Back to Work Safely and COVID-19 Pandemic

BACK TO WORK SAFELY AND COVID-19
PANDEMIC
AIHA Tidewater Local Section
Presented by:
Bernard L. Fontaine, Jr., CIH, CSP, FAIHA
November 4, 2022
Courtesy of Scientific American

2
Disclaimer
This transformative remix of scientific work constitutes a fair-use of published copyrighted
material as provided by section 107 of the United States copyright law. Some of the content
material contained herein including but not limited to statements or photographs may contain
content not authorized by its owner. However, for training and educational purposes only, the
use of this information is allowed based on fair-use and applicable licenses. AIHA nor the
AIHA Tidewater Local Section endorses either brand name of products, use or application
described in this presentation. The Windsor Consulting Group, Inc. has no financial interest.
The following presentation cannot be reproduced, sold, distributed, or otherwise used in any
other matter than training and educating people on the subject matter related to the SARS
CoV-2 virus and COVID-19 pandemic. The goal is to begin a dialog with occupational health
and safety professionals about returning employees back to work while protecting the
communities served. The information regarding any of the subject matter including, but not
limited to, building ventilation, air filtration, airflow, cleaning and disinfection, and
environmental testing are not all inclusive on the subject matter.

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Other Sources of SARS CoV-2
• Drinking water, wastewater, and fecal sludge
• Sanitation and plumbing discharge into global
oceans and streams
• Toilets and handling fecal material
• Management of healthcare waste
• Environmental cleaning and laundry
• Disposal of grey water from cleaning
• Safe management of corpses
• Water quality and facilities for hand hygiene
• Use of public pools, beaches and facilities
Where can SARS CoV-2 be found?

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Incubation Period
• Time from exposure to
symptoms onset
• With COVID-19,
symptoms may show
up 2-14 days after
exposure
• CDC indicates people
are most contagious
when clinically
symptomatic
• Several studies show
people also may be
contagious before
developing symptoms

8
Coronavirus Comparative Analysis

9
Coronavirus Comparative Analysis

CLICK TO EDIT MASTER
TITLE STYLE
SARS CoV-2
AEROSOLS
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Courtesy of
Scientific American

17
Aerosol Transmission
With the
stitched
cotton mask,
droplets
traveled 2.5
inches.
With the
cone-style
mask,
droplets
traveled
about 8
inches.

TITLE STYLE
AEROSOL SCIENCE
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Courtesy of
Scientific American

Aerosol Generation
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Aerosol Generation
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Aerosol Generation
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Aerosol Generation
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Aerosol Decay and Removal
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Resuspension of PM10
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Modeling Aerosols in Classroom
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SARS CoV-2 in Air
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SARS CoV-2 on Surfaces
Source: van Doremalen N,
Bushmaker T, Morris DH, et al.
Aerosol and Surface Stability of
SARS-CoV-2 as Compared with
SARS-CoV-1. N Engl J Med.
2020;382(16):1564‐1567.
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SARS CoV-2 on Surfaces
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TITLE STYLE
BUILDING
VENTILATION
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Courtesy of
Scientific American

• Building ventilation circulates air throughout a built
environment
• Outdoor ventilation or the heating, ventilating, and air-
conditioning (HVAC) system of a building supplies and
removes air naturally (windows) and/or mechanically to
and from a space
• HVAC systems most often consist of mechanical parts
which should provide air to building occupants at a
comfortable temperature and humidity that is free of
harmful concentrations of air pollutants
What is building ventilation?
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Building Ventilation Diagram
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Natural Building Ventilation
• Ventilation design relies on natural sources such as
wind and temperature differences in order to flow
fresh air through a building
• Best suited for open plan layouts and minimize
noise pollution and external air
• Not suited for buildings with small spaces or
buildings needing a constant air temperature
• Not suited for buildings that need to control for
relative humidity
What is building natural ventilation?
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Building Ventilation
• Ensure there is an adequate flow of fresh air to workspaces and
optimize the ventilation system settings by:
• Maximize fresh air through your ventilation system
• Ensure restroom is under negative pressure
• Ensure that the proper filtration is being used to control SARS-
CoV-2 transmission
• Clean and disinfect all HVAC intakes and returns daily
• ASHRAE updates for more information.
• If pedestal, desk or hard mounted fans are used, minimize air
from fans blowing from one person directly to another.
• Fans may be useful to reduce the heat-related illness in plants
Prior to re-occupancy, review configuration of workspaces
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Building Ventilation – Interzone Airflows
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Gymnasium
Office and
waiting
room
Laboratory
Classroom
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High performance metal
mesh and HEPA filters,
UVC
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Building Ventilation for Industry
• Engineering Controls
• General exhaust ventilation
• Local exhaust ventilation
• Fans
• Air filtration
• Building and room filtration
• Ultraviolet germicidal irradiation
• Administrative Controls
• Personal Protective Equipment (PPE)
• Important suggested measures
Hierarchy of Controls
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TITLE STYLE
AIRFLOW
DISTRIBUTION
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Courtesy of
Scientific American

Airflow Distribution
• Coughing
• Sneezing
Loud talking
• Singing
• Screaming
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X
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Multizone Airflow Dispersion Modeling
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TITLE STYLE
AIR FILTRATION
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Courtesy of
Scientific American

