Your employer is required to implement measures to eliminate or minimize the potential for exposure to COVID-19 while you work. Personal protective equipment is only one of those measures and must be combined with others to reduce risks to you.
- Your workplace OH&S rights – COVID-19 PPE
You have a right to a safe workplace. View HEU's poster on your basic health and safety rights.
Your rights & personal protective equipment (PPE)
Right to know:
- Your employer must provide you with training in how to correctly put on, take off, dispose of, or maintain the personal protective equipment you need for your job, to protect you from COVID19.
- Your employer must inform you when you must use the PPE. For example, Look for signage are patient room doors.
- Your employer must inform you of the other measures implemented to reduce the potential for exposure to COVID19.
Right to Participate
- You have the right to ask questions about what measures are in place to protect you and to raise the concerns you have. Two ways to participate are speaking directly with your supervisor, and connecting with your JOHSC member.
Right to Refuse Unsafe Work
- You have the right to refuse to do unsafe work, such as tasks you believe will put you or anyone else at risk of injury or work-related illness. You must follow the process.
- While your concern is being investigated, you may be assigned to temporary alternative work at no loss of pay, until the matter is resolved.
- You cannot be disciplined in any way for exercising your right to refuse unsafe work even if WorkSafeBC decides the work is safe.
- Which Personal Protective Equipment do I need?
You must wear personal protective equipment (PPE) when providing care to someone under investigation or confirmed with COVID-19.
People release respiratory fluids when they exhale (for example, when we breathe, cough, sneeze, sing, shout, exercise, or talk). These fluids vary in size from large droplets to very small aerosols. Aerosols can linger in the air, especially in indoor spaces.
According to Health Canada, the virus that causes COVID-19 spreads from an infected person to others, through these respiratory fluids, in three main ways:
- breathing in infectious particles or aerosols at short or long range
- having infectious droplets or aerosols land on the eyes, nose, or mouth
- touching eyes, nose, or mouth with hands that have the virus on them
Point of care risk assessments
The provincial policy “Mask Use in Health Care Facilities During the COVID-19 Pandemic” requires all staff to wear a medical mask at all times, including in common areas and break rooms, unless eating or drinking.
It also requires employers to provide N95 respirators and additional PPE in circumstances where a health care worker determines there is an elevated risk of transmission.
The policy states:
“Access to additional PPE for health care workers, such as respirators, will be provided in circumstances where, based on a point of care risk assessment, a health care worker determines there is elevated risk of COVID-19 transmission through patient/resident interaction.”
BC CDC updated its point of care risk assessment (PCRA) resource. The updated resource includes examples of scenarios that may elevate risk of COVID-19 aerosol transmission and support a request for additional PPE, including an N95 respirator.
All healthcare workers are entitled to do a point of care risk assessment (PCRA).
Even if you have not received specific training on how to do a PCRA, you can take the following steps to evaluate the situation, and identify hazards to support your request for additional PPE, including an N95 respirator.
Before a task or interaction with a patient or resident, think about what conditions (hazards) elevate the risk of transmission (and exposure to respiratory droplets and aerosols), such as:
- What are the patient behaviours – for example, are they coughing, yelling, sneezing or vomiting. Are they able to wear a mask?
- Are visitors present? Are they wearing masks?
- Are symptomatic patients mobile?
- Is the patient suspected to have or confirmed to have COVID-19?
- Are you providing direct face-to-face care, or in close contact?
- Are you assisting with an aerosol generating medical procedure (AGMP)?
- Are you in a space where there’s an ongoing AGMP? Or where one has recently occurred?
- Is the room a shared room such as a multi bed room, activity room, or dining room?
- What’s the ventilation like?
- How long will your interaction be?
The updated PCRA resource includes a number of examples of scenarios that may elevate risk of COVID-19 aerosol transmission:
- In a room or unit with multiple patients who are suspected or confirmed to have COVID-19 (such as a cohort unit or COVID-19 test collection and assessment centre).
- In a room or unit where frequent or unexpected 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).
If you identify hazards that you believe increase the risk of COVID-19 transmission while performing your work duties:
- Stop your task and speak with your supervisor
- Request an N95 respirator. You must 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 to be.
- 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: Phone: 604-276-3100 (Lower Mainland)or 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.
- Health Authority Employees call the Workplace Health Call Centre at 1-866-922-9464.
- 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.
Phone: 604-456-7236 or toll free: 1-855-456-7236
Our email and voice mail is monitored Monday through Friday, from 8:30 am to 5 pm.
Download the full provincial policy on mask use in health care facilities
AGMPs and N95s
Health care workers must wear an N95 respirator, instead of a medical mask, when performing or assisting with an aerosol-generating medical procedure (AGMP).
Employers are also required to provide N95 respirators and additional PPE in circumstances where a health care worker determines there is an elevated risk of transmission. See the section just above this for how to do a risk assessment.
