Could you provide guidance on the use of plexiglass barriers for workplaces for “sneeze guard” droplet protection, specifically for a County clerk who works with the public. Is there any research on this? What is best practice? How large should the barriers be if used, what material, where should they be located? Should they hang from the ceiling or freestanding on their desks ? How far from the employee should they be located?

Social distancing guidance recommends maintaining 2 meters (6 feet) distance between individuals to reduce the potential for transmission of COVID-19. In some settings, e.g., a customer interacting with a worker or other workplace settings, it may not be feasible to maintain the 2-meter distance. Physical barriers are an example of an engineering control that can reduce droplet transmission in these settings.12  Plexiglass, a transparent acrylic plastic, can be used as partitions between individuals. 

Multiple organizations suggest the use of plexiglass or other barriers for a variety of industries to reduce exposure. CDC and OSHA both recommends use of plexiglass or clear plastic barriers in  pharmacies between the worker and customers at pickup counters.1,2  Similarly, WHO mentions the use of physical barriers at registration desks, triage desks or pharmacy windows in the healthcare setting.3  

Plexiglass is advantageous because it is readily available, easily worked, smooth, transparent and easily cleanable.  Tempered glass, and polycarbonate are similar, but more durable and  expensive.  Properties such as scratch and impact resistance should be considered before making a selection.  In installing barriers, consideration should be given to ventilation requirements to avoid interference with HVAC systems.
 
CDC and OSHA recommends the use of barriers such as plexiglass, strip curtains or similar impermeable dividers to separate manufacturing workers or meat and poultry processing workers, if feasible.4-6 In addition, OSHA suggests installing plexiglass partitions in retail establishments when it is not feasible to maintain social distancing.7 For rideshare, taxi, or care service workers, OSHA also suggests installing a plexiglass partition between the driver and the passenger compartments, if possible.8 OSHA suggests restaurant and beverage vendors offering takeout or curbside pickup install plexiglass partitions if feasible when sensible social distancing is not possible.9 CDC suggests placing a barrier (e.g. sneeze guard) between customers and airport retail and food service workers as a means to physically increase the distance between workers and customers.10 

The Canadian National Collaborating Centre for Environmental Health (NCCEH) published guidance for use of such partitions. The NCCEH authors state: “Partitions are proposed to serve three critical functions: 1) intercepting the respiratory droplets that are thought to transmit the virus, 2) re-enforcing physical distancing requirements, even when users are unwilling or forgetful; and 3) reducing reliance on masks, both due to the shortage of these items and user comfort.”11 The dimensions of the barrier should take into account the breathing zone areas of both users and reflect the posture (sitting or standing) of the users. The height of the partition needs to be greater than the tallest standing user. The partition should be as wide as possible, typically reflecting the length of the desk or counter. There usually will need to be an opening in the plexiglass or other barrier to permit the transfer of paperwork or other items, e.g., prescription medications in a pharmacy, between the users.  These openings should be as small as possible and should be placed to the side of the sitting user, i.e., not directly in front of the staff person’s breathing zone.  The barriers can be mounted on the surface of the desk or counter or can be hung from the ceiling.  Ideally, the arrangement should allow the maintenance of a 2-meter separation between users. The NCCEH authors state:  “Because partitions are intercepting respiratory droplets, they must be treated as contaminated surfaces and should be cleaned regularly according to a set protocol.” 11 Disinfectants or cleaners that will not damage the barrier need to be chosen. 

Citations

  1. OSHA, COVID-19 Guidance for Retail Pharmacies, accessed May 30, 2020, https://www.osha.gov/Publications/OSHA4023.pdf.
  2. U.S. CDC, Guidance for Pharmacists and Pharmacy Technicians in Community Pharmacies during the COVID-19 Response, May 28, 2020, https://www.cdc.gov/coronavirus/2019-ncov/hcp/pharmacies.html.
  3. World Health Organization, Rational use of personal protective equipment for coronavirus disease 2019 (COVID-19), February 27, 2020, https://apps.who.int/iris/bitstream/handle/10665/331215/WHO-2019-nCov-IPCPPE_use-2020.1-eng.pdf.
  4. CDC, Manufacturing Workers and Employers, Interim Guidance from CDC and OSHA, accessed May 30, 2020. https://www.cdc.gov/coronavirus/2019-ncov/community/guidance-manufacturing-workers-employers.html.
  5. OSHA, COVID-19 Guidance for the Manufacturing Industry Workforce, accessed May 30, 2020, https://www.osha.gov/Publications/OSHA4002.pdf
  6. CDC, Meat and Poultry Processing Workers and Employers: Interim Guidance from the CDC and OSHA, accessed May 30, 2020, https://www.cdc.gov/coronavirus/2019-ncov/community/organizations/meat-poultry-processing-workers-employers.html.
  7. OSHA, COVID-19 Guidance for Retail Workers, accessed May 29, 2020, https://www.osha.gov/Publications/OSHA3996.pdf.
  8. OSHA, COVID-19 Guidance for Rideshare, Taxi and Car Service Workers, accessed May 30 2020, https://www.osha.gov/Publications/OSHA4021.pdf.
  9. OSHA, COVID-19 Guidance for Restaurants & Beverage Vendors Offering Takeout or Curbside Pickup, accessed May 30, 2020. https://www.osha.gov/Publications/OSHA4017.pdf
  10. CDC, What Airport Retail or Food Service Workers Need to Know about COVID-19, Retail or Food Service Workers, Accessed May 30, 2020,  https://www.cdc.gov/coronavirus/2019-ncov/community/airport-retail-factsheet.html.
  11. National Collaborating Centre for Environmental Health (NCCEH), Physical Barriers for COVID-19 Infection Prevention and Control in Commercial Settings, May 13, 2020, https://ncceh.ca/content/blog/physical-barriers-covid-19-infection-prevention-and-control-commercial-settings
  12. https://www.grocerydive.com/news/grocers-install-plexiglass-barriers-to-checkout-counters/574839/

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Disclaimer:
The Forum does not necessarily represent an official ACOEM position. The Forum is intended for health professionals and is not intended to provide medical or legal advice, including illness prevention, diagnosis or treatment, or regulatory compliance. Such advice should be obtained directly from a physician and/or attorney. Questions are answered with the best available data or recommendations at the time.