The Health, Safety and Environment Department has fielded a huge number of calls about the spread and consequences of swine flu over the past few weeks, This special edition of Health and Safety Matters outlines developments to date, and the GMB approach. We will update Safety Representatives through further special editions once further information is available. What is Swine Flu? Swine flu is a respiratory illness caused by a virus that usually infects pigs. People do not normally get swine flu but human infection can happen, and has increased rapidly in the UK in Summer 2009. The latest outbreaks in countries around the world have been caused by a new version of the swine flu virus called H1N1 influenza. In April 2009 a new strain of influenza broke out in Mexico and by the middle of June, the World Health Organisation had declared a world- wide pandemic. The Mexican outbreak appears to be a new version of the H1N1 strain of influenza type A. H1N1 is the same strain which causes seasonal outbreaks of flu in humans on a regular basis. But this latest version of H1N1 contains genetic material that is typically found in strains of the virus that affect humans, birds and swine. The fatality rate for previous pandemics has varied from 0.2% to 2% of the population, with between 25% and 50% of the population being affected during the outbreak. The worst case scenario is that the 50% of the population could become ill over a period of 3-6 months, resulting in a maximum of 750,000 deaths. Many of these will be people with reduced or developing immune systems – the elderly; children; pregnant women; and those with existing health conditions. However this is the worst of the likely outcomes and, in reality any pandemic would probably be much less severe. The present flu virus seems at present to be “milder” than some previous ones but that could change as it mutates. Realistically the H1N1 strain is going to be around for months, not days. In any case, the UK has 34 million doses of the drugs – more than enough to go around; anyone who needs treatment will get it promptly simply by calling their GP or NHS Direct.
GMB SAFETY REPS What are the symptoms of swine flu? The symptoms of this swine flu in people are similar to the symptoms of regular human seasonal flu and include:
• Fever • Fatigue • Lack of appetite • Coughing • Sore throat • Pain in muscles and joints • Headache and chills.
Some people with swine flu have also reported vomiting and diarrhoea. Am I at risk of catching swine flu? The swine flu virus is contagious and can spread between people. The swine flu virus is thought to spread in the same way as seasonal flu:
• From person to person by coughing or sneezing. • From touching an object such as a door handle which has virus on it from someone
Taking hygienic precautions can help to reduce transmission of all viruses, including the swine flu virus. This includes:
• Covering your nose and mouth when coughing or sneezing, using a tissue when
• Prompt and careful disposal of dirty tissues • Frequently washing hands with soap and water to reduce the spread of the virus
from the hands to the face or to other people
• Cleaning hard surfaces (such as door handles) frequently using a normal cleaning
I think I may have been exposed to the swine flu virus - what should I do? If you think you may have swine flu, you should first check your symptoms on call NHS Direct (0845 46 47) or call the Swine Flu information line on 0800 1 513 513. If you are still concerned, you should call your GP, who can provide a diagnosis over the phone. It is also important to make sure you follow the basic hygiene precautions described above. You must contact your employer as soon as you develop symptoms – do not got into work under any circumstances unless directed to by a medical professional Can swine flu be treated? The swine flu virus can be treated with anti-viral medication called Oseltamavir (Tamiflu) and Zanamivir (Relenza), which reduce the development of the virus and lessen the symptoms.