Air Filtration
• Use the most efficient filters possible to maintain
ability to supply adequate air flow
• Consider using stand alone portable HEPA units
• Change to MERV 13-14 or HEPA filter
• Ensure that filters are installed in the correct
orientation relative to airflow, that they are the
appropriate size, and that they are seated in the
filter rack properly
• Minimize air flowing around filters instead of
through them
Regularly clean or replace HVAC system filters
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TITLE STYLE
BUILDING INSPECTION
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Courtesy of
Scientific American

Building Inspection
• Open all outdoor air intakes
that are closed
• Adjust or repair those that are
not working properly
• Regardless of air flow required
for heating and cooling, the
minimum outdoor air flow
recommended by ASHRAE
should always be provided to
each interior space
Inspect outdoor air intakes
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Building Inspection
• Dysfunctional exhaust fans can
result in suboptimal pressure
differences throughout the building
• Exhaust fans can create or
exacerbate IEQ problems. Odors
and harmful vapors can circulate
throughout the entire interior space
being supplied by an HVAC system
Inspect building exhaust fans
to work properly
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Building Inspection
• WHO’s 3-foot rule based on 1930’s
research by Harvard’s William Wells
• CDC 6-foot rule based on research of
SARS 2003 pandemic
• MIT research suggests “turbulent gas
clouds” released by individuals travel
up to 23-27 feet
• Suggested new rule – 30 feet. Being
implemented by San Francisco DPH
Why 6-Feet and How Close is Too Close?
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Building Inspection
• Minimum HVAC inspection and maintenance
requirements that preserve a system’s ability to
achieve acceptable thermal comfort, energy efficiency,
and indoor air quality in commercial buildings
• Does not apply to single family or multiple dwelling
residential occupancy, buildings used for commercial,
industrial or manufacturing process, and
• Does not apply as a means to circumvent any safety,
health or environmental requirements
Inspect HVAC Systems
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Building Inspection
• Technology was developed and tested at the
University of Oregon
• By swabbing air ducts and surfaces, researchers
believe they can identify places of exposure and
public at risk
• One expert was encouraged by the results, but
suggested more consideration about reliability,
cost and practicality related to the technology
Testing Surfaces and HVAC Systems
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ASHRAE® Standards
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TITLE STYLE
AIR SAMPLING FOR SARS
CoV-2
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Courtesy of
Scientific American

Air Sampling for SARS CoV-2
• Air testing is an investigative tool used to characterize
the nature and extent of contaminants in air and to
determine whether contaminant sources affect indoor
air quality to the workforce, public or environmental
air quality
• Pre-sampling inspection should be done prior to each
sampling event to identify working or environmental
conditions that may affect or interfere with testing.
• Inspection should evaluate the structure, floor layout,
physical conditions, and airflows of the building(s)
being studied
• Number of personal and area samples depends on
information to identify a workplace hazard/risk
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• Fourteen of 40 air samples in ICU (35%) tested positive
and 2 of 16 from the general ward (12.5%)
• Eight of 12 ICU air vent swabs (66.7%) tested positive,
as did 1 of 12 (8.3%) general ward swabs, results confirm
risk of aerosol exposure
• Aerosol was near air vents (5/14 [25.7%]), in patient
rooms (8/18 [44.4%]), and doctor's offices (1/8 [12.5%]), indicating
that aerosolized virus near and downstream of patients
• Upstream areas posed a risk based on virus in a doctor's office, max
transmission distance of SARS-CoV-2 aerosol 4 m (13 ft)
https://www.cidrap.umn.edu/news-perspective/2020/04/study-finds-evidence-covid-19-air-hospital-
surfaces
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Daniel Verreault et al. Microbiol. Mol. Biol. Rev. 2008;
doi:10.1128/MMBR.00002-08
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doi:10.1128/MMBR.00002-08
25 mm
PTFE filter
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doi:10.1128/MMBR.00002-08
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“BioSpot-
VIVAS” Sampler
MAGIC™
CPC
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PAM
S
High Resolution ELPI®+ DLPI+ LISST-Portable|XR
Fluke TSI Alnor
TSI
Dusttra
k
Aerosol and
Dust Monitors
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• PTFE filter and NIOSH cyclone sampler at a
rate of 3.5 l/m for 10 min collected similar
amounts of viral RNA in artificial generated
aerosols and variable relative humidity (RH)
• Using a ferret model, the PTFE filter, NIOSH
cyclone sampler and Andersen impactor
collected up to 3.66 log10 copies of RNA/liter
air, 3.84 log10 copies of RNA/liter air and 6.09
log10 copies of RNA/liter air at peak recovery
periods
Ref: Bekking C, Yip L, Groulx N, Doggett N, Finn M, and Mubareka S.
Evaluation of bioaerosol samplers for the detection and quantification of
influenza virus from artificial aerosols and influenza virus-infected
ferrets. Influenza Other Respir Viruses. 2019;13(6):564‐573.
doi:10.1111/irv.12678
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• On a pig farm, several air samples were
collected using liquid cyclonic collector
(Midwest Micro-Tek) processing 400
l/min of air – 0.9 to 2.1 km downwind.
• Aliquot of 10 mL minimum essential
medium (MEM) solution supplemented
the 4% bovine albumin serum (BAS).
The cyclonic collector was run for 30
minutes allowing airborne particles to
be mixed with collection media solution.
Ref: Corzo CA, Culhane M, Dee S, Morrison RB, Torremorell
M. Airborne detection and quantification of swine influenza a
virus in air samples collected inside, outside and downwind
from swine barns. PLoS One. 2013;8(8):e71444. Published
2013 Aug 8. doi:10.1371/journal.pone.0071444
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TITLE STYLE
BACK TO WORK SAFELY
GUIDES
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Courtesy of
Scientific American

