ISO 45006:2023 Occupational Health and Safety Management: Guidelines for organisations on preventing, controlling and managing infectious diseases, by Finbarr Stapleton, Antaris Consulting.
Why does an organisation need guidelines on controlling and managing infectious diseases?
Over the past 20 years there have been numerous outbreaks of infectious diseases including Ebola and Zika viruses, severe acute respiratory syndrome (SARS), Middle Eastern respiratory syndrome (MERS) and of course the COVID-19 pandemic.
There are several factors that are making these outbreaks more and more likely such as:
- Global Population Growth and Urbanisation (Higher Population Density).
- Increasing travel rates (the number of airline flights has doubled since 2000)
- Climate Change (rising temperatures and changing weather patterns expand the range of vectors such as mosquitos, fleas, ticks as well as allow for the spread of waterbourne diseases).
- Falling vaccination levels and the rise of vaccine preventable diseases (e.g. measles, etc.)
- Pathogens are becoming more drug resistant.
- Human behaviour such as cutting costs and taking shortcuts in preventing hygiene preventable diseases.
The above list is not exhaustive but we can conclude that that there is an increasing risk to organisation’s from infectious diseases.
What is this ISO 46006 standard about?
This new set of guidelines were published in December 2023.
ISO 45006 gives guidelines for organizations on how to prevent or control exposure to infectious agents at the workplace and manage the risks associated with infectious diseases that:
- present a risk of severe ill health or death and can impact the health, safety and well-being of workers and other relevant interested parties;
- present a lower risk to health yet have a significant impact on the organization, its workers and other relevant interested parties.
Who do these guidelines apply to?
The ISO 45006 guidelines can be applied to organizations of all sizes and sectors.
However, ISO 45006 does not provide comprehensive guidance to those parts of an organization that implement mandated infection controls such as hospitals and medical or biological laboratories because there is an inherent potential for exposure to infectious diseases. There are other sources of guidance available for these parts of an organization.
How is the ISO 45006 guidance structured?
The standard doesn’t exactly follow the Annex SL format of the ISO 45001 OHS management system standard but does contain many of the same elements.
The ISO 45006 guidelines follow the Plan, Do, Check, Act (PDCA) cycle and are designed to deliver continual improvement in our risk management for infectious diseases.
Clause 4 Context of the Organisation and Diversity considerations
The guidelines recommend that the organization be aware of known and emerging infectious diseases that can, or are likely to, significantly affect the organization or its activities.
In doing so it should take account of internal issues (e.g. sources of infectious agents in the workplace that can result in an infectious disease) and external issues (e.g. local culture of kissing, hugging or shaking hands) as well as diversity of workers and others (e.g. vulnerable workers or their close relatives that may be immunocompromised).
Diversity and inclusivity guidance is included throughout the guidelines.
The organization should seek advice from trusted bodies and specialists such as the WHO, ILO, public health authorities, epidemiologists, infectious disease experts, etc.).
The guidance also notes that some people may carry and spread diseases without showing symptoms.
Clause 5 Characteristics of infectious diseases:
The new guidance outlines the characteristics of infectious diseases that we should consider in our assessment of the risk.
Clause 6 Leadership and worker participation
ISO 45006 gives guidance for top management to lead by example and demonstrate their commitment to effectively manage risks to workers and other relevant interested parties arising from infectious diseases that are, or can be, in the workplace.
Worker participation and consultation is essential according to the guidance.
Roles and responsibilities and guidelines on competency of staff are also provided.
Clause 7 Communication
Communication with workers and interested parties on controls for preventing exposure to and transmission of infectious agents and managing the risks related to an infectious disease is strongly recommended in the guidelines.
Clause 8 Hazards, Risks and Controls
ISO 45006 provides guidance on hazard identification and assessment of risks as well examples of risk controls risk including the hierarchy of controls. This is a fundamental component of the guidelines.
Planning of changes are also included in the guidelines.
Clause 9 Psychological Health and Well Being
This is an interesting part of the standard in that it recognises the Psychological impact of infectious disease on the company’s workforce.
Examples of this could include:
- Social isolation
- Fear of becoming ill and infecting others
- Financial issues (medical costs, inability to work or cost of quarantine, etc.)
- Stress and fatigue from having to wear PPE for long periods
- Feeling overwhelmed by the volume of work when covering for others who are off sick
- Worries about the financial implications of contracting an illness
The standard suggests that the organisation refer to ISO 45003 Guidance on managing psychosocial risks.
The ISO 45006 guidelines suggests controls to manage psychosocial risks.
Clause 10 Resources
The standard gives guidance on resources that may be required to prevent exposure to and transmission of infectious agents and manage the risks related to an infectious disease.
Examples could include:
- Arrangements for infection control
- Redesign of workplace, layout changes, protective barriers, etc.
