Ebola Biosafety And Infectious Disease Response Worker .

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National Institute ofEnvironmental Health SciencesWorker Training ProgramEbola Biosafety and Infectious DiseaseResponse Worker Training ProgramA Multisector, All-Hazards Approach to Biosafety PreparednessThe NIEHS Worker Training Program(WTP) is implementing infectious diseaseresponse training for workers acrosssectors who may be exposed to infectiousdiseases. This addresses an importantgap revealed by the 2014 Ebola outbreak.Health care practitioners in an operations-leveltraining at the Regional Medical Center in Anniston,Alabama. (Photo courtesy of UAB)The Ebola Biosafety and InfectiousDisease Response WTP beganJune 1, 2016, and will run throughMay 31, 2019. NIEHS is buildingfederal capacity for biosecurity,biopreparedness, and rapid responseto emerging infectious diseases,including developing an infrastructureof trainers and organizations whocan be a resource during emergencies.NIEHS launched the program with thefollowing federal agencies: Centers for Disease Control andPrevention (CDC) U.S. Department of Health andHuman Services Office of theAssistant Secretary for Preparednessand Response National Institute of OccupationalSafety and Health Occupational Safety and HealthAdministrationThe program is funded through a 10 million transfer to NIEHS WTPvia CDC using Ebola emergencysupplemental appropriations.Program Accomplishments as of May 31, 2018:Occupations Trained:Approximately1,000 coursesto 23,000 workers,with more than 90,000contact hours,and in-person trainingsin 37 statesacross the country. Airport/airline workersApproximately65 train-the-trainer andtrainer developmentcourses were providedto more than 900workers across thecountry to becometrainers or increase theircapacity to train.94% of training participants across a variety ofcourses agreed or strongly agreed that the trainingprepared them to recognize infectious disease hazardson the job, and 93% agreed or strongly agreedthat the training prepared them to safely respond toinfectious disease events on the job.**Data from four grant recipients using common evaluation questions.More than40 new curriculaare available in the NIEHSWTP ClearinghouseCurricula Catalog.The curricula include: Hands-onskills and adultlearning techniques. Construction workers Corrections workers Custodial/environmentalservice workers Death care workers EMS and first responders Health care workers Homeless outreach teams Continuingeducationcredits acrossseveral specialties. Military personnel Approval orintegration intostate and nationalorganizations. Public health workers Nail salon technicians Occupational health andsafety professionals Security and customs workers Volunteers/disaster workers Vulnerable populations

UMET trains health professionals on PPE for infectious diseases in San Juan, Puerto Rico. (Photo courtesy of NJ/NY Hazardous Materials Worker Training Center)Building Capacityfor InfectiousDisease ResponseAcross the CountryGrant recipients are developing anddelivering evidence-based infectioncontrol and hazard recognition trainingto worker populations they can accessthrough labor unions and partnerships.By learning how to protect themselvesduring an outbreak, these workersbecome part of a preventive strategywhich helps keep their worksites andcommunities safe.Firefighters at the Omaha Fire Departmentare trained on PPE by University of Nebraska,consortium member under Indiana UniversityBloomington. (Photo courtesy of Jonathan Rosen)2Each grant supports a consortium withsubgrants to expand their reach tomore states and worker populations.The eight primary grant recipients are: Biosafety and Infectious DiseaseTraining Initiative (BIDTI) at IndianaUniversity Bloomington Deep South Biosafety WTP atThe University of Alabama atBirmingham (UAB) Duke Infectious Disease ResponseTraining Program (DIDRT) at DukeUniversity Emory Ebola Biosafety andInfectious Disease Response WTP atEmory University International Chemical WorkersUnion Council (ICWUC) Center forWorker Health and Safety Education Laborers’ International Union ofNorth America (LIUNA) Training andEducation Fund New Jersey/New York (NJ/NY)Hazardous Materials Worker TrainingCenter at Rutgers University United Steelworkers Tony MazzocchiCenter (USW TMC)The Ebola Biosafety and InfectiousDisease Response WTP builds off theoverall NIEHS WTP, with its 30-yearhistory of hazardous waste workerand emergency response trainingacross the country, responsivenessto federal regulations and guidance,and strong position on and trainingin infectious disease response overapproximately two decades.

