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Suggested Citation:"Appendix A: Workshop Agenda." Institute of Medicine. 2008. Preparing for an Influenza Pandemic: Personal Protective Equipment for Healthcare Workers. Washington, DC: The National Academies Press. doi: 10.17226/11980.
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Suggested Citation:"Appendix A: Workshop Agenda." Institute of Medicine. 2008. Preparing for an Influenza Pandemic: Personal Protective Equipment for Healthcare Workers. Washington, DC: The National Academies Press. doi: 10.17226/11980.
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Suggested Citation:"Appendix A: Workshop Agenda." Institute of Medicine. 2008. Preparing for an Influenza Pandemic: Personal Protective Equipment for Healthcare Workers. Washington, DC: The National Academies Press. doi: 10.17226/11980.
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Suggested Citation:"Appendix A: Workshop Agenda." Institute of Medicine. 2008. Preparing for an Influenza Pandemic: Personal Protective Equipment for Healthcare Workers. Washington, DC: The National Academies Press. doi: 10.17226/11980.
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Suggested Citation:"Appendix A: Workshop Agenda." Institute of Medicine. 2008. Preparing for an Influenza Pandemic: Personal Protective Equipment for Healthcare Workers. Washington, DC: The National Academies Press. doi: 10.17226/11980.
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Suggested Citation:"Appendix A: Workshop Agenda." Institute of Medicine. 2008. Preparing for an Influenza Pandemic: Personal Protective Equipment for Healthcare Workers. Washington, DC: The National Academies Press. doi: 10.17226/11980.
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A Workshop Agenda Institute of Medicine Workshop on Personal Protective Equipment for Healthcare Workers in the Event of Pandemic Influenza: Next Steps and Research Directions Thursday, February 22, 2007 Lecture Room National Academy of Sciences 2100 C Street, NW Washington, D.C. Purpose: Examine research directions for personal protective equipment for healthcare workers in the event of pandemic influenza. 7:30-8:00 Continental Breakfast, Lecture Room 8:00-8:10 Welcome Lewis Goldfrank, Chair 8:10-9:15 Panel 1: Understanding the Threat for Healthcare Workers • What is known about the transmission of influenza to healthcare workers? What is known about the relative magnitude of the various infection modes? • What are the key challenges to research on influenza transmission (technical, economic, operational, and other challenges)? • What research is needed? What are the models for research? 173

174 PREPARING FOR AN INFLUENZA PANDEMIC Donald Low, moderator 8:10-8:25 Transmission of Influenza Michael Gardam, University Health Network, Toronto 8:25-8:40 Exposure Modeling Mark Nicas, University of California, Berkeley 8:40-8:55 Epidemiology of Influenza in Hospital and Long-Term Care Settings Keith Woeltje, Washington University 8:55-9:15 Discussion 9:15-10:30 Panel 2: Understanding the Risks to Healthcare Workers in Various Settings • Do the influenza transmission risks differ between various healthcare settings and types of care? • What are the key challenges for research in this area, particularly “real-time” research? • What research is needed? Trish Perl, moderator 9:15-9:25 Hospital Workers Leonard Mermel, Rhode Island Hospital. 9:25-9:35 Emergency Response Workers and Emergency Departments Allan Morrison, INOVA Fairfax Hospital 9:35-9:45 Home Healthcare Workers Bill Borwegen, Service Employees International Union 9:45-9:55 Public Health Workers Debra Berg, New York City Department of Health 9:55-10:30 Discussion 10:30-10:45 Break

APPENDIX A 175 10:45-12:00 Panel 3: Designing and Engineering PPE: Next Steps • What are the state-of-the-art technologies for personal protective equipment for healthcare workers? • What design and engineering breakthroughs are on the horizon? • What are the key technical challenges that must be addressed in the design and development of PPE for healthcare workers over the short term (1-3 years), medium term (3-5 years), and long term (5-10 years)? • What research is needed? Sundaresan Jayaraman, moderator 10:45-11:05 Next Steps and Challenges in Respirator Design and Engineering Alan Hack, Los Alamos National Laboratory (retired) Daniel Japuntich, 3M 11:05-11:25 Next Steps and Challenges for Medical Fabrics and Gowns Stephanie Pasko, Medline Industries 11:25-11:35 Next Steps in Materials Engineering Zane Frund, MSA 11:35-12:00 Discussion 12:00-12:45 Lunch 12:45-1:45 Panel 4: Using Personal Protective Equipment: Individual and Institutional Issues • What is known about the key factors influencing individual use of PPE by healthcare workers? • What are the next steps and research needs regarding training and supervision issues? • What are the key challenges to research in this area? • What research is needed?

