COVID-19 prevention for agricultural communities

By University of Nebraska Medical Center, Central States Center for Agricultural

Safety and Health, Omaha, NE

As a farmer, rancher, or agricultural worker, you are part of the essential critical infrastructure workforce.

The Central States Center for Agricultural Safety and Health (CS-CASH), at the University of Nebraska Medical Center, provides guidance on the prevention and spread of the COVID-19 virus while working in agriculture and when returning home from work. Steps to prevention include eliminating exposure, finding as many ways as possible to reduce person-to-person contact, using administrative authority to establish new work guidelines as necessary, and making use of all appropriate Personal Protective Equipment.

To remain healthy and able to do your work, here are some essential precautions you can implement each day.

TAKE EXTRA CARE TO AVOID INJURIES

Since hospitals are currently overwhelmed with COVID-19 patients and medical provider resources are already strained, all farm/ranch workers will benefit from taking extra precautions to avoid work-related injury or illness. Whatever task you undertake, ensure that you are aware of and practicing safety principles.

Carefully follow the Center for Disease Control (CDC) guidelines on prevention of COVID-19, as well as instructions/recommendations from State and local government officials, medical providers, extension resources, and other trusted sources.

Take time to create a written business plan that outlines how your operation will go forward in case someone becomes ill and is unable to function in their job. Review the plan with everyone who is involved in daily activities and take steps to ensure that the plan could and will be implemented if necessary.

Review your operation’s daily activities and seek ways to avoid person-to-person contact. Postpone any tasks that require personal interaction but aren’t necessary for day-to-day operations.

Whenever possible, complete work activities remotely rather than as a group or person-to-person. As often as you can, take advantage of electronic communications.

Learn more about and review Safe Operating Procedures (SOP) at this University of Nebraska - Lincoln link: https://ehs.unl.edu/sop#node-781 .

ON-SITE RESPIRATORY PROTECTION

You, your family members, and all your workers can utilize the masks/respirators commonly used to deal with agricultural dust, gases, etc. to help combat the spread of COVID-19.

Common agricultural use respirators include

• N95/100 masks for dust

• Half mask with cartridges for dust and gases (including pesticides)

N95/100 masks also protect against viruses. If these types of masks are not available, a tight-fitting surgical mask or home-made mask may provide some protection. If you are infected, wearing a mask as you complete agricultural activities helps protect the wearer from both agricultural hazards (dust, gases, etc.) and from being exposed to or exposing others to COVID-19.
Anytime your work requires you to interact with others or be in a confined space or public area, wear the mask or home-made face covering if a mask is not available. Doing so can help protect you from droplets that are breathed out.

If your N95 mask has a valve, be aware that your exhaled breath escapes through the valve. This breath is not filtered. If your mask features an exhale valve, tape it shut. This minimizes the spread of small particles and droplets that are breathed out.

To ensure that your mask is effective, do a seal check to make sure the mask fits closely around your nose and mouth. Find details about how to complete a check by watching this CS-CASH video at https://www.youtube.com/watch?v=fSNNS8_jiB8&feature=emb_logo .

Before and after removing the mask, wash your hands. When working in dirty or high-dust environments, you can place a clean cloth/bandana over the mask to help protect it. Keep the mask clean, and in good condition, so it remains effective.

When not in use, store masks in a clean, dry location. Anytime you re-use a mask, assume it carries some contamination. Wash or sanitize your hands after putting it on and before and after taking it off, cleaning, caring for, and storing.

Short videos about selecting, using, and caring for respiratory masks in an agricultural setting are available at this link: https://www.youtube.com/playlist?list=PLY7XQBihZRNulSg7vOVk4VKYuaA4afNud .

Anyone who has been exposed to or infected with COVID-19 should wear a mask. Before putting the mask on, sanitize your hands. Avoid adjusting or touching the mask while you are wearing it.

EXTENDED USE/LIMITED RE-USE OF DISPOSABLE FACEMASKS, RESPIRATORS, AND PROTECTIVE EYEWEAR

Medical staff must have access to the necessary supplies to perform patient care safely.

To help prevent a shortage or exhaust the current supply of facemasks, respirators, and eye protection, please review these guidelines.

Extended use: wearing the same N95 respirator for repeated encounters without removing the respirator between encounters.

Re-use: using the same N95 respirator for multiple encounters but removing it between at least some of the encounters. The respirator is stored between encounters and re-used.