Training HighlightsBelow are training highlights from NIEHS grants as of May 31, 2018.HHealth Care Workers,Faculty, and StudentsDeep South Biosafety WTP, withconsortium member The University ofMississippi Medical Center (UMMC)STATES: Alabama, MississippiThis program has offered awarenessand operations-level courses inMississippi and Alabama to a varietyof sectors and occupations at hospitalbased institutions, and has publishedresources such as personal protectiveequipment (PPE) checklists and atrain-the-trainer best practices guide.For refresher courses, UMMC andUAB offer simulation training, allowingparticipants to get further hands-onexperience. UAB and UMMC havealso trained faculty and students fromschools of nursing across Alabamaand Mississippi.DIDRT, with consortium membersUniversity of Louisville and GeorgeMason University (GMU)STATES: Kentucky, North CarolinaDIDRT’s training in the health careand academic health center sectorsincludes training Duke Universityclinical microbiology lab workers,stem cell transplant lab workers,Duke Human Vaccine Institute labworkers, and Duke University SpillResponse Team members. Under DIDRT,University of Louisville launched anoperations-level training for third-yearnursing students. This training has beenincorporated into the school’s nursingcurriculum for students preparingthemselves for the clinical setting.NJ/NY Hazardous MaterialsWorker Training Center, withconsortium member UniversidadMetropolitana (UMET)TERRITORY: Puerto RicoUMET supports responders to disastersand outbreaks through their training inPuerto Rico. UMET provided four-hourPPE for Infectious Diseases coursesto responders, facilitating knowledgeand skills development in the selection,putting on, and removal of PPE.USW TMC, with consortiummember Communications Workersof America (CWA)STATES: California, Illinois, New YorkUSW TMC and CWA have bothtrained health care union membersthrough this consortium. USW TMCconducted a train-the-trainer programto certify a cadre of trainers for theUSW health care sector. Additionally,University Professional and TechnicalEmployees (UPTE)/CWA Local 9119and CWA’s Occupational Safetyand Health Department conductedinfectious disease safety and healthtraining sessions for CWA-representedemployees at University of Californiamedical centers (designated EbolaTreatment Centers).University of Louisville nursing students participatein an operations-level training.(Photo courtesy of DIDRT)3

Emergency First RespondersEmory Ebola Biosafety and InfectiousDisease Response WTPSTATES: Florida, Georgia, Nebraska,South Carolina, national reachFirst responders learn strategies for safe transportof potentially infectious patients from the EmoryEbola Biosafety and Infectious Disease ResponseWTP in Atlanta, Georgia.(Photo courtesy of Jonathan Rosen)Emory is working closely with largenational emergency response partnersAmerican Medical Response andAir Methods Corporation. Throughthese partnerships, more than4,800 awareness courses havebeen completed across the country.Additionally, operator- and technicianlevel courses have been taught inGeorgia, Florida, South Carolina, andNebraska. Emory’s training is reachingtransport providers in critical places,such as the Hartsfield-Jackson AtlantaInternational Airport, which has anon-site quarantine station and could beinvolved in transport to the Emory EbolaTreatment Center.to roughly 1,500 Washington, D.C.,fire and emergency medical services(EMS) personnel in the 2018-2019program year. In addition, GMU trainedthe Spokane Ebola Response Teamwith American Medical Response,facilitated by the Washington StateRegion 9 Healthcare Coalition. Thisfirst responder team is responsiblefor the medical transport of highlyinfectious patients.Deep South Biosafety WTP, withconsortium member AlabamaFire College Workplace SafetyTraining (AFC WST)STATES: Alabama, MississippiAFC WST trains first responders in theSoutheast, focusing on firefighters andEMS in Alabama and Mississippi. AFCWST delivers both infectious diseaseawareness and operations courses tofire department employees, such as theVestavia and Pelham Fire Departmentsoutside Birmingham, Alabama.DIDRT, with consortium member GMUSTATES: District of Columbia, Virginia,WashingtonWorkers in a pre-apprenticeship program at theCypress Mandela Training Center in Oakland,California, participate in an infectious diseaseawareness course. (Photo courtesy of ICWUC)4DIDRT is training both rural and urbanfirefighters to prepare for potentialexposures to infectious pathogens. GMUconducted an exercise for the FauquierCounty Fire Department in Warrenton,Virginia, where the firefighters had torespond to and transport a simulatedsick patient from a residence during anepidemic. Under GMU’s leadership, theentire DIDRT consortium will provideinfectious disease response trainingConstruction Trades andWorkforce DevelopmentLIUNA Training and Education FundSTATES: Iowa, Louisiana, Michigan, NewJersey, New York, PennsylvaniaLIUNA Training is preparing constructioncraft laborers to work safely in hospitalor other health care settings or toconduct cleanup, decontamination,and disinfection activities followingan infectious disease incident. LIUNATraining is also delivering Infection

Control Risk Assessment (ICRA) training.ICRA is required by health care facilitiesand employers for on-site constructionprojects to protect against pathogensspreading via construction dust orworkers encountering contaminatedsurfaces or airborne pathogens.ICWUCSTATE: CaliforniaIn Oakland, trainers at the CypressMandela Training Center taughteight infectious disease awarenesscourses to almost 150 students aspart of the center’s pre-apprenticeshipprogram. Many graduates go on tojobs in the skilled trades. The courseswere supported through ICWUC’spartnership with the Coalition of BlackTrade Unionists.Criminal Justice in New York, New York.Topics included Ebola, resiliency, Zika,and hands-on follow-up.2017 Hurricane ResponseMany NIEHS grant recipients providedtraining to workers in response tothe 2017 hurricane season and theinfectious disease hazards posed duringcleanup and recovery. Some deliveredtrain-the-trainer courses, which allowsfor local dissemination of infectiousdisease safety information.ICWUC, with consortium membersAmerican Federation of State,County, and Municipal Employees(AFSCME); National Nurses United(NNU); American Federation ofTeachers (AFT); and NationalCouncil for Occupational Safety andHealth (NCOSH)TexasNJ/NY Hazardous Materials WorkerTraining Center, with consortiummember World Cares Center (WCC)STATE: New YorkWCC supports volunteer work fordisasters or outbreaks. For theirinfectious disease program, WCCprovides resiliency courses as wellas experiential/hands-on training asa follow-up to awareness classes onZika and resiliency. WCC has also helda series of trainings for the disasterresponse team at John Jay College ofSTATE/TERRITORIES: Puerto Rico, Texas,U.S. Virgin IslandsSTATES/TERRITORY: Florida, Puerto Rico,Disaster Preparedness,Response, and RecoveryUSW TMCICWUC consortium members havemany union members and localpartners in hurricane-affected areaswho need ongoing training and PPEto protect themselves during cleanup.AFSCME, NNU, and AFT delivereddisaster training that included infectiousdisease concepts to their memberseither in Puerto Rico or traveling thereto volunteer. ICWUC also partneredwith University of Puerto Rico to traingraduate students. ICWUC conductedinfectious disease train-the-trainercourses in Fort Lauderdale, Florida,for NNU and in Houston, Texas, for theNCOSH local partner.After deploying emergency responsetraining teams to hurricane-affectedregions, the need for infectious diseaseawareness training for hurricanesurvivors became apparent. USW TMCwill conduct an infectious diseasetrain-the-trainer course for 20 teammembers in the third program year,preparing them for future deployments.Emory Ebola Biosafety and InfectiousDisease Response WTPSTATE/TERRITORY: Kentucky, Puerto RicoAs a partner with Emory through theRegion IV Public Health Training Center,University of Louisville trainers preparedelectrical lineman working for LouisvilleGas & Electric/Kentucky Utilities prior todisaster relief work in Puerto Rico. Thegroup was chosen to restore power toremote areas of the island following thedevastation of Hurricane Maria.University of Puerto Rico students and AFSCMEmembers in San Juan take part in a PPE exerciseto protect themselves during disaster cleanup.(Photo courtesy of ICWUC)5

Death CareDeep South Biosafety WTPSTATE: AlabamaPPE practice session during an operationslevel training with the Alabama State MortuaryOperations Response Team in Tuscaloosa,Alabama. Training was provided by UAB.(Photo courtesy of UAB)The program delivered awareness,operations, and train-the-trainercourses to the Alabama State MortuaryOperations Response Team (SMORT), agroup of volunteers who meet and trainannually to prepare for a response toa potential mass casualty event. Theoccupations trained included a forensicpathology specialist, funeral directorsand coroners, and representatives fromemergency management agencies.BIDTISTATES: Illinois, OhioBIDTI trained senior students atWorsham College of Mortuary Sciencein Wheeling, Illinois, to provideinfection control information specificto the mortuary industry. The trainingwas for those who might handlehighly infectious deceased bodies,instilling good practices beforegraduates enter the workforce. BIDTIalso provided a session at the OhioEmbalmers Association professionalembalmer seminar.EVS managers and staff of the Indiana casino andresort participate in community-level training fromIndiana University Bloomington.(Photo courtesy of BIDTI)6Environmental Service (EVS)Workers, Sanitation Workers,and Domestic CleanersLIUNA Training and Education FundSTATES: District of Columbia, TexasLIUNA Training instructors trainedservice employees who are primarilyjanitorial, housekeeping, and foodservice workers in large governmentfacilities, often Veterans Affairshospitals. These EVS workers inhospitals or other settings generally donot have the opportunity for infectioncontrol education and PPE trainings.The joint labor-management ServiceContract Education and Training TrustFund facilitated the training.USW TMC, with consortium membersNational Day Laborer OrganizingNetwork (NDLON) and Make the RoadNew York (MRNY)STATE: New YorkNDLON affiliate Wind of the Spiritconducted 21 classes in year two,reaching more than 500 peopleengaged in a wide range of work,including cleaning, sanitation, highwaycleaning, and portable sanitary reliefmaintenance. MRNY conductedadditional classes for participantsprimarily from Latino immigrantcommunities. These workers come froma variety of jobs, including domesticand commercial cleaning workers,private trash collectors, and laundryworkers. These training sessionshelp participants maintain their job

or obtain jobs that require infectiousdiseases training, and understandtheir rights as workers and theresponsibilities of employers.BIDTISTATES: Indiana, KentuckyBIDTI trained EVS managers and staffof a large hotel and casino resort insouthern Indiana that is frequentedby residents of surrounding Midweststates. BIDTI also trained EVS workers,as well as all aircraft rescue andfirefighting personnel, based atIndianapolis International Airport.Homeless Outreachand Substance AbusePrevention WorkersBIDTI, with consortium memberHarvard UniversityNail Salon TechniciansNJ/NY Hazardous Materials WorkerTraining Center, with consortiummember New York Committeefor Occupational Safety andHealth (NYCOSH)STATE: New YorkNYCOSH is delivering five-dayinfectious disease training coursesfor nail salon technicians that coverthe multiple infectious hazards facedon the job, such as fungal infections,bacterial infections, and other bloodborne pathogens. The courses alsoaddress methods of infection controland demonstrate the use of PPE withhands-on activities. The training hasbeen delivered in Spanish and Nepalesein New York City, with courses in Koreanplanned for the third program year.MilitaryLIUNA Training and Education FundSTATES: California, Michigan,national outreachLIUNA Training provided three infectiousdisease awareness courses for 43National Guard Reserve membersof LIUNA Local 1776. These reservemembers gained skills for potentiallyhazardous situations, such as beingdeployed to areas with inadequatesanitation or to disaster sites. Tenmembers were trained at the MichiganLaborers Training and ApprenticeshipInstitute, and the rest were trainedat a National Guard conference insouthern California.STATES: Indiana, MassachusettsBIDTI is training homeless coalitionsand communities, substance abusecouncils, and street outreach teamsthat encounter many individualswith injection drug use problemsand associated infectious diseasesin Indiana, and has trained stafffrom a domestic women’s shelter inMassachusetts. These training effortscan address the spread of infectiousdiseases associated with the opioidepidemic and Indiana’s increasedincidence rates of hepatitis C andhepatitis C/HIV co-infection, whileteaching skills transferable to a highlyinfectious disease scenario.Nail salon technicians learn about infection control and PPE in a training from NYCOSH.(Photo courtesy of NJ/NY Hazardous Materials Worker Training Center)7

Airline and Airport WorkersAirlines, Envoy Air, and PiedmontAirlines. The CWA Occupational Safetyand Health Department works withthe Association of Flight Attendants(AFA)-CWA trainers to conduct trainingsessions for flight attendants. AFA-CWArepresents 50,000 flight attendantsemployed by over 25 airline companies.ICWUC, with consortium memberUniversity of MinnesotaSTATE: MinnesotaUniversity of Minnesota is deliveringinfectious agents training to cabincleaners, flight attendants, andmaintenance personnel from two airlinecompanies, Sun Country Airlines andGlobal Aviation Services . The workersare learning about infectious agents,biological hazards, and PPE that canbe used for a biological response in aworkplace setting.USW TMC, withconsortium member CWASTATES: Illinois, TexasCWA is training passenger agents andflight attendants on infectious diseasehealth and safety. For passengeragents, they are working with AmericanRutgers University delivered twofour-hour PPE for Infectious Diseasecourses for public health students andprofessionals. Additionally, they havebeen using social media to disseminatekey public health messages incollaboration with the State of NewJersey Department of Health, suchas providing a Facebook Live eventon “Flu Facts.”Emory Ebola Biosafety and InfectiousDisease Response WTPSTATES: Alabama, Florida, Georgia,Kentucky, Mississippi, North Carolina,South Carolina, TennesseeEmory is partnered with the HealthResources and Services AdministrationRegion IV Public Health Training Centerto provide training for public healthpersonnel at or associated with stateor local health departments, as wellas health care workers who practicein rural areas of the United States andare supported by Area Health EducationCenters. The Public Health TrainingCenter offers serious contagiousdisease awareness and hands-oneducation and training.STATES: North Carolina, Tennessee8STATE: New JerseyPublic Health WorkersDIDRTTraining for Sun Country Airlines cabin crew byUniversity of Minnesot

provides resiliency courses as well as experiential/hands-on training as a follow-up to awareness classes on Zika and resiliency. WCC has also held a series of trainings for the disaster response team at John Jay College of Criminal Justice in New York, New York. Topics included Ebola, resiliency, Zika, and hands-on follow-up. 2017 Hurricane .

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