Review| Volume 105, ISSUE 1, P17-23, May 2020

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Realigning the conventional routes of transmission: an improved model for occupational exposure assessment and infection prevention

  • C.K. Brown
    Corresponding author. Address: Occupational Safety and Health Administration, US Department of Labor, 200 Constitution Ave., NW, N3653, Washington, DC, 20210, USA. Tel.: +1 502 301 0562.
    Biodefense Program, Schar School of Policy and Government, George Mason University, Arlington, VA, USA

    Directorate of Technical Support and Emergency Management, Occupational Safety and Health Administration, US Department of Labor, Washington, DC, USA
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  • A.H. Mitchell
    International Safety Center, League City, TX, USA

    Department of Environmental and Occupational Medicine, School of Medicine, University of Maryland, Baltimore, MD, USA
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Published:March 12, 2020DOI:


      Current recommendations for standard and transmission-based precautions in place for patients who are suspected or known to be infected or colonized with infectious agents are best suited to prevent the transfer of micro-organisms to other patients – that is, to prevent the acquisition of a healthcare-associated infection, rather than to protect the healthcare worker from self-contamination resulting in a potential occupationally acquired infection. This article reviews current recommended infection prevention and control practices and offers a framework for better protection and controls from an occupational health point of view. We offer a model with two exposure routes – contact and aerosol – resulting from work activities and environments, shifting the focus away from particular pathogenic micro-organisms’ typical methods for spreading to patients or to other non-workers in hospital and community settings.


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