Florida Atlantic University

Division of Research and Graduate Studies

Standard Operating Procedures (SOPs)

Section C - Occupational Health

Table of Contents

1 Personal hygiene (06/04)
2 Occupational Health and Safety Program (06/04)
    2.D Administrative Procedures (06/04)
    2.E Facility Design and Operation (06/04)
    2.F Exposure Control (06/04)
    2.G Education and Training (06/04)
    2.H Occupational Health-Care Services (06/04)
        2.H.d Federal Recommendations for Occupational Health-Care Services for Research Programs That Involve Experimentally or Naturally Infected Vertebrate Animals(06/04)
        2.H.e Assessment of Risk Associated with Animal-Related Research
(06/04)
        
(06/04)
        2.H.i Activities of an Occupational Health-Care Service
(06/04)
            2.H.j Identification of Persons at High Risk (06/04)
            2.H.k Interaction with Environmental Health and Safety Staff
(06/04)
            2.H.l Pre-placement (Pre-assignment) Medical Evaluations (06/04)
            2.H.m Periodic Health Evaluations (06/04)
            2.H.m.iii Episodic Health Evaluations (06/04)
            2.H.m.iv Recognition, Evaluation, Recording, and Follow up of Adverse Health Outcomes (06/04)
            2.H.m.v Medical Management of Worker-Compensation Cases (06/04)
            2.H.m.vi Immunization  (06/04)
            2.H.m.vii Medical Recordkeeping  (06/04)
            2.H.m.viii Serum-Banking Sect.  (06/04)
            2.H.m.ix Exit Evaluations Sect.  (06/04)
            2.H.m.x Non-occupational Health Care (06/04)
        2.H.n Program Evaluation  (06/04)
        2.H.n.iii Equipment Performance  (06/04)
        2.H.n.iv Information Management (06/04)
            2.H.n.iv.2 Occupational Health and Safety Information-Management (06/04)
        2.H.o Emergency Procedures (06/04)
        2.H.p Program Evaluation (06/04)
        2.H.q Specific procedures for VS personnel (06/04)
3 Biohazard control (06/04)
4 Special Considerations (06/04)
    4.A Facilities and Procedures for Animal Research with Hazardous Agents (06/04)
5 Table for Suggested Physical Examination (06/04)

Handout (06/04)

 

Occupational Health

A.      REFERENCE 

a.        Laboratory Animal Welfare Act, as amended by the Animal Welfare Act of 1985, 1989, 1990, 1991 7USC 2131 et seq

b.       Animal Welfare Regulations, Code of Federal Regulations, Title 9, Parts 1, 2 and 3

c.        "Guide for the Care and Use of Laboratory Animals", DHEW Publication No. (NIH) 86-23, 1996

d.       "Public Health Service Policy on Humane Care and Use of Laboratory Animals", OPRR (NIH), 1986

e.        “Occupational Health and Safety in the Care and Use of Research Animals”, NRC, 1997

f.         “Biosafety in Microbiological and Biomedical Laboratories”, CDC/NIH, 4^th ed., 1999

B.       PURPOSE

a.        The purpose of this is to provide a standard operating procedure (SOP) for the people working with Laboratory Animals. Deviations from this procedure require approval by the University Veterinarian except in emergencies, when any appropriate action may be taken to protect animals and personnel.

C.       APPLICABILITY

a.        This SOP applies to all personnel involved in the handling and care of Laboratory Animals used for biomedical research or teaching at the Florida Atlantic University.

D.      SAFETY PRECAUTIONS

a.        Laboratory Animals can be carriers of zoonotic diseases. Caretakers are encouraged to wear proper attire which includes gloves and work uniform. On occasions, Laboratory Animals will bite or scratch which could lead to injuries.

E.       PROCEDURES

1.     Personal hygiene

A.      It is the purpose of this policy to protect the public, the staff, and the laboratory animals from incidental exposure to communicable and zoonotic diseases.

B.       It is essential that the animal care and investigative staffs maintain a high standard of personal cleanliness. Facilities and supplies for meeting this obligation are provided. Clothing suitable for use in the animal facility is supplied and will be laundered by the animal facility. Personnel should change clothing often enough to maintain personal hygiene. Outer garments worn in animal rooms are not intended to be worn outside the animal facility. No work clothes are to go home.

C.       Personnel must change into supplied clothing prior to working in the animal facility, and must remove supplied clothing prior to leaving the animal facility building (the only exception to the removal of clothing is made when personnel are on authorized business between campus animal facilities). Animal facility personnel are authorized up to ten minutes at the beginning and end of each work shift for changing clothing. At lunch, individuals are authorized 10 minutes at the beginning and end of the lunch period for changing clothes.

D.      It is highly recommended that animal care personnel avail themselves of the shower facilities prior to leaving work. This is especially important for individuals who live with someone who is pregnant, aged, ill, or otherwise susceptible to disease.

E.       Hand washing is an important part of personal hygiene, both to prevent "hand-to-mouth" transmission and to prevent the spread of disease between groups of animals.

F.       Personnel are not permitted to eat, drink, smoke, or apply cosmetics in the animal facility or when animals are present except in locker rooms and designated break areas (no smoking anywhere per University policy)

G.       Allergies can be fatal. Personnel have to be aware at all times that the dander or hair they may have on them could be fatal to someone. Wear clothes to use with animals and then change prior to going out of the facility especially into a café or elevator.

2.     Occupational Health and Safety Program

A.      Federal requirements and guidelines for Occupational Health and Safety Programs include Occupational Safety and Health Administration (OSHA), Public Health Service Policy on Humane Care and Use of Laboratory Animals, National Institute of Health (NIH) Guidelines for Research Involving Recombinant DNA Molecules, and Animal Welfare Act. Also, recommendations are included in the Guide for the Care and Use of Laboratory Animals and Biosafety in Microbiological and Biomedical Laboratories.

