Pandemic Preparedness and Response Plan



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Pandemic Preparedness and Response Plan INTRODUCTION: In the event of a pandemic influenza, our company will be prepared to play a key role in protecting our employees health and safety and to limit the negative impact on our business. Planning is critical. This plan provides specific activities which will enable us to achieve these goals. ORGANIZATION: Pandemic Coordinator: o Name: o Position: o Contact Information: Pandemic Team Members: Area Name Position Contact Information Operations Human Resources Health and Safety Logistics Finance Developed with funds provided by the Susan Harwood Training Grant Program from the Occupational Safety and Health Administration. 1

REDUCTION OF IMPACT ON BUSINESS List of critical business processes: Process Name Description Critical Nature Process A Process B Process C Process D List of Essential Employees Critical Business Process Essential Employees Contact Information Process A Process B Process C Process D List of Critical Inputs to Business Process to maintain business operations Category Name of Organization Contact Information Raw Materials Suppliers Developed with funds provided by the Susan Harwood Training Grant Program from the Occupational Safety and Health Administration. 2

Sub- Contractors/Services Logistics List of Ancillary Workforce to Replace Essential Employees if Necessary: Critical Business Process Process A Essential Position Category Name Contact Information Contractors Employees in other Job Titles Retirees Process B Contractors Employees in other Job Titles Retirees Developed with funds provided by the Susan Harwood Training Grant Program from the Occupational Safety and Health Administration. 3

Process C Contractors Employees in other Job Titles Retirees Process D Contractors Employees in other Job Titles Retirees List of scenarios likely to have an impact on business: Type of Event Impact on Business Financial Impact Critical Processes Impacted Community Containment Measures Enforced quarantine School and/or business closures Public Transportation Closure Restriction on travel into or out of community Restriction on domestic travel. Developed with funds provided by the Susan Harwood Training Grant Program from the Occupational Safety and Health Administration. 4

Restriction on International travel Interruption of critical input to business process Sources of reliable pandemic information: Organization Source Type of Information Medical Medical Director Local Local Public Health Government Department State State Department of Government Health Federal OSHA Government CDC Trade Association EPA Name Contact Information Link Pandemic Emergency Communications Plan: o The emergency communications plan includes the identification of key contacts, chain of communications, and process for communicating business and employee status. o The Communications Plan will be updated on a Quarterly Basis REDUCTION OF IMPACT ON EMPLOYEES Communication and education: o Develop and disseminate programs and materials covering pandemic fundamentals. These include: Signs and symptoms of influenza. Modes of transmission. Personal and family protection strategies: Developed with funds provided by the Susan Harwood Training Grant Program from the Occupational Safety and Health Administration. 5

Hand hygiene Coughing/sneezing etiquette. Contingency plans. o Employee fear and anxiety can be expected due to rumors and misinformation. Plan for communications accordingly and verify accurate information by consultation with local public health officials and other reliable sources of factual information. Reliable information resources are given below: Organization Type of Information Contact Information o Special cultural/linguist needs: Organization Contact Person Contact Information Type of Special Needs Number of people with those needs Resource/ Contact Person to Meet Need Internal External: Customer, contractor, etc o Provide information to employees about the Pandemic Preparedness and Response Plan. Developed with funds provided by the Susan Harwood Training Grant Program from the Occupational Safety and Health Administration. 6

Planning for employee absences: o It is essential to forecast and allow for employee absences. The table below lists types of scenarios when high rates of employee absences may be anticipated: Scenario Impact on Employees Anticipated Absentee Rate Community Containment Measures Enforced quarantine School and/or business closures Public Transportation Closure Restriction on travel into or out of community Reduction in the frequency and type of face-to-face contact: o In order to reduce the spread of the flu, it is necessary to modify the frequency and type of face-to-face contact (such as hand-shaking, seating in meetings, office layout, shared workstations, etc): Among employees Between employees and customers. o Steps which may be taken include: Avoid crowded settings that increase the risk of exposure to someone who may be infected. If it is absolutely necessary to be in a crowded setting, the time spent in a crowd should be as short as possible. Some basic hygiene (see www.cdc.gov/flu/protct/stopgerms.htm) and social distancing precautions may be taken. Also see (www.osha.gov) Employee Health: o Employees are encouraged to have and to report influenza vaccinations Developed with funds provided by the Susan Harwood Training Grant Program from the Occupational Safety and Health Administration. 7

o Evaluate employee access to and availability of health care services during a pandemic on a basis. o Evaluate employee access to and availability of mental health and social services during a pandemic on a basis. o List of healthcare, mental health and social services. Type of Service Name Location Contact Information Healthcare Mental Health Social Services Employees with special needs: o Identify employees with special needs. Name Special Need(s)/requirements Contact Information o Review and update list of employees on basis. Infection Control Supplies: Developed with funds provided by the Susan Harwood Training Grant Program from the Occupational Safety and Health Administration. 8

o Sufficient and accessible infection control supplies will be available in all business locations. Types of supplies include: Hand-hygiene products. Tissues and receptacles for their disposal. Ensure the availability of medical consultation and advice for emergency response. Provide information for the at-home care of ill employees and family members. Communication and Information Technology Infrastructure: o Enhancements to communication and information infrastructure needed to support employee telecommuting and remote customer access. Category Department Job Title Contact Information Need Internal Customer Communication of information concerning pandemic status: o Information concerning pandemic status and actions is to be communicated to the following groups both inside and outside the worksite in a timely and consistent way, including redundancies in the emergency contact system: Employees Developed with funds provided by the Susan Harwood Training Grant Program from the Occupational Safety and Health Administration. 9

Vendors Suppliers o The following platforms are to be used: HOTLINE: WEBSITE: POLICIES SPECIFIC TO A PANDEMIC Implementation of Response Plan Action Activation of Response Plan Altering Business Operations Transfer business knowledge to key employees Termination of Response Plan Person Authorized to Initiate Action Description of condition(s) to Initiate Action Due to the unique nature of a pandemic event, specific policies are needed and are to be reviewed on a basis. A list of these policies is provided below: Policy Description Status Employee Compensation and Sick-Leave Unique to a Address issues unique to a pandemic (e.g., non-punitive, liberal leave) including policies on when a previously ill person is no longer Developed with funds provided by the Susan Harwood Training Grant Program from the Occupational Safety and Health Administration. 10

Pandemic Flexible Worksite Policy infectious and can return to work after illness. Establishes policies relating to items such as: Telecommuting Flexible work hours Staggered shifts Prevention of Influenza Spread at the Worksite Establishes policies to prevent spread of influenza spread in the workplace. Items which may be addressed include: Promotion of respiratory hygiene/cough etiquette. Exclusion of people with influenza symptoms. Travel Restrictions Establishes a policy for: Restricting travel to affected geographic areas (both domestic and international locations). Evacuating employees working in or near an affected area and when an outbreak begins. Guidance for employees returning from affected areas. See CDC travel recommendations (www.cdc.gov). COORDINATION WITH EXTERNAL ORGANIZATIONS Share the organizations Pandemic Preparedness and Response Plan with others so that the capabilities and plans of all parties will be understood. These may include: Developed with funds provided by the Susan Harwood Training Grant Program from the Occupational Safety and Health Administration. 11

Type of Organization Name Contact Information Capabilities Insurer Health Plans Major Healthcare Facilities Collaborate with federal, state, and local public health agencies and/or emergency responders to participate in their planning process, share our pandemic plan, and understand their capabilities and plans. Communicate with local and/or state public health agencies and/or emergency responders about the assets and/or services which the business could contribute to the community during a pandemic. Share best practices with other businesses in the community, chamber of commerce, and associations to improve community response efforts. Developed with funds provided by the Susan Harwood Training Grant Program from the Occupational Safety and Health Administration. 12

Developed with funds provided by the Susan Harwood Training Grant from the Occupational Safety and Health Administration. 1 Program

Pandemic Preparedness and Response Plan Example INTRODUCTION: In the event of a pandemic influenza, our company will be prepared to play a key role in protecting our employees health and safety and to limit the negative impact on our business. Planning is critical. This plan provides specific activities which will enable us to achieve these goals. ORGANIZATION: Pandemic Team Coordinator: o Designating a specific person to be responsible for the development, implementation, and oversight of the Pandemic Preparedness and Response Plan is an essential first step. The following individual has been appointed: Name: Position: Contact Information: Pandemic Team Members: o The Pandemic Preparedness and Response Plan may impact all aspects of the business. As such, the following individuals have been appointed as Team Members and will provide necessary support to the Pandemic Team Coordinator. o The names individuals, representing various areas, which have been appointed to serve as team members are given below: Developed with funds provided by the Susan Harwood Training Grant from the Occupational Safety and Health Administration. 2 Program

Name Area Contact Information List the name of each individual appointed to the team -For each named individual provide the name of the group or function that that individual represents. -Examples of groups or functions which may be represented include: Operations Human Resources Health and Safety Medical Logistics Finance Provide contact information for each named team member. Developed with funds provided by the Susan Harwood Training Grant from the Occupational Safety and Health Administration. 3 Program

REDUCTION OF IMPACT ON BUSINESS List of critical business processes: o Critical business processes are those which are essential for the delivery of critical outputs of the business. These are categorized as core activities and profit creators. These are determined by mapping the business processes, used to generate the outputs of goods and/or services o Critical business processes are given in the table below: Process Name Description Critical Nature List the name of each process which has been determined to be critical. Provide a brief description of each named process including inputs and outputs of each process. Provide a brief description of the critical nature of each named process. List of Essential Employees o Essential employees are those who are involved with the critical business processes listed above. These are those who are essential for the delivery of critical outputs of the business. Loss of essential employees may result in the loss of the ability to perform essential business processes. o Essential employees are given in the table below: Critical Business Process Essential Employees Contact Information List the name of each process which has been determined to be critical. Provide the name of each person identified as an essential employee for each named critical business process. Provide the contact information for each named person. List of Critical Inputs to critical business processes to maintain business operations o Critical inputs are those goods and/or services needed to maintain critical business processes. o Critical inputs are given in the table below: Critical Business Process Critical Input Name of Supplier List the name of each process which has been determined to be critical. List the type of each critical input for each critical business process. Types may List the name of each supplier of Developed with funds provided by the Susan Harwood Training Grant from the Occupational Safety and Health Administration. Contact Information Provide the contact information for each named supplier. 4 Program

include: Raw Materials Suppliers Contractors each critical input. List of Ancillary Workforce to Replace Essential Employees if Necessary: o In the event of a pandemic, it may be necessary to replace essential employees who exhibit symptoms of an influenza-like illness or otherwise not able to perform their regular job work functions. It is necessary to identify individuals that can be called upon replace those essential employees and therefore continue the operation of critical business processes. o Individuals which could replace essential employees, if necessary, are given below: Critical Business Process List the name of each process which has been determined to be critical. Essential Employee List the name of each essential employee for each critical business process Name of Replacement List the name of individual who could/would replace each essential employee for each critical business process. Name/Category List the category of each named replacement. Categories may include: Retirees Employees in other job titles Contractors Contact Information Provide the contact information for each named replacement. List of scenarios likely to have an impact on business: Type of Event Impact on Business Financial Impact Critical Processes Impacted Community Containment Measures are measures to separate infected or exposed persons by use of isolation, quarantine, or other restrictions on movement and activities -Absenteeism -Decreased interaction with customers -Cancellation of public events -Decreased production -Decreased revenue generation Review Developed with funds provided by the Susan Harwood Training Grant from the Occupational Safety and Health Administration. 5 Program

including: -Cancellation of public events -School closings -Closings of businesses, libraries, theatres Enforced quarantine -Absenteeism -Decreased interaction with customers -Cancellation of public events -Decreased production -Decreased revenue generation -Interruption of shipments of supplies and products. Review School and/or business closures Public Transportation Closure Restriction on travel into or out of community Restriction on domestic travel. Restriction on International travel Absenteeism Absenteeism Increased commuter delays -Absenteeism -Commuters may be unable to return to homes -Interruption of shipments of products and supplies -Interruption of regular sales operations. -Interruption of shipments of products and supplies. -Interruption of normal international business travel. -Decreased production -Decreased revenue generation -Decreased production -Decreased revenue generation -Decreased production -Decreased revenue generation -Decreased production -Decreased revenue generation -Decreased production -Decreased revenue generation Review Review Review Review Review Interruption of critical inputs to business process -Interruption of international shipments of products and supplies -Interruption of critical business processes -Decreased production -Decreased revenue generation Review Sources of reliable pandemic information: o A One-stop access to U.S. Government pandemic flu information is found at www.pandemicflu.gov. Information available includes: Developed with funds provided by the Susan Harwood Training Grant 6 Program from the Occupational Safety and Health Administration.

Plan and Preparation General Information Local information Frequently asked questions Monitoring of Outbreaks Health & Safety Tests, Vaccines, Medications, and Masks Animal and Bird Issues Global Activities Economic Impacts Travel Research Activities News, Multimedia, and Social Media Glossary of terms. Developed with funds provided by the Susan Harwood Training Grant from the Occupational Safety and Health Administration. 7 Program

o Other sources of information are provided in the table below Organization Source Type of Information Medical Medical -Prevention Director -Symptoms -Treatment -Containment Local Government Local Public Health Department -Information -Preparedness -Prevention -Symptoms -Local data Contact Information Name and contact information of Medical Director or lead provider of medical services County Health Department Phone: Fax: E-Mail: City Health Department Phone: Fax: E-Mail: Link Provide link for the Medical Director or lead provider of medical services Example: http://co.hancock.oh.us/bd health http://www.ci.findlay.oh.u s/?id=72 State Government Federal Government State Department of Health -State Pandemic Preparedness and Response Plan -Health Statistics -Health Care Providers and Services - Local Health Departments Ohio Department of Health 246 N. High Street Columbus, Ohio 43215 General Information: 614-466-3543 Occupational -Safety and health Safety and information. Health -Worker protection Administration -Respiratory (OSHA) protection -Guidance on preparing 1-800-321- workplaces for an OSHA(6742) influenza pandemic -Frequently asked questions Developed with funds provided by the Susan Harwood Training Grant from the Occupational Safety and Health Administration. US Dept of Labor OSHA 200 Constitution Ave Washington, D.C. 20210 http://www.odh.ohio.gov http://www.osha.gov 8 Program

Trade Association International Centers for Disease Control and Prevention (CDC) Environmental Protection Agency (EPA) Name of applicable trade association(s) World Health Organization (WHO) -General information -Plans and preparation -Local information -Health and safety -Tests, vaccines, medications, and masks -Global Activities -Economic impacts -Travel -News -Basic information about pandemic flu -Government preparations -Recommended preparations EPA s response Roles -Information for EPA employees -Industry practices -Industry updates -Pandemic preparedness and response -Levels of pandemic alert -Checklist for influenza planning Centers for Disease Control and Prevention 1600 Clifton Rd Atlanta, GA 30333 800-CDC INFO 800-232-4636 TTY 888-232-6348 cdcinfo@cdc.gov USEPA Ariel Rios Building 1200 Pennsylvania Avenue, N.W. Washington, DC 202-272-0167 TTY 202-272-0165 Contact information of applicable trade association(s) World Health Organization Avenue Appia 20 1211 Geneva 27 Switzerland Telephone: + 41 22 791 21 11 http://www.cdc.gov http://www.epa.gov Link(s) of applicable trade association(s) http://www.who.int Developed with funds provided by the Susan Harwood Training Grant from the Occupational Safety and Health Administration. 9 Program

Pandemic Emergency Communications Plan: o Information flow during a pandemic is very important. o The emergency communications plan includes the identification of key contacts, chain of communications, and process for communicating business and employee status. The means of communication according to the plan may include: Mass e-mailings Use of website Text messaging Telephone Hot Line Phone bank o The Communications Plan will be updated on a Quarterly Basis Developed with funds provided by the Susan Harwood Training Grant 10 Program from the Occupational Safety and Health Administration.

REDUCTION OF IMPACT ON EMPLOYEES Communication and education: o Develop and disseminate programs and materials covering pandemic fundamentals. These include: Signs and symptoms of influenza. Modes of transmission. Personal and family protection strategies: Hand hygiene Coughing/sneezing etiquette. Contingency plans. o Employee fear and anxiety can be expected due to rumors and misinformation. Plan for communications accordingly and verify accurate information by consultation with local public health officials and other reliable sources of factual information. Reliable information resources are given below: Organization Type of Information Contact Information Example: Ohio Department of Mental Health The Ohio Department of Mental Health maintains a list of provider agencies throughout the state. Local resources are located by county or zip code. Providers are listed within the county or within 10 miles of the zip code. Ohio Department of Mental Health 30 E. Broad Street, 8 th Floor Columbus, Ohio 43215 3430 General questions: Phone: 614-466-2596 TTY: 614-752-9696 questions@mh.state.ohio.us Toll-free bridge line for consumers and families: Developed with funds provided by the Susan Harwood Training Grant 11 Program from the Occupational Safety and Health Administration.

Phone: 877-275-6364 TTY: 888-636-4889 askodmh@mh.state.oh.us Examples of local providers for Hancock County Ohio listed by the Ohio Department of Mental Health Century Health, Inc 1918 North Main Street Findlay, OH 45840 Lutheran Social Services of Northwestern Ohio, Inc. 115 East Lima Street Findlay, Ohio 45840 o Special cultural/linguist needs: Organization Contact Person Contact Information Type of Special Needs Number of people with those needs Resource/ Contact Person to Meet Need Internal HR Manager Phone: Email Example: Japanese language Identify number of people with the need at each location Identify resource that can meet that need for each location Example: Hispanic Identify number of people with the need at each Identify resource that can meet that Developed with funds provided by the Susan Harwood Training Grant 12 Program from the Occupational Safety and Health Administration.

language location need for each location External: Customer, contractor, etc Example: XYS CO. Ying Yin Chinese language Determine if the individual customer, contractor has adequate resources or requires support to normal business practices during pandemic. Identify resource that can meet that need for each location o Provide information to employees about the Pandemic Preparedness and Response Plan. Planning for employee absences: o It is essential to forecast and allow for employee absences. The table below lists types of scenarios when high rates of employee absences may be anticipated: Scenario Impact on Employees Anticipated Absentee Rate Community Containment Infected or exposed List estimated rate Measures Enforced quarantine Some employees may be List estimated rate required to miss work during the period of the quarantine. School and/or business Some employees may miss List estimated rate closures work because of the need to care for children due closing of schools and day care facilities. Public Transportation Closure Some employees may be dependent upon public transportation to commute and from their place of employment and would be forced to be absent from work. List estimated rate Developed with funds provided by the Susan Harwood Training Grant 13 Program from the Occupational Safety and Health Administration.

Restriction on travel into or out of community Such restrictions would impact employees who may commute from one community to another and would not be able to get to the workplace. Some employees who may be involved with vacation or business travel may not be able to return to their workplace. List estimated rate Reduction in the frequency and type of face-to-face contact: o In order to reduce the spread of the flu, it is necessary to modify the frequency and type of face-to-face contact (such as hand-shaking, seating in meetings, office layout, shared workstations, etc): Among employees Between employees and customers. o Steps which may be taken include: Avoid crowded settings that increase the risk of exposure to someone who may be infected. If it is absolutely necessary to be in a crowded setting, the time spent in a crowd should be as short as possible. Some basic hygiene (see www.cdc.gov/flu/protct/stopgerms.htm) and social distancing precautions may be taken. Also see (www.osha.gov) Employee Health: o Employees are encouraged to have and to report influenza vaccinations o Evaluate employee access to and availability of health care services during a pandemic on a basis. o Evaluate employee access to and availability of mental health and social services during a pandemic on a basis. o List of healthcare, mental health and social services. Type of Service Name Location Contact Information Healthcare List name(s) of Healthcare provider(s) List address of Healthcare List contact information for Healthcare provider(s) provider(s) Mental Health List name(s) of Mental List address of List contact information for Developed with funds provided by the Susan Harwood Training Grant 14 Program from the Occupational Safety and Health Administration.

Social Services Health care providers List name(s) of providers of social services. Mental Health care provider(s) List address for providers of social services Mental Health care provider(s) List contact information for providers of social services Employees with special needs: o Identify employees with special needs. Name Name of Individual with special need Name of Individual with special need Name of Individual with special need Name of Individual with special need List special need(s) requirement Example: Hearing impaired Example: Limited mobility Example: Medications Example: Vision impaired Contact Information List the address, phone number, and e-mail for each person with the special need. List the address, phone number, and e-mail for each person with the special need. List the address, phone number, and e-mail for each person with the special need. List the address, phone number, and e-mail for each person with the special need. o Review and update list of employees on a basis. Infection Control Supplies: o Sufficient and accessible infection control supplies will be available in all business locations. Types of supplies include: Hand-hygiene products. Tissues and receptacles for their disposal. Ensure the availability of medical consultation and advice for emergency response. Developed with funds provided by the Susan Harwood Training Grant 15 Program from the Occupational Safety and Health Administration.

Provide information for the at-home care of ill employees and family members. Communication and Information Technology Infrastructure: o Identify and list necessary enhancements to communication and information infrastructure needed to support employee telecommuting and remote customer access if normal access to business facilities are interrupted as a result of the pandemic. o Identification and listing should include essential personnel within the business (Internal) o Identification and listing should also include essential personnel outside of (external) the business such as key customers, contractors, and suppliers. Category NAME Department or Company Job Title Need Contact Information Internal List name(s) of individuals with need. List department of each individual List job title of each individual List the specific need of each individual List contact information for each individual. External List name(s) of individuals with need. List Company and Department of each individual List job title of each individual List the specific need of each individual List contact information for each individual. Communication of information concerning pandemic status: o Information concerning pandemic status and actions is to be communicated to the following groups both inside and outside the worksite in a timely and consistent way, including redundancies in the emergency contact system: Employees Vendors Suppliers o The following platforms are to be used: Developed with funds provided by the Susan Harwood Training Grant 16 Program from the Occupational Safety and Health Administration.

HOTLINE: WEBSITE: POLICIES SPECIFIC TO A PANDEMIC Implementation of Response Plan Action Activation of Response Plan Altering Business Operations Transfer business knowledge to key employees Termination of Response Plan Person Authorized to Initiate Action Member of senior management or designee with recommendation by Pandemic Coordinator Member of senior management or designee with recommendation by Pandemic Coordinator Member of senior management or designee with recommendation by Pandemic Coordinator Member of senior management or designee with recommendation by Pandemic Coordinator Description of condition(s) to Initiate Action Decision is made based upon timely information from public health authorities about pandemic conditions. Decision is made based upon timely information from public health authorities about pandemic conditions. Decision is made based upon timely information from public health authorities about pandemic conditions and occurrences of influenza-like illnesses of employees group. Decision is made based upon timely information from public health authorities about pandemic conditions. Due to the unique nature of a pandemic event, specific policies are needed and are to be reviewed on a basis. A list of these policies is provided below: Policy Description Status Employee Compensation and Sick-Leave Unique to a Pandemic Address issues unique to a pandemic (e.g., non-punitive, liberal leave) including policies on when a previously ill person is no longer List any current policy or status of Developed with funds provided by the Susan Harwood Training Grant 17 Program from the Occupational Safety and Health Administration.

Flexible Worksite Policy Prevention of Influenza Spread at the Worksite Travel Restrictions infectious and can return to work after illness. Establishes policies relating to items such as: Telecommuting Flexible work hours Staggered shifts Establishes policies to prevent spread of influenza spread in the workplace. Items which may be addressed include: Promotion of respiratory hygiene/cough etiquette. Exclusion of people with influenza symptoms. Establishes a policy for: Restricting travel to affected geographic areas (both domestic and international locations). Evacuating employees working in or near an affected area and when an outbreak begins. Guidance for employees returning from affected areas. See CDC travel recommendations (www.cdc.gov). development o such a policy. List any current policy or status of development o such a policy. List any current policy or status of development o such a policy. List any current policy or status of development o such a policy. Developed with funds provided by the Susan Harwood Training Grant 18 Program from the Occupational Safety and Health Administration.

COORDINATION WITH EXTERNAL ORGANIZATIONS Share the organization s Pandemic Preparedness and Response Plan with others so that the capabilities and plans of all parties will be understood. These may include: Type of Organization Name Contact Information Capabilities Insurer List current insurers List contact information for insurer List type of capabilities or coverage provided by the insurer Health Plans List applicable health plans used by the organization List contact information for each health plan List types of capabilities being provided by the health plan provider. Major Healthcare Facilities List major healthcare facilities which may be used during a pandemic List contact information for each major healthcare facility. List types of capabilities being provided by each major healthcare facility. Collaborate with federal, state, and local public health agencies and/or emergency responders to participate in their planning process, share our pandemic plan, and understand their capabilities and plans. Communicate with local and/or state public health agencies and/or emergency responders about the assets and/or services which the business could contribute to the community during a pandemic. Share best practices with other businesses in the community, chamber of commerce, and associations to improve community response efforts. Developed with funds provided by the Susan Harwood Training Grant 19 Program from the Occupational Safety and Health Administration.