As the coronavirus (COVID-19) pandemic continues to impact daily operations throughout the globe, EHS managers have been tasked with taking important measures to protect the health and safety of their workforce.
One of the ways in which EHS professionals can identify which workers are at greatest risk of being exposed to the virus is through following risk assessment processes. By using a risk matrix to gauge the likeliness of exposure, as well as the severity of any resulting illnesses, safety managers can identify groups of workers most at risk, can prioritize, and put control measures in place to protect them.
Whether you’re new to the world of risk management or are just looking for a refresher, we’ve put together the following article to help you assess risks of occupational COVID-19 exposures.
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What is a risk matrix?
A risk assessment matrix is a tool that project managers and safety professionals use to assess the various risks of workplace hazards. EHS workers assess risks by evaluating the severity of a potential hazard, as well as the probability that it will occur.
Risk matrices come in many different shapes and sizes (for more on the various levels of risk matrices, check out our recent article), but they all function the same way. First, a hazard’s severity and probability are each ranked on a point-based scale. These values are then multiplied to calculate the resulting risk assessment.
In the case of COVID-19, risk analysis depends on the characteristics of the virus, including how well it spreads between people; the severity of resulting illness; and the measures available to control the impact of the virus (for example, proper use of personal protective equipment [PPE]).
A risk matrix can have as many levels of probability and severity values as needed for a particular hazard.
In the agency’s guidance on preparing workplaces for COVID-19, the Occupational Safety and Health Administration (OSHA) has categorized job functions into four risk exposure levels. We’ve fleshed out these four divisions in the following paragraphs. When you’re determining what probability values would be useful to set for your risk matrix, it’s a good idea to use these 4 categories as a starting point.
Very High Exposure Risk
According to OSHA, workers with a very high probability of exposure include:
- Healthcare workers (e.g., doctors, nurses, dentists, paramedics, emergency medical technicians) performing aerosol-generating procedures (e.g., intubation, cough induction procedures, bronchoscopies, some dental procedures and exams, or invasive specimen collection) on known or suspected COVID-19 patients.
- Healthcare or laboratory personnel collecting or handling specimens from known or suspected patients.
- Morgue workers performing autopsies, which generally involve aerosol-generating procedures, on the bodies of people who are known to have, or suspected of having, COVID-19 at the time of their death.
High Exposure Risk
Workers with a high probability of exposure include:
- Healthcare delivery and support staff (e.g., doctors, nurses, and other hospital staff who must enter patients’ rooms) exposed to known or suspected COVID-19 patients. (Note: when such workers perform aerosol-generating procedures, their exposure risk level becomes very high.)
- Medical transport workers (e.g., ambulance vehicle operators) moving known or suspected COVID-19 patients in enclosed vehicles.
- Mortuary workers involved in preparing (e.g., for burial or cremation) the bodies of people who are known to have, or suspected of having, COVID-19 at the time of their death.
Medium Exposure Risk
- Medium exposure risk jobs include those that require frequent and/or close contact with (i.e., within 6 feet of) people who may be infected with COVID-19, but who are not known or suspected patients.
- In areas where there is ongoing community transmission, workers in this category may have contact with the general public (e.g., in schools, high-population-density work environments, and some high-volume retail settings).
- In areas without ongoing community transmission, workers in this risk group may have frequent contact with travelers who may return from international locations with widespread COVID-19 transmission.
Lower Exposure Risk
Lower exposure risk jobs are those that do not require contact with people known to be, or suspected of being, infected nor frequent close contact with (i.e., within 6 feet of) the general public. Workers in this category have minimal occupational contact with the public and other coworkers.
At this stage, it’s difficult to predict the effects that the virus may have upon an individual. Thus far, epidemiological evidence suggests that COVID-19 manifests as a non-severe disease in most cases. However, according to the most recent data compiled by the Centers for Disease Control and Prevention (CDC), some groups are at higher risk of becoming severely ill from the virus. When determining values for the Severity component of your matrix, these groups should be categorized into the value assigned the highest number of points. Your other severity values may vary depending on the demographics of your workforce.
Risk of Becoming Severely Ill
Groups at risk of becoming seriously ill from COVID-19 include:
- People aged 65 years and older
- People who live in a nursing home or long-term care facility
- People with chronic lung disease or moderate to severe asthma
- People who have heart disease with complications
- People who are immunocompromised. Many conditions can cause a person to be immunocompromised, including cancer treatment, bone marrow or organ transplantation, immune deficiencies, poorly controlled HIV or AIDS, and prolonged use of corticosteroids and other immune-weakening medications.
- People of any age with severe obesity or certain underlying medical conditions, particularly if not well controlled, such as those with diabetes, renal failure, or liver disease
People who are pregnant should be monitored since they are known to be at risk with severe viral illness. However, to date data on COVID-19 has not shown increased risk.
As explained above, risk assessment scores are determined by multiplying the scores for the probability and severity values together. The following chart displays sample risk assessment values for a possible generic risk matrix.
Setting Controls for Risk Mitigation
Once you've completed your risk assessments, you can begin to put controls in place to mitigate exposures as best as possible.
OSHA has put together guidance for workplaces on the appropriate engineering and administrative controls, as well as personal protective equipment (PPE) for workers with lower, medium, and high exposure risks. We've also put together a few tips on how EHS managers can develop plans to deal with the virus in the workplace.