B.       The program involves the University, IACUC, Veterinary Services, Environmental Health and Safety, and the Departments that use animals.

C.       The program has nine key elements to it.

a.        Administrative Procedures

b.       Facility Design and Operation

c.        Exposure Control

d.       Education and Training

e.        Occupational Health-Care Services

f.         Equipment Performance

g.       Information Management

h.       Emergency Procedures

i.         Program Evaluation

D.      Administrative Procedures

a.        Administrative procedures are carried out by the IACUC in their approval process for protocols and programs.

                                             i.Prior to the approval of an animal use protocol, the committee has to review and approve the animal use.

                                            ii.The committee evaluates and assures that all risks are evaluated and approved by the corresponding hazard committee. i.e. Infectious agents, recombinant-DNA molecules that are not exempt from federal guidelines, hazardous chemicals, radiation, or the use of animals that present unique hazards.

b.       Along with the IACUC, the Office of Veterinary Services (VS) performs administrative functions in the training of personnel, tracking diseases and other risks, etc.

c.        Principal Investigator has the responsibility to submit with his/her protocol all pertinent information associated with any hazard including hazards to other personnel and animals.

E.       Facility Design and Operation

a.        Facility design is based on

                                             i.Species to be maintained

                                            ii.Type of research

1.        Consideration is given to space requirements associated with confining and limiting hazards, collection of hazards and their storage, etc.

b.       Special consideration is given to the ventilation system, space arrangement and layout, support areas, traffic patterns, and access to utilities and mechanical areas.

c.        Consideration is made concerning the prevention and control of ergonomic hazards.

                                             i.Physical stress in repetitive operations

                                            ii.Lifting and movement

d.       Equipment design and layout

F.       Exposure Control

a.        Exposure controls include engineering controls, work practices, and the use of personal protective equipment

                                             i.Engineering controls.

1.        This control includes the use of "barriers", special equipment such as hoods with exhausts systems, down draft necropsy tables, one time pass air, filter tops for cages, HEPA filtered air, etc. to separate animals from human exposure.

                                            ii.Work practices.

                                          iii.Limit exposure by using restricted areas, time of exposure, etc.

                                          iv.Proper education of personnel.

                                           v.Proper procedures to reduce direct and indirect exposure

1.        Handling and Transport of Animals

A.      Use proper protective measures appropriate for the hazard as outlined in the protocol. Should include hazards to other animals, people handling or transporting the animals and other personnel that might come in contact with the animals, either directly or through aerosol methods.

2.        Personal hygiene

A.      No eating, drinking, smoking or applying cosmetics in an animal facility (with or without animals present) or when animals are present (such as in a laboratory).

3.        Housekeeping

A.      All areas that involve animals will be maintained clean and neat.

B.       Work surfaces should be disinfected before and after use each day. Floors should be disinfected at least once a week or more often if appropriate.

a.        Dust should be considered a factor in cleaning. Only "wet" cleaning or HEPA filter vacuums should be used to suppress dust.

C.       Waste disposal

a.        In cooperation with Environmental Health and Safety, all waste will be appropriately disposed on a regular basis as appropriate for the material.

4.        Restraint of animals

A.      All precautions should be used in the handling of animals.

B.       Only experienced/trained personnel should handle them.

C.       Appropriate mechanical or pharmaceutical devices/agents should be used when appropriate to avoid hazards for the animal and personnel. (Note. Some pharmaceutical agents can be hazardous in themselves.)

5.        Cleaning cages

A.      Many hazards are associated with cage cleaning. Among them are bites from animals, escape of animals, sharps, crushing injury, lifting injury, noise, steam, slippery floors, electrical, improper disposal of waste, etc.

6.        Personal protective equipment

A.      All personnel handling animals or working around them should wear appropriate gloves.

B.       All caretakers will be provided work uniforms to be worn in the facility.

a.        In certain areas such as within a barrier, the work uniforms will be sterilized or disposal type.

C.       A minimum of clean lab coats provided by the University will be worn by all personnel working with or around animals.

a.        Special hazards require a higher level of protection. This will be stated on the door as is approved in the protocol.

D.      Under no circumstances should clothing worn with and working around animals be worn outside the area where animals are kept nor should they be taken home to be cleaned.

E.       Other protection devices that will be required as determined by Environmental Health and Safety, VS, physician, etc. will be provided by the University and the personnel will be encouraged to use it. This would include allowing time for donning and proper removal of the protective devices. Besides the suits, lab coats and gloves, protective gear would include special gloves, respirator masks, disposal booties, special shoes, hearing and eye protection, etc.

F.       All areas used by personnel working with animals should be identified by Environmental Health and Safety and VS for their potential hazards and provide proper equipment and education.

G.       Education and Training

a.        Administratively, all training will be recorded by VS that involves animals, their use, and the environment associated with the animals. Other departments may keep records for specific training as appropriate such as Environmental Health and Safety and Radiation Safety.

b.       All personnel working with animals, in an animal environment, on a protocol, or others as deemed appropriate will take the General Training Course located on the VS web. (www.fauvet.fau.edu)

                                             i.Additional special training is provided as On-The-Job (OJT) training. Records are kept by VS for the caretakers. Principal Investigators are to ensure all personnel on their protocol are properly OJT trained.

1.        All caretakers, after completing the General Training Course and meeting with the veterinarian for a discussion, will start a check-list of assigned task training (OJT).

2.        A task list will be created by the Facility Manager of all tasks expected of the caretakers

A.      Each item will be taught/discussed and then signed off by both the teacher and the trainee and dated.

                                            ii.Films, slides, and special training are provided by the veterinarians and/or the veterinarian technician upon request.

                                          iii.From time to time, additional special training will be conducted.