176 PREPARING FOR AN INFLUENZA PANDEMIC Bonnie Rogers, moderator 12:45-12:55 Healthcare Workers and PPE: Lessons from SARS Allison McGeer, University of Toronto 12:55-1:05 The Influence of Safety Culture and Climate on Compliance with PPE Robyn Gershon, Columbia University 1:05-1:15 Wearability and Tolerability of PPE Research Study Lewis Radonovich, Department of Veterans Affairs 1:15-1:25 Compliance and Training Elizabeth Bryce, University of British Columbia 1:25-1:45 Discussion 1:45-2:50 Panel 5: Certifying and Regulating Effective PPE— Next Steps • What are the next steps in improving standards and certification? What are the key challenges to these next steps? • What type of post-certification surveillance should be performed? What are the key challenges? • Given that some healthcare workers may purchase respirators and other PPE at retail stores, what type of controls are necessary to ensure that these workers are properly protected? • Are there requirements for risk assessments to be performed for healthcare workers prior to using PPE so that the equipment selection matches the risk? If so, are risk assessments standardized and/or are records required to be maintained? Howard Cohen, moderator 1:45-1:55 National Personal Protective Technology Laboratory, NIOSH Roland Berry Ann, NPPTL

APPENDIX A 177 1:55-2:05 Consumer Product Safety Commission Rik Khanna, CPSC 2:05-2:15 Food and Drug Administration Miriam Provost, FDA 2:15-2:25 Occupational Safety and Health Administration Amanda Edens, OSHA 2:25-2:35 American National Standards Institute Jim Johnson, JSJ and Associates 2:35-2:50 Discussion 2:50-3:00 Break 3:00-4:00 Breakout Sessions—Research Priorities (Participants can choose which breakout session to attend) • What are the major challenges for moving forward on research in each area (technical, economic, operational challenges)? • What are the short-term (1-3 years), medium-term (3-5 years), and long-term (5-10 years) research priorities? • Room 150: Transmission of Influenza in Healthcare Settings Janine Jagger, moderator • Room 180: Engineering and Designing PPE Kent Oestenstad, moderator • Lecture Room: Using PPE—Behavioral and Compliance Issues David Prezant and Sharon Marable, moderators • Room 148: Certifying and Regulating Effective PPE Lewis Goldfrank and Howard Cohen, moderators

178 PREPARING FOR AN INFLUENZA PANDEMIC 4:00-4:15 Break 4:15 Return to Lecture Room 4:15-4:45 Reports from Discussion Sessions Lewis Goldfrank, moderator 4:45-5:45 Public Forum—Registered Speakers Darryl Alexander, American Federation of Teachers Judene Bartley, Association for Professionals in Infection Control and Epidemiology David Calfee, Society for Healthcare Epidemiology of America Richard Duffy, International Association of Fire Fighters Larry Green, Syntech Intl. Suzanne Haynes, Department of Health and Human Services Office on Women’s Health Daryl Kauffman, Kirk U.S. Army Health Clinic Bill Kojola, AFL-CIO Glenn Paulson, New Jersey Center for Public Health Preparedness, University of Medicine and Dentistry of New Jersey 5:45 Adjourn

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During an influenza pandemic, healthcare workers will be on the front lines delivering care to patients and preventing further spread of the disease. As the nation prepares for pandemic influenza, multiple avenues for protecting the health of the public are being carefully considered, ranging from rapid development of appropriate vaccines to quarantine plans should the need arise for their implementation. One vital aspect of pandemic influenza planning is the use of personal protective equipment (PPE)—the respirators, gowns, gloves, face shields, eye protection, and other equipment that will be used by healthcare workers and others in their day-to-day patient care responsibilities.

However, efforts to appropriately protect healthcare workers from illness or from infecting their families and their patients are greatly hindered by the paucity of data on the transmission of influenza and the challenges associated with training and equipping healthcare workers with effective personal protective equipment. Due to this lack of knowledge on influenza transmission, it is not possible at the present time to definitively inform healthcare workers about what PPE is critical and what level of protection this equipment will provide in a pandemic. The outbreaks of severe acute respiratory syndrome (SARS) in 2003 have underscored the importance of protecting healthcare workers from infectious agents. The surge capacity that will be required to reduce mortality from a pandemic cannot be met if healthcare workers are themselves ill or are absent due to concerns about PPE efficacy.
The IOM committee determined that there is an urgent need to address the lack of preparedness regarding effective PPE for use in an influenza pandemic. Preparing for an Influenza Pandemic : Personal Protective Equipment for Healthcare Workers identifies that require expeditious research and policy action: (1) Influenza transmission research should become an immediate and short-term research priority so that effective prevention and control strategies can be developed and refined. The current paucity of knowledge significantly hinders prevention efforts. (2) Employer and employee commitment to worker safety and appropriate use of PPE should be strengthened. Healthcare facilities should establish and promote a culture of safety. (3) An integrated effort is needed to understand the PPE requirements of the worker and to develop and utilize innovative materials and technologies to create the next generation of PPE capable of meeting these needs.
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