- Worker participation and consultation
Clause 11 Implementation of Controls for managing infectious diseases
This section of the contains guidance to prevent and mange infectious diseases.
- Controls need to take into account of vulnerable groups
- Personal Hygiene Controls (handwashing, use of sanitisers, etc.)
- Work related travel controls (health guidance, immunization depending on destination, evacuation of ill workers, etc.)
Clause 12 Implementation of controls for contagious diseases
This Clause of the standard gives practical guidance to prevent and manage transmission of contagious diseases.
This could include:
- Being aware and keeping up to date with public health information on these types of diseases
- Communication, information and training (e.g. how to self-screen, quarantine or isolation information)
- Communication on vaccines availability (including information on possible )
- side effects
- Enhanced hygiene, cleaning and disinfection
- Sufficient personal hygiene facilities
- Safe disposal of contaminated waste
Other guidance in this clause includes controls such as:
- General workplace infection controls (an extensive list of possible controls are provided)
- Use of toilets and handwashing facilities (the standard suggests specific controls such as avoiding overcrowding, signage as well as avoiding touch using automatic rather than manual operated facilities (taps, flushes, etc.)
- Meetings and visits to workplaces (remote working, restrictions on visitors, etc.)
- Deliveries (gives practical guidance on reducing risk from deliveries)
- Working from home
- Working in other people’s homes
- Working in multiple locations
- Working with the public
Clause 13 Implementation of controls for non-contagious infectious disease
- This section of the guidance outlines controls and processes to prevent and manage non-contagious diseases. There is an extensive list of possible controls suggested such as:
- Fresh air and ventilation systems
- Maintenance activities (e.g ventilation systems)
- Maintenance of water systems to prevent water bourne infectious agents (e.g. legionella)
- Prevention of mosquitos, rodents, etc., through pest control, etc.
- The above list is by way of example and is not exhaustive.
Clause 14 Implementation of controls for endemic diseases
- This gives guidance on how to manage risks relating to infectious diseases that are endemic to a place where the worker lives and operates or possibly travels through (such as malaria through use of suitable control, insect repellent, vaccines, etc.)
Clause 15 Use of personal protective equipment and face coverings
This is section of the guidance provides extensive guidance on protective equipment.
It suggests the organisation should consider the use of appropriate PPE to protect workers from risks from infectious diseases. This should be suitable and appropriate.
The type of equipment will need to take account the characteristics of the infectious agents and gives detailed guidance on
- Selection of appropriate equipment
- Protective gloves
- Face and respiratory protection
The guidance takes into account the practicalities and issues with the use of face coverings such as the need to temporarily remove it or the need for lip reading, etc.
Clause 16 Emergency preparedness and response
The guidelines recommend that an organisation should be prepared for:
- emergencies relating to infectious agents in the workplace (e.g. mould in the ventilation system);
- other emergencies (e.g. fires, floods, earthquakes) that can increase spread of infectious diseases.
Emergencies involving issues such as Legionella or Norovirus are mentioned as examples in the guidelines.
Clause 17 Management of suspected or confirmed cases of a relevant infectious disease
The organization should have processes to manage suspected and confirmed cases of a relevant infectious disease, and to limit exposure and transmission at work.
The guidelines cover issues such as screening, testing, contact tracing, quarantine and vaccination. Consultation with workers and confidentiality also need to be considered.
Reporting of cases to the authorities may also need to be considered.
Clause 18 Performance evaluation
ISO 45006 recommends that the organization should have processes to monitor, measure, analyse and evaluate performance. The use of both proactive (leading) and reactive (lagging) indicators with emphasis on proactive indicators that drive performance improvement and reduction in ill-health should be considered.
Proactive indicators include:
- the number of inspections related to infectious diseases (benchmark against previous years);
- the % of determined controls implemented;
- the % of workers who have competed training on infectious diseases that can impact the workplace
Examples of Reactive indicators include:
- the number of ill health cases related to infectious diseases (benchmark against previous years);
- the number (or percentage) of positive Legionella samples of water systems at each site;
- the % of workers infected compared with organizations in the same sector (or general population) during the same period of time.
Management reviews should be carried out at planned intervals by top management.
Clause 19 Improvement
ISO 45006 recommends that the organization should determine opportunities to improve its risk management related to relevant infectious diseases and implement necessary actions.
Overall, ISO 45006 provides very detailed and practical guidance on what the organisation actually needs to do to prevent, control and manage infectious diseases at workplaces. It doesn’t really require a lot of interpretation as the guidance is very specific and practical.
You can find out some more information on the guidelines at the link below.
New guidelines for infectious diseases | IOSH magazine
Antaris can support organisations to develop systems for preventing, controlling and managing infectious diseases. To find out more, please visit our website Occupational Health & Safety Training – Antaris Consulting