1.        Outside consultants such as detergent specialist, fire marshals, EH&S, radiation safety, pest control specialist, crematorium specialist, investigators, etc. will be asked to conduct training.

H.      Occupational Health-Care Services

a.        Occupational Health Program identifies hazards associated with animal use, their tissues and the environment in which employees work. The main goal is prevention. The second goal is early care. Both of these are provided through the Occupation Health Program which includes physicians, nurses, assistants, etc. All are part of the Occupational Health Program Committee who work together to provide a safe place to work.

b.       The amount of protection required is based on many factors; time with animals is only one. At the University, the factors are greatly reduced with the absence of non-human primates. Most of the animals used do not carry a zoonotic disease.

                                             i. The Occupational Health Program involves all personnel who work daily with animals including laboratory animal technicians (Veterinary Services), managers, supervisors, veterinarians, etc. The program also includes research technicians, Principal Investigators and others who have contact with animals. It also includes visitors, students, and anyone who works with animal products, chemicals, radiation, biohazards, etc. in relation to or with animals.

c.        Federal requirements are stated earlier.

d.       Federal Recommendations for Occupational Health-Care Services for Research Programs That Involve Experimentally or Naturally Infected Vertebrate Animals

e.        Assessment of Risk Associated with Animal-Related Research

Source: CDC-NIH 1993

f.         Responsibilities of an Occupational Health-Care Service

                                             i.An occupational health-care service has various important responsibilities:

                                            ii.To commit to developing a detailed knowledge of the occupational hazards of employees and an understanding of the temporal and spatial distribution of those hazards. These are referred to below as "that knowledge" and "that understanding."

                                          iii.To understand the medical presentation of occupational illness and injuries for which employees are at risk.

                                          iv.To understand the characteristics of the workforce, the nature of sensitivity or susceptibility factors among members of the workforce, and how these factors affect the ability of employees to perform their tasks.

                                           v.To apply that knowledge to an understanding of how employment presents a direct threat to employees' health.

                                          vi.To communicate that understanding to the health, safety, and management teams to assist them in making program decisions that are based on the best available medical knowledge.

                                        vii.To communicate that understanding to potential and current employees so that they can decide whether to accept potential hazards.

                                       viii.To communicate the necessary medical information in the event of an occupational illness or injury in a timely fashion to persons with a need to know, including human-resources, worker-compensation, health and safety, and supervisory personnel.

                                           ix.To strive to maintain objectivity in the face of conflicts that occur because of the occurrence of work-related illness or injury.

                                            x.To educate employees about early warning signs of occupational illness or injury that should prompt medical action or evaluation.

                                           xi.To provide the institution a considered judgment, based whenever possible on aggregate information, as to the status of Occupation-related illness and injury among employees.

                                         xii.To participate in the identification of employees at high risk because of animal-related research.

g.       The effectiveness with which those responsibilities are carried out depends on the health-care provider's knowledge of the employee health risks associated with the care and use of research animals at the institution. It also depends on the opportunity to foster genuine collaboration among all program activities of the University that manage, support, and conduct the animal care and use program.

h.       There is a major need for a basic, accessible body of knowledge about health risks to employees. Health-care providers need to have appropriate training and experience to establish and maintain an effective health-care service as part of an occupational health and safety program for employees involved in the care and use of research animals. The information needed to conduct an occupational health program is typically acquired from many sources. It is essential that veterinarians, investigators, and environmental health and safety professionals participate in the orientation and continuing training of health-care providers about zoonoses. exposures, illnesses, and other health risks associated with the care and use of research animals. Infectious-disease specialists, allergists, dermatologists, and pulmonologists might also have to be consulted about aspects of employee health.

i.         Activities of an Occupational Health-Care Service

                                             i.The selection of occupational health-care services is based on knowledge of occupational hazards, the nature of health risks associated with animal care and use activities at the University, and the diversity of employees, the work environment, and the mission of the University. An occupational health-care service that provides comprehensive health-care services to all employees engaged in the care and use of research animals without consideration of employee risks is expensive and might not convey the understanding that employees must have to minimize occupational-health risks. Greater value comes from occupational health-care services that are selectively and judiciously based on work activities that place employees at risk of occupational injury or illness. For example, a preplacement medical evaluation usually consists of a review of functional demands of a position, hazards associated with the animal species involved, potential experimental hazards, and the employee's medical history. Such an evaluation makes good sense if an employee is being assigned duties that require heavy lifting, the handling, of animals that are known to be potential sources of zoonotic infections, the cleaning of cages, or the handling of blood borne pathogens. But it would not be prudent or cost-effective to perform preplacement evaluations of employees only on the basis of substantial contact with research animals, because resources would be directed where hazards do not exist.

                                            ii.The occupational health-care services can include preplacement medical evaluations, periodic health evaluations, episodic health evaluations, analyses of adverse health outcomes, medical management of worker-compensation cases, immunizations, medical recordkeeping, serum-banking, exit evaluations, and non-occupational health care. The value and relevance of those activities for employees at risk are discussed in the sections that follow. No activity should be selected for inclusion in a University's occupational health-care service without consultation with environmental health and safety professionals (Environmental Health and Safety) and discussion with representatives of the research and animal care and use programs.

j.         Identification of Persons at High Risk

                                             i.The University should identify employees at risk because of animal-related research and determine who should participate in the various activities provided by the health-care service. Categories of employees whose activities should be reviewed are investigators, technicians, animal-facility operators, clerical and other support personnel, students, trainees, visitors, maintenance and housekeeping, personnel, engineers, and facility-management technicians. The service components that are needed vary with the nature and intensity of the risk.

k.        Interaction with Environmental Health and Safety Staff (Environmental Health and Safety)

                                             i.Interaction between occupational health-care service staff and environmental health and safety staff is necessary to develop, workplace-exposure information needed for health-care services. Such interaction constitutes a process for alerting, environmental health and safety professionals to hazards that might require additional control. This interaction is also important for assessing risks associated with activities related to animal research and helps to establish criteria for selecting employees who will routinely receive health-care services.

