Institute for Laboratory Animal Research Journal

Volume 44 (1)

Introduction. ILAR 44 (1): 001.
[Reviewer's Note - Any parts of this introductory article which recapped specific articles published in this ILAR issue were not reviewed as other LABSG members will be summarizing these articles for the LABSG list.] The book, Occupational Health and Safety in the Care and Use of Research Animals, is widely accepted as a basis for the design and operation of successful occupational health and safety programs for animal research facilities. This text is considered a companion reference to "The Guide" and is the primary reference document used by the Public Health Service and AAALAC International. Potential physical, biological, chemical, and zoonotic hazards associated with research animals are also discussed in this text. The focus of this ILAR issue was to update information in this reference. Because musculoskeletal disorders are perhaps the single greatest risk to worker health and safety, ergonomics in the animal research setting has received more consideration by focusing attention on potential hazards of the job activity itself. The increased attention to biosafety and potential bioterrorism, as well as research on emerging and re-emerging diseases, has also led to increased questions and concerns relating to personnel safety in animal laboratories. Allergy continues to be a common medical condition affecting individuals working with lab animals. The goal of occupational medicine programs should be prevention through implementation of strategies that decrease allergen exposure. Medical surveillance programs are key in identifying persons at risk, as well as early recognition of lab animal allergy symptoms. Personal protective equipment (PPE) is part of occupational health and safety programs. However, there can be confusion regarding proper selection and use of PPE for specific situations, especially the issue of respiratory protection and the wide diversity of equipment available. Occupational medicine is now recognized as an integral part of a successful occupational health and safety program. Services such as immunization, health evaluation, and emergency medical treatment are usually provided by an institution's occupational medicine service but typically on the request of the research program managers. Research program involvement has been generally reactive rather than proactive as an integral part of the overall program. More recently, risk management has expanded from identifying hazards and protecting employees to evaluating the job and the relative risk to the individual employee.

Questions:

No questions

An ergonomics process for the care and use of research animals. ILAR 44 (1): 003.
Background:
Stress and Strain from manual animal handling are the most common conditions that adversely affect the health of animal care workers. Sprains and strains are the second most prevalent type of occupational injury in the U.S. Workplace injury can result in 3-5x the direct medical cost when all work-related factors are considered. Other issues animal-related infrastructures must deal with included rapid scientific changes, evolving research trends, limited physical space, lack of qualified personnel, and increasing financial constraints. Research institutions that recognize the risk of musculoskeletal disorders (MSDs) and have established preventative programs focused on sustained ergonomic effort have reduced injuries and illnesses, with improved worker performance. It is important that institutions can recognize, evaluated, and control potential MSD risks associated with animal care.
Ergonomics Program Goals and Measures:
The primary goal of a comprehensive ergonomics program is to support and enhance the quality of work for animal caretakers by improving the fit between the job and the person. Objectives in achieving this goal include; (1) Reducing employee pain and suffering, (2) Improving performance by removing barriers between people and tasks, (3) Minimizing the number of potential error-provoking situations, (4) Avoiding the direct costs of workplace injuries (wage replacement payments and medical care expenses), (5) Preventing the indirect costs of work-related accidents (lower employee morale, lost productivity, employee turnover, and cost of hiring or training replacement workers).
Management Planning and Roles:
Ergonomic initiatives are most effective when applied in a systematic fashion. A process model based on the Shewart Plan-Do-Check-Act (PDCA) continuous improvement cycle may be used. An effective ergonomics initiative integrates strategic (high-level) and tactical (front-line) activities.
Strategic Activities:
Plan: Understanding the current situation and develop goals and strategies.
Do: Implement a management process and infrastructure to meet the goals.
Check: Monitor progress toward meeting goals.
Act: Standardize effective activities and improve ineffective activities.
Tactical Activities:
Plan: Identify and prioritize opportunities for improvement.
Do: Analyze jobs and implement improvements.
Check: Determine whether each action achieved desired results.
Act: Revisit individual actions to ensure plan compliance.
Integrating Ergonomics Activities with Existing Health And Safety Policies:
An institution should select elements of an ergonomic program that can be integrated into the worker protection already afforded as part of the institution's overall animal care and use program. The breadth and depth of each ergonomics program will vary dramatically between institutions according to the types of safety hazards present and the level of MSD hazard control sophistication available to the site. Typical leaders for the ergonomics initiative are site health and safety specialists who have acquired sufficient tactical and strategic application skills and knowledge in appropriate human factors disciplines. These factors include; (1) MSD hazard posed by the animals and materials used, (2) Task exposure intensity, duration, and frequency, (3) Capability of the personnel, (4) History of occupational illness and injury in the particular workplace. Operational and day-to-day responsibility for safety in the workplace ultimately resides with the laboratory or facility supervisor and should be reflected in safe work practices performed by all employees.
Ergonomic Risk Management - Six-Step Approach:
Successful ergonomics processes follow a systematic, proactive approach driven by risk reduction strategies. Following are six steps to recognition, evaluation, and control of MSDs in caring for and using research animals: (1) Identify job tasks with potential risk and review animal handling concerns with employees in those areas, (2) Evaluated risk areas using a risk survey checklist, and prioritize highest risk tasks and their room cause contribution to MSDs, (3) Apply appropriate hazard control measures, (4) Train and educate exposed researchers and technicians on animal handling risks with documented prevention strategies to ensure proper equipment use, (5) Confirm the effectiveness of the hazard prevention changes, and promote enhanced communication between researchers and caregivers regarding work factors to identify additional ergonomics issues, (6) Anticipate future opportunities for MSD risk reduction by repeating the process for additional problematic job tasks.
Basic MSD Risk Factors:
An introduction to the contributing factors that lead to MSDs can assist institutions in the "Do" portion of the Plan-Do-Check-Act process. One way to visualize musculoskeletal trauma is to think of your joint structures as a bucket with fixed capacity. Microtrauma from job- and non-job-related activities drips into each joint's "trauma bucket." If we place more trauma into the bucket than the natural healing process can absorb, the result is impaired movement or, in the worst cases, a disabling injury. Consequently, MSDs are based on a dose and exposure relation. There are three physical work-related factors contribute to microtrauma: (1) the force applied by the person, (2) the frequency of the force of application, and (3) the posture assumed during the activity.
Combinations of Risk Factors: Extreme postures, combined with force and frequency, will cause damage more quickly than when the postures are more natural or neutral. It is therefore the combination of force, frequency, and posture that contributes to wear and tear injuries. It is therefore essential that MSD hazard reduction process remove one, two, or all three of these components of MSDs.
Additional Physical Work Factors: Additional physical work factors such as the duration of exposure, localized body contact stress, vibration, and temperature extremes also contribute to accelerated MSD development. Vibration exposure may lead to Raynaud's phenomena (vibrational white finger). The longer the duration of this continuous work, the longer the required recovery time. Other factors include repeated or continuous contact with hard or sharp objects, cold temperatures, insufficient pauses and rest breaks for recovery, and unfamiliar or unaccustomed work where potentially awkward positions and excessive forces may be applied.
Identification of MSD Indicators:
Three types of interrelated data indicators are typically used to determine musculoskeletal problems.
(1) Review of Medical Records (Past): Industry best practices suggest that institutions that have more than one work-related case of MSD per 200,000 hours or more than a twofold difference in MSD incidence rate between animal handling departments and other departments, should consider further problem evaluation.
(2) Survey of Workers (Present): A job- or task-based employee survey examining the likelihood of excessive physical fatigue or discomfort can also be an important indicator of potential MSD concerns.
Tips for administering an employee include:
· Following up on employee survey reports of MSD signs and symptoms is essential. Don't do a survey unless you are prepared to act on the results.
· No names should be required on the forms, and the collection process should ensure anonymity.
· Survey participation should be voluntary.
· The survey should be conducted during work hours.
· A second survey, using the same form, should be completed after ergonomic changes have been implemented (minimum of 4 weeks after). This is done to indicate whether the intended goals have been achieved.
(3) MSD Risk Assessment Job Surveys: The strongest evidence of MSD can be found through a review of the risk factors present in a job or task, although OSHA 300 medical records and employee discomfort surveys may provide some evidence of MSD problems in the workforce. The primary method of risk assessment is an observational checklist completed during a walk-through review of a job or task to identify obvious ergonomic concerns. There is also a more detailed, quantitative risk assessment tool, called Baseline Risk Identification of Ergonomic Factors (BRIEF). The BRIEF survey provides each area of the body, a risk score that indicates the ergonomic acceptability of the task. Jobs that expose an area of the body to three or more risk factors are considered high risk, two risk factors indicate medium risk, and one or no risk factors indicate low risk.
Manual Material Handling Assessment Tools: Animal care activities require constant manual handling effort, presenting many opportunities for musculoskeletal injury to the worker. There are two additional risk assessment models, the National Institute of Occupational Safety and Health lifting calculation and psychophysical exertion tables. These methods provided an additional level of screening for jobs with manual material handling issues by providing information, such as, (1) Recommended weight limits (RWL), (2) Relative measures of physical stress during lifting/lowering (lifting index or LI), (3) Perceived maximum loads for carrying, pushing, and pulling. In general, as the LI increases, a greater percentage of the population is at risk for injury from performing lifting task.
Animal Handling Tasks and MSD Risk:
Based on results of quantitative risk assessments, several animal handling tasks have been categorized as high risk for developing MSDs. One body area is identified as high risk in the following animal handling activities: Rodent cannulation, rodent tail bleeding, cage cleaning, rodent dosing (SQ), handling animals with forceps, cage material storage and setup, aseptic room egress/ingress, changing rabbit pans, cart handling, canine transfer, rodent dosing (gavage), rodent necropsy, feed bag handling, high-density rodent cage changing, water bottle handling, nonhuman primate cage changing, and autoclave access. Activities requiring frequent or prolonged work above shoulder height (1.2 meters) can also be particularly stressful. High-risk body areas include, hand/wrists, elbow, shoulders, neck, back, and legs.
MSD Hazard Prevention
As soon as MSD risk factors have been identified and measured, the analyst must devise an appropriate risk exposure control strategy, with the goal of increasing the overlap between worker capabilities and task demands to improve the fit of the job with the worker. To ensure proper facility design and equipment purchases, thus avoiding the risk of MSD, ergonomic design specifications should be considered from the inception of all facility projects. Ergonomic standards formalize the limits of human capabilities into a format that is easily applied when developing purchasing criteria. For example, facility designers should consider incorporating automated systems for tasks that require frequent material handling and transport to eliminate MSD risk exposures. The article has a table listing common animal handling engineering controls.
Administrative Controls: Workplace policies, procedures, and practices that minimize the exposure of workers to risk conditions. An example would be scheduling more breaks to allow for rest and recovery. In general these are considered less effective than engineering controls, as they do not eliminate the hazard.
Work Practice Controls: Changes to work practices can reduce or control worker exposure to job risks; however they do not eliminate the risk. An example of work practice control would include training workers to recognize risk factors for MSDs, and teaching others effective work practices and lifting principles that can ease the task demands or burden.
Verifying risk factors and identifying corrective actions at the design stage of work processes can ensure that operations for the care and use of animals can be developed that impose no undue stress and strain on the worker.

