Communicable diseases

Direct spreading of communicable diseases is most commonly caused by coughing and sneezing, or by particles not washed from hands before (for example) shaking hands.

Indirect spreading of communicable diseases can be caused by eating contaminated food or drinking contaminated water, or by insect bites.

Communicable diseases range from common viruses such as 'flu and viral gastroenteritis, through to major public health issues such as tuberculosis, hepatitis, and HIV (human immunodeficiency virus).

While the diseases vary significantly, many of the measures used to control them are the same.

The planning and implementation of these measures is part of occupational safety and health (OSH) practice. It can also be referred to as occupational hygiene, which is the discipline of protecting worker health by controlling workplace hazards that can cause harm.

Bugs, epidemics and pandemics

Some communicable diseases are not typically fatal to otherwise healthy people but can still have a significant impact on businesses if they are ‘going around’.

For example, hospitals in the United Kingdom often close wards when a group of patients has norovirus, which causes diarrhoea and vomiting. This means not admitting new patients, keeping patients in for longer than planned, and stopping or reducing visits to the ward. This is a major operational change which affects all hospital workers, who are also at risk of contracting the infection and needing time off work.

Communicable ‘bugs’ such as flu and norovirus are endemic – this means a certain number of cases are predictable at any given time. A baseline figure can be estimated and considered a ‘normal’ volume of cases.

There is no standard number of people who need to be infected before an outbreak of illness can be called an epidemic. The number does need to be significantly above the baseline figure.

A pandemic is an epidemic which spreads across a larger area – several countries, or the whole world, such as Covid-19.

Know the latest situation

Awareness and understanding of communicable diseases in your area, and areas to which workers may travel, is critical for occupational safety and health professionals.

Where a disease is known to be endemic in a region, you should consider and apply control measures such as:

• barriers
• additional hygiene protocols
• personal protective equipment (PPE).

This is done to prevent the avoidable spread of infection between workers.

Where workers travel overseas, both their travel and their return should be risk assessed. Vaccinations should be up to date and the worker's health checked before they return to work.

Controlling the risk of infection

Different work environments will face a different level of risk from infection. This should be considered as part of risk assessment processes. In addition to obvious higher-risk environments of doctor’s surgeries and hospitals, working environments which carry a greater risk include those which:

• are open to the public, such as libraries
• have multiple appointment-based visitors, such as job-centres
• are used by children, such as soft-play centres
• are used by a high volume of short-term users, such as buses and trains
• contain animals, such as farms and agricultural attractions or zoos.

A series of standard infection control precautions should be applied in all workplaces as a norm and adapted based on local risk assessments.

Standard precautions include:

• hand hygiene
• respiratory and cough hygiene, and using tissues
• safe management and regular cleaning of equipment
• management of laundry, including uniforms and PPE
• management of blood and body fluid spills
• waste management.

OSH professionals should work closely with facilities management and others who maintain the working environment to ensure these precautions are taken across the board.

Business leaders should also consider the role they play in controlling the risk of infection. Workers who are not entitled to paid sick days can be advised not to work while contagious, but they may feel they have no choice. Even where paid sick leave is available many workers feel pressure to come into the workplace. This can lead to avoidable infection.

Some workplaces carry a high risk of infection and have the potential to experience severe consequences if an outbreak of infection occurs. This particularly applies to the hospitality industry. The risk of transferring infection to customers through hand contact, infected food, or unclean utensils must be controlled. Standard food hygiene precautions may need to be enhanced when one or more workers contracts an illness. This might mean more regular wiping of surfaces or the wearing of face masks, as well as gloves, when preparing food.

There are some communicable diseases which can be tested for, and for which testing may be an appropriate part of risk control. For example, some parts of the United States require healthcare workers to be tested for tuberculosis (TB) before they can work in a healthcare facility. If a test proves positive, the worker will undergo a course of treatment and start work once they are no longer contagious.

Incident and emergency response

Due to the varying nature of workplaces, incident response protocols cannot be standardised. However, some measures to be considered in the event of an infectious disease occurring in the workplace include:

• provision of paid sick leave for workers
• agreed actions, such as distancing or working at a different location, for vulnerable workers who may be at increased risk of infection or likely to suffer more if infected
• increased regularity of cleaning of equipment, machinery, workspaces, water coolers and door handles
• agreeing a process for those who think they may be ill, which may include working from home temporarily where this is possible
• provision of PPE such as face masks and gloves where appropriate
• erecting barriers between workers and customers, as was common during the Covid-19 pandemic
• temporary closure of the business for deep cleaning to take place.

OSH professionals and infection control

You should develop and implement policies and processes relating to infection control.

Steps you can take include:

• work with senior leaders and people professionals (such as human resources teams) to create a culture where sickness absence is understood.
• risk assess the working environment, including for vulnerable workers who may be at greater risk from infection.
• raise worker awareness of any current outbreaks.
• provide information, instruction and training for workers on minimising the spread of infection.
• plan emergency response for an outbreak in the workplace.