l.         Preplacement (Preassignment) Medical Evaluations

                                             i.The preplacement evaluation serves several functions in the occupational health-care service. Every employee who is identified to participate in various activities of the health-care service and is subject to substantial risk in the animal care and use program should undergo a preplacement medical evaluation. It establishes baseline health information on employees before exposure to the risks associated with animal-related research. Pre-existing conditions that can affect an employee's capability to perform the essential functions of his or her position without risk of substantial harm might be identified. Another function is to discuss medical conditions that might alter an employee's exposure-risk profile; these could include current conditions (such as tuberculosis) and possible future conditions (Such as pregnancy in women of child-bearing age). Medical conditions that could temporarily alter fitness for duty or require on-site emergency treatment (such as diabetic hypoglycemia and epileptic seizures) can be noted, and appropriate contingency plans can be made. The preplacement medical evaluation also presents an opportunity for education about potential hazards in the workplace, the need for accommodation or personal protection, and medical symptoms that should prompt an employee to seek occupational-health evaluation between routine visits.

m.      Periodic Health Evaluations

                                             i.Scheduled, periodic health evaluations are often a key component of occupational-health programs. They are most useful when carefully designed to obtain information that can be used to verify the success of the occupational health and safety program in reducing occupational illness and injury. The components and frequency of evaluations depend on the nature of potential hazards. Symptoms of health alterations that are of insufficient severity to be labeled disease can prompt preventive measures. Knowledgeable and experienced people, including representatives of worker compensation, environmental health and safety, personnel (human resources), and the occupational health-care service, should determine the need for and design of periodic health evaluations. There should be a schedule for the re-evaluation of previous decisions, the interval for which depends on changes in exposure or workforce characteristics, injury and illness experience, and the availability of new guidance regarding good occupational-health practice.

                                            ii.Physical examinations need not be a routine part of periodic medical evaluations. Periodic workplace physical examinations are typically performed on healthy persons and rarely alter judgments about their fitness for duty. Resources can be better spent on aggregating and analyzing health-status information. performing worksite tours, and tailoring health programs to be specific to the circumstances of each worksite. The time spent with an employee in a medical evaluation might be better spent in taking a careful history based on a knowledge of worksite risks, informing the employees of the nature of hazards and the means of protecting against them, and warning signals of illness.

                                          iii.Episodic Health Evaluations

1.        Persistent symptoms, symptoms that indicate the onset of a work-related illness, or the occurrence of a work-related injury should prompt appropriate medical evaluation and care. A physical examination focused on the chief complaint is typically needed as a routine part of an episodic health evaluation. The results of some evaluations (such as the finding of an eye injury) are referred directly to specialists, and a mechanism is needed to make the health-care service staff and the environmental health and safety staff also aware of them. As a general rule, any event that leads to medical evaluation and any loss of work that is thought to be work-related should be reported to the occupational-health information system (BLS 1986).

                                          iv.Recognition, Evaluation, Recording, and Follow-up of Adverse Health Outcomes

1.        The incidence and prevalence of medical symptoms, injuries, or illnesses should be assessed periodically. Several mechanisms are used to recognize adverse health risks and adverse health outcomes. Incident reports are completed when medical symptoms occur as the result of a workplace event or exposure. They should be reviewed by the health-care service to determine whether medical evaluation is needed; the information should also be reviewed by the environmental health and safety staff to determine whether their involvement is needed.

2.        "Near-miss reports" may be prepared by employees when equipment malfunction or performance error almost results in an accident or substantial exposure. Near-miss reports are usually kept by the environmental health and safety staff but can be reviewed by health-care providers.

                                           v.Medical Management of Worker-Compensation Cases

1.        The management and treatment of worker-compensation cases by the occupational health-care service might be an effective way to reduce incidence, severity, and costs of occupational injuries and illnesses (McGrail and others 1995). This service can provide closer monitoring of an employee's ability to return to work than an outside provider unfamiliar with the work setting. Return-to-work examinations allow for review of injuries and illnesses (work-related or personal) not being followed by the occupational health-care service and can facilitate an appropriate and safe return to the worksite.

                                          vi.Immunization

1.        Immunization programs are an accepted method of protecting people from some infectious diseases. The decision to immunize an employee should be made because of a clearly defined, recognized risk at the time of preplacement, periodic, or episodic health evaluations (guidance for administration of specific vaccines and toxoids, such as for hepatitis B, rabies, and tetanus, is provided by the Public Health Service Advisory Committee on Immunization Practices (IPAC 1996).

                                        vii.Medical Recordkeeping

1.        It is the responsibility of the University to maintain medical records related to an employee's participation in a health-care service activity. The responsibility may be delegated to a contract medical service, but there should be a provision for transfer of records if the contractual arrangement terminates.

2.        Aggregation of occupational-health data is commonly overlooked. Preplacement and periodic health evaluations are performed on many workers, but their results are seldom analyzed in the aggregate for informational purposes. The information derived from aggregate data can be of great use in guiding program decisions. Consultation with epidemiologists can be useful because they understand how and why information should be aggregated.

                                       viii.Serum-Banking

1.        Serum-banking is the collection and frozen storage of serum samples drawn from employees who might be at risk for occupationally acquired infection. Typically, the purpose of the program is to give the University the ability to compare serum obtained after an acute illness or exposure with serum obtained before the illness or exposure began, Although serum-banking has generally been regarded as a standard component of occupational-health programs, it should be conducted only when there is a clear reason for obtaining the specimens and there is a plan to analyze the data as part of a risk-assessment strategy. CDC and NIH (CDC-NIH 1993) recommend serum-banking- and serologic surveillance when a substantial risk of occupational illness is associated with an agent under study and methods are available to measure immunologic response to the agent (see Table 7- 1 ).