General Secretary Paul Kenny GMB 22-24 Worple Road London SW19 4DD
Antiviral medication does not cure the infection, but reduces its impact and helps the body recover. It should be taken as soon as possible, ideally within 48 hours of the infection starting. How will I get antiviral medication if I need it? People with symptoms and others at risk will be assessed by their GP. If Swine Flu is confirmed, the patient's GP will give them an authorisation voucher, which a flu friend can take to an antiviral collection point to pick up their antivirals. This may be a pharmacy or a community centre. The Department of Health is advising that everyone establish a network of "flu friends" - friends and relatives - who can help if you fall ill. They could, for example, collect medicines and food for you. Is there a vaccine to protect against swine flu? There is no vaccine currently available, as the virus that is circulating is a new strain. However, a vaccine is already being developed to immunise people against swine flu. The government has said that it expects the first batches of vaccines to arrive in August, with around 60 million doses available by the end of the year - enough for 30 million people - with more following after that. Why is swine flu a trade union issue? A swine flu pandemic will have cause major upheaval in the workplace. Many workers will be absent from work at any one time, through a combination of illness, the need to look after family members, and the potential inability to travel to work using public transport. By working in partnership trade unions and employers can help to minimize the impact of a swine flu pandemic, by ensuring that the workforce are educated and informed on transmission issues, and helping to ensure that there is no panic. Safety reps will have a key role to play in ensuring that those workers who are ill as a result of infection stay at home and do not come in to work. What can Safety Reps do? Safety reps should ensure that their employer has either a specific policy in place for dealing with pandemic influenza, or a general policy covering major incidents that also covers pandemic influenza. There have been several pandemic flu scares over the past decade (Bird Flu; SARS), so large employers and public sector organizations should have existing plans and procedures in place. Unions must be involved in the development and implementation of any such policies, as they will need to be credible to employees and must have the confidence of the whole
GMB SAFETY REPS
workforce. It cannot be left to employers alone to decide on what is an appropriate response. When considering your employer’s response to pandemic influenza the following are some of the areas that you may wish to address: i) Are the proposals reasonable and practical? Many employers will simply add ‘‘swine flu’’ onto an existing emergency plan without making any real changes. To have practical value, the employer must actually go through the process of considering what effect all the different possible scenarios would have on their staff and how they operate. This should include the worst likely situation of up to 50% of the workforce being absent from work, resulting disruption to transport and the disruptions to other services, such as emergency repair work or planned maintenance. The key questions that safety reps should ask are:
• Does the employer’s plan underestimate the possible absence rate in the event of a
major pandemic, as a consequence of employee infection and/or if the schools close?
• Have they looked at issues around supply of materials or services? • Have all departments been involved in drawing up the plan? • Does it treat all staff equally? • Have they considered the operation of functions such as cleaning and catering, if
these are not done ‘‘in-house’’?
ii) Dealing with sickness absence Some employers are planning for absenteeism rates of up to 50%. This is on the basis that it will not only be those who are ill that are unable to come into work, but also those looking after family members or those with children in the event of schools being closed. In addition, in the event of a severe pandemic, some staff will be afraid to come into work for fear of contracting the virus. There may also be difficulties with public transport. Trades unionists will have to ensure that employers do not encourage staff to come in when they are ill. It is vital that all staff who are ill remain at home until fully recovered. The HSE and government advice is clear. “Advise your staff to stay at home if they are sick with flu-like symptoms and send home any employees who are displaying flu-like signs/symptoms.”
It is likely that increased sickness absence may put pressure on other employees to work longer hours to cover for those who are off. Employers will still be covered by the Working Time Regulations and it will not help if those employees who remain at work find their
General Secretary Paul Kenny GMB 22-24 Worple Road London SW19 4DD
health being undermined by excessive pressure. In the event of a pandemic breaking out, safety reps should negotiate with their employers over issues such as staff taking leave. iii) Remote or lone working The requirement for staff to stay away from the workplace to stop the spread of swine is likely to lead to sharp increases in working from home. This should generally be encouraged, but there must be arrangements made to ensure that systems are in place to enable them to do so. This requires consideration of IT issues, including internet access, DSE assessment and the management and coordination of work. Another issue for trade unions is the fact that many workers, such as cleaners, are simply not able to work from home. Safety reps should ensure that in negotiating policies on working from home, there is no discrimination between roles. Staff should not be disadvantaged through not being able to work at home because of the nature of their job. Where employees are required to work in pairs, such as making home visits or delivering cash and valuables, risk assessments should be revised, and personal tracking systems should be implemented. If