Questions:

No questions

Chemical safety in animal care, use and research. ILAR 44 (1): 013.

Introduction
 A collaborative effort is necessary to control exposure of animal care people and research people to chemicals that may overlap between animal facilities and the research laboratory. The assessment to ensure chemical safety should include the investigator, the institutional veterinarian, the animal care supervisor, and a health and safety professional.
 
Hazard Recognition
 Everyone who is associated with research and animal care should be consulted on possible chemical hazards. Additionally an expert review and/or audit should be made of the research and animal care programs by an environmental health and safety professional who is trained in recognition, measurement, and control of chemical hazards and can identify chemical hazard and recommend solutions. Ultimately, chemical hazard safety is everyone's responsibility.
 
Regulatory Requirements
 Many local, state, and federal regulations, as well as numerous "standards of practice" control chemical safety in research involving animals. "Standards of practice" are guidelines issued by nonregulatory organizations such as National Institute for Safety and Health (NIOSH), Centers for Disease Control and Prevention, the National Research Council, etc. "Standards of practice" are enforced under OSHA's (Occupational Safety and Health Administration) "General Duty" clause that requires that a workplace should be free of hazards.
1. Animal Care Facility
 The Hazard Communication Standard of OSHA addresses the chemical use in the animal facility. The "Standard" is a prescriptive regulation that mandates the development and maintenance of a written hazard communication program for the workplace. It may include a) a list of hazardous chemicals present, b) properly labeled containers of chemicals in the workplace as well as containers of chemicals being shipped to other workplaces, c) compiling, preparing, and distributing material safety and data sheets (MSDS) to employees and customers, and d) developing/implementing an employee training program address hazards of chemicals and available protective measures.
2. Laboratory Environment
 OSHA's Occupational Exposure to Hazardous Chemicals in Labortories is a performance-based standard to address the variable aspects of the laboratory environment. A "Chemical Hygiene Plan" is required which includes writing agent-specific standard operating procedures (SOP's) for each "particularly hazardous substance" classified as carcinogens, reproductive toxins, and substances with a high degree of acute toxicity. Additional information included in the plan should specify the establishment of a designated control area (controlled access), use of containment devices (engineering controls), appropriate waste mamagement procedures, and decontamination procedures. Other groups of hazardous chemicals (eg. flammable materials, corrosive materials, and oxidizers) should be covered in more generalized SOP's which cover procurement, distribution, storage, safe usage, disposal, and emergency procedures.
 