A.      Currently, no known disease or condition nor species are present that would warrant the storage of serum.  If a disease or condition is identified, then storage of serum would immediate began for those involved.

2.        Substantial issues should be considered in advance of instituting a serum-banking program, including chain of custody, confidentiality, identification and handling of samples, retention, potential deterioration of sample quality over time and cost. The program should include informed consent of employees and allow them to decline to participate. The collection and storage of employee serum should not be performed in the absence of a functioning occupational health and safety program.

                                           ix.Exit Evaluations

1.        An exit evaluation is defined as a medical evaluation performed when an employee terminates employment. Its purpose is to determine the employee's health status when exposure to potential hazards ceases. Such an evaluation has potential value for medical and legal reasons. As a practical matter, however, few employees are interested in undergoing, evaluations when they leave an employer; after the final paycheck has been disbursed; there are few incentives for the employee to return. It is unlikely that information useful to an occupational health and safety program will be obtained from exit interviews.

                                            x.Nonoccupational Health Care

1.        The occupational health-care service should not be the source of primary medical care for employees. Its use as such a source is discouraged because it diverts resources from aspects of the program aimed at reducing workplace health risks.

2.        Some employers choose to use the occupational health-care service for general health promotion, such as blood-pressure measurement, cholesterol screening, and education about healthy lifestyles. The enthusiasm for that kind of promotion should be tempered by an honest assessment of the institution's resources that are available for occupational health.

n.       Program Evaluation

                                             i.Evaluation of the adequacy of a health-care service should focus on whether the health-care providers meet legal requirements and ethical guidelines, accomplish the mission of the occupational-health program, recognize the essential elements of the health-care service, and deliver the appropriate components of the service.

                                            ii.The following conditions are indicators that a program is adequate:

1.        Health-care providers tour the facility and are knowledgeable about the workplace-hazard profile.

2.        The health-care service is aware of the occupational-health profiles of employees as reflected in the worker-compensation claims experience, the 300 log, first-aid reports, and incident reports.

3.        Medical histories elicit risk-related events (such as the frequency and severity of animal bites).

4.        The health-care service requests consultation from the environmental health and safety staff in the case of health alterations or occupational disease or injury.

5.        The health-care service participates in the development of activities of the occupational health and safety program.

6.        The health-care service provides information to the institution about the occurrence of work-related illnesses and injuries.

                                          iii.Equipment Performance

1.        Environmental Health and Safety is responsible for programs for certifying and monitoring equipment to ensure that it is capable of providing the necessary protection and maintaining adequate performance.

2.        The American National Standards Institute (ANSI) publication will be used for monitoring the ventilation in laboratories.

3.        All HEPA filters should be tested at least once a year.

4.        Ventilation system should be twice a year for proper amount of air flow, one time pass air, and for pressures relative to other rooms.

5.        Autoclaves are to be tested regularly. All loads processed and tests conducted will be recorded. Biological indicators will be used for the tests. Where there is a print out of the temperatures, pressures and times, the print outs will be added to the record of use.

6.        Fire inspection is conducted by the University.

                                          iv.Information Management

1.        Record keeping is a multitask job performed by several units. VS has primary responsibility for their personnel. Environmental Health and Safety will maintain records of training they conduct. Radiation safety will maintain records of their training. Researchers will maintain records of the people associated with their protocol.

2.        Occupational Health and Safety Information-Management

o.       Emergency Procedures

                                             i.See SOP E

                                            ii.Veterinary care is provided 24 hours a day, 7 days a week. Two veterinarians are employed full time. Two other veterinarians working in non-veterinary jobs at the University or as a local volunteer act as back-up in case of an emergency.

                                          iii.Medical care for personnel is provided 24 hours a day, 7 days a week. A medical center with full emergency care is near the University.

                                          iv.Emergency generators are available at some facilities.

                                           v.In all emergencies, personnel are protected first, then animals and lastly the facilities.

p.       Program Evaluation

                                             i.Monitoring of the program is performed formally and informally by several units or organizations.

1.        USDA performs inspections on a regular basis.

2.        AAALAC accreditation is expected in summer of 2004

3.        IACUC performs at least semiannual inspections.

4.        VS continuously monitors elements of the program.

5.        Three areas of objective data are evaluated:

A.      The University's injury and illness experience

B.       The University's regulatory compliance performance

C.       Results of efforts to promote health and safety through continuing interactions among major participants in the occupational health and safety program.

D.      The data sources should include the results of exposure monitoring, worker compensation records, OSHA recordable injuries and illnesses, results of special health and safety studies or investigations, training records, minutes and reports of the University health and safety committees and any related actions taken by the IACUC, and results of inspections conducted by regulatory agencies.

6.        Subjectively, the University should measure the effectiveness of interactions among the major participants in the program is whether the health and safety policies, rules and recommended practices are relevant to the hazards that are present and can be implemented in a practical manner. (Relevance and practicability influence altitudes and positive attitudes toward the occupational health and safety program minimize risks.)

q.       Specific procedures for VS personnel

                                             i.Caretaker personnel are required to be scheduled by the Facility Manager prior to starting work for training and physicals

1.        Personnel who elect not to take the physicals or get the recommended vaccinations, have to sign a waiver.

                                            ii.The University Veterinarian will keep the Occupational Physician apprised of all health related situations in the facilities and with the VS personnel.

                                          iii.Employees physicals

1.        Based on

A.      Species

B.       Contact time

C.       Amount of direct contact

D.      Special considerations such as biohazards, immunodeficient, etc.

2.        When/frequency/type of physicals

A.      Pre-employment

a.        Everyone requiring physicals for working with animals will get a pre-employment physical (pre-animal contact, pre-hazardous procedure, etc., not necessarily "pre-employment" at FAU.)

