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Letter
Occupational Health Response
to SARS
David Koh,*
Meng-Kin Lim,* Choon-Nam Ong,* and Sin-Eng Chia*
*National University of Singapore, Singapore
Suggested
citation for this article
To the Editor: Severe acute respiratory syndrome (SARS), an occupational
disease risk for healthcare workers, warrants an occupational health response,
as clearly described by Esswein et al. (1). Occupational
health professionals played a role in the assessment of healthcare facilities
in Taiwan and many other countries. For example, occupational health professionals
were invited to perform audits in at least 2 hospitals in Singapore during
the height of the crisis, (2) and to conduct follow-up
discussions with the hospital management. In addition to assessment of
the industrial hygiene aspects, which included evaluating the ventilation
modifications needed for effective infection control, temperature and
humidity were significant factors affecting the use of protective gear
in a tropical country like Singapore. The occupational health audits included
site inspections and reviews of work processes of those areas where actual
transmission of SARS had occurred and where triage of febrile patients
was taking place. Other issues identified as requiring urgent attention
were providing sufficient rest, shower, and changing facilities for staff,
monitoring staff sickness absenteeism, and proactively managing staff
mental health. Occupational health physicians subsequently served on hospital
SARS debriefing committees that reviewed institutional shortcomings and
recommended new measures for future outbreaks. An occupational health
service unit headed by a trained occupational health physician was formed
in 1 hospital.
Other occupational groups, as well as healthcare workers, are also at
potential risk. These groups may include the following: 1) food handlers,
defined as persons who handle, kill, or sell food animals, and persons
who prepare and serve food. (More than one third of the cases in China
with onset of SARS before February 1, 2003, were in food handlers [3].);
2) public transportation workers and airline crew (4);
and 3) laboratory workers handling samples or items contaminated with
SARS-associated coronavirus (5). In Singapore, 2 taxi
drivers were infected after ferrying SARS patients to healthcare facilities,
and 1 Singapore Airlines cabin attendant came down with the infection
after a flight with infected passengers on board. Occupationally acquired
SARS infections have been documented in Singapore, Taiwan, and Beijing.
Clearly, occupational health responses are needed in these occupational
settings.
The recognition of SARS as an occupational disease has broader implications.
Depending on country legislation, persons who contract SARS while performing
their work may be eligible for worker's compensation. Employers would
be obligated to provide a safe and healthy workplace for their employees.
References
- Esswein EJ, Kiefer M, Wallingford K, Burr G, Lee LJH,
Wang JD, et al. Environmental
and occupational health response to SARS, Taiwan, 2003. Emerg Infect
Dis. 2004;10:1187–94.
- Koh D, Lim MK, Chia SE. SARS: health care work can be hazardous to
health. Occup Med. 2003;53:241–3.
- World Health Organization. Consensus document on the epidemiology of severe
acute respiratory syndrome (SARS). 17 Oct 2003. Geneva: The Organization;
2003.
- Olsen SJ, Chang HL, Cheung TY, Tang AF, Fisk TL, Ooi SP, et al. Transmission
of the severe acute respiratory syndrome on aircraft. N Engl J Med.
2003;349:2416–22.
- Normile D. Severe
acute respiratory syndrome: lab accidents prompt calls for new containment
program. Science. 2004;304:1223–5.
Suggested citation
for this article:
Koh D, Lim M-K, Ong
C-N, Chia S-E. Occupational health response to SARS [letter]. Emerg Infect
Dis [serial on the Internet]. 2005 Jan [date cited]. Available
from http://www.cdc.gov/ncidod/EID/vol11no01/04-0637.htm
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