In June 2009, the World Health Organization declared an Influenza A (H1N1) pandemic

Canada has been experiencing a second wave or resurgence of this virus and there is the possibility of a third wave before the flu season is over. Reducing the spread and mitigating the effects have become a public health priority.

Vaccines and anti-viral medication are the only interventions that have been tried and shown unequivocally to reduce the spread, and mitigate the impact of influenza.

Vaccination is one of the most important interventions for preventing transmission of influenza to healthcare personnel. Its ability to prevent influenza transmission in both work and community settings is especially important, because influenza is a community-based infection that is transmitted in household and community settings. Other interventions that work in healthcare settings alone will not prevent such transmission.

Vaccine not mandatory - but choosing to refuse may mean being sent home without sick pay.

 Legislation and case law do not support mandatory vaccination against the Pandemic (H1N1) 2009 virus. However, choosing to refuse may mean being sent home without sick pay. Alberta Health Services (AHS) has adopted a policy which applies to exposed workers during an outbreak. Many other healthcare employers are using these AHS policies as guidelines. If a worker has refused to receive the H1N1 vaccine and antiviral medication for non medical and non religious reasons, that worker will be required to stay off work for 96 hours (4 days) without pay, unless he/she draws from vacation or overtime banks. Similar policies have been challenged at arbitration many times. The decisions have upheld an employer's right to have policies in place to prevent and contain outbreaks, especially with a vulnerable patient population. The policies have been viewed as reasonable, and not violating the Charter rights of employees, because they do not require employees to be vaccinated to maintain their employment status.

Personal Protective Equipment (PPE) Needed Even After Vaccination

Remember, even if you are vaccinated, you may not be fully protected. Healthcare workers are particularly at risk. You need to continue daily selfassessment for influenza like illness (ILI). In addition, you need to continue to use PPE. There is always the possibility of new strains of influenza virus as well as other infectious respiratory agents.

To Date, No Scientific Confirmation of Mode of Transmission of this Virus. A lot of basic scientific research is being done right now to try to determine how much influenza virus gets aerosolized and under what circumstances. Even the initial distance the virus spreads is under review.

Choose To Be Safe

To protect themselves, their families, their co-workers and their patients, healthcare workers should use the highest level of personal protective equipment until it is confirmed that a lower level is safe.

During the H1N1 Influenza pandemic any healthcare worker who is in contact within 2 metres (6 feet) of a patient with known or suspected ILI, should wear PPE, including a fit tested, NIOSH approved, N95 respirator, gloves, gown and goggles or face shield.

Since there is no current data to confirm the route of transmission, it must be assumed that H1N1 is transmitted by all routes (contact, droplet and airborne) until there is scientific certainty.

Surgical masks are not certified to provide respiratory protection. Alberta Health Services has made it clear that they will not stop a worker who chooses to wear a N95 respirator, if the worker feels it is necessary based on a point of care risk assessment.

Safety Requirements

Wearing PPE is a legal obligation, NOT a personal choice. Any worker without medical or religious reasons for refusing to be fit tested may be subject to disciplinary action or charged under OHS legislation.

Employers must provide workers with PPE and provide mandatory education on how to perform a "fit check" each time they don the equipment and how to safely remove all PPE. Employers who do not comply, may be charged under OHS legislation

Accommodating Special Needs

Human Rights legislation protects workers from discrimination on "protected grounds". This means that the employer must make changes to "accommodate" workers who are unable to comply with safety requirements for medical or religious reasons. Usually this means they will assign them other duties where there is no exposure risk or perhaps provide another form of PPE which does not require a sealed fit.

Whether or not they have been vaccinated, employees who are pregnant, or who have underlying medical conditions which place them at risk, should not be asked to work with patients who have suspected or confirmed ILI.

Workers who are unable to be fit tested or who cannot achieve a proper facial seal or have not been provided with proper PPE including respiratory and eye protection, cannot be asked to work with persons who have suspected or confirmed ILI. Such workers should ask to be reassigned to other duties. Any member requiring assistance should contact his or her Labour Relations Officer.

WCB Coverage

If you become ill due to workplace exposure to the Pandemic (H1N1) 2009 virus, you must file a WCB claim. You are entitled to coverage. Your employer should confirm the workplace connection. If you require assistance, call 1-800-252-7904 and ask to speak to an HSAA Disability Advocate.

If you become symptomatic, and it is not due to a workplace exposure, you are entitled to use your sick leave or short term disability.

Unsafe Work Refusal

Refusing to perform unsafe work is not only a right, it is a legal requirement in Alberta. You can and should, refuse to perform any work duties that create a risk of injury and illness where the employer has not implemented appropriate control measures.

No Disciplinary action may be taken against a worker for refusing unsafe work.