Risk Levels for Vulnerable Populations
• Very High Exposure Risk - jobs with high potential for
exposure to known or suspected sources of COVID-19 during
specific medical, postmortem, or laboratory procedures
(healthcare workers performing aerosol-generating procedures
on infected persons).
• High Exposure Risk - jobs with high potential for exposure to
known or suspected sources of COVID-19 (healthcare delivery
and support staff exposed to infected persons, medical
transport and mortuary workers.
• Medium Exposure Risk - jobs requiring frequent and/or close
contact with infected people who may be infected COVID-19.
Areas with ongoing community transmission including travelers
in shared rides or returning from domestic or international
locations with widespread COVID-19 transmission.
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Hierarchy of Infection Controls
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Engineering Controls
• Evaluate building ventilation system
• Improve air filtration and airflow
• Open windows and doors, and use fans
• Drive-thru or delivery service
• Plastic shields, physical barriers and sneeze
guards
• Signs on floor for standing and operating
equipment and machinery
• Alter workspace for greater distancing between
work stations
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Engineering Controls for High Risk Operations
• Examples include healthcare, dental and laboratories:
• Negative pressure isolation rooms
• Biological safety cabinets/HEPA filtration
• UV germicidal irradiation systems
• Patient enclosures
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• Patient check-in areas and healthcare workers in hospital
emergency rooms
• Protect receptionists from patients checking in for
appointments.
• Plastic sneeze guards around cashiers, bank tellers,
pharmacy drop-off and pick-up windows and other customer
service areas
• Hung in restaurants between tables to protect guests
• Heating and air conditioning technicians and plumbers can
place barriers around their work activity
• Installed in between workers on the production line where
physical distancing cannot be maintained
Plastic Partitions and Sneeze Guards
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Administrative Controls
• Monitor public health communications
• Encourage workers to report symptoms, stay home
• Develop strategies to: manage worker concerns and
communicate with workers
• Remind workers of support services
• Communicate to partners, suppliers, other contractors
on policies and practices
• Encourage social distancing and the use of cloth face
coverings
• Cancel group events or mass gatherings
• Close/limit use of shared spaces
• Consider policies for flexible sick leave, staggered and
alternative work schedules
• Schedule stocking during off-peak hours
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Administrative Controls
• Enable sick workers to stay home or worker time off to care
for someone sick at home
• Report illness and record as potential workers’
compensation claim and OSHA illness
• Establish work from home policy
• Minimizing contact among workers and clients inside rooms
and other interior spaces
• Discontinue non-essential travel domestic
• Prevent use of reusable bags in grocery and convenience
stores,
• Limiting the number of staff present for high potential
exposure tasks
• Use drop boxes and travel in separate vehicles
• Training and education of staff and contractors
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AIHA Back to Work Safely™
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Tips to prevent Legionella growth
• Develop a comprehensive water management
program (WMP) for all devices that use water
• Ensure water heater is properly maintained and
temperature is correctly set
• Flush your water system
• Clean all decorative and drinking water fountains
• Ensure hot tubs/spas are safe for use
• Keep cooling towers clean and well maintained
• Ensure fire sprinkler systems, eye wash stations,
and safety showers are clean and well-maintained
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Tips to prevent mold growth
• Keep humidity levels as low all day long
• Allow free exchange of airflow throughout building
• Fix any leaks in the roof, walls, or plumbing
• Clean up and dry out building fully and quickly
(within 24–48 hours) after a flood or sewer backup
• Remove or replace carpets and upholstery that
are soaked and cannot be dried right away
• Don’t store cardboard boxes on concrete floor
• Drain stormwater away from property
• Report any musty odors to the property manager
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Tips for pest management
Category Concern Solution
Pluming traps Evaporated sewer traps Rehydrate and flush system
Ejector pits and sumps Stagnant water Run water and purge ejectors
Grease and oil traps Stagnant water Pump and clean traps
Trash – sanitary garbage Organic material, residues Clean receptacles and trash
Food, beverages, candy Food and nutrient sources Inspect areas frequently
Kitchenette/office appliances Food rot and source Clean and unplug appliances
Windows and doors Entry through openings Check and inspect often
Food facilities Storage, grease, food debris Clean and check gaskets
Fireplaces Harborage in flues Install screens and close dampers
Rugs and carpets Human occupancy and spillage Vacuum, steam clean and shampoo
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Key elements of a back to work plan
• Management leadership and employee participation
• Hazard identification and assessment
• Hazard prevention and control
• Risk communication, education, and training
• System evaluation and improvement
• Family preparedness
• Emergency operations procedures
• Post pandemic recovery and return back to work
• Integrate with business continuity and emergency
preparedness plans
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• Be informed and prepared
• Maintain social distancing (6 feet)
• Wash hands frequently
• Use alcohol-based hand sanitizer
• Avoid touching eyes, nose, and mouth
• Stay home when you are sick
• Cough or sneeze into a tissue or your elbow
• Clean and disinfect frequently touched objects and
surfaces such as cell phones
• Be prepared if child’s school, daycare facility, or
worksite is temporarily closed
What can individuals do?
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Five steps for proper hand washing
• Wet your hands with clean, running water (warm or
cold), turn off the tap, and apply soap.
• Lather your hands by rubbing them together with the
soap. Lather the backs of your hands, between your
fingers, and under your nails.
• Scrub your hands for at least 20 seconds. Need a timer?
Hum the “Happy Birthday” song from beginning to end
twice.
• Rinse your hands well under clean, running water.
• Dry your hands using a clean towel or air dry them.
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Basic hygiene and social distancing
• Stay home when sick or caring for someone sick
• Wash hands or use sanitizer frequently and after
coughing, sneezing, blowing nose, or using
restroom
• Avoid touching your nose, mouth, and eyes.
• Cover coughs and sneezes with tissues or do it
in your sleeve
• Dispose of tissues in no-touch bins
• Avoid close contact with coworkers or customers
• Avoid shaking hands or other physical contact
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PPE for jobs with high potential exposure
• Face/eye protection
• Gloves
• Gowns
• Respirators
• At least N95 disposable
• PAPR or full or half face elastomeric for greater
protection
• Counterfeit respirators in the supply chain
• NOTE: a worldwide shortage of PPE!
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An N95, KN95, FFP2 respirator is the minimum level of
protection to prevent inhaling coronavirus. Some
disposable respirators are sold as counterfeit devices.
Respirators are needed for a potential for aerosol
transmission
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Non-NIOSH
approved
respirators
filtration
performance by
International
Standards
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KN95
mask
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• Written program
• Selection according to hazard
• Medically fit to wear
• Fit-testing (quantitative/qualitative)
• Proper use of respirators
• Respirator maintenance
• Labeling/color coding filters
• Employee training
• Program evaluation
• Recordkeeping
Respiratory programs must comply with all elements of
OSHA Standard 29 CFR 1910.134
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FDA recalls 100+ brands of hand sanitizer
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• Must be hands-on and frequent
• Should not be primarily computer based
or lecture
• Must include an opportunity to drill the
actual process of donning and doffing
PPE and respirators
• Should include a trained observer
• Cover site specific decontamination
procedures
Training and practical demonstrations

