the industry type and the need for contact within 6 feet of people known to be, or suspected of being, infected with SARS-CoV-2. Other factors, such as conditions in communities where employees live and work, their activities outside of work (including travel to COVID-19-affected areas), and individual health conditions, may also affect workers’ risk of getting COVID-19 and/or developing complications from the illness.

OSHA has divided job tasks into four risk exposure levels: very high, high, medium, and lower risk, as shown in the occupational risk pyramid, below. The four exposure risk levels represent the probable distribution of risk. Most American workers will likely fall in the lower exposure risk (caution) or medium exposure risk levels

Risk Pyramid | Photo Credit: OSHA
Lower Exposure Risk (Caution)

Jobs that do not require contact with people known to be, or suspected of being, infected with SARS-CoV-2. Workers in this category have minimal occupational contact with the public and other coworkers. Examples include:

  • Remote workers (i.e., those working from home during the pandemic).
  • Office workers who do not have frequent close contact with coworkers, customers, or the public.
  • Manufacturing and industrial facility workers who do not have frequent close contact with coworkers, customers, or the public.
  • Healthcare workers providing only telemedicine services.
  • Long-distance truck drivers.
Medium Exposure Risk

Jobs that require frequent/close contact with people who may be infected, but who are not known to have or suspected of having COVID-19. Workers in this category include:

  • Those who may have frequent contact with travelers who return from international locations with widespread COVID-19 transmission.
  • Those who may have contact with the general public (e.g., in schools, high population density work environments, and some high-volume retail settings).
High Exposure Risk

Jobs with a high potential for exposure to known or suspected sources of SARS-CoV-2. Workers in this category include:

  • Healthcare delivery and support staff (hospital staff who must enter patients’ rooms) exposed to known or suspected COVID-19 patients.
  • Medical transport workers (ambulance vehicle operators) moving known or suspected COVID-19 patients in enclosed vehicles.
  • Mortuary workers involved in preparing bodies for burial or cremation of people known to have, or suspected of having, COVID-19 at the time of death.
Very High Exposure Risk

Jobs with a very high potential for exposure to known or suspected sources of SARS-CoV-2 during specific medical, postmortem, or laboratory procedures. Workers in this category include:

  • Healthcare workers (e.g., doctors, nurses, dentists, paramedics, emergency medical technicians) performing aerosol-generating procedures (e.g., intubation, cough induction procedures, bronchoscopies, some dental procedures and exams, or invasive specimen collection) on known or suspected COVID-19 patients.
  • Healthcare or laboratory personnel collecting or handling specimens from known or suspected COVID-19 patients (e.g., manipulating cultures from known or suspected COVID-19 patients).
  • Morgue workers performing autopsies, which generally involve aerosol-generating procedures, on the bodies of people who are known to have, or are suspected of having, COVID-19 at the time of their death.
Job Duties Affect Workers’ Exposure Risk Levels

As workers’ job duties change or they perform different tasks in the course of their duties, they may move from one exposure risk level to another. Additional examples of workers who may have increased risk of exposure to SARS-CoV-2 include those in:

  • Other types of healthcare positions (including pre-hospital and medical transport workers, allied medical care professionals, and support staff)
  • Emergency response (e.g., emergency medical services workers, firefighters, and law enforcement officers)
  • Other postmortem care positions (e.g., funeral directors)
  • Research or production laboratory workers
  • Airline operations
  • Retail operations, particularly those in critical and/or high-customer-volume environments
  • Border protection and transportation security
  • Correctional facility operations
  • Solid waste and wastewater management
  • Environmental (i.e., janitorial) services
  • In-home repair services
  • Travel to areas where the virus is spreading
  • Pastoral, social, or public health workers in jobs requiring contact with community members who may spread the virus
  • Transit and delivery drivers, depending on their degree of close contacts with the public

This list is not intended to be comprehensive, and employers should always rely on thorough hazard assessments to identify if and when their workers are at increased risk of exposure to the virus on the job.

How Does COVID-19 Spread?

Although the pandemic possibly originated from humans exposed to infected animals, SARS-CoV-2—like other coronaviruses—spreads between people and cause COVID-19. The CDC acknowledges that at this time, there is no evidence that companion animals, including pets, can spread COVID-19 to people or that they might be a source of infection in the United States.

