Workplace: Employer and Employee responsibilities

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Workplaces must be aware, accommodate their employee’s health conditions where possible, and be prepared for an emergency. There are also responsibilities for the employee who is at risk of an allergic reaction.

Responsibilities of the workplace for anaphylaxis management include:

1. Staff education and training
2. Staff communication
3. Emergency response plan
4. Adrenaline (epinephrine) injector for general use

1. Staff education and training

The workplace should ensure that an appropriate number of staff, on site at any given time, have first aid training specific to anaphylaxis. A&AA encourages all staff to complete the free online anaphylaxis e-training course developed by the Australasian Society of Clinical Immunology and Allergy (ASCIA), the peak medical organisation for allergic disease. The course teaches people how to recognise and treat anaphylaxis and takes approximately one hour to complete. Staff who successfully complete the training receive a certificate.

It is also recommended that each workplace purchases an adrenaline injector trainer device (with no needle or medication) to practise with. A&AA suggests that staff revise the signs and symptoms of an allergic reaction and practise using the trainer device 2-3 times a year during staff/Occupational Health & Safety meetings. You can purchase training devices from our online shop.

A&AA has short 2 minutes videos that show the signs and symptoms of allergic reactions, how to position a child or an adult in an emergency and EpiPen® and Anapen® administration. Visit our page on preparing for an emergency.

2. Staff communication

Consider placing some general information about allergies and anaphylaxis in work memos, circulars, newsletters, industry publications. You may even want to put an ASCIA First Aid Plan for Anaphylaxis on the staff notice board.

Make a note of Food Allergy Week (FAW), held in May each year, and consider awareness raising activities. More information on FAW can be found on A&AA website.

3. Emergency response plan

It is important that the workplace has an emergency response plan specific to anaphylaxis because it requires urgent and specific emergency care.

If a staff member shows signs and symptoms of an allergic reaction, it is important to follow their individual ASCIA Action Plan or the ASCIA First Aid Plan for Anaphylaxis. 

If it is safe to do so, it is strongly advised that the person lay on the ground wherever they are and call for help. The adrenaline injector (and ASCIA Action Plan) must be brought to the individual and administered either by the individual or by a colleague. Ideally a colleague that has undergone training should administer the adrenaline injector, but if a trained staff member is not present, anyone can read the instructions on the device and give the adrenaline according to instructions on the ASCIA Action Plan.

Once the adrenaline is given, an ambulance must be called.  If another adrenaline injector is available, it should be brought to the individual in case they need another dose.  Instructions on when to give a second dose are on the ASCIA Action Plan. Whoever calls the ambulance should stay on the call with ambulance control (and with the patient) until the ambulance arrives.

A staff member should go to the building entrance to direct the ambulance to the patient. If the person having anaphylaxis is in an unsafe location and needs to be moved, they must be moved in the lying position (for example on a stretcher). They must not stand up or walk. 

Those who work closely with employees with an allergy who are at risk of anaphylaxis should know where the staff member’s medical kit containing their adrenaline injector and ASCIA Action Plan is kept.

The workplace needs to have an emergency plan for the management of anaphylaxis in different locations of the workplace and consider all aspects of emergency care including, for example:

• Who brings the medical kit to the employee having the allergic reaction?
• Who gives the adrenaline injector if the employee having the anaphylaxis cannot self-administer it?
• Who calls an ambulance?
• Who stands on the roadside and in other areas to direct paramedics to the patient quickly?

4. Adrenaline (epinephrine) injector for general use

Food, insect and medication allergies are on the increase, as are anaphylaxis presentations to hospitals.

When deciding whether to have an adrenaline injector in a workplace first aid kit a risk assessment should be completed. The risk assessment should consider whether there is an increased risk of the following in the workplace:

• A person in the workplace is more likely to be exposed to allergens known to trigger anaphylaxis (e.g. bees, wasp, jack jumper ant). High risk environments, such as beekeepers, should consider having an adrenaline injector available, even if no worker has previously had an allergic reaction.
• A person, previously undiagnosed, having anaphylaxis (such as during a large-scale event where food is being served/available for purchase). The more employees there are in a workplace, the greater the chance someone might have their first anaphylaxis.
• A person known to be at risk of anaphylaxis not having their personal adrenaline injector available, accidentally misfiring the injector or the injector having expired.
• A second or third dose of adrenaline being needed to treat anaphylaxis before medical help arrives at the scene.
• Difficult access to a worksite for emergency services or the geographical location of worksite (distance from emergency services).

The ASCIA First Aid Plan for Anaphylaxis (orange in colour) must be stored with the adrenaline injector for general use and instructions on the plan must be followed when someone is thought to be having a severe allergic reaction (anaphylaxis).

If a workplace has an adrenaline injector in a first aid kit, staff need to be trained in when and how to administer the adrenaline injector following instructions on the ASCIA First Aid Plan for Anaphylaxis.

An EpiPen® or Anapen® for first aid kits (not prescribed to an individual through the Pharmaceutical Benefits Scheme) can be purchased over the counter at a pharmacy at the cost of approximately $100 per device. You should ask for an adrenaline injector with an expiry date of at least 10 months.

The EpiPen®300  (containing 300mcg of adrenaline) is for children over 20kg and adults. The EpiPen®300  or Anapen® 500 (containing 500mcg of adrenaline) is for children and adults over 50kg.

Responsibilities of the employee at risk of a severe allergic reaction

The employee should be encouraged to tell their employer they have an allergy and are at risk of anaphylaxis at the commencement of employment. An optional question about food allergies could be included on the employee details form as part of their onboarding process.

Any employee who has been diagnosed with severe allergy and been prescribed an adrenaline (epinephrine) injector (such as Anapen®, EpiPen®) should have an ASCIA Action Plan for Anaphylaxis kept with their adrenaline injector. Employees who carry an adrenaline injector should inform the employer, supervisor, or person in charge of its location, for example on their desk or in their bag.

The adrenaline injector should always be stored in the same place when the employee is at work. It must always be easily accessible and not be kept in a locked room, drawer or cupboard. If the employee’s role involves travel or visits to different workplace sites, they should carry their adrenaline injector every time they leave their main place of work.

Some allergic reactions can occur very quickly and can be severe. NO employee, no matter how old they are, should be expected to be completely responsible for the self-administration of their adrenaline injector as they may become quite unwell very quickly. Assistance should be provided as they may not be able to administer the adrenaline injector themselves in an emergency.