Hazard Information Resources
1. Material Safety Data Sheets (MSDS)
 These are OSHA-mandated document that provid information on the hazards of exposure, health effects, physical and chemical characteristics, and recommended protective measures for hazardous chemicals. These sheets are supplied by chemical manufacturers, importers, and chemical distributors (from manufacturers or importers).
 The availability of MSDS's depends on the classification of the workplace. A current MSDS should be on file for all hazardous chemicals used in the animal care facility. MSDS's are required on hazardous chemicals being received into the research facility. MSDS's should be available to employee on all workshifts either by electronic MSDS databases or on hard copies.
2. Registry of Toxic Effects of Chemical Substances (RTECS)
 The RTECS is a database for more than 152,000 chemicals that includes toxic data on primary irritation, mutagenic effects, acute toxicity, reproductive effects, tumorigenic effects, and other multiple dose toxicity. Specific numeric toxicity values include the median lethal dose, lethal concentration, 50% kill (LC50), lowest published toxic dose (TD Lo), and toxic concentration, as well as species and route of administration.
 
Specific Hazards
Hazards Associated with General Animal Care and Use
1. Disinfectants and Sterilants
 These agents are applied to destroy or irreversibly inactivate specific pathogenic microorganisms on inanimate surfaces. Each of these toxic compounds has specific potential health effect, standards and recommendations for safe use, recommended environmental monitoring, and exposure control methods (manufacturer-supplied information and NIOSH Guidelines for Protecting the Safety and Health of Health Care Workers).
 If a disinfectant or sterilant must be diluted or activated before use, special care such as additional engineering controls, personal protective equipment (PPE), or specialized work practices should be employed.
 Glutaraldehyde is used as a high-level disinfectant for heat sensitive equipment, a tissue fixative in histology and pathology labs, and as a hardening agent in the development of radiographs. Acute and chronic signs associated with glutaraldehyde exposure include throat and lung irritation, asthma and asthma-like symptoms, nose irritation, sneeezing, wheezing, nosebleeds, burning eyes, rashes, and staining of hands. These can occur following inhalation or skin contact when preparing or activating glutaraldehyde solutions, disinfecting equipment, fixing tissues, or developing X-ray films. Do not use glutaraldehyde for general disinfection/decontamination of environmental surfaces. Control methods involve containment of glutaraldehyde (fume hoods, ventilation); wearing gloves, goggles or faceshield, and aprons; and sealing/covering all containers.
2. Corrosive Substances
 Corrosive chemicals cause visible destruction of, or irreversible alteration in, living tissue at the site of contact. They can be solids, liquids, or gases and may cause adverse effects on the skin, eyes, respiratory tract, and the gastrointestinal tract. Corrosive liquids can include bromine, sulfuric acid, phosphoric acid, aqueous sodium hydroxide solution, and hydrogen peroxide. Some corrosive solids are sodium hydroxide and phenol. Some corrosive gases are chlorine, ammonia, and nitrogen dioxide. When using corrosive substances, the skin, face, and eyes should be protected by corrosive-protectant gloves, protective clothing and eyewear or face shields. OSHA requires suitable stations for quick drenching or flushing of the eyes and body if employees are esposed to corrosive chemicals.
3. Euthanizing Agents
 Several inhalants used in euthanasia can be hazardous to personnel due to rish of explosion (ether), narcosis (halothane), hypoxemia (nitrous oxide and carbon dioxide), addiction (nitrous oxide), or health effects resulting from chronic exposure (nitrous oxide and carbon monoxide). Adequate ventilation (chemical fume hood or scavenging system) can prevent exposure.
 Personnel performing euthanasia with pharmaceutical agents should be trained, knowledgable, and competent to avoid percutaneous or contact exposure risk.
4. Tissue Fixatives
 Both formaldehyde and glutaraldehyde are used as tissue fixatives.
Formaldehyde is classified as a "probable human carcinogen" under conditions of unusually high or prolonged exposure. OSHA lowered the national standard for formaldehyde exposure in 1987 from 3 parts per million (ppm) to 1 ppm over an 8-hour workday. In 1992, the exposure limit was again lowered to 0.75 ppm. Additionally OSHA established a short-term exposure limit (STEL) which directs that employees cannot be exposed to an airborne concentration of formaldehyde that exceeds 2 ppm during any 15 minute period.
 Formaldehyde can cause injury and corneal damage if splashed into the eye. Eyes, nose, and throat are irritated by airborne concentrations that exceed 0.1 ppm. Signs at higher concentrations include coughing, chest tightness, and increased heart rate. 100 ppm will endanger life and health. Some people who become sensitized may experience respiratory irritation or asthma.
 Employees exposed to formaldehyde must be monitored according to OSHA requirements unless the employer can document that the presence of formaldehyde or formaldehyde-releasing products in the workplace cannot result in airborne concentrations of formaldehyde that cause the employee to be exposed at or above the action level or the STEL. OSHA also mandates that the employer should institute engineering and work practice controls such as working under a fume hood or local exhaust ventilation, wearing goggles, and wearing chemical resistant gloves. Spills shoule be cleaned by specially trained personnel wearing special respiratory protection and other PPE.
5. Waste Anesthetic Gases
 Inhalation of anesthetic gases (e.g. halothane, methoxyflurane, isoflurane, nitrous oxide) can cause spontaneous abortion and congenital anomalies in women in early pregnancy. High levels of unscavenged gases in workers may lead to adverse neurological effects, reproductive risks, and developmental anomalies in offspring.
 In 1999, OSHA published Anesthetic Gases: Guidelines for Workplace Exposures, which includes providing adequate maintenance of anesthetic equipment to avoid leaks, selecting the optimal size endotracheal tube, utilizing appropriate scavenging, and using care to minimize fugitive emission of gases.
6. Hazardous Drugs
 "Hazardous drugs" are pharmaceutical agents considered hazardous by the American Society of Hospital Pharmacists which may cause genotoxity, carcinogenicity, teratogenicity or fertility impairment, and serious organ or toxic manifestations at low doses in experimental animals or treated patients. OSHA's "Controlling Occupational Exposure to Hazardous Drugs" provides guidelines on prevention of employee exposures durng animal research to establish the toxicity and effecacy of hazardous drugs. It includes a provision for a written Hazardous Drug Safety and Health Plan which could be attached to an animal protocol to ensure the safety for research staff who work with hazardous when reviewed by the IACUC.
7. Hazards Associated with Experimental Protocols
 Two factors to consider are the dangerous qualities of the experimental agent and complexity and type of experimental procedure. Mixing a test chemical into feed could result in respiratory or dermal exposure. Applying a test chemical to the skin of experimental animals could be spread by handling the animal, clipping hair, changing bedding, or sweeping the animal room floor. Vapors should be considered when applying test materials to the skin. Inhalation challenges are particularly hazardous and should only be done by investigators with appropriate experience and adequate containment equipment.
8. High-Risk Experimental Agents
 OSHA has established a "baseline" of agents that necessitate additional evaluation by the institution to ensure that health and safety issue of employees are adequately expressed. Specific issues include the capacity of the laboratory to work safely with the agent, the safety and security of the animal housing facility, communication between the research and animal care personnel to ensure adequate definition and understanding of responsibilities, and participation by the Occupational Health and Safety team.
9. Chemicals of Unknown Hazard
 Chemicals of unknown hazard should be treated as a chemical that is hazardous to humans and a plan should be devised for handling the chemical from receipt to disposal 
Controlling Occupational Exposures to Chemicals
 Controlling hazardous chemicals should involve a complete understanding of the physical properties of a chemical and the potential routes of exposure which will help select the proper use of engineering controls, work practices (administrative controls), and PPE.
1. Engineering Controls
 Engineering controls separate the hazard from the worker and may include installing both general and local exhaust ventilation (chemical fume hood), isolating work processes from the hazard (splash barriers), or enclosing equipment or work processes (glove-box cabinets).
Engineering controls are the preferred method of minimizing potential chemical exposures (first line of defense).
2. Administrative Controls and Work Practices
 Proper training of employees will allow them to understand the rationale, risks, and procedures to safely handle hazardous chemicals. Giving employees substantial information on the safe handling of chemicals (administrative controls) is the most critical element in assuring that employees work safely in order to avoid unnecessary exposure to themselves, co-workers, and the environment.
3. Personal Protective Equipment (PPE)
 PPE is used when engineering controls and work practices cannot limit exposures to an acceptible limit. Every employer must assess the workplace for possible hazards and select and require the employee to use the types of PPE that will protect the employee from the hazards identified in the assessment.
 A. Gloves (Hand Protection)
  - Employers should select and require employees to use hand protection if the employee's hands are potentially exposed to chemical hazards such as skin absorption of harmful substances, severe cuts or lacerations, severe abrasions, puncture, chemicalburns, thermal burns, and harmful temperature exptremes. The gloves should be appropriate for the hazard and the conditions of use.
  - Glove selection should be made with careful consideration  given to the permeability of the materials being handled, particularly when handling organic solvent which can permeate of dissolve gloves. Gloves should be inspected for discoloration, punctures, or tears and replaced if needed.
  - 8-12% of regularly exposed health care workers exposed to natural latex rubber become sensitized to it. They may have skin rashes; hives; nasal, eye, or sinus signs; asthma; and shock.
  - Nonlatex should be worn whenever possible. If latex gloves are needed, powder-free, low-protein gloves are recommended.
 B. Protective Clothing
  Laboratory coats, gowns, and aprons which cover parts of the body that could be exposed to a hazardous chemical are examples of protective clothing. A buttoned laboratory coat with the sleeves rolled down will provide an adequate barrier in most routine labs. Woven or porous materials should not be used to protect against a liquid or a gas. Protective clothing should be removed and left in the work area.
 C. Eye and Face Protection
 Examples of eye and face protection are eye glasses, goggles, and face shields. These should be worn if there is as risk of injury from flying objects or particles or from chemical vapors or splashes.
 D. Respiratory Protection
  Respiratory protection should not be necessary with adequate engineering controls and work practices in place. If the air can be contaminated with harmful dusts, fogs, fumes, mists, gases, smokes, sprays, or vapors, the emloyer must provide respiratory protection. OSHA mandates that "any workplace where respirators are necessary to protect the health of the employee or whenever respirators are required by the employer, the employer shall establish and implement a written respiratory protection program with worksite-specific procedures.
 The written program should include selection of respirators to use in the workplace; medical evaluations for employees required to wear respirators; fit-testing for tight respirators; procedures for proper use of respirators in routine and reasonably emergency situation; and procedures and schedules for cleaning, disinfecting, storing, inspecting, repairing, discarding, and maintaining respirators.
 E. Voluntary Use of Respirators
  Some exposure situations may occur where an employer may choose to permit employees to wear a respirator even though regulatory protection is not required. OSHA emphasizes employee and ensuring that the repirator does not become a hazard (medical or maintenance issues). If employees use a filtering facepiece to reduce particulate exposures, a written respiratory program and employee exam is not required. Employee often use respiratory protection to protect against animal allergens.
 F. Foot Protection
  Special foot protection is usually not required for work in research labs but may be necessary for some operations in the animal care facility. OSHA requires protective footwear if there is a danger of foot injuries due to falling rolling objects or objects piercing the side of the shoe.
 