N95 respirators are required for health care workers involved in the following procedures when patients or residents are suspected or confirmed to have COVID-19, or have influenza-like illness:
- Autopsies involving respiratory tissues
- CPR with bag valve mask ventilation
- Bronchoscopy and bronchoalveolar lavage
- Continuous positive airway pressure (CPAP) or bilevel positive airway pressure (BiPAP)
- Intubation and extubation procedures
- Nasopharyngeal aspirates, washes, and scoping
- Nebulized therapy
- Open airway suctioning
- Sputum induction
You must wear an N95 if you are:
- assisting with one of these procedures
- going into a room to assist while one is being done
- entering a room immediately after one is done
- entering a room after one is done, before the required air clearance time has lapsed.
The requirement for an N95 during and after an AGMP is for any occupation, and includes care aides in long term care.
For example, if you are assisting a resident with COVID-19 during their nebulizer treatment, or entering their room to provide care immediately after one is done, you are required to wear an N95.
You must be fit tested for an N95 and be provided with training in its use.
Your employer is required to inform you if you need an N95 for your work and provide you with a fit test each year.
If an AGMP is being performed, staff must be informed. For example, a sign saying “airborne precautions” may be posted at a patient’s door.
- Is there guidance for the safe-handling of deceased persons with suspected or confirmed COVID-19?
Yes, the BC CDC and Ministry of Health have published Provincial Guidance.
According to the guidance, workers must follow Routine Practices, which includes the appropriate use of PPE, performing diligent hand hygiene with plain soap and water or alcohol-based hand sanitizer (70% alcohol content), appropriate cleaning and disinfecting of equipment, and appropriate environmental cleaning.
Your employer is required to inform you of what PPE you need and procedures to follow if your tasks involve moving or handling a deceased person.
- What is the guidance for laundry and cleaning in health care settings?
The Ministry of Health provides a “COVID-19 Information Sheet for Environmental Service Providers in Health Care Settings”.
It provides guidance on:
- personal protective equipment for housekeeping and environmental service staff
- environmental cleaning
- waste management
- handling laundry
The document confirms the following:
- Environmental service staff are not to enter rooms or open-air COVID-19 units where an Aerosol Generating Medical Procedure (AGMP) has been conducted until required time has elapsed for air exchanges, and to use a fit-tested N95 respirator if entry to a room is required immediately after an AGMP procedure or before the required air clearance time has lapsed.
- For cleaning tasks in rooms where an AGMP is not involved, the PPE housekeeping and environmental service staff working in COVID19 units or rooms on droplet and contact precautions is:
- Eye protection (goggles, face shield, a mask with a visor, or safety glasses)
- Mask (surgical/procedure mask or one suited to the cleaning products being used)
- Closed work shoes
It also states “During the COVID-19 pandemic, all persons working in or visiting a Long-Term Care and Seniors Assisted Living facility should wear a surgical mask for the full duration of their shift or visit:
- Surgical masks should be removed just prior to breaks or when leaving the facility.
- Surgical masks should be changed if the masks become wet, damaged or visibly soiled.
- Once removed, the mask must be disposed of or placed in a receptacle for reprocessing. Do not put the mask back on.
- How do I clean my eye protection?
If you are provided reusable eye or facial protection, it must be disinfected before use.
In some cases, such as acute care/hospital sites, there may be a procedure in place to have equipment reprocessed for you.
In smaller settings like community health or long-term care, you may be assigned to clean this equipment. In this case, your employer is required to provide you with information, training, and supplies to complete the task.
The BC CDC has published the following guidance on how to care for PPE
- My eye or facial protection is too hot/making me dizzy/doesn’t fit right.
You must wear personal protective equipment (PPE) as required by your employer, including eye or facial protection (such as a face shield, visor or goggles).
Your employer must ensure that eye or facial protection fits properly and that the PPE itself does not create a hazard when you’re wearing it. Your employer should also consult with your Joint Occupational Health and Safety Committee (JOHSC) about what PPE is right for you and the hazards at your workplace.
If your eye or facial protection doesn’t fit right or is making you hot or dizzy, here are some steps you can take:
- Tell your supervisor. Explain that when you wear the eye or face protection that the employer has provided, you are experiencing symptoms that could lead to injury and that it is a ‘near miss’ incident.
- Report the ‘near miss’ incident.
- If you work for a health authority, report it to the employer’s Workplace Health Call Centre at 1-866-922-9464
- If you work for an affiliate or independent employer, fill out an Incident/Injury Report. Ask your supervisor for the form.
- Tell your JOHSC Worker Representative about it so they can raise the issue at their next meeting. If you don’t have a JOHSC at your workplace, contact your Shop Steward for assistance.
If you are a JOHSC Worker Representative and you or your coworkers are experiencing this, add the issue of eye protection to the agenda for your next JOHSC meeting. Explain the situation and work as a committee to come up with solutions, for example that the employer provide different sizes of eye protection or different kinds of eye protection options for workers to choose from. These sections in the OHS Regulation might be helpful in this discussion:
- OHS Regulation 8.4 says that JOHSC should be consulted when evaluating whether PPE is required and what PPE is appropriate.
- OHS Regulation 8.3 states that the PPE must not in itself create a hazard to the worker wearing it.
- OHS Regulation 8.14 says that eye protection must fit the worker properly.