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 A transition program is recommended for
facilities in which anthrax contamination has been identified and
normal work operations are conducted. Three examples of this
situation include the following:
- Normal work activities were resumed in a contaminated facility
following decontamination and clearance sampling efforts.
- Original sampling identified low levels of surface and air
contamination and therefore occupancy is permitted.
- Occupancy is permitted outside an established exclusion zone
in which decontamination is being performed.
The
duration of the program would generally be dictated by sampling
results obtained during the transitional period. Site-specific
transitional elements should be developed for each facility and
incorporated as part of the regular site health and safety plan (HASP).
It is recommended that an industrial hygienist develop these
elements or at a minimum provide input during the development phase.
Transitional Program elements to be included in the HASP include
some or all of the following elements, as applicable:
| Hazard
Awareness Training |
Hazard awareness training
is intended to communicate information concerning hazards of
anthrax and appropriate protective measures to employees. This
program may include, but is not limited to:
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 Elements of the transition program.
- The health hazards of anthrax, including routes of
entry, signs and symptoms
of exposure, synergistic effects, and any medical
conditions which would place employees at increased risk
(i.e., immunocompromised individuals).
- Operations in the work area where anthrax has been
identified.
- Dissemination of sampling results to employees, including
information on how to gain access to such results.
- Any applicable control measures, such as appropriate
engineering controls, work practices, housekeeping, or personal
protective equipment (PPE).
- Implementation of interim standard operating procedures to
control anthrax exposure during operations, maintenance,
cleaning, etc.
- Frequent updates regarding any on-going anthrax sampling,
decontamination, control, medical surveillance, and related
activities being performed at the facility, as applicable.
Additional detailed information may be found
at the following site:
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| Medical
Surveillance |
 A medical surveillance
program is necessary to ensure that employees receive
appropriate preventive care. Medical surveillance includes,
but is not limited to:
- Identification of employee population at risk and
establishment of controls for such employees (such as work
reassignment, PPE,
prophylactic medication, etc.).
- Administrative follow-up on absentees (such as sick
leave, etc.).
- Selection of prophylactic medication, as appropriate.
- Response to symptoms reported by employees.
Additional detailed information may be found at the following sites:
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| Transitional
Sampling |
Transitional
sampling is conducted to confirm that the occupied areas remain safe
for occupancy. Sampling during this period is continued until
repeatable results demonstrate that contamination remains below an
established target level. Additional information can also be found
in the chapter on sampling. Elements of transitional sampling
include, but are not limited to, the following:
-
 Determination of appropriate sampling techniques.
Recommended techniques include non-aggressive high-volume
air sampling, aggressive HEPA vacuum surface sampling, and
if appropriate bulk sampling (such as bulk samples from
HEPA vacuum bags used to clean surfaces).
- Use of high-volume air sampling as an essential tool in
order to characterize levels of anthrax in the air and
provide inhalational exposure information to employees.
- Identification of specific locations and frequency of
sampling.
Additional detailed information may be found at the following site:
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| Personal
Protective Equipment |
 The
workplace must be reassessed in order to select and use
appropriate personal
protective
equipment (PPE) to protect employees from the
anthrax hazards present. The specific types of PPE utilized
would be dependant on the actual operation in question and
results from the reassessment. Examples of work operations
where modifications to PPE may be necessary are as follows:
- Operating equipment or working on surfaces where anthrax was
previously identified.
- Performing maintenance tasks, such as cleaning equipment or
changing HEPA vacuum filters.
Additional detailed information may be found
at the following site:
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| Personal
Hygiene |
 A
personal hygiene program should be implemented to limit exposures and
control the spread of anthrax contamination. Procedures that may be
required include the following:
- Assuring that food or beverage is not present or
consumed, tobacco products are not present or used, and
cosmetics are not applied.
- Regular washing of the hands and/or face, and before
eating, drinking, using tobacco, or applying cosmetics.
- Showering as necessary.
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| Interim
Standard Operating Procedures |
Interim
standard operating procedures (SOPs) must be developed to address
special work activities necessary under the transitional program.
Affected employees should receive training on the interim
SOPs. These SOPs may include, but are not limited to, the
following topics:
-
 Maintenance and housekeeping procedures developed or
modified to control the spread of contamination and
protect employees. Examples of procedures include:
- Use of HEPA vacuums for cleaning surfaces instead of
sweeping or other methods,
- Cleaning, maintenance, and filter and bag removal
for HEPA vacuums,
- Maintenance and cleaning of facility equipment,
- Cleaning of floors and other surfaces, and
- Handling and disposal of wastes.
- Changes to regular work operations and equipment, as
applicable.
- Modifications to facility-wide mechanical systems,
particularly heating, ventilation, and air-conditioning (HVAC)
systems. Examples of HVAC modifications include:
- Increase in ventilation rates (air changes per hour)
- Increase in percentage of outside air
- Use of HEPA filters to collect dust in circulated air
- Other applicable major elements being implemented as part of
the transitional program, as described previously (such as
training, medical surveillance, sampling, PPE, and hygiene).
Additional detailed information may be found
at the following site:
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