Conclusion
 Many guidelines and regulations exist to control the risk of chemical exposures. The IACUC can play an important role when reviewing animal research protocols. In many cases, general institutional policies may direct control of exposure, but high-risk chemical hazards or chemical of unknown hazard should elicit a comprehensive review to ensure that health and safety issues have been addressed.
Questions:
1. What is the primary chemical safety regulation for the animal care facility?
2. What is the primary chemical safety regulation for the research lab?
3. Who is responsible for distribution of material and safety data sheets?
4. Name 5 types of PPE.
Answers
1. Hazard Communication Standard (OSHA, 1996)
2. Occupational Exposure to Hazardous Chemicals in Laboratories (OSHA, 1991)
3. Chemical manufacturers, chemical distributors, importers
4. Gloves, protective clothing, eye and face protection, respiratory protection, and foot protection

What's hot in animal biosafety? ILAR 44 (1): 020.
This article reviews recent issues in animal biosafety. It starts by pointing out that the re-emergence of bioterrorism threat has heightened awareness of biosecurity and improved biosafety.
The "Biosafety in Microbiological and Biomedical Laboratories" (BMBL) manual is the written guidelines by the CDC and NIH. CDC also began hosting a biannual biosafety symposia. The American Biological Safety Association (ABSA) offers a web site which provides more information and guidelines.
The authors of this article have picked eight different subjects they consider "hot" for veterinarians working with laboratory animals. These include biosecurity, arthropod borne diseases, containment issues, occupational hazards associated with wildlife and livestock research, toxins of biologic origin, prion research, animal carcass disposal and wild polio virus.
Biosecurity: New regulations include the USA Patriot Act of 2001, which restricts individuals registered to work with highly infectious biological agents and toxins (select agents). The Public health security and bioterrorism act requires all possessors of select agents, certain plant pathogens and organisms defined by USDA as high consequence pathogens to be registers in a classified national database.
Arthropod-borne diseases: A subcommittee on Arbovirus laboratory safety of the American Committee on Arthropod borne viruses has classified lab work on West Nile virus to BSL-3. Routine diagnostic testing may be in BSL-2. All specimen handling needs to be in a class II biologic safety cabinet.
There are new guidelines for arthropod containment levels (ACL 1-4) characterized by increasingly restrictive containment facilities, equipment, and practices. Factors which determine the appropriate level include the BSL of the agent of interest, genetic alterations of the vector and whether the vector is indiginous to the area.
Containment Issues: The basic biosafety guidelines for working with research animals are provided in the BMBL. Appropriate levels of containment are determined by first conducting a risk assessment with focus on animal to human spread of pathogens. Work with genetically modified animals may involve unique containment issues.
Occupational Hazards Associated with Wildlife and Livestock Research: This can be especially challenging when animals are housed in non-traditional vivaria. Authors include an assessment outline that covers knowing the animal, knowing the diseases normally associated with that animal species, developing an occupational health program, implementing restraint and engineering controls and most importantly, advance training of personnel.
Working with toxins of biological origin: Since BSL guidelines really fit for work with toxins, a system has been proposed for four chemical safety levels which describe practices, equipment, and facilities for each CSL. A pilot project is scheduled at the CDC to evaluate this system. CDC also regulates the use and possession of select agent toxins.
Considerations for Prion Research Involving Animals: Understanding the unique biology of prions is cornerstone to a biosafety program. Section VII-D of BMBL provides guidelines for assessment of risk and containment levels required. Procedures for safe handling and disposal of contaminated tissues is fundamentally important for an effective prion biosafety program, since these agents are extremely resistant to conventional inactivation including irradiation, boiling, dry heat and chemicals such as formalin and alcohol. BMBL recommends immersions in 1 N NaOH or sodium hypochlorite for at least one hour before autoclaving at 134oC for 4.5 hour, followed by incineration.
Animal Carcass Disposal by Hot Alkaline Hydrolysis: Due to increase local, state and federal regulations environmental regulations against incineration, the disposal of carcasses in an environmentally responsible manner is a significant concern. A recently described alternative is hot alkaline hydrolysis (which is capable of inactivating the agents of TSEs). This process uses temperature, pressure and high pH in combination to reduce complex biological samples to their constituent sugars, amino acids, and soaps. Only calcium based bone fragments and undigested cellulose remain after hydrolysate is removed. These are sterile and can be disposed of as non-infectious waste. The hydrolysate is also sterile and can be diluted and disposed of in either the sewer system or landfill. This method does require significant personnel training due to the risks involved with high heat and pressurized systems.
Working Safely with Wild Poliovirus: Since poliovirus eradication is an attainable goal, the concern for biosafety of poliovirus in a laboratory setting after eradication is complete is raised. A worldwide inventory of biomedical facilities is currently underway to establish the location of existing stocks as an effort to limit all remaining stores of wild poliovirus. When poliovirus vaccines are no longer given to laboratory personnel, it will be classified as a BSL-4 agent.

Questions:

1. The CDC and NIH have written guidelines for biosafety in the laboratory. These guidelines are called…
a. Guide for care and use of laboratory animals.
b. Occupational Health and Safety in the care and use of research animals
c. Biosafety in microbiological and biomedical laboratories
d. Primary Containment for Biohazards
2. Hot alkaline hydrolysis involves the use of…
a. temperature
b. pressure
c. acidity
d. all of the above
3. BMBL recommends the following for inactivating prions…
a. autoclaving and incineration
b. chemical and incineration
c. autoclaving and chemical
d. chemical, autoclaving and incineration

Answers:

1) c
2) d
3) d

Laboratory animal allergy: an update. ILAR 44 (1): 028.
Symptoms of LLA

LLA, induced by the IgE response, runs a gamut of nasal, ocular, dermal and upper and lower respiratory symptoms, initially mild and requiring strong exposure of antigens. With increased exposure and/or sensitization to other animal allergens, the rhinitis, conjunctivitis, congestion, sneezing and itching may proceed to more serious levels of reaction, including status asthmaticus. Once sensitized, repeated exposures require less and less of the antigenic material to initiate a response. Most persons (70%) who become sensitized convert in the first three years of employment. Those that do not show symptoms in this time frame remain at risk.

Risk Factors for the Development of LAA

Bush et al concluded that there is an odds ration for developing LAAA of 3.35 in atopics compared with nonatopic workers. Atopy defined as a positive skin test on in iviro test (RAST/ELISA). This generalization was recently refined by studies that showed that apprentices working in animal health technology facilities were at increased risk for LAA if (1) there were atopic, (2) had respiratory symptoms in the pollen season (3) were sensitized to cat or dog allergens, (4) had baseline airway hyper-responsiveness and/or (5) had an increasing number of hours of contact with laboratory animals. All of these studies suggest there is a relation between atopy and a predisposition to form IgE antibodies. Smoking, while suggestive, is not as clear cut a risk factor as atopy.

Mechanism of LAA

Inhalation or other (skin) exposure of allergens (protein or glycoproteins) to CD4+ and T-helper lymphocytes initiates a series of reactions, including "memory". Subsequent exposure sets off the production of IgE antibodies and a cascade of events called type 1 or immediate hypersensitivity reactions.

Development of IgE Antibodies

Allergens (inhaled) or experiencing dermal contact are "processed" by monocytes and macrophages (lung) or dendritic cells and Langerhans cells in the skin which present the antigen to T-lymphocytes. IN the presence of the appropriate cytokine milieu, Th2 CD4+ T-helper cells are formed. The TH2-cells produce IL-4 and IL-13 which provoke the production of IgE. The interaction of allergens and IgE result in the immediate and late-phase allergic response. This response is aided by the production of IL-5 which promotes maturation and recruitment of eosinophils to sites of allergic reaction.

The Allergens

Allergenic proteins for laboratory animals are primarily associated with the hair (follicles), dander, serum and saliva for dogs, cats, rabbits and rats. For the mouse and guinea pig, the saliva is of lesser important but the urine is a very important source of these allergens. In the serum (mouse, rat, cat and dog) it is primarily albumin that is allergenic. The urinary allergens of the species listed above as well as in the horse and cow and used for carrying odor molecules, specific to the species, and are classified as lipocalins. While not the most sensitizing, rodent allergens have received the greatest attention because of the numbers of these animals used in the laboratory environment and the number of people exposed directly or indirectly to these allergens in that environment.

Exposure Assessment

RAST test (radioallergosorbent test) and ELISA (Enzyme-linked immunosorbent assay) are the two most common methods to assess airborne allergens loads, though standardization in the industry and interpretation does not exist. A significant portion of animal allergens are found on particles less that 5 aerodynamic microns and may stay suspended for extended periods of time. Inhalation is the major route of exposure to animal allergens, whether urinary proteins, danders or hair proteins. Gordon and Newman-Taylor have demonstrated (pharmaceutic industry setting) that urinary aeroallergen exposure, from greatest to least, is ranked according to groups as follows: Animal technician; Cage cleaner; Post-mortem Technician; Scientist; Supervisor and Slide Production Technician. Almost every study to date, though not in quantitative agreement, has demonstrated that the atopic individual already sensitized to some form of allergen is much more easily sensitized to animal allergens than a nonatopic individual.