the revised risk assessments shows that risks of violence to workers are increased, then the number of visits should be reduced to ensure proper staffing, or activities should be suspended if paired accompanied visits cannot be guaranteed. iv) Personal protection Many employers have opted to stockpile gloves, masks, and hand-sanitising liquid as an extra form of control measure. GMB does not endorse this approach, outside of the health sector. Gloves will not prevent infection, as workers still touch their skin with the gloves on and then touch another surface or person. In addition, latex gloves carry significant risks of producing an allergic reaction (dermatitis) and were they to be used during an outbreak they create additional disposal issues. There is also no evidence that, outside health care situations, the general use of facemasks has any actual effect on protecting people, and their use is not generally recommended by the Department of Health. There is some evidence that people think that if they wear a mask, even if they are ill, they can still come to work, which would actually lead to increased risk. The guidance from HSE is clear: “It should not be necessary for workers to wear masks routinely when in contact with the general public. However, there may be some situations
GMB SAFETY REPS when it will be advisable for a worker to wear a mask. Such a situation will depend on the nature of the work and where it is to be carried out. Employers should carry out a risk assessment and, amongst other things, determine:
• Whether workers are likely to encounter members of the public who are displaying symptoms, for example, in a healthcare setting it is highly likely that contact with the public (patients) will include persons who have symptoms of influenza;
• Where contact with people displaying symptoms is likely, what measures can be
• The length and frequency of contact with members of the public.” This is not the case in the healthcare sector where there is likely to be close or frequent contact with symptomatic patients, and the use of gloves and masks may be required. The use of hand-sanitising liquid is slightly different. It may be that some public organisations will make it available at key entry areas or where there is likely to be contact between people. Public transport systems may use some form of sanitising spray in the event of an outbreak. However, care should be taken to ensure that any products used are fully safe to use and are not likely to exceed their sell-by date within the next few years if they are buying future supplies for storing. v) Cleaning and using air-conditioning the workplace Some organisations will increase their cleaning regimes in the event of an outbreak. However, they should bear in mind that it is likely that the number of cleaning staff may be reduced as a result of illness. Damp rather than dry dusting should be carried out during a pandemic to avoid the generation of dust, and it is recommended that the cleaning of surfaces be carried out using a freshly prepared solution of detergent and hot water followed, where necessary, by a chlorine-based disinfectant solution. There may also be proposals to switch off air conditioning systems in large open plan offices or workshops as a way of preventing the virus spreading. This is not recommended by the HSE, who state, ‘‘the overall effect would be to create more static air which may result in discomfort and ill health effects. The main advantage of air conditioning is that it has a dilution effect on stale/contaminated air and also provides a more comfortable environment overall. Therefore continue running any air conditioning system already provided for the workspace.’’ Should my employer purchase anti-viral medicines? Many employers are considering the private purchase of anti-viral medicines using the Internet. Some businesses have already bought supplies for their staff and, in some cases, are giving their workforce the opportunity to purchase supplies for family members in the event of an outbreak. GMB strongly opposes this policy, and believes it is contrary to the wider public interest. Should an outbreak occur, the limited stocks of anti-virals available should be distributed on the basis of need and effectiveness, and in accordance with an ethical framework.
General Secretary Paul Kenny GMB 22-24 Worple Road London SW19 4DD
While there is a priority case for the health sector, social care and emergency services, large corporations stockpiling supplies to keep their staff at work could have serious implications for other sectors. In any case, such a strategy is unlikely to work as employers would have to continue giving the medicine to individuals throughout the outbreak. This is not what anti-virals are intended for, nor is it the best use of stocks during a pandemic. The Department of Health does not recommend the stockpiling of private supplies of anti- virals by employers. The advice for businesses is not to buy stocks of Tamiflu or Relenza. They are only effective on people who are in the early stages of the virus, so you could give them to all of your staff today but by next week they would be unprotected. In addition, both Tamiflu and Relenza are prescription drugs, and it is illegal for anyone who is not medically qualified to give them to another person. My employer has taken no steps to plan for swine flu. What can I do? In the first instance, raise the issue formally with your line manager, and call for a meeting of the Health and Safety Committee as soon as possible. If this does not happen, or your employer ignores the issue, contact your Regional Organiser or Regional Health and Safety Officer for further advice. If this does not resolve the issue, contact the National Health, Safety and Environment
Where can I go for further information? The first source for updated guidance and information is the official NHS Swine Flu website:
The Health Protection Agency has detailed guidance for both workers and employers: Guidance from the Department of Health on risk assessment on pandemic flu can be found at:
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