B.       Annual/Biennial

a.        At this time, all persons requiring physicals because of contact with animals or hazardous experiments associated with animals will get at least biennial physicals. Exceptions will be determined by the physician.

C.       Post-employment

a.        Whenever possible, a post-employment physical should be conducted. (Post-animal contact, post-hazardous procedure, etc.)

D.      What

a.        Always, the decision is made by the physician at the time of the exam

b.       Emphasis on the physician to use his/her professional expertise to modify the physical as appropriate. The suggested procedures that may be included are medical history (work history), history of any allergies, animal use history, vision and hearing tests, urine and stool tests (parasites, etc.), blood tests (CBC, Hematocrit -hemoglobin, parasites, clotting factors, chemistries [liver and kidney profile, cholesterol]), radiographs, titers for rabies, toxoplasmosis (applicable to child bearing females), Q Fever, brucellosis, tuberculosis, and pregnancy (if applicable) (Pregnant females are not normally allowed in the animal facility.).

                                          iv.Immunization

A.      Determined by the physician

                                           v.Record keeping

1.        Who

A.      The Clinic will maintain records for physicals, tests, vaccinations, etc.

B.       They will be responsible for biennial physical, re-vaccinations, etc.

C.       Sponsored Research will receive a report of the personnel who have completed physicals, etc.

2.        Where

A.      Medical records will remain with the clinic

B.       Reports, training records, animal records, zoonotic surveillance, etc. will remain on file in Sponsored Research

3.        Tracking

A.      Original scheduling will be done by the individual through Sponsored Research

B.       Follow up scheduling will be done by the clinic

C.       Sponsored Research will monitor personnel through reports from the clinic

                                          vi.Training

1.        VS will perform initial training in the General Training Course

2.        Environmental Health and Safety and other safety departments will perform training as requested by individual or determined by one of the "hazard" committees

3.        Handouts and lectures by VS will be required for each individual. Other information will be provided as determine on an individual basis

4.        All training will take place prior to animal use or hazardous situation

5.        Recurring and ongoing training will be provided by VS as required.

6.        In the training, personnel will be instructed to notify their supervisor of illnesses and of suspected health hazards and report any injuries immediately.

7.        Every effort will be made to monitor, and reduce exposure to potentially hazardous biological, chemical, and physical agents.

3.      Biohazard control

A.     It is the purpose of this policy to set minimum standards for the use of biohazardous agents in the facility.

B.     Each facility will provide for the special features and safety equipment needed to protect the animal care staff, other occupants of the laboratory animal care facility, the laboratory animals, and the environment from exposure to biohazardous materials.

C.     All biohazardous materials will be contained within the study environment. Proper ventilated areas and appropriate animal caging systems will be provided when hazardous biological, chemical, and physical agents are to be used in animal experimentation.

D.     Biohazardous agents will be contained and used in physically separate areas from the other animal housing and support areas, including research and clinical laboratories and patient areas.

E.      All areas using biohazardous agents will be required to be posted as such, and access to these areas will be limited to authorized personnel.

a.       These areas will be designed and constructed to facilitate housekeeping and cleaning procedures.

F.      Experimental animals involved in biohazardous studies will be housed so that potentially contaminated feed, feces, urine, and bedding can be handled in a controlled manner.

G.     Carcass disposal will be handled in a similar controlled manner.

H.     Animal care personnel will wear specifically designed outer wear, such as fully fastened jump suits, shoes, shoe covers, head covers, and gloves.

a.       Personnel working in areas where potentially biohazardous airborne agents are present will be required to wear protective respiratory equipment.

I.        Personnel should shower when entering and leaving the designated biohazardous animal care areas.

J.       All protective clothing shall remain in the animal care facility.

4.      Special Considerations

A.     Facilities and Procedures for Animal Research with Hazardous Agents

a.       OSHA Standards and Procedures

b.      A specific management plan will be developed and followed for each hazardous agent.

                                             i.Warning signs on the door to the room will include what the agent is, its effect on personnel and animals, defense mechanisms for protection, and responsible persons to contact in an emergency.

                                           ii.Personnel will be issued and required to wear protective clothing as appropriate. (e.g. fully fastened jump-suits, boots or shoe covers, head covers, gloves, respirator masks, dosimeters, etc.) Personnel will be encouraged to shower when leaving the animal care or dosage preparation areas and under no circumstances be allowed to wear protective clothing and equipment out of the area.

                                          iii.Methods of measuring and limits of exposure will be specified.

                                         iv.Disposal of contaminated excreta, animals, animal parts, equipment, supplies, etc. will be specified.

c.       Hazard-exposed animals will be housed physically separate from other animal housing and support areas.

                                          i.These biohazard areas will be designed to control and contain the hazardous agent. Appropriate equipment will be provided to minimize exposure of the animals and personnel such as proper hoods, trash disposal, cleaning utensils, etc.

5.   Table for Suggested Physical Examination

Handout

Florida Atlantic University

Occupational Health Program

Presented by Veterinary Services

Welcome to the Florida Atlantic University's Occupational Health Program for Personnel who have contact with animals. There are two areas that require your attention prior to starting work with animals. They are enrolling in the Occupational Health Program and training in animal care and use.







