Adapting a U.S. occupational health and safety process to an international training program on the safe and effective use of personal protective equipment during avian influenza outbreaks

The protection of health care workers through the use of personal protective equipment and other universal precautions has been well-established, albeit variable, practice in the U.S. for many years, particularly during infectious disease outbreaks. Ensuring these same protections in developing countries has been more of challenge for a variety of reasons, including a lack of resources, absence of regulations/guidance, and lack of training and education opportunities. Under a contract for the U.S. Agency for International Development (USAID), we developed a set of training materials to educate animal and human health officials on the safe and effective use of personal protective equipment, decontamination supplies, and laboratory sampling and testing kits for use during avian influenza outbreaks. Although these training modules were based on well-established occupational safety and health models, several concessions were made to accommodate the reality of working in developing nations – such as providing case studies addressing not re-using PPEs. After a pilot implementation of the modules in 15 countries in Africa, Central Asia, Asia and the Middle East, it was determined that the modules would need to be further tweaked to take into account cultural and socio-economic differences (e.g., the proper fitting of PPE in countries where religious practice dictates the wearing of facial hair and headwear). This presentation will outline the development of an occupational health and safety training program for use in the international arena, present observations from the pilot implementation, and discuss implications on ensuring worker health and safety in developing countries.