Provincial public health officials have updated the Point of Care Risk Assessment (PCRA) tool used by health care workers to assess the risk of exposure to COVID-19 in their interactions with patients. This may support requests for N95 respirators in a wider range of health care settings.
The updated guidance, published by the Ministry of Health and the BC Centre for Disease Control on February 2, includes examples of scenarios that may elevate risk of airborne or aerosol transmission and support the use of N95 respirators when working with patients with suspected or confirmed COVID-19:
- In a room or unit with multiple patients who are suspected or confirmed to have COVID-19.
- In a room or unit where frequent or unexpected Aerosol Generating Medical Procedures (AGMPs) may occur.
- If there is prolonged close proximity (more than 15 minutes of face-to-face contact) to the patient.
- If the patient has excessive and sustained coughing without wearing a medical mask for source control.
- If it is anticipated that the patient will be doing an activity with heavy expiratory exertion (such as shouting).
Many HEU members work in situations that are reflective of the scenarios above, but where they have been limited to droplet and contact precautions and not provided access to N95 respirators. These scenarios should expand workers’ access to N95 respirators by clarifying that there is an increased risk of airborne and aerosol transmission in these settings.
The updated PCRA also requires that a respirator such as an N95 be provided where organizational risk assessments, part of worksite exposure control plans, determine there is elevated risk for aerosol transmission.
Employers are required to develop and implement exposure control plans that identify potential for exposure to COVID, and implement control measures to protect workers from transmission.
The union says this guidance must inform the site exposure control plans and be enforced by WorkSafeBC.
The PCRA should be accessible to all health care workers. But many do not receive an orientation on conducting PCRAs and are unaware of this mechanism for securing additional PPE including respirators.
In addition, the PCRA process puts the responsibility on individual workers to assess their risk before every interaction when their employer should be proactively making those decisions based on the exposure control plan and the application of the precautionary principle.
HEU has been urging the Ministry of Health and public health officials to revise its policies on mask use so that health care workers have expanded access to N95s.
The updates to the PCRA requires employers to secure an adequate supply of N95s from the provincial inventory, and to ensure workers are trained to do PCRAs, and are fit tested for the supplied N95.
If you identify hazards that you believe increase the risk of COVID-19 aerosol transmission while performing your work duties:
- Stop your task and speak with your supervisor.
- Request an N95 respirator. You are required to be fit-tested for your respirator before working in a situation where it’s needed. If you haven’t been fit-tested for the N95 respirator, request a fit-testing from your employer.
- Tell your JOHS Committee worker rep about the situation and your concern, for follow-up at the next meeting.
If you are denied:
- Stop your task and speak with your supervisor.
- Connect with your worksite steward or Joint OHS Committee member for support to problem solve the situation with your supervisor.
- Call WorkSafeBC prevention line and request to speak with an Officer:
o Phone: 604.276.3100 (Lower Mainland)
o Toll-free: 1.888.621.7233 (1.888.621.SAFE)
- Use your unsafe work refusal process. How to refuse unsafe work
- Formally report the concern to your employer.
o Health Authority Employees call the Workplace Health Call Centre at 1-866-922-9464.
o Affiliate/Independent employees, ask your supervisor for the appropriate form. It may be called a hazard report or an incident report form.
For further assistance, please email or call the HEU OHS Department with your name, worksite, number to reach you and a brief description of your concern.
Email: ohs@heu.org
Phone: 604-456-7236 or toll free: 1-855-456-7236
Our email and voice mail is monitored Monday through Friday, from 8:30 a.m. to 5 p.m.