Valley Fever - Cal/OSHA

Most job-site dust hazards come from what the crew is cutting or grinding. Valley Fever comes from the ground itself. The fungus that causes it, Coccidioides, lives in the top 2 to 12 inches of soil in many parts of California, and its spores get into the air when that soil is disturbed — by digging, grading, driving on dirt roads, or wind. This Cal/OSHA Valley Fever Toolbox Talk covers California Labor Code Section 6709, the law that requires construction employers in high-risk counties to train their crews on Valley Fever every year, and what that training has to teach.

Where the boundary of this talk sits#

This talk covers Valley Fever and California's construction training law. General dust and silica controls belong to the dust and silica talk; respirator fit and use belong to the respiratory protection talk; trench and excavation hazards belong to their own talks.

The anchor#

Here is the distinction that carries this whole talk: Valley Fever is not caused by anything the crew brings to the job — it comes out of the ground they are standing on, in the top few inches of soil, whenever that soil is dug, graded, driven over, or blown — so on a California earthwork job in a high-risk county the first dust control is not the respirator, it is the water truck, and the early cough or "flu that won't go away" is the one symptom worth reporting, because early diagnosis and treatment help keep the disease from progressing.

Who the law covers#

Labor Code Section 6709(b) applies to a construction employer with employees working at worksites in counties where Valley Fever is highly endemic, where work activities disturb the soil. The statute names the counties of Fresno, Kern, Kings, Madera, Merced, Monterey, San Joaquin, San Luis Obispo, Santa Barbara, Tulare, and Ventura, and says the list includes but is not limited to them. It defines highly endemic as an annual incidence rate of Valley Fever greater than 20 cases per 100,000 persons per year.

The list can grow. Under subdivision (e), when the State Department of Public Health's annual report first identifies a county as highly endemic, the law does not apply there in that initial year, but it does apply to employers in that county the following year. Crews working outside the named 11 counties should check the latest CDPH report rather than assume they are exempt.

The soil-disturbing activities the statute names include digging, grading, or other earth moving operations, vehicle operation on dirt roads, and high winds. Subdivision (f) confirms the law covers construction broadly: construction, alteration, painting, repairing, construction maintenance, renovation, removal, or wrecking of any fixed structure or its parts.

The deadline: every year by May 1#

Section 6709(c) requires covered employers to provide effective awareness training on Valley Fever to all employees by May 1, 2020, and annually by that date after that. A crew that starts work in a named county in June should not assume last year's training still counts.

What the training must cover#

The law lists eight topics:

1. What Valley Fever is and how it is contracted.
2. High-risk areas, types of work, and environmental conditions when the risk of contracting Valley Fever is highest.
3. Personal risk factors that may create a higher risk for some individuals — the statute names pregnancy, diabetes, a compromised immune system, having received an organ transplant, and taking immunosuppressant drugs.
4. Personal and environmental exposure prevention methods, which may include water-based dust suppression, good hygiene when skin and clothing are soiled by dust, limiting contamination of drinks and food, working upwind from dusty areas when feasible, wet cleaning dusty equipment when feasible, and wearing a respirator when exposure to dust cannot be avoided.
5. The importance of early detection, diagnosis, and treatment to help prevent the disease from progressing.
6. Recognizing common signs and symptoms: fatigue, cough, fever, shortness of breath, headache, muscle aches or joint pain, a rash on the upper body or legs, and symptoms similar to influenza that linger longer than usual.
7. The importance of reporting symptoms to the employer and seeking medical attention from a physician for diagnosis and treatment.
8. Common treatment and prognosis.

The statute allows training materials from federal, state, or local agencies, such as the CDC or the State Department of Public Health.

What the crew should know about the disease#

Valley Fever does not spread from person to person. The California Department of Public Health's fact sheet says symptoms usually look like the flu and appear between seven and 21 days after breathing in spores. According to the CDC, some people who are exposed never have symptoms, about 5 to 10 percent of people who get Valley Fever develop serious or long-term lung problems, and in about 1 percent the infection spreads from the lungs to other parts of the body. That is why the law puts so much weight on the flu that won't go away: an early diagnosis is the difference the training is trying to make.

Controls on the job#

Cal/OSHA's guidance on Valley Fever tells employers to minimize the area of soil disturbed; use water, appropriate soil stabilizers, or re-vegetation to reduce airborne dust; provide enclosed, air-conditioned cabs for vehicles that generate dust; provide NIOSH-approved respiratory protection with particulate filters rated N95, N99, N100, P100, or HEPA; and provide coveralls and change rooms, and showers where possible, so workers change into clean clothes and shoes before leaving the worksite. Cal/OSHA's guidance also points to its respiratory protection standard, Section 5144, for respirator use. CDPH's fact sheet adds two practical rules: keep the soil wet before and during digging or earth moving, and suspend work during heavy wind or dust storms.