Occupational Health and Safety in the Laboratory Animal Facility

Prevention of LAA

There is evidence that with education and training, modification of work practices and instituting engineering controls (use of filter-top cages, HEPA room ventilation, increased air exchanges and dust free bedding) along with use of PPE (mandatory respiratory protection), an incidence of LAA was reduced from 10% to zero in an industrial setting.

Preplacement Evaluation

Preplacement medical evaluations, done by Occupational Health Clinical staff, can be used to place workers in appropriate settings that will reduce and/or minimize the risk of developing LAA, establishing a baseline for future comparisons. Noted risk factors in the evaluation may trigger testing for non-animal allergens as well as those of animal nature to which the employee will be exposed in the work environment.

Exposure Reduction

Techniques for reducing allergen exposure include (1) substitution, (2) engineering controls (3) administrative controls and (4) PPE. These techniques have been previously discussed with the exception of substitution. Substitution refers to the use of another species that is less allergenic and/or one to which the worker has not been sanitized. Dust mist respirators can remove up to 98% of rodent urinary allergens from the air. Respirators could be those approved by the NIOHS and used with a written program in place. PPE, including gloves are absolutely essential for minimizing/preventing contact allergic reactions but also followed by thorough hand washing, perhaps showering and not wearing latex and/or powdered gloves which may help provoke and/or worsen dermal allergic reactions. Preplacement evaluations and medical surveillance programs have demonstrated efficacy in reducing risk of occupational asthma. Early disease detection prevents progressive impairments of worker's health.

Evaluation and Treatment of the Individual with LAA

Allergic symptomatology associated with exposure to animals should be evaluated by occupations health specialists so that evaluations can be made; remedial procedures and tests performed and the workers placed in the least provocative environment. Diagnosis is confirmed by demonstration of specific IgE antibodies to the allergen(s) in question. If asthma is suspected, appropriate pulmonary function tests, both inside and outside the facility prior to and after medication must be done and compared for completeness. The longer a persons suffers from animal allergen asthma, the longer it will take to recover and the greater is the risk of permanent pulmonary embarrassment and dysfunction.
PPE does not afford the degree of protection that it provides for many other types of hazardous exposure. The nanograms of antigen that can see off allergic and asthmatic disease in sensitized personnel can easily evade PPE. Even with pharmacologic intervention combined with PPE, very sensitive person continue to suffer and must leave the environment. Asthma in this environment increases the risk of anaphylaxis and preparations by the individual, fellow workers and the work supervisor should be in place.

*** There are some great appendices to this paper that might act as guides or formats for development of questionnaires or evaluation forms for new and continue-need clients in the Laboratory Animal industry. These should be looked at carefully.

Questions:

1. RAST, when used in reference to antigen testing, is an acronym for _____________________
2. The antibody responsible for initiating type 1 inflammatory and allergic reactions in sensitized persons is ____________________________________.
A. IgG
B. IgM
C. IgE
D. IgA
3. A lipocalin is ______________________________________________.
4. Four common engineering controls in an animal facility might be _________________, _____________________, __________________- and ___________________.

Answers:

1. RAST is the acronym for radioallergosorbent test.
2. IgE is the antibody responsible for initiating inflammatory and allergic reactions in sensitizied persons experiencing a type 1 reaction.
3. A lippocalin is a protein found in the urine of many species that is found to be a carrier for molecules associated with species specific odors.
4. Engineering controls in a facility would include: (1) Use of HEPA filtration; (2) increase in room air exchange to reduce the particular matter (3) electrostatic charged surfaces in addition to HEPA filtration, (4) ventilated racks, (5) filter tops on shoe box caging, (6) use of dust free bedding among others.

Use of personal protective equipment for respiratory protection. ILAR 44 (1): 052.
Effective management of occupational hazards requires application of the principles of: Anticipation, Recognition, Evaluation and Control. With proper recognition and evaluation, exposure potential is defined allowing for the most effective engineering controls. PPE, Personal Protective Equipment is an effective control for many types of exposures.
Authors recommend development of an inventory of potentially hazardous materials, including chemical, biological and physical. Following the listing, comes characterization of the tasks performed with hazardous agents and the equipment used in those processes to understand fully the potential for exposure when these tasks are performed.
Safety Standards
Guides for Safety Standards in the U.S are the Occupational Exposure to Hazardous Chemicals in Laboratories pub (OSHA 1990) and Hazard Communication Standards (OSHA 1994). Materials categorized as health hazards include irritants, corrosives, sensitizers, carcinogens, genotoxins, neurotoxins, hepatotoxins ,nephrotoxins, reproductive toxins, radioactive substances and biological agents.
Where required, the Standard Operating Plan must contain a written Chemical Hygiene Plan establishing standard operating procedures for hazardous work. The plan details control measures for maximum reduction to air contamination , procedures for working with hazardous chemicals and measures to reduce employee exposure
The bottom line: In establishing the required safe workplace, exposure protection must be attempted first through engineering and administrative controls. PPE can only used after it has been found that engineering and administrative controls are not providing a sufficient level of protection..
Respiratory Protection Program Elements
Where required respirator use has been established, there must be a written respiratory protection program and a suitably trained program administrator to oversee the program. Guide for the need for required programs can be obtained from the American National Standards Institute Practices for Respiratory Protection and the National Institute for Occupational Safety and Health Respirator Decision Logic. The written program should contain at least the following elements: Procedure for selecting respirators; Periodic evaluation of required users; Fit testing procedures; Procedural guide for routine and emergency use; Inspection of routine and emergency units; Provisions for maintenance and care of units; Provisions for adequate breathing air quality, quantity and flow for atmosphere-supplying respirators Training of employees related to hazard exposure in routine and emergency situations and Program evaluation and auditing.
Air-purifying Respirators
Air-purifying respirators are particulate filtering or vapor/gas removing units. The former relies solely on pore size of the mask material, with or without the aide of electrostatic charge to "catch" particulate material pulled through the mask by the wearer. They have no efficacy with vapors/gases.
Activated charcoal filters or cartridges rely on adsorption or absorption to substrate for filtration. The filter surface may be sorbent coated for specificity for certain agents Specific adsorptive surfaces/cartridges are coded by color and published by the American National Standards Institute.
Air-purifying respirators come as quarter to full facepiece masks with and without adsorptive cartridges for gas/vapors. Only the full facepiece mask affords eye protection. The also range from one-use disposable, multiple-use disposable to disposable cartridges canister/filter with sanitation and reuse of the mask "hard" parts.
Quarter and half mask respirators have assigned protective factors (APF) of approximately 10 while the full facepiece respirators have APFs of 50 to 100. Recall that the APF is the factor of reduction of the contaminant to which the user will be exposed.
To avoid over tiring the wear of these mask and pulling air across densely packed mask material, cartridges and filters, Powered Air-purifying Respirator (PAPR) units can be had which have blowers that pull air through the filtration/cartridges and present this low resistance filtered air for the wearer to breath.
Supplied-air Respirators
Cylinders or compressors are used to supply at least grade "D" (Compressed Gas Association) air at a flow of 4 to 15 Cubic Feet per Minute (CFM) depending upon whether the respirators are half masks, full facepieces, loose-fitting hoods or helmets. These respirators, require regular testing for trap and filter efficiency and may be used in immediately dangerous to life and health atmospheres if independent auxiliary air is available.
SCBA
This self-contained breathing apparatus unit is little used in the laboratory environment and must be used by highly trained individuals, primarily in an atmosphere of unknown gases, vapors or particulates where freedom of movement is especially desired.
Ensuring Proper and Safe Use of Respirators
Training:
Training should entail the specific components and limitations of respirator chosen, based on the anticipated hazard, and information on those hazards specifically. Both routine and emergency use of the chosen respirator should be a component of the initial training and annual updates.
Respirator Fit Testing:
Respiratory testing takes place prior to actual use of the unit as well as with imminent use , the former conducted by testing personnel the latter done by the user prior to exposure. Trainer conducted fit tests are both qualitative (odor or taste perception by user when outside of mask has been exposed) and quantitative, where the contaminant is actually measured inside of the mask during outside contamination. Critical fit testing is to be done by the wearer prior to exposure by causing the mask to be suck to the face when the wearer inhales and covers the intake port or lifted off the face slightly when the wearer exhales and covers the output port. Fit tests are to be done annually or when a new type of mask is provided or if there has been significant weight gain or loss or changes in the conformation of the face expected. Facial hair may not be worn if it interferes with proper fit and integrity of required masks.
Inspection, Cleaning, Maintenance, and Storage: Once fitted, the respirator must be keep clean for individual use and sanitized after use by others. At least monthly inspections are required on parts and materials with non-use storage in such a fashion as to protect it from airborne contaminants and/or chemicals that might cause material deterioration. Repairs should be done only by qualified manufacturer representatives or designee.
Medical Evaluation: Respirator wearers must be psychologically and physically able to cope with this restrictive device while conducting routine tasks. Wearers must be evaluated annually using a mandatory medical questionnaire.
Program Evaluation and Auditing: The program is continuously monitored using data and medical surveillance to evaluate effectiveness with modifications as appropriate to reduce exposure potential.

