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Anthrax Q & A: Worker Safety

What are CDC’s recommendations for protecting mail handlers?
CDC and the U.S. Postal Service are collaborating to ensure that all mail handlers and postal workers are protected against exposure to anthrax. Detailed guidelines may be found on these Web sites:

If these recommendations are followed does it mean workers will stop getting sick with anthrax?
The interim recommendations that have been developed are based on the limited information available on ways to avoid infection and the effectiveness of various prevention strategies. As new information becomes available the guidelines will be updated. These recommendations do not address instances where a known or suspected exposure has occurred. Workers should be trained in how to recognize and handle a suspicious piece of mail ( In addition, each work site should develop an emergency plan describing appropriate actions to be taken when a known or suspected exposure to B. anthracis occurs.

What kinds of anthrax worker safety guidelines are being issued?
The recommendations are divided into four categories. They are engineering controls, administrative controls, housekeeping controls, and personal protective equipment for workers. The guidelines describe measures that should be implemented in mail-handling/processing sites to prevent potential exposures to B. anthracis spores.

Is CDC telling all mail handling operations to adopt these anthrax worker safety guidelines immediately?
Every facility is different and should be evaluated based on the recommendations in the guidelines, and the recommendations implemented should be selected on the basis of an initial evaluation of the work site. This evaluation should focus on determining which processes, operations, jobs, or tasks would be most likely to result in an exposure should a contaminated envelope or package enter the work site. Many of these measures (e.g., administrative controls, use of HEPA filter-equipped vacuums, wet-cleaning, use of protective gloves) can be implemented immediately; implementation of others will require additional time and efforts.

What kinds of engineering controls should mail-handling/processing operations consider implementing for detecting anthrax spores?
B. anthracis spores can be aerosolized during the operation and maintenance of high-speed, mail-sorting machines, potentially exposing workers and possibly entering heating, ventilation, or air-conditioning (HVAC) systems. Engineering controls can provide the best means of preventing worker exposure to potential aerosolized particles, thereby reducing the risk for inhalation anthrax, the most severe form of the disease. In settings where such machinery is in use, the following engineering controls should be considered:

  • An industrial vacuum cleaner equipped with a high-efficiency particulate air (HEPA) filter for cleaning high-speed, mail-sorting machinery
  • Local exhaust ventilation at pinch roller areas
  • HEPA-filtered exhaust hoods installed in areas where dust is generated (e.g., areas with high-speed, mail-sorting machinery)
  • Air curtains (using laminar air flow) installed in areas where large amounts of mail are processed
  • HEPA filters installed in the building’s HVAC systems (if feasible) to capture aerosolized spores. (Note: Machinery should not be cleaned using compressed air [i.e., blow-down/blow-off].)

What administrative controls should mail-handling/processing sites consider implementing to protect workers from exposure to B. anthracis spores?
Strategies should be developed to limit the number of people working at or near sites where aerosolized particles may be generated, such as mail-sorting machinery and places where mailbags are unloaded or emptied. In addition, restrictions should be in place to limit the number of people including support staff and nonemployees entering areas where aerosolized particles may be generated. This recommendation applies to contractors, business visitors, and support staff.

What housekeeping controls in mail-handling/processing sites are recommended to protect workers from exposure to B. anthracis spores?
In the mail-handling work-site, dry sweeping and dusting should be avoided. Instead, the area should be wet-cleaned and vacuumed with HEPA-equipped vacuum cleaners.

What personal protective equipment for workers in mail-handling/processing sites is recommended to protect workers from exposure to B. anthracis spores?
Personal protective equipment for workers in mail-handling/processing work sites must be selected on the basis of the potential for cutaneous or inhalation exposure to B. anthracis spores. Handling packages or envelopes may result in skin exposure. In addition, because certain machinery such as electronic mail sorters can generate aerosolized particles, people who operate, maintain, or work near such machinery may be exposed through inhalation. People who hand sort mail or work at other sites where airborne particles may be generated such as where mailbags are unloaded or emptied may also be exposed through inhalation.

What are some examples of personal protective equipment and clothing that could be used to protect workers who handle mail from exposure to B. anthracis spores?

  • Protective, impermeable gloves should be worn by all workers who handle mail. In some cases, workers may need to wear cotton gloves under their protective gloves for comfort and to prevent dermatitis. Skin rashes and other dermatological conditions are a potential hazard of wearing gloves. Latex gloves should be avoided because of the risk of developing skin sensitivity or allergy.
  • Gloves should be provided in a range of sizes to ensure proper fit.
  • The choice of glove material such as nitrile or vinyl should be based on safety, fit, durability, and comfort. Sterile gloves such as surgical gloves are not necessary.
  • Different gloves or layers of gloves may be needed depending on the task, the dexterity required, and the type of protection needed. Protective gloves can be worn under heavier gloves such as leather, heavy cotton for operations where gloves can easily be torn or if more protection against hand injury is needed.
  • For workers involved in situations where a gloved hand presents a hazard such as those who work close to moving machine parts, the risk for potential injury resulting from glove use should be measured against the risk for potential exposure to B. anthracis.
  • Workers should avoid touching their skin, eyes, or other mucous membranes since contaminated gloves may transfer B. anthracis spores to other body sites.
  • Workers should consider wearing long-sleeved clothing and long pants to protect exposed skin.
  • Gloves and other personal protective clothing and equipment can be discarded in regular trash once they are removed or if they are visibly torn, unless a suspicious piece of mail is recognized and handled. If a suspicious piece of mail is recognized and handled for anthrax, the worker’s protective gear should be handled as potentially contaminated material (see “Guidelines for Hand Hygiene and Environmental Infection Control,” 2002 and 2003, available at
  • Workers should wash their hands thoroughly with soap and water when gloves are removed, before eating, and when replacing torn or worn gloves. Soap and water will wash away most spores that may have contacted the skin; disinfectant solutions are not needed.

Are there some areas in the postal setting that present a greater risk to some workers than others for anthrax exposure?

  • People working with or near machinery capable of generating aerosolized particles, such as electronic mail sorters, or at other work sites where such particles may be generated should be fitted with NIOSH-approved respirators that are at least as protective as an N95 respirator.
  • People working in areas where oil mist from machinery is present should be fitted with respirators equipped with P-type filters.
  • Because facial hair interferes with the fit of protective respirators, workers with facial hair like beards or large moustaches may require alternative respirators such as powered air-purifying respirators [PAPRs] with loose-fitting hoods.
  • Workers who cannot be fitted properly with a half-mask respirator based on a fit test may require the use of alternative respirators, such as full facepiece, negative-pressure respirators, PAPRs equipped with HEPA filters, or supplied-air respirators.
  • If a worker is medically unable to wear a respirator, the employer should consider reassigning that worker to a job that does not require respiratory protection.
  • In addition, the use of disposable aprons or goggles by persons working with or near machinery capable of generating aerosolized particles may provide an extra margin of protection.

How can I recognize suspicious packages that have anthrax?
Only specially trained personnel can distinguish between a real bioterrorism attack and a false one. If you suspect that a package, letter, or anything else contains a harmful biological agent, call 911 to activate the local emergency response system; in communities without 911 systems, notify local law enforcement authorities. Guidance on identifying suspicious packages and letters and what to do until the authorities arrive are available on CDC’s Web site at

What can the consumer buy to protect against germ or chemical warfare such as anthrax?
Currently, the CDC does not recommend consumers buy any particular product to protect against biological or chemical attacks.

What should be done with clothing contaminated with anthrax? Is washing in a regular home washer and dryer ok? Does CDC recommend adding bleach to the wash?
Contact your state or local public health department for advice. Clothing can be decontaminated using soap and water, and 0.5% hypochlorite solution (one part household bleach to 9 parts water).

Are other solutions used at hospitals for cleaning blood spills also effective against anthrax?
(Source: Interim Recommendation for Firefighters and other First Responders) The recommendation for decontaminating equipment is a 0.5% hypochlorite solution (1 part household bleach to ten parts water).

What actions need to be taken if a facility is found to have an environmental sample positive for anthrax?
The number and location of positive environmental samples will be used to guide clean-up efforts. Positive environmental samples alone do not indicate the need for antibiotics or the need to close a facility. Employees, visitors, and family members of employees at these facilities are advised to monitor their own health carefully and report any unusual symptoms to a physician.

  • Page last updated December 2, 2002
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