Aerosolized Transmissible Diseases Guidance Document

Prior to COVID-19, pandemic influenza viruses have emerged four times in the previous one hundred years. This includes “Spanish” influenza (H1N1) in 1918, “Asian” influenza (H2N2) in 1957, “Hong Kong” influenza (H3N2) in 1968, and H1N1 “swine” influenza in 2009 (Saunders-Hastings & Krewski, 2016; Taubenberger, 2005). In early May 2024, the first reported human case of avian flu (H5N1) that had also infected cows in the US appeared in the literature (Uyeki et al., 2024). In late August 2024, OSHA released a hazard alert providing information for dairy workers on avian influenza in dairy cattle, together with personal protective equipment (PPE) recommendations (OSHA, 2024). Genetic sequencing of some of the newer variants revealed a “rapid evolutionary progression” (Singh et al., 2024). As of December 2024, at least 46 human case patients with mild H5N1 infection and one case of critical illness have been reported (Ison & Marrazzo, 2024; Garg et al., 2024). This emphasizes that the lessons learned from previous epidemics and pandemics need to be incorporated into occupational health practice now and in the future. In response to the 2009 H1N1 pandemic, the AIHA (2009) adopted a position statement on that outbreak and worker health. This guidance document serves as an update to provide a more comprehensive analysis of lessons learned from the two most recent pandemics: H1N1 in 2009 and COVID-19 in 2019-2023.