Protecting Workers from Ebola: Eight Knowledge Generation Priorities

On November 3, the Institute of Medicine and the National Research Council of the National Academies convened a workshop of distinguished representatives from the public and private sectors.   The participants were asked to suggest priorities for research that will “provide public health officials, healthcare providers, and the general public with the most up-to-date information about transmission, health risks, and measures that should be taken to prevent spread of [Ebola virus disease] in the U.S.” NIOSH was pleased to contribute to this dialogue, specifically by addressing issues critical for protecting heath care workers from work-related infection.

Researchers and practitioners have decades of experience related to the use of sampling, analysis, personal protective equipment (PPE) and other traditional measures for assessing exposures and minimizing the risks of occupational illness and injury in the industrial setting. That knowledge underpins standard industrial hygiene practices in factories, mines, and construction sites. Strategic research is vital for building a comparably robust base of evidence for reducing occupational risks from infectious diseases in the complex health care setting. By stimulating the knowledge needed to better meet the challenges of Ebola today, we also lay a stronger foundation for anticipating tomorrow’s potential threats from other novel infectious diseases in our 21^st Century world of international commerce and rapid air travel.

NIOSH’s recommendations on priorities for generating new knowledge to protect workers from Ebola were summarized in a plenary presentation by NIOSH Director John Howard, M.D. The recommendations address priorities in two general areas: PPE and biological behavior of the Ebola virus.

In the category of research on PPE, NIOSH suggests five questions for priority attention:

• How do we quantify worker exposure to match appropriate PPE with the required level of exposure protection?
• What are the best test methods to determine if a given type of PPE will protect the worker?
• What are the most effective donning and doffing procedures to prevent worker self-contamination?
• Are there novel PPE designs that will be more effective for health care workers to use in patient care settings?
• How can we prioritize PPE distribution in the health care system to best utilize the supply chain?

In the category of biological behavior, we suggest three questions for priority attention:

• How long does Ebola virus remain viable on surfaces, including on PPE?
• What types of disinfectants and contact times are needed to inactivate Ebola virus?
• What are the best sampling methods to detect viable Ebola virus on surfaces and on PPE?

A video of Dr. Howard’s presentation at the workshop, which provides further details on the recommendations for research, can be found on the IOM website .In some cases, the recommendations reflect studies that address needs that have already been identified by our stakeholders, and that already are under way in our laboratories, and we look forward to discussing those studies at greater length in future NIOSH Science Blogs. We also look forward to the report that will come out of the November 3 workshop. For additional information about the workshop, click here.  These efforts are building on President Obama’s announcement of a Grand Challenge to help health care workers on the front lines provide better care and stop the spread of Ebola. More information about the Grand Challenge is available on the website.

In the meantime, we invite you to share your questions and comments as we continue to work with diverse colleagues to identify needs and opportunities for world-class research on Ebola virus disease.

John Howard, MD, is the NIOSH Director.

Margaret Kitt, MD, is the NIOSH Deputy Director.

Maryann D’Alessandro, PhD, is the Director of the NIOSH National Personal Protective Technology Laboratory.

CDR Lisa Delaney, MS, CIH, is Associate Director for the NIOSH Emergency Preparedness and Response.

Chad Dowell MS, CIH, is an Industrial Hygienist with the NIOSH Emergency Preparedness and Response Office.