Questions:

1. In reference to OSHA mandated controls for respirators and those required to wear them for routine and/or emergency work performance, the following acronyms stand for:
NIOSH
ANSI
PAPR
ARF
PPE
IDLH
SCBA
2. According to this review, fit testing is recommended
(a) semi-annually
(b) at least annually
(c) biannually
(d) annually or more often if there have been weight changes
3. An engineering control would include all of the above except:
(a) HEPA filtration of the air entering an animal space
(b) HEPA filtered hood in the animals space for toxicological work
(c) HEPA filtered SCBA for working in this space
(d) Ultraviolet radiation through which the room air is passed prior to exhaustion

Answers:

1. NIOSH = National Institute for Occupational Safety and Health
ANSI = American National Standards Institute
PAPR = Powered air purifying respirator
ARF = Assigned Protection Factor
PPE = Personal Protective Equipment
IDLH = Immediately Dangerous to Life and Health
SCBA = Self-contained Breathing Apparatus
2. According to this review, fit testing should be done at least once a year and more often if there have been significant changes in weight, face surgery, growth of facial hair, dental work that might change face contours or a new type of mask is being used.
3. Choices A, B and D are engineering controls….factors being done to the environment to minimize hazard contact for the worker. The SCBA is considered PPE (respirator).

Occupational medicine programs for animal reserach facilities. ILAR 44 (1): 057.
Occupational Medicine Programs for Animal Research Facilities:
The core mission of occupational health and safety programs is to maximize employee health and productivity through targeted delivery of preventive and wellness services, and active management of injury, disease, and disability. Most institutions have developed effective programs for controlling hazards and minimizing occupational risks of injury and illness in the workplace. The Occupational Health and Safety Services assist institutional leaders and managers of the animal care and use activities in establishing health and safety policies and promoting high standards of safety. Ten key elements of an effective Occupational Health and Safety Program are discussed below.
Organizational Strategy and Management Support:
A fully integrated health and safety program combines qualified health care professionals with professionals from the Departments of Environmental Health and Safety, Human Resources, and Risk Management or Loss Control (Legal Department). Centralized units are best, in order to provide guidance across the entire institution. The Occupational Health and Safety Program is most effective when health and safety are the primary responsibility of the line manager or the principal investigator and when there is an institutional champion who vigorously supports the program.
Population Health Management:
The head of the Occupational Medicine Department should serve as the Chief Health Officer for the organization. Because it is more effective to prevent than to treat disease, public health interventions such as preventive services and proactive interventions are preferred. The process of identifying and intervening on high-prevalence medical "intervention targets" is often referred to as population health management. Usually only 80% of a health and welfare benefit or service is used by only 20% of the population. Using data collected on workers compensation, disability, and health care costs allows identification of important injuries or diseases that significantly affect these costs in the population of each business. The identification of these areas represents intervention targets. Intervention targets are generally categorized into one of three types listed below.
(1) Population Intervention Targets: Interventions that take place at the level of the entire workforce. Examples include Wellness and Health Education Programs.
(2) Individual Intervention Targets: Individuals who already have a disease can be approached through secondary prevention programs. Examples include interventions for hypertension, lipid abnormalities, diabetes, and depression management programs.
(3) Workplace Intervention Targets: Specific work sites where employees experience elevated rates of injury or illness or patterns of injury that occur across the entire worksite are good examples of potential workplace intervention targets.
Information Management:
Occupational Health and Safety and Occupational Medicine Departments make use of large amounts of information. Occupational Medicine Departments should have a written confidentiality policy and require Occupational Medicine employees to sign a confidentiality statement at least annually. Expert legal counsel should be sought to determine if any requirements apply and are covered under the Health Insurance Portability and Accountability Act (HIPPA) of 1996. Electronic medical records to improve patient care and readily access information are encouraged. However, confidentiality and limited access to some kinds of information are paramount and must be ensured. Table 1 in the article provides the occupational health and safety information elements that can be shared in an information management network.
Federal Requirements and Guidelines for Occupational Healthcare Services:
The occupational Safety and Health Act mandates that employers provide a safe and healthy workplace for their employees. For example, under OSHA blood borne pathogens standard, an institution needs to offer Hepatitis B vaccinations to employees who handle blood, organs, or other tissues from animals and to make available to an employee a confidential medical evaluation immediately after exposure to animal tissues that are contaminated with a blood borne pathogen. Examples of unregulated hazards include allergens and ergonomic concerns. Organizations should develop their own standards and policies, and procedures to address these issues. The PHS Policy on Humane Care and Use of Laboratory Animals of 1986 requires institutions that receive federal funds to provide occupational healthcare services to employees who work in laboratory animal facilities and have substantial animal contact. Medical surveillance programs and specific occupational healthcare services are recommended in Biosafety in Microbiological and Biomedical Laboratories (CDC-NIH 1999).
Assessment of Health Risks:
Accurate risk assessment is the first critical task to ensure employee health in an animal care facility. Hazard types at work are found in Table 2 of the articles. These hazards can be categorized into Physical, Chemical, and Biological Hazards. Examples of risk assessment variable associated with animal-related research are found in Table 3. These include, exposure intensity, exposure frequency, hazards posed by animals, hazards posed by materials used in or with animals, susceptibility of employee, expected incidence or prevalence of disease, history of occupational illness or injury in the position or workplace, and regulatory requirements.
Facility Design and Operation:
During the design of a new facility or the renovation of an existing one, hazards associated with the care and use of animals should be addressed in a collaborative effort and should involve the investigators, who will use the facility, the manager, and other principal staff of the institution's animal care and use program and Environmental Health and Safety Staff. Animal care work should be performed in dedicated facilities. Transportation should be limited to designated corridors and routes. Filter top cages can reduce allergen contamination of these corridors. The facility design process is critical in planning for management of risk in the workplace and should also include careful attention to prevention and control or ergonomic hazards in the design of animal facilities. Additional attention should be given to engineering controls, including ventilation systems, for control of animal allergen exposures.
Exposure Control Method:
Exposures to occupational hazards are controlled through the application of engineering controls, work practices, and the use of personal protective equipment in a hierarchical structure. Medical input is required for the respiratory protection program and also be needed for glove selection if the employee has medical issues related to glove use.