 

Last Updated: February 14, 2003

1. Everyone should be aware of the University's Occupational Health Program. It is designed to protect you. If you have contact with animals or animal products, you should consider enrolling in the program. Contact the Veterinary Services for more details specific to you. (297-4233)

2. Emergency numbers:

Medical

General emergency........................................911

Ambulance.(FAU Rescue).............................911

Poison Center.....................................911

Fire......................................................911

University Veterinarian.........................................297-4233

Environmental Health and Safety.........................297-3095

Police Services.........................................................297-3500

3. Reporting Injuries

a. Any injury or hazardous exposure received while on the job should immediately be reported to your immediate supervisor. In the event of serious injury, medical assistance should be sought immediately.

b. Minor slips on wet floor, animal bites, mashed fingers, etc. should all be reported. This will help us evaluate the work place and try to make it safer. It is in your best interest because what may seem minor, may become major such as a bite or scratch from a cat which has lead to death because the person considered it minor and insignificant at the time of injury. By the next day it can be a bad infection with high fever and headache, so no matter how little, report it.

c. Once you report it to your immediate supervisor, he/she will fill out a Workers Compensation First Report of Injury form and may send you to the Occupational Health Clinic or your primary care physician.

4. Personal Hygiene

a. Personal hygiene is something we all do daily, but when working in an animal area, the transfer of disease from you to the animals or the animals to you is very important. Here are a few good rules:

i. Do not eat, drink, smoke (no smoking at the University), chew your finger nails, put pencils in your mouth or apply cosmetics in areas where animals are housed or used.

ii. Protective clothing is recommended at all times when working in animal areas. You should wear a work uniform (or in some cases a lab coat is sufficient) when handling animals, carts, cages, etc. This uniform should be removed when leaving the animal area. Other protective clothing should include a pair of disposal gloves. In some cases, mask and eye protection are appropriate.  Contact lens should not be worn when handling infectious diseases, dangerous chemicals including gas anesthetics or other materials that could adhere or stick under the contacts.  If contacts have to be worn, a full face mask should be used.

iii. Handle all infected or contaminated materials in such a way as to minimize aerosols.  This includes hair and bedding which could lead to aerosols.

iv. All work surfaces should be decontaminated daily and after any spill of animal related material.

v. One of the most important actions you can take is to wash your hands after each time you handle animals or their equipment, before leaving the area, and most importantly, prior to eating or drinking.

5. Animal Bites and Scratches

a. Animal bites and scratches have been mentioned before. It is most important for you to learn how to handle animals properly to avoid unnecessary exposure to these dangers. You will receive both formal and on-the-job (OJT) training in this area. Unfortunately, not all animals have heard the lecture and so occasionally workers get bitten or scratched. When this happens, notify your immediate supervisor. Wash the wound in running water while scrubbing with povidone-iodine. Scrub for 10 minutes and then see your doctor.

6. Animal Diseases

a. Zoonoses (diseases transmitted from animal to man) will be discussed thoroughly in your training lecture. Most of the animals we purchase are specifically raised for biomedical laboratory research. These animals are less likely to have diseases since their environment and contact is controlled. However, occasionally animals come in contact with untrained personnel or other animals in shipment, etc. and thus may become infected with a disease. Some departments use wild animals of unknown disease status so all these should be considered infected. Finally, your own pets present a reservoir for infections that can be transmitted to the laboratory animals.

The following are a few of diseases to be especially aware of:

1. Tetanus:

The Public Health Service Advisory Committee on Immunization Practices recommends immunization against tetanus. It is suggested that you keep your tetanus vaccination up-to-date at all times. Any puncture wound may require a booster.

2. Leptospirosis:

The disease is usually transmitted through the urine of several different animals such as the dog, farm animals, and wild rats. Protection should include gloves and face mask.

3. Allergies:

If you have known allergies, they should be discussed with your physician. Symptoms include runny nose, sneezing, eye irritation, skin redness and itching, and asthma. The wearing of a face mask, gloves, long sleeves, etc. may help prevent contact with the agent causing the allergy. Tests can be conducted to determine which animal you are allergic to. Then the physician can determine the best course of action for you to take including possible reassignment to a different area.

4. Ringworm:

Cats and rabbits can be carriers without clinical signs of the fungus that causes ringworm. In humans, the disease usually consists of small, scaly, semi-bald, grayish patches with broken, lusterless hairs, with itching. However, other symptoms may appear. It is usually associated with the hair which in each of these animals can be floating around in the room. Prevention is to wear proper clothing and practice good personal hygiene.

5. Toxoplasmosis:

This disease is generally associated with the feces of cats. Normally, it takes over 24 hours for the eggs to hatch so by changing the litter pans daily, one should not be exposed to the disease. It is of most importance to pregnant women since it can cause miscarriages, still births or various congenital defects. For this reason, pregnant women should not work with cats. Approximately 1/3 of the United States population has had this disease at some time. Usually this disease is quite mild and may be mistaken for a simple cold or viral infection, however, it can be a lot worse.

6. "Q" Fever:

"Q" Fever infects many animals including humans, dogs, cats, sheep, goats, etc.  In some areas, about 1/3 of the human population have been exposed to the disease. Sheep, goats and cows have the highest infection rate. All sheep and goats are considered infected and are tested for "Q" Fever when they arrive at the University unless bought from a certified vendor who has tested the herd. If you are going to be working with sheep or goats, you should discuss vaccination for yourself with your physician. The areas where these animals are kept are considered off-limits to visitors. The disease is spread through the feces and urine of these animals. It gets in the air and you can breathe it into your system. The highest chance of getting the disease is when working with abdomen organs. There may be little or no symptoms, to a bad cold with fever and headache to becoming very sick and in a couple of instances, dying. You should wear all of your protective clothing (mask, gloves, clothes, boots, etc.) and shower afterwards.

7. Rabies:

Rabies is throughout the United States with most dogs and cats being vaccinated. It attacks all warm blooded animals including humans. Most laboratory animals are protected through vaccinations and isolation, however, wild and farm animals may bring it into the laboratory. Rodents generally do not spread the disease through bites but most of the other animals do. They do not have to act "rabid" but may just act sick. Personnel working with dogs and cats should be vaccinated for rabies if rabies is endemic in the area. Any person receiving a bite wound should first wash the wound in running water for 10 minutes using povidone-iodine scrub and then secondly, see a doctor immediately.