1. Extended use is preferred over re-use, with the assumption that it is safer to leave mask protection in place to reduce the risk of self-contamination through frequent donning/doffing the same equipment.

2. Facemasks, N95s, and eye protection can be re-used in a careful and limited way during periods of short supply.

3. Guidance is for re-use by a single person (no sharing). This applies to both respirators and eye protection.

4. Disposable N95 respirators worn for protection from COVID-19 may be re-used or worn for extended use as long as they are able to seal, were not worn during an aerosol-generating procedure, or have reached the end of their use by being soiled, damaged or moist from sweat or insensible fluid loss through breathing.

5. To help ensure use by a single person:

1. label the N95 respirator and storage container with the user’s name

2. Write the name on the elastic straps.

1. Document dates and times of use on the storage container to track overall use.

DONNING AN N95 RESPIRATOR

1. Complete hand sanitizing.

2. Don the N95 respirator.

3. Perform a negative/positive seal check.

4. Ensure the respirator is breathable. If not, the respirator is not reusable.

REMOVING A FACEMASK/N95 RESPIRATOR

1. Complete hand sanitizing.

2. Remove the mask/respirator by holding the ear loops. The front is likely to be contaminated, so remove slowly and carefully.

3. After removing the mask, inspect it for contamination, distortion in shape/form, or soiling. If the mask is wet, it should be discarded.

4. If the mask is not visibly contaminated or distorted, carefully store to maintain the mask shape.

SANITIZING/DISINFECTING N95 RESPIRATOR

3M, the manufacturer of N95 respirators, has reviewed numerous studies on a variety of sanitizing, disinfecting, and sterilizing methods sometimes used or promoted. Overall, studies illustrated that some disinfecting processes result in damage to the respirator, rendering it unusable. In summary, testing showed:

1. Microwave generated steam, 2 minutes, full power: metal nose clip and stables melted surrounding plastic; nosefoams delaminated; straps on 1870 lost elasticity.

2. Ultraviolet germicidal irradiation, 30 minutes (15 minutes per side): Straps on 1870 lost elasticity; strong burnt odor; nosefoam compressed on 1860.

3. Moist heat 30 minutes, 140F, kitchen-type oven: metal nose clip and staples melted surrounding plastic; nosefoam delaminated; straps on 1870 lost elasticity.

4. Ultraviolet irradiation, 15 minutes: no observable physical damage.

5. Ethylene oxide (flammable, colorless gas) 1 hour 100% EtO Sterilizer: No observable physical changes.

6. Hydrogen Peroxide Gas Plasma, 55 minutes, 113F: Filter penetration exceeded 5% on multiple samples.

7. Hydrogen Peroxide vapor: No observable physical changes.

8. Bleach, 30 minutes: Nosefoam slightly tarnished; staples oxidized to varying degrees; discolored or dissolved inner nose pad.

9. Liquid hydrogen peroxide, 30 minutes, 6% hydrogen peroxide solution: Staples oxidized to varying degrees.

HAND HYGIENE: ON AND OFF THE FARM

Everyone on the farm – you, family members, employees, visitors – should diligently practice handwashing every day. Basic handwashing steps include:

1. Wet your hands with clean, running water (warm or cold), turn off the tap, apply soap.

2. Lather your hands by rubbing them together with the soap. Lather the backs of your hands, between your fingers and under your nails.

3. Scrub your hands for at least 20 seconds (hum “Happy Birthday” song twice).

4. Rinse your hands well under clean, running water.

5. Dry your hands using a clean towel or air dry them.

Find details about appropriate handwashing procedures at this link:
https://www.cdc.gov/handwashing/when-how-handwashing.html .

When working in the field or barn, it is crucial to be able to wash your hands regularly. Instructions from the University of Minnesota on building a low-cost hand washing station can be found at this link: https://foodsafety.ces.ncsu.edu/wp-content/uploads/2014/03/handwashing_station_instructions.pdf?fwd=no

When possible, use soap to wash your hands. If soap isn’t available, use hand sanitizer. In the event hand sanitizer, with at least 60% alcohol, isn’t available, a recipe to create hand sanitizer has been provided by the Nebraska Medicine: https://www.nebraskamed.com/COVID/how-to-make-your-own-hand-sanitizer-2020

Wash/sanitize your hands throughout the day as you work at home, in your office, the farm shop, driving vehicles, in public places, etc. Anytime there’s a risk of exposure to COVID-19.

If feasible, carry sanitizing wipes with you and use the wipe to touch surfaces, such as door handles, that may be contaminated. Dispose of the wipe with each use. To help reduce the potential for virus infection, avoid touching your face, mouth, eyes, and nose.

DISINFECT SURFACES: ON AND OFF THE FARM

Everyone in the farm environment comes in contact with a variety of surfaces throughout the day, both on and off the farm. Those surfaces include cell phones, touch screens at stores and businesses, ATMs, vehicle steering wheels and controls, tools, utensils, tables, chairs, doorknobs, light switches, phones, tablets, remote controls, keyboards, handles, desks, toilets, sinks.

Touching contaminated surfaces has been shown to be a means to transmit COVID-19 and other viruses. On the farm, it will be critical to sanitize common work areas where people are touching surfaces throughout the day. Other means of contaminating these kinds of surfaces include sneezing, coughing, placing contaminated items on the surface, etc.

To sanitize these surfaces, wear disposable gloves, use water in combination with cleaning and disinfecting agents, disinfecting wipes, etc. Cleaning helps remove germs, dirt and impurities from a surface. To disinfect a surface, use EPA-registered disinfectants to kill germs on surfaces. Disinfecting should be done after cleaning to further reduce the risk of spreading infection.

The active ingredient in bleach – sodium hypochlorite – is very effective at killing the virus. Make sure to allow the bleach to work for a minimum of 10-15 minutes before wiping the surface with a clean cloth.

Find cleaning/disinfecting details at this CDC site: https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/cleaning-disinfection.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fcoronavirus%2F2019-ncov%2Fprepare%2Fcleaning-disinfection.html .

WHEN TO USE DISPOSABLE GLOVES

1. Wear gloves when handling or transporting any item/equipment that is or is suspected to be contaminated.

2. Wear gloves when cleaning and disinfecting surfaces that are or are suspected to be contaminated.

3. Remove and discard gloves once cleaning or disinfecting is completed.

4. DO NOT wash or re-use the gloves.

5. Complete hand hygiene procedure after glove removal and disposal.

6. Note: wearing disposable gloves in public is not recommended. It can give a false sense of security. Gloves may become contaminated and you may inadvertently touch your cell phone, steering wheel, etc., contaminating items and surfaces in your environment. In public settings, sanitizing your hands after touching surfaces may be more effective.

WHEN YOU RETURN HOME FROM WORK.
To protect your family and your community after returning from work, leave personal protective equipment that has been used throughout the day at your worksite or in your truck. Wash your hands before leaving work and use disinfectant on your hands before entering your home. Remove your shoes and leave them outside or by the door. If possible, change your clothes and shower before contacting anyone in your household.

HOW CAN YOU GET INFECTED WITH COVID-19?

Currently, medical providers know that COVID-19 can be spread through person-to-person contact or from touching a contaminated surface or object.

COVID-19 spreads in person-to-person contact:

1. Between people who are in close contact, less than 6 feet between them.

2. Through respiratory droplets produced when an infected person coughs, sneezes, or talks.

3. These droplets can land in the mouths or noses of people who are nearby or possibly can be inhaled into the lungs.

4. Some recent studies have suggested that COVID-19 may be spread by people who are not showing symptoms.

5. Maintaining good social distance (about 6 feet) is very important in preventing the spread of COVID-19.

Additional details about how it is spread can be found at https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/how-covid-spreads.html .

WHAT IF I AM SICK?

If you have a fever or a cough, you may have COVID-19. Most people have mild illness and are able to recover at home (see this link for home recovery details https://www.cdc.gov/coronavirus/2019-ncov/if-you-are-sick/caring-for-yourself-at-home.html .

If you are sick, keep track of your symptoms. An emergency warning sign of COVID-19 includes trouble breathing, a signal that you need immediate medical attention.

Stay in touch with your doctor. Call before you seek medical care. Be sure to immediately seek care if you experience trouble breathing or have any of these other emergency warning signs:

• Persistent pain or pressure in the chest

• New confusion or inability to arouse.

• Bluish lips or face.

This is not an all-inclusive list. Please consult your medical provider for any other symptoms that are severe or concerning.
If you call 911, inform the operator that you have or believe you might have COVID-19. If possible, put on a face mask before medical help arrives. More details are available at https://www.cdc.gov/coronavirus/2019-ncov/if-you-are-sick/steps-when-sick.html#warning-signs .

Funding for this educational article comes from the Central States Center for Agricultural Safety and Health and the University of Nebraska Medical Center.