According to the CDC, person-to-person transmission occurs during close (within 6 feet) contact with a person with COVID-19, primarily from respiratory droplets produced when an infected person coughs or sneezes. These droplets, particularly when aerosolized, can be deposited in the mouth, nose, or eyes of nearby people or be inhaled into the lungs. Airborne transmission from person-to-person over long distances (including as a result of evaporating droplets that leave behind infectious particles known as droplet nuclei) is believed to be unlikely.

People can also become infected with SARS-CoV-2 by touching surfaces or objects contaminated with the virus, and then touching their mouths, noses, or eyes. Current evidence suggests that novel coronavirus may remain viable for hours to days on a variety of surfaces. Frequent cleaning of visibly dirty and high-touch surfaces, followed by disinfection, can help prevent SARS-CoV-2 and other respiratory pathogens (germs) from spreading in workplaces.

Person-to-person spread is likely to continue to occur under current pandemic conditions.

There is still more to learn about the transmissibility, severity, and other features associated with SARS-CoV-2.

Identifying Potential Risks and Sources of Exposure

OSHA requires employers to assess occupational hazards to which their workers may be exposed. Some OSHA standards, such as those for personal protective equipment (PPE) (29 CFR 1910.132) and respiratory protection (29 CFR 1910.134), include these types of requirements.

In assessing potential hazards, employers should consider if and when their workers may encounter someone infected with SARS-CoV-2 in the course of their duties. Employers should also determine if workers could be exposed to environments (e.g., work sites) or materials (e.g., laboratory samples, waste) contaminated with the virus.

Depending on the work setting, employers may also rely on the identification of sick individuals who have signs, symptoms, and/or a history of travel to COVID-19-affected areas, to help identify exposure risks for workers and implement appropriate control measures. It is also possible that someone may have been in close contact (within about 6 feet) with someone with COVID-19 in their community and, thus, may have had exposure. The Control and Prevention page provides guidance for controlling risks for worker exposures.

Additional Information

The CDC provides information about risk assessment for COVID-19.

Additional Resources

OSHA Guidance on Preparing Workplaces for COVID-19

Excerpt: from “OSHA Guidance on Preparing Workplaces for COVID-19” p.14

Personal Protective Equipment (PPE)
While engineering and administrative controls are considered
more effective in minimizing exposure to SARS-CoV-2, 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.
Examples of PPE include: gloves, goggles, face shields, face
masks, and respiratory protection, when appropriate. During
an outbreak of an infectious disease, such as COVID-19,
recommendations for PPE specific to occupations or job tasks
may change depending on geographic location, updated
risk assessments for workers, and information on PPE
effectiveness in preventing the spread of COVID-19. Employers
should check the OSHA and CDC websites regularly for
updates about recommended PPE.
All types of PPE must be:
■ Selected based upon the hazard to the worker.
■ Properly fitted and periodically refitted, as applicable
(e.g., respirators).
1 5
■ Consistently and properly worn when required.
■ Regularly inspected, maintained, and replaced,
as necessary.
■ Properly removed, cleaned, and stored or disposed of,
as applicable, to avoid contamination of self, others, or
the environment.
Employers are obligated to provide their workers with PPE
needed to keep them safe while performing their jobs. The
types of PPE required during a COVID-19 outbreak will be
based on the risk of being infected with SARS-CoV-2 while
working and job tasks that may lead to exposure.
Workers, including those who work within 6 feet of patients
known to be, or suspected of being, infected with SARS-CoV-2
and those performing aerosol-generating procedures, need to
use respirators:

■ National Institute for Occupational Safety and
Health (NIOSH)-approved, N95 filtering facepiece
respirators or better must be used in the context of a
comprehensive, written respiratory protection program
that includes fit-testing, training, and medical exams.
See OSHA’s Respiratory Protection standard, 29 CFR
1910.134 at
■ When disposable N95 filtering facepiece respirators are
not available, consider using other respirators that provide
greater protection and improve worker comfort. Other
types of acceptable respirators include: a R/P95, N/R/P99,
or N/R/P100 filtering facepiece respirator; an air-purifying
elastomeric (e.g., half-face or full-face) respirator with
appropriate filters or cartridges; powered air purifying
respirator (PAPR) with high-efficiency particulate arrestance
(HEPA) filter; or supplied air respirator (SAR). See CDC/
NIOSH guidance for optimizing respirator supplies at: