Interim Guidance for Employers for Protection of Migrant and Seasonal Farmworkers from the Novel H1N1 Flu Virus

May 5, 2009 1:13 AM ET

This document provides interim guidance for employers of migrant and seasonal farmworkers for the prevention of the novel H1N1 flu virus. All CDC guidance relating to novel H1N1 flu, including those relating to workplaces, remains applicable. This guidance is intended to provide supplemental information recognizing the unique characteristics of this worker population.

Background

A novel H1N1 flu virus has infected humans in the United States and Mexico. The Centers for Disease Control and Prevention (CDC) has determined that this novel H1N1flu virus is contagious and is spreading from human to human. However, at this time, it is not known how easily the virus spreads between people.

The symptoms of this novel H1N1 flu are similar to the symptoms of regular human seasonal influenza and include:

• Feeling feverish or temperature greater than 100°F (37.8°C) if measured.
• Cough
• Sore throat
• Stuffy or runny nose
• Body aches, headache, chills and fatigue, diarrhea, vomiting

Migrant and seasonal farmworkers in the United States represent a large labor market, estimated at 2.5 million workers. Seventy-five percent of migrant farmworkers are Mexican-born. Characteristics of migrant workers include poverty, limited education, frequent mobility, and environmentally poor living conditions. Many may not speak or read English well. Furthermore, most migrant farmworkers have limited access to health care services. For these reasons, the health status of migrant workers is difficult to monitor. In addition, since more than half of migrant and seasonal farmworkers are estimated to be undocumented, workers may hesitate to report cases of flu.

For more information about the demographic characteristics of U.S. farmworkers, see http://www.dol.gov/asp/programs/agworker/report9/toc.htm.

General information about novel H1N1 flu virus is available at http://www.cdc.gov/h1n1flu.

Interim Recommendations

Avoid stigmatization
It is important to emphasize that the spread of novel H1N1 flu is occurring in countries around the globe including Mexico and many states in the United States so it will be difficult to determine the risk of any migrant worker spreading novel H1N1 flu. Employers can play an important role in communicating this message within the workplace and to their surrounding communities. This should help avoid unwarranted stigmatization of this population. More information about the effect of stigmatization is available at http://www.upmc-biosecurity.org/website/focus/swine_flu_updates/pdf/2009-04-29-NoStigma.pdf.

Encourage workers to report illness to their employer
Low-wage farmworkers may be reluctant to forego wages or possibly forfeit their jobs to stay home when they are ill. It is important that employer policies not discourage self-reporting and self-isolation by ill workers. To the extent possible, employers should provide some assurance of wage or job protection for ill workers who are willing to self-isolate or who need to be absent from work to seek medical care. Employers should provide training to workers on novel H1N1 flu including symptoms, how it is spread, high risk groups for complications of the flu, and how to protect themselves and others. General information about novel H1N1 flu is available in English (http://www.cdc.gov/h1n1flu/general_info.htm ) and Spanish (http://www.cdc.gov/h1n1flu/espanol/influenza-porcina-info-general.htm ). Migrant health clinics and other migrant community organizations could be a resource for providing this information. See http://www.migrantclinician.org/health_centers.html for locations of Migrant Health Centers.

Exclude ill workers from the workplace
Workers who have symptoms of a flu-like illness (fever with runny nose, cough or sore throat) should not be allowed to work while they are ill. They should be encouraged to remain at home until they are better or, if necessary, to seek medical care from their health care provider. Since most migrant farmworkers do not own their own vehicle and may not have a regular health care provider, employers may need to contact Emergency Medical Services for transportation of sick workers to the nearest hospital emergency department for care.

Ensure public health messages reach workers
Employers may be an important conduit for information coming from public health officials. Employers should ensure that all information from public health authorities is passed on to workers. By working with migrant farmworker health organizations, employers can help to ensure that public health messages are delivered in a culturally competent manner. Health awareness messages should be in languages appropriate to the local migrant worker population. For migrant farmworkers, the most common languages are Spanish, Haitian Creole, and indigenous languages such as Mixteco and Zapotec.

Ensure a hygienic workplace
Personal hygiene measures such as frequent hand washing and cough etiquette are important factors in limiting the spread of infection during a pandemic. Employers should ensure that the workplace has adequate facilities for maintaining personal hygiene, including frequent hand washing. Supplementing existing handwashing facilities with hand sanitizer (e.g. providing individual-sized bottles to workers, placing bottles/dispensers on trucks) may be beneficial. Minimum hygiene standards for workplaces are regulated by Federal and State laws (see, for example, http://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=FACT_SHEETS&p_id=137 for hand washing requirements in the Occupational Safety and Health Administration field sanitation standard). However, during a pandemic, employers should strive to provide optimal rather than minimal standards of hygiene in the workplace.

OSHA regulations applicable to workplace sanitation are available at http://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=STANDARDS&p_id=9790.

Ensure adequate housing when housing is provided by the employer
When worker housing is provided, employers should ensure that housing is not overcrowded and can accommodate the isolation of ill persons and voluntary quarantine of contacts. Guidelines for home care of sick persons can be found at http://www.cdc.gov/h1n1flu/guidance_homecare.htm. In addition, Federal law and regulations set standards for housing provided for migrant workers (see, for example, http://www.osha.gov/pls/epub/wageindex.download?p_file=F28165/wh1465.pdf, http://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=STANDARDS&p_id=9791 and http://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=INTERPRETATIONS&p_id=18958). Employers should also assist State and local health authorities with implementation of measures intended to reduce the spread of the novel H1N1 flu virus. See http://www.cdc.gov/h1n1flu/mitigation.htm for more information.

For More Information

• Guidance on Preparing Workplaces for an Influenza Pandemic
• http://www.osha.gov/Publications/OSHA3327pandemic.pdf

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