8. Diseases of monkeys:

Monkeys are closely related to humans and therefore, readily can transmit diseases to humans. All protective clothing should always be worn and extreme caution taken at all times. Realize that some diseases are non-clinical in one species but fatal in another.  Stay alert and do everything according to your training. Do not hesitate to ask your supervisor for assistance.

Herpesvirus simiae (B virus) in monkeys is a disease similar to a disease we get called herpes simplex which produce sores on our lips. The difference is that our disease will kill them and their disease will kill us. It is transmitted through bites. The wound should be thoroughly cleaned with lots of water and a chlorine bleach solution of 1 to 10 dilution. As with any bite, immediately let your supervisor know and see your physician.

Tuberculosis is another disease shared by humans and monkeys. Wear your protective clothing and face masks to prevent exposure to the disease in the air or on objects. The animals and you will be tested regularly for the disease.

9. Tularemia:

It is a disease found in rabbits, squirrels, muskrats, beavers, deer, cats, sheep, cattle, amphibians and fish. It can be transmitted by direct contact, bites, ticks, deer flies and mosquitoes. Breaks in the skin or getting the organism in the eye can lead to an infection. While it is rare to find this disease in "Laboratory Animals", certainly the wild animals that are used at the University could be carriers or other animals could become infected by wild animal exposure. Ensuring all holes and cracks are sealed to prevent wild animals and flying insects from entering the laboratory is one of the best methods of prevention. Personnel working with animals that are considered infected or have a high risk for infection can get vaccinated for the disease.

10. Salmonellas:

Occurs in several animals including pigeons. It is transmitted through their feces. Animals may not show signs of the disease but can still infect other animals. Disease can be very mild to diarrhea, stomach pain, fever, chills, headache, nausea and vomiting.

11. Diseases of birds:

Personnel working with birds should be aware that there are several diseases that you should be concerned with.

Psittacosis is a disease that almost any bird can have including chickens, turkeys and pigeons. Birds may not show much signs of the disease but can still transmit it through their feathers, excreta, etc. Avoid contact with obviously infected birds. When working with birds, wear your protective clothing including a mask and gloves.

Newcastle Disease can be transmitted from birds to humans generally through the virus getting into your eye. Face masks and washing afterwards should help to prevent it.

12. Rat bite fever:

Non-clinical in rodents and hard to culture. Infection comes from contaminated milk or food but other animals can carry it too such as the dog or cat.

13. Cat scratch fever:

It is a slow disease that can last for several months found primarily in cats. It can occur from bites or scratches. Wounds should be thoroughly cleaned and see a physician.

14. Brucellosis:

Found in dogs and farm animals. All should be tested for the disease.

15. Pasteurellosis:

Rabbits and cats can be carriers of pasteurella disease and transmit it through bites and scratches. Extra precaution should be taken to prevent bites and scratches of these animals by using appropriate handling techniques and requesting assistance when required. Bites and scratches should be thoroughly cleaned and you see a physician.

It should be obvious now that there are quite a few diseases that can be transmitted from animals to people. It rarely happens in the laboratory because everyone is aware of it and takes extreme cautions. Any bite or scratch should be immediately treated, notify your supervisor and go to the doctor. Any illness, especially fevers, headaches, vomiting, diarrhea, etc. should be reported to your supervisor. It may be related to your work. Pay attention in class, listen to your supervisor, and try to do the job as you have been trained.

7. Some diseases that animals can carry are not transmitted to man but can be highly contagious to other animals. E.g. pinworms, mites, mouse hepatitis virus, etc. Please use all recommended procedures when working with the animals to prevent spread of diseases from one room to another. And again, if you have contact with animals outside the animal facility, make sure you wear appropriate clothing and use proper hygiene.

8. Other biohazards relate to experiments that use infectious agents. You should find out what is being used, what care should be taken to prevent exposure and know the signs and symptoms of exposure.

a. Physical hazards

i. Working in and around animals presents many physical hazards to the personnel.

ii. Some of the possible injuries are:

(1) Bites, scratches, kicks, crushing, etc. injuries caused by animals.

(2) Back injuries from lifting, pushing, twisting, and falling.

(3) Hearing loss.

(4) Eye injuries.

(5) Electrical shock.

(6) Puncture wounds from needles, animals or equipment.

(7) Exposure to allergens, biohazards, chemicals, or radiation.

(8) Burns from hot or cold.

(9) Vehicle accidents

(10) Stress

(11) Other trauma from broken glass, compressed tanks of gas not stored properly, explosions from ether, etc.

b. Chemical hazards

i. There are many chemicals that can cause cancer, damage to tissues, birth defects, etc.

ii. These effects may not be obvious until years later such as radiation exposure.

iii. Some of the more potent drugs/chemicals commonly used that you should be aware of are: formaldehyde, ethylene oxide, ethyl alcohol, pesticides, hexachlorophene, etc. The list goes on and on, over hundreds of thousands.

iv. Chemicals you use routinely to clean with are all potentially dangerous either inhaled or in contact with the eyes or skin.

v. One group of chemicals that are dangerous are the inhalant gases. Ether is the worse. It can cause a multitude of symptoms and it is highly explosive. It remains dangerous even in tissues of animals after euthanasia. Methoxyflurane is the next toxic being nephrotoxic and hepatotoxic. Halothane is next toxic and isoflurane is the least toxic. Besides liver and kidney damage, one can get immune suppression, bone marrow suppression, enzyme induction, abortion, birth defects, pruritus and CNS disturbances. If you wear contact lens, they can absorb the gases and do further damage. The best reference for further information are the Guide for the Care and Use of Laboratory Animals, 1996 edition, “Occupational Health and Safety in the Care and Use of Research Animals”, NRC, 1997, and “Biosafety in Microbiological and Biomedical Laboratories”, CDC/NIH, 4^th ed., 1999