Engineering Controls: Engineering controls are a combination of safety equipment and physical features of the facility that help minimize hazardous exposures of personnel and the surrounding environment. Commonly used engineering controls in animal care and use facilities are: barriers and airlocks, chemical fume hoods, biological safety cabinets and isolation cages.
Work Practices: Work practices constitute a critical element in controlling exposure. Employees should understand the hazards associated with the procedures they are performing, recognize the rout through which they are exposed to the hazard, select work practices that minimize exposures, and through training and experience acquire the discipline and skill necessary to sustain proficiency in the conduct of safe practices. Table 4 provides a list of work practices to reduce hazardous exposure.
Personal Hygiene: Scrupulous attention to personal hygiene is essential for all personnel who care for and use research animals. Complete change of clothing may be necessary to limit potential spread of hazardous biological agents.
Housekeeping: All animal care areas, including areas in which hazardous materials are used or stored, should be kept neat and clean. Wet mopping and the use of high-efficiency particulate air (HEPA)-filtered vacuum cleaner are appropriate for suppressing dust.
Personal Protective Equipment: The use of personal protective equipment is the final measure for controlling exposures to potentially hazardous agents. This provides a physical barrier to hazardous materials that may otherwise come into contact with employees' skin, eyes, mucous membranes, and clothing. Respiratory protection should be mandatory to control occupational exposures to aerosols and animal allergens, unless engineering controls can be proven to reduce allergen exposure to safe levels. For employees with primary laboratory animal allergies, a higher level of respiratory protection may be necessary to prevent development of additional allergies to laboratory animals. Gloves are the most commonly used personal protective clothing. Gloves should be long enough to cover the area to be protected, and disposable vinyl or latex examination or surgical gloves should not be reused. Uniforms, gowns, or laboratory coats are often provided to prevent contamination of animal care personnel by animal urine and feces as well as biological and chemical agents used in the facility. Face protection is advised if the eyes, nose, or mouth may be exposed through splashes or splatters of potentially hazardous agents.

Administrative Procedures: Adequate administrative procedures are vital to the success of an Occupational Health and Safety Program. Researchers and managers should be held accountable, especially where substantial risks for human health effects exist. Appropriate occupational health professionals should serve on a committee that reviews the program.
Occupational Healthcare Service Activities: The wide variety of acceptable arrangements for providing occupational healthcare services reflects the variation in institutional needs and resources, including the size of the animal care and use program, the nature of the risks, and access to occupational healthcare services. Each institution should select or contract for appropriate professional guidance and occupational healthcare services to meet the occupational health needs of its employees. Occupational Medicine programs for animal facilities should cover all persons whose duties place them near research animals, their derived products, and their tissues.
Occupational Healthcare Service Responsibilities:
Strategic Organization of Medical Resources: A health and productivity model for occupational health consists of three distinct but related medical services:
(1) Occupational Medicine Management: The comprehensive, integrated service of occupational medicine management is best delivered by a team of experienced occupational health professionals with extensive experience. Smaller institutions may contract for this expertise from an outside occupational medicine provider.
(2) Centralized Health and Compliance Services: Centralized health and compliance services are best supported by software systems designed to efficiently deliver transaction-based occupational health services that use the latest in telecommunications and expert system applications.
Clinical service: Provision of high-quality, courteous, and timely medical evaluations; impairment assessments; medical surveillance examinations; and occupational injury and illness diagnosis and treatment.
Medically related absence (disability) management: This service is best provided by dedicated nurse case managers supported by physicians. The most proactive programs address the psychosocial factors that cause prolonged time lost form work and also seek to prevent initial and repeated episodes of disability where appropriate.
Compliance services: This service supports institutional safety management and regulatory compliance programs with expert reporting systems to manage OSHA reporting requirements.
Health promotion:
(3) Medical Information Management: Management of medical information is required to maintain employee medical records and documentation necessary to support service delivery modules. The Population Health approach facilitates continued measurement through the development and implementation of systems for tracking and reporting information and finding related to population health, health determinants, and the effectiveness of interventions.
Occupational Healthcare Responsibilities: Effective Occupational Medicine service depends on the Occupational Medicine Department's knowledge of the employee health risks associated with the care and use of research animals at the institution. This article lists twelve steps a department should use to carry out the mission to preserve and promote health. Table 5 provides federal recommendations for occupational healthcare services for research involving animals and animal research involving recombinant DNA.
Identification of Persons at High Risk: Occupational healthcare services should identify employees at risk because of animal-related work and determine who should participate in the various activities provided by the respective service.
Preplacement Medical Evaluation: This provides the opportunity to discuss medical conditions that may alter employee's exposure-risk profile; these conditions could include pregnancy in women of childbearing age.
Medