Proceedings of a Workshop

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International Standard Book Number-13: 978-0-309-60340-9
Digital Object Identifier: https://doi.org/10.17226/29364

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Suggested citation: National Academies of Sciences, Engineering, and Medicine. 2026. Personal Protective Equipment for Influenza A(H5N1) in High-Risk Farm Settings: Proceedings of a Workshop. Washington, DC: National Academies Press. https://doi.org/10.17226/29364.

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PLANNING COMMITTEE FOR A WORKSHOP ON PERSONAL PROTECTIVE EQUIPMENT FOR INFLUENZA A(H5N1) IN HIGH-RISK FARM SETTINGS¹

SHAWN GIBBS (Chair), Texas A&M University

BETHANY BOGGESS ALCAUTER, National Center for Farmworker Health

JEFFREY B. BENDER, University of Minnesota

DOUGLAS CHAPIN, Chapin Family Farms, LLC

HEREK L. CLACK, University of Michigan

MICHELLE KROMM, Food Forward, LLC

BETH LIPTON, Washington State Department of Health

MATTHEW NONNENMANN, University of Nebraska

MICHAEL PAYNE, University of California, Davis

ANABEL RODRIGUEZ, Texas A&M University

MATTHEW SPENCER, U.S. Poultry & Egg Association

XIMENA VERGARA, California Department of Public Health

Project Staff

AUTUMN DOWNEY, Senior Program Officer

LISA M. BROWN, Senior Program Officer

EMILY PACKARD DAWSON, Program Officer (until October 2025)

NICHOLAS A. MURDOCK, Associate Program Officer (from November 2025)

EMILY MCDOWELL, Research Associate

ASHLEY BOLOGNA, Research Assistant

RAYANE SILVA-CURRAN, Senior Program Assistant (until November 2025)

CLARE STROUD, Senior Program Director, Biomedical and Health Sciences

Consultants

ANNA NICHOLSON, Science Writer

TAMARA HAAG, Science Writer

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¹ The National Academies of Sciences, Engineering, and Medicine’s planning committees are solely responsible for organizing the workshop, identifying topics, and choosing speakers. The responsibility for the published Proceedings of a Workshop rests with the workshop rapporteurs and the institution.

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Reviewers

This Proceedings of a Workshop was reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise. The purpose of this independent review is to provide candid and critical comments that will assist the National Academies of Sciences, Engineering, and Medicine in making each published proceedings as sound as possible and to ensure that it meets the institutional standards for quality, objectivity, evidence, and responsiveness to the charge. The review comments and draft manuscript remain confidential to protect the integrity of the process.

We thank the following individuals for their review of this proceedings:

Although the reviewers listed above provided many constructive comments and suggestions, they were not asked to endorse the content of the proceedings nor did they see the final draft before its release. The review of this proceedings was overseen by JONATHAN M. SAMET, Colorado School of Public Health. He was responsible for making certain that an independent examination of this proceedings was carried out in accordance with standards of the National Academies and that all review comments were carefully considered. Responsibility for the final content rests entirely with the rapporteurs and the National Academies.

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Acknowledgments

The National Academies’ staff wish to express their gratitude to the National Institute for Occupational Safety and Health’s National Personal Protective Technology Laboratory for sponsoring the workshop; to the speakers whose presentations and discussions helped inform workshop discussions; to the members of the planning committee for their work in developing the workshop agenda and shaping the discussions; and to additional National Academies staff and consultants, without whom this workshop and the accounting thereof would not have been possible.

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Contents

1 Introduction

Workshop Chair Welcome and Opening Remarks

National Institute for Occupational Safety and Health Opening Remarks

National Center for Immunization and Respiratory Diseases Opening Remarks

Workshop Objectives

Organization of the Proceedings

2 H5N1 Transmission and Implications for Personal Protective Equipment Use

Animal Infection and Transmission of H5N1

Environmental Transmission of H5N1

Human Infection and Transmission of H5N1

Discussion

3 Current Practices and Policies for H5N1 Infection Control and Prevention in Farm Settings

Federal Perspective: National Institute for Occupational Safety and Health

Public Health Perspective: Minnesota Department of Health

Poultry Perspective: Use of Personal Protective Equipment in Outbreak Prevention and Response Efforts

Dairy Perspective: Factors Affecting Personal Protective Equipment Usage

Discussion

4 Individual Barriers to Personal Protective Equipment Use for H5N1 Infection Control and Prevention in High-Risk Farm Settings

Insights from Farmworkers and Producers

Research-Based Perspectives from the Field and Practical Experiences from Researchers

Personal Protective Equipment Training and Education Programs

Agricultural Extension Perspective

Discussion

5 Systemic Barriers to H5N1 Infection Control and Prevention in High-Risk Farm Settings

Farmworker Advocacy Organizations

Producers and Co-Ops

Community Partners

Discussion

6 Improving Existing Personal Protective Equipment Access and Feasibility of Use

Engaging Workers in Worker Health Initiatives

Engaging Partners in PPE Distribution

Research Priorities

Discussion

7 Innovative Personal Protective Equipment Technology and Research

Research Priorities and Gaps

Lessons Learned from Innovative Products

Wearable Air Curtains: Novel Respiratory Protection Against Airborne Pathogens

Wearable Technologies and Design of Personal Protective Equipment

Regulatory Pathways and Standards

Discussion

8 Communications, Training, and Education Gaps and Strategies

Health Communications and Information Accessibility

Training and Education Programs

Discussion

9 Optimizing Personal Protective Equipment for High-Risk Farm Settings

Industry Stakeholders

Research Perspective

Public Health Perspective

One Health Perspective

Roundtable Discussion

10 Workshop Closing Remarks

Closing Remarks from the Workshop Chair

Closing Remarks from Workshop Sponsor

11 References

Appendixes

A Workshop Agenda

B Biographical Sketches of the Speakers and Session Moderators

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Box and Figures

BOX

1-1 Statement of Task

FIGURES

2-1 State-to-state movement of dairy cattle driving H5N1 transmission in the United States

2-2 Self-reported personal protective equipment use among symptomatic poultry workers, July 2024

3-1 Example of dairy worker personal protective equipment in use

4-1 Results from National Center for Farmworker Health survey on current personal protective equipment usage by state, 2025

5-1 Percent of milk cow inventory by size of operation, 2017 and 2022

6-1 Research priorities to improve existing personal protective equipment accessibility and feasibility of use

7-1 Example of a wearable air curtain model with backpack containing electro-mechanical components

9-1 Total Worker Health® hierarchy of controls

Abbreviations and Acronyms