Where the duty sits#

California Labor Code 6709 requires the training: (b) who is covered and the definition of highly endemic; (c) annual training by May 1 and the eight required topics; (d) acceptable training materials; (e) newly endemic counties; (f) scope. Cal/OSHA's Valley Fever guidance and 8 CCR 5144 cover the controls and respirators.

What can go wrong?#

• A grading crew starts in Kern County with no Valley Fever training on record.
• The water truck runs only in the morning, and the afternoon wind lifts dust across the whole site.
• An operator runs a dozer with the cab door open because the air conditioning is broken.
• A laborer with a cough for three weeks keeps working and never tells anyone.
• Crew members eat lunch in the dust and drive home in dusty work clothes.

How do we manage this properly?#

• Train by May 1 every year — all eight topics, for every employee in a covered county.
• Wet the ground first — before and during digging, grading, and earth moving.
• Stop in heavy wind — dust storms spread spores.
• Closed cabs — with working air conditioning on dust-generating equipment.
• Respirators when dust can't be avoided — NIOSH-approved particulate filters.
• Keep dust off food and out of the truck — wash, change, and clean equipment wet.
• Report lingering flu symptoms early — and see a physician.

Before you start#

Confirm the county, whether it is on the list or in the latest CDPH report, and the date of this year's training. Check that the water truck is running and assigned. Point out where to report symptoms.

Talk it over#

• What work on this job disturbs the soil the most?
• What would make you suspect Valley Fever instead of a normal cold?
• Where do you eat, and how dusty is it?

The bottom line#

Valley Fever comes from spores in the top few inches of California soil, released whenever the ground is dug, graded, driven on, or blown. In the highly endemic counties, construction employers must train every employee on it by May 1 each year. Wet the ground, stop in heavy wind, keep cabs closed, use respirators when dust can't be avoided, and report a cough or flu that lingers.

Frequently asked questions about Valley Fever in construction#

Which counties require Valley Fever training?

Labor Code Section 6709 names Fresno, Kern, Kings, Madera, Merced, Monterey, San Joaquin, San Luis Obispo, Santa Barbara, Tulare, and Ventura, "including, but not limited to" those counties. A county becomes covered the year after the State Department of Public Health's annual report first identifies it as highly endemic — more than 20 cases per 100,000 persons per year.

Does the training apply if our crew never digs?

The law applies at worksites in covered counties "where work activities disturb the soil," and it names more than digging: grading and other earth moving, driving on dirt roads, and high winds. A crew that works on a site where others are grading, or drives dirt haul roads every day, is working where the soil is disturbed.

Can Valley Fever spread from one worker to another?

No. The CDC says Valley Fever does not spread from person to person. Workers get it by breathing spores from disturbed soil.

Download the Cal/OSHA Valley Fever toolbox talk PDF#

Download this Cal/OSHA Valley Fever Toolbox Talk as a printable PDF in English and Spanish, and use it for the annual training before May 1.

Related toolbox talks#

• Dust and Silica
• Respiratory Protection
• Excavation and Trenching
• Personal Hygiene

Sources#

• California Labor Code §6709 ((a) fungus in top 2 to 12 inches of soil; (b) construction employers in highly endemic counties including Fresno, Kern, Kings, Madera, Merced, Monterey, San Joaquin, San Luis Obispo, Santa Barbara, Tulare, and Ventura, soil-disturbing activities, highly endemic = more than 20 cases per 100,000 per year; (c) training by May 1, 2020, and annually, eight required topics; (d) materials; (e) newly endemic counties; (f) scope): https://codes.findlaw.com/ca/labor-code/lab-sect-6709/
• Cal/OSHA, Protection from Valley Fever (at-risk work; employer prevention measures; respirators with N95, N99, N100, P100, or HEPA filters; §5144): https://www.dir.ca.gov/dosh/valley-fever-home.html
• California Department of Public Health, Preventing Work-Related Coccidioidomycosis (Valley Fever) (June 2013) (not spread from person to person; symptoms 7 to 21 days after exposure; wet soil before and during digging; suspend work in heavy wind): https://www.cdph.ca.gov/Programs/CCDPHP/DEODC/OHB/HESIS/CDPH%20Document%20Library/CocciFact.pdf
• CDC, About Valley Fever (no person-to-person spread; some exposed people never have symptoms; 5 to 10% serious or long-term lung problems; about 1% spread beyond the lungs): https://www.cdc.gov/valley-fever/about/index.html

Written by FieldSafetyTalk's safety professional — a CSP, ASP, CHST and OSHA Authorized Outreach Trainer with 14+ years of international construction safety experience across federal, heavy civil, and industrial projects.

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