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OSHA Hazard Communication Standard
The hazard communication standard, 29 CFR 1910.1200,
establishes a worker’s right to know about chemicals in the
workplace
Employers are required to develop:
• List of all hazardous chemicals in the workplace
• Labels on containers
• Chemical information (safety data sheets)
• Training
• Written program and worker access to information
These rights may be relevant to the cleaning and disinfecting of chemicals

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COVID-19 Guidance Documents
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Building Reopening Readiness
• Ensure HVAC systems operate properly
• Increase circulation of outdoor air
• Evaluate building and its mechanical
and life safety systems
• Conduct a thorough hazard assessment
• Identify work and common areas
• Include all workers in a workplace
communication plan
• Communicate with contracting company
CDC Reminds Us
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• Engineering
• Facilities/equipment
• Administrative
• Management and
communications
• Clean and disinfect
• Worker training
• Reporting illness
• Personal protective
equipment (PPE)
Prior to re-occupancy
use checklist
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• Prevent transmission among employees
• Monitor federal, state, and public health
communications
• Reinforce how workers can protect themselves and
others from COVID-19
• Plan to conduct daily in-person or virtual health
checks
• Conduct a hazard assessment of the workplace
• Plan for when employee is sick at work or move them
away from co-workers, customers, and visitors
• Develop action plan for suspected/confirmed cases
• Maintain healthy business operations
• Maintain a healthy work environment
Prior to re-occupancy use checklist
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• Eliminate reception seating areas and request guests phone ahead
• Install a plastic partition at the reception area
• Review floorplans and remove or reconfigure seats, furniture and
workstations to preserve physical distancing
• Reconfigure workstations so employees don’t face each other, or
place partitions between them
• Temporarily replace amenities with high contact frequency, such as
water coolers, coffee makers, and bulk snacks and use alternatives
(e.g., touchless sensor water dispensers; request workers bring their
own water bottles/coffee mugs
• Provide individually wrapped snacks
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• Consider using signage to deter use of such amenities
• If vending machines are used, provide and require cleaning and
disinfectants to wipe down after each use
• Reduce tasks for a large number of people to congregate in one
area
• Design work to reduce or eliminate trade stacking in the same area
• Encourage employees to use virtual meeting tools, including phone
and virtual teleconference, in lieu of in-person meetings
• If in-person meetings are essential, limit 10 people or less
depending on local, state, and federal guidelines
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• Disinfectant wipes or spray should be left in each
conference room and employees should wipe
down all surfaces and equipment (e.g., mouse,
keyboard, phone) touched during the meeting
• Consider limiting in-person meetings to 10 people
or less, if virtual meetings are not feasible
• In-person meetings should be done promptly to
avoid prolonged airborne exposure.
• Lingering or socializing before/after meetings
should be discouraged
Disinfect conference rooms daily
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• Common areas (lobby, security check-in)
• should be cleaned and disinfected on a daily
• Regulate the use of common areas with clear
signage (including maximum occupancy) and
physical distancing measures in accordance
with public health guidelines
• Provide cleaning supplies to use before/after in
common spaces and contact surfaces
• Encourage staff not to linger or socialize
• Use physical distancing or partitions between
sitting areas and work stations
Disinfect lobby and common areas daily
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• Disinfect all surfaces and commonly touched
equipment (e.g., check-in tablets)
• Avoid communal meals/food in common areas
where employees may congregate
• In buildings with cafeteria-style service or food
courts, protective measures should be
implemented like reduced capacity, staggered
lunch schedules, pick-up only, removal of self-
serve food and dinnerware/ drinkware, physical
distancing, physical barriers, limiting people who
can sit together, enhanced disinfection and
sanitization, and touchless payment options
Disinfect lobby and common areas daily
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• Clean and disinfect kitchen work areas daily
• Kitchen equipment should be cleaned routinely
• Disinfect coffee machines, refrigerator handles, and
ice machine handles at least 3-times/day.
• Clean dishwashers at beginning and end of shift
• Clean silverware and dinnerware in dishwasher or
use disposable option
• Store silverware so that it’s not easily touched when
a worker is retrieving item
• Ice machines with hand scoop shouldn’t be used
• Clean hand-operated beverage and water faucets
• Don’t congregate in the kitchen or galley area
Disinfect kitchens and galley areas
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• Reduce occupant capacity during peak times, or
stagger breakfast/lunch or dinner schedules
• Consider pick-up only to manage crowds
• Remove self-serve food, hot/cold food bars and
communal serving stations
• Remove reusable dinnerware/drinkware
• Replace condiments with individually wrapped items
• Implement physical distancing by allowing seating at
every other table, or expanding the dining area to
include more space.
• Consider physical barriers in between seating
Changes for cafeterias and break rooms
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• Limit the number of people sitting together
• Implement enhanced disinfection/sanitization
• Consider adding touchless payment options
and/or pre-ordering of food items
• Require gloves for all back of house staff
• If hand-washing protocols are not rigorously
followed, consider providing gloves to servers
• Require face coverings front of the house staff
• Encourage all other employees to wear face
coverings and gloves, and use hand sanitizer
Changes for cafeterias and break rooms
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• Coordinate with vendors and reduce loading dock
worker contact with delivery drivers;
• Allow workers to wear face masks
• Report any safety and health concerns
• Encourage workers to stay home if sick
• Maintain at least 6-feet between co-workers
• Discourage sharing of tools or equipment.
• Disinfect shared tools after each use
• Wash hands and alcohol-based hand rubs
• Routinely clean and disinfect surfaces and equipment
EPA) approved cleaning chemicals
Changes for loading and delivery operations
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REALM Project
• After 2-days of quarantine in stacked configuration, SAR
CoV-2 virus was not detectable on archival folders
• After four days of quarantine in stacked configuration,
virus was not detectable on braille pages, glossy book
pages, and board book
• Magazine pages had trace amounts of virus at 4-days
• After 3-days of quarantine no virus was detected in hard-
and soft-back covered books, plain paper pages inside a
book and plastic book coverings
• Other materials examined include: DVD/CD
polycarbonate audio books, video, and music, talking
books, USB cassettes, storage bags and containers
Reopening Archives, Libraries and Museums
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TITLE STYLE
CLEANING AND
DISINFECTION
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Courtesy of
Scientific American

Clean, Sanitize and Disinfect
• Designed for essential
workspaces and
environmental communities
• Specific principles, procedures
and work practices
• Requires periodic oversight
and confirmation of
workmanship
• Establish trained team of
environmental service
technicians
• Selection and use of EPA N-
listed registered disinfectants
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Cleaning and Disinfection
• HVAC cleaning
• Duct cleaning
• Bipolar ionization
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Ref: https://youtu.be/ti7QnbFjCSI
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Survival Half-Life of SARS CoV-2 on Prototypic Fomites, PPE and Air
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• Detergents
• Degreasers
• Abrasives
• Acids
Classes of Cleaning Agents
• High concentration alcohol-based
• Chlorine-based
• Phenol-based
• Quaternary amine-based
• Quaternary amine /Low concentration alcohol-based
Classes of Disinfectants
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• Building ventilation
• Air filtration devices and media
• Ultraviolet light devices
Airborne Contamination
• Manual cleaning methods
• Electrostatic sprayers
• Hydrogen peroxide vapor
• Ultra-low volume (ULV) sprayers
• Hudson aerosol sprayers
• Ultraviolet light surface contact
Surface Cleaning and Disinfection
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• Water helps remove and dislodge surface grim and dirt but doesn’t
dissolve any fats and oils
• Soaps and detergents remove fats and oils and reduce surface water
tension
Method:
• Quarter fold clean cloth/wipe and turn to a new surface with each stroke
• Use parallel, linear and overlapping strokes working for dirtiest to
cleanest – never in a circular motion
• Air or wipe dry with clean disposable paper towels, clean cloth or towel
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aiha.org | 132

Ref: https://youtu.be/pbSd7gjFgvs
aiha.org | 134

Clean, Santize and Disinfect
• Wear disposable or reusable gloves
• Wipe in one direction
Tips to Clean and Disinfect
Surfaces
• Surface stay wet with disinfectant for 10
minutes/sanitize after 30 secs
• Read manufacturer’s instructions
• Large surfaces use a spray and dry
• Avoid using the same wipe or cloth
• Frequently replace wipes or cloths
• Discard everything in the trash
Clean inside crevasses
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• Doorknobs, light switches, handrails, kitchen appliances, countertops,
drawer handles, tables, sinks, faucet and toilet handles, drinking
fountains, elevator buttons, push plates, phones, key/remote controls
• When cleaning workspaces, cubicles and other office areas, make
sure to disinfect frequently touched surfaces and objects, such as
sign-in areas, desks, chairs, phones, printers, keyboards and
computer mice
• Clean restrooms frequently
• For vehicles: clean door handles, window buttons, locks, payment
machines, arm rests, seat cushions, buckles and seatbelts.
• Wipe down surfaces that drivers touch, steering wheel, radio buttons,
turn indicators and cup holders
Focus on Shared and High-Touch Non-Porous Surfaces
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• Enveloped viruses like coronaviruses – SARS CoV-2 are
easily deactivated by proper cleaning and disinfection
• Not all disinfectants are created equal
• Use EPA N-listed registered chemical substances
• Use the product as directed by the manufacture for
effectiveness and safety
• Don’t rush – adhere to proper dwell times as prescribed
• Wear gloves and wash hands often
• Don’t waste good disinfection efforts by using poor work
practices to clean first
Clean and Disinfect Interior Building Surfaces
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• If surfaces are dirty, clean with detergent or soap and water prior to
disinfection
• For disinfection, diluted household bleach solutions, alcohol solutions
with at least 60% alcohol, and EPA-registered household disinfectants
• Prepare a bleach solution with 1/3 cup of bleach with 1-gallon of water or
4 teaspoons of bleach with 1-quart of water
Methods to Clean and Disinfect Non-Porous Surfaces
• Do not shake dirty laundry; this can disperse virus in the air
• Wash items according with the manufacturer's instructions. Launder
using the warmest water setting for the items and dry completely.
• Clean and disinfect hampers or carts for transporting laundry
Linens, Towels, Clothing, and Other Laundry Items
aiha.org | 138

• For other soft items (carpeted floor, drapes, upholstered sofas
and rugs), follow the manufacturer’s instructions or use a cleaning
product specifically for that item
• For example, use a steam cleaner or apply a disinfectant product
that is appropriate for type of fabric, and vacuum as usual
• Wear appropriate gloves or other personal protective equipment
(PPE) as instructed on the product label
• Throw away gloves after each cleaning, and wash hands with
soap and water for at least 20 seconds
Clean, Sanitize and Disinfect Porous Surfaces
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• Consider putting a wipeable cover on electronics
• Follow manufacturer’s instruction for cleaning and disinfecting
• If no guidance, use alcohol-based wipes or sprays containing at
least 70% alcohol. Dry the surface thoroughly.
• Spraying, misting, or fogging cloud computing servers and other
similar hardware should not be done to avoid damage unless
prescribed by the manufacturer
Clean electronics (tablets, touch screens, keyboards, and
remote controls)
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• Sprays electrostatically charged mist (“dry fog”) onto surfaces and
objects with disinfecting solution and atomized air by sprayer
electrode
• Coats surfaces uniformly even if the mist is only sprayed from one
side
• Positively charged particles adhere to surfaces and objects
Electrostatic Sprayers
• Disinfectant applied as fog, fumigate, or electrostatic spray
• Areas should be vacant during application and afterward (~1-2 hours)
• Safe for sensitive surfaces, such as wood, upholstery and electronics,
but not paperwork, clothing, food, dishware, wall decorations
• Only works on surface that can be electrostatically charged
Caution
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• Applied as a low-temperature antimicrobial vapor used to
disinfect air and surfaces
• Special equipment generates HPV by passing aqueous
H2O2 with a vaporizer and circulates the vapor
• After HPV mixes in the interior space it is circulated back to
the generator, where it is deconstructed into water and
oxygen
• Only safe to enter when HPV concentrations fall to safe
levels <1 ppm or vented to the outside air
• Considered a "dry process" that leaves no surface residue
• Requires skilled application and monitoring since H2O2
concentrations could exceed occupational exposure limits
Hydrogen Peroxide (H2O2) Vapor
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• Two-step process ionizes 7.8% H2O2 solution into fine mist/fog
of Reactive Oxygen Species (ROS) that inactivates virus
• Electrostatically charged mist improves dispersion and surface
coverage as droplets repel each other’s attraction to oppositely
charged items in the area
• After disinfecting, solution decomposes into oxygen and water
Ionized Hydrogen Peroxide (H2O2)
• Requires skilled application and monitoring as H2O2
concentrations could exceed occupational exposure limits
• Fine mist may activate smoke detectors
Cautions
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• Can produce a range of droplet sizes to create a
mist using pressure to vaporize and deliver
disinfectants
• Fogging machines generate a fog or mist form
droplets between 5-50 microns (μm) in diameter
• Droplets <10 microns can remain airborne for hours
increasing chance of bonding with aerosols and
particulates
• Can be applied to hard surfaces after effective
cleaning
Ultra Low Volume (ULV) Foggers
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• Create large droplets to deliver best surface wetting
application
• Relatively easy to use, portable and can cover large
areas with longer contact time
Airless Sprayers
• Disinfectant “sticks” to surface providing even
application and longer contact time
• User can see what areas are covered with spray
• Relatively easy to use and portable
• Somewhat slower application than airless sprayer
Foaming Sprayer
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PPE to Clean, Sanitize and Disinfect
• Cleaning staff should wear disposable gloves and gowns for all tasks in the
cleaning process, including handling trash
• Remove gloves after cleaning a room occupied by ill person
• Wash hands immediately after removing gloves
• Report tear in gloves or any potential exposures to supervisor
• Cleaning staff should clean hands often by washing hands with soap and
water for 20 seconds
• If soap and water are not available and hands are not visibly dirty, use
alcohol-based hand sanitizer containing 60-95% alcohol may be used
• If hands are visibly dirty, first wash hands with soap and water
• Follow normal preventive actions, including hand washing and avoid
touching eyes, nose, or mouth with unwashed hands
aiha.org | 146

RIA, IICRC, and AIHA Report
• Professional cleaning for restoration
contractors
• Pre-work preparations
• Wiping touchpoints and applying
disinfectants
• Post work project evaluation
• Managing service operations
• Risk assessment and management
• Joint task force with stakeholders
• Training and education
aiha.org | 147

TITLE STYLE
UV GERMICIDAL RADIATION
aiha.org | 148
Courtesy of
Scientific American

Ultraviolet (UV) Light
• All wavelengths of UV
radiation are
carcinogenic to humans
• Predominant frequency
is 254 nm in the UV
spectrum
• Most vulnerable are
eyes and skin
• Some UV lamps
generate ozone vapor
in air
• ACGIH TLV® -
ultraviolet radiation
exposure
aiha.org | 149

Health Hazards from UV Radiation
• Skin cancer
• >1M cases of non-melanoma skin cancer diagnosed annually. Other
UV skin concerns are basal and squamous cell carcinomas.
• Most skin cancers appear after age 50, but begins at an early age
• Actinic keratoses and premature aging (photoaging)
• Chronologically-aged skin shows changes after age 40 or older
• Freckling, fine wrinkling, and dilation of capillaries seen at early age
• Cataracts and other eye disorders
• Change in crystalline lens causes blurred vision leading to blindness
• Immune system damage
• Suppresses immune responses to fight certain diseases like skin cancer
Health Effects from UV Exposure
aiha.org | 150

Ultraviolet (UV) Light
• UV non-ionizing energy first used to disinfect surfaces in 1877
• Ultraviolet (UV) light inactivates fungi, bacteria and virus - cannot be used on
“dirty” surfaces – damages paint, plastics and air filters
• Three categories of UV radiation spectrum:
• UVA (320 – 340 nm) longest wavelength, least harmful, and least
effective (> 15 min.) to inactivate viruses – useful in air ducts
• UVB (290 – 320 nm) responsible for sunburns with prolonged exposure
along with risk of skin cancer and cellular damage
• UVC (200 – 290 nm) is extremely harmful but effective in inactivating
viruses – damage plants and affect eye retina from exposure
• ACGIH TLV for UV radiation exposure limits but no standards for disinfecting
in air or surfaces
• Effectiveness depends on wavelength, exposure and contact time
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Germicidal Irradiation
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1500
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Ultraviolet-C Light
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Occupational Exposure to UV Radiation
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Occupational Exposure to UV Radiation
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aiha.org | 157

• UV irradiation is used in
three ways:
• Upper room UVGI
fixtures with air mixing to
disinfect room air near
the ceiling
• Mobile UVGI units to
disinfect high touch
surfaces (lamps, robots,
etc.)
• UVGI lamps in HVAC
exhaust ventilation and
supply air ducts
aiha.org | 158

aiha.org | 159

Mobile UV light source placed into
hotel room before reoccupancy.
UV robot scans stores in a mall
after hours of operations.
UV light disinfects a large ballroom
after ceremony at convention.
aiha.org | 160

Handheld UV light devices good
sterilization tool for small objects.
A bus is being disinfected by UV light
on March 4, 2020 in Shanghai, China.
UV light inside a subway train car at a
New York City maintenance facility.
aiha.org | 161

UVC Instrumentation
Design Specifications
• Professional UV tester, wavelength range:
248nm - 262nm; peak wavelength: 254nm;
irradiance measurement range: 3999uW/cm²
(39.99mW/cm²); resolution 1uW/cm2.
• UV probe consists of visible light isolation
diaphragm, narrow band filter and gallium
arsenide sensor. Very sensitive and gives a
fast response.
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TITLE STYLE
POST CLEANING
VERIFICATION
aiha.org | 163
Courtesy of
Scientific American

Post Cleaning Verification
• Training personnel
• Monitoring workers
• Artificial intelligence
• Deconning work areas
• Decontamination of workers
• Decontamination of equipment
• Measuring cleanliness
• Respirator fit-testing
aiha.org | 164

• Background information relative the concern and need to sample
• Locations within the building to sample
• Plan should consider randomness of contact surfaces and uniformity of
areas for sample collection
• Need for collecting sample controls for quality assurance
• Parameters for assay – quantitative or qualitative
• Outcome of test results and determinate of cleanliness
• Changes to cleaning and disinfection plan or methods
• Periodicity of collecting environmental surface samples for quality control
Consideration when collecting environmental surface
samples
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Consideration for how to collect environmental surface samples:
aiha.org | 166

• Performed by third party consultant providing oversight of
the cleaning and disinfection process
• Checks of engineering controls used, proper methods for
cleaning, and spot checks of surfaces for signs of visible
debris after cleaning is done
• Surface samples (counters, floors, tables, knobs,
appliances, computers) and heavy-use areas
• Sample solid surface area of 25 cm2 and refrigerate
samples until shipping overnight
• Sampling can take as little as a few minutes and expedited
to a certified lab. Test results 2-3 days
aiha.org | 167

• Hospitals and other healthcare facilities
• Physician, dental and veterinarian offices
• Government and municipal buildings
• Service and hospitality work environments
• Nursing homes and assisted living facilities
• Offices buildings, tenant and retail spaces
• Schools and child care centers
• House of worship and religious gatherings
• Meat packers, prisons, ships and cruise lines
• Warehouses and public transportation
• Restaurants and bars
• Nail, hair, and other beauty salons
Collecting environmental samples
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• ATP is a bioluminescence test that quickly determines the amount of
living organisms present through the detection of ATP
• Test is done by measuring the light produced through ATP’s reaction
with luciferase, a natural firefly enzyme
• The more light produced by using the luminometer is indicative of the
quantity of ATP in the sample
• While this science continues to expand into new fields, this type of
biologic test method has existed for 50 years
• It is not useful method for the detection of viruses since they are not
living organisms
• Use primarily in sanitation, infection control, and safe drinking water
• Test results shown in Relative Light Units (RLU) in 10 seconds
Adenosine Triphosphate (ATP) Testing
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• Lab analysis called PCR to detect small amounts of
the RNA (genetic material) that is very specific to a
virus or other organism
• PCR testing methods for are still evolving
• Relatively simple and widely used molecular biology
technique to amplify and detect DNA and RNA
sequences
• PCR test cannot differentiate between viable and
non-viable virus
• May give false positive results from surfaces cleaned
with antimicrobial and not wiped-down
• RT-PCR is used for qualitative analysis while qRT-
PCR is more quantitative and used for validation
Polymerase Chain Reaction (PCR) Testing
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• Used to improve cleaning and disinfection
of high-touch surfaces
• Liquid sprayed on surface before cleaning
that leaves an invisible marker when dry
• Fluorescent light used to see if the
marker was removed by the cleaning
Fluorescent Marker Testing
aiha.org | 171

Comparison Cleaning Efficacy Tests
aiha.org | 172

Comparison Cleaning Efficacy Tests
aiha.org | 173

TITLE STYLE
REFERENCES
aiha.org | 174
Courtesy of
Scientific American

Reference Materials
aiha.org | 175

Reference Materials
aiha.org | 176

National Safety Council
• Phasing. Create a transition to return to work aligned with risk
and exposure levels
• Sanitize. Before employees return, disinfect the workplace, and
make any physical alterations needed for physical distancing
• Screenings. Develop a health status screening process for all
employees
• Hygiene. Create a plan to handle sick employees, and
encourage safe behaviors for good hygiene and infection control
• Tracing. Follow proper contact tracing steps if workers get sick
to curb the spread of COVID-19
Outline 10 Actions for Safer Reopening
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National Safety Council
• Mental health. Commit to supporting the mental and emotional
health of your workers by sharing support resources and policies
• Training. Train leaders and supervisors in the fundamentals of
safety, risk assessment and hazard recognition, but the impacts of
COVID-19 on mental health and well-being
• Engagement plan. Notify employees in advance of the return to
work, and based on job roles, bringing groups back one at a time
• Communication. Develop an open and transparent plan for
workers on return-to-work process
• Assessment. Outline main guidance to provide a simplistic
structure to the extremely complex return-to-work decision
Outline 10 Actions for a Safer Reopening
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Other Considerations
• Fear and worry about own health and the health of loved ones, financial
situation or job, or loss of support services
• Increase in workplace and domestic violence issues
• Xenophobic anxiety from discrimination of Chinese immigrants
• Changes in sleep or eating patterns
• Difficulty sleeping or concentrating based on fear of uncertainty
• Worsening of chronic or mental health conditions
• Loss of social interaction with coworkers, family and friends
• Increased use of tobacco, and/or alcohol and other substances.
Mental health, anxiety, depression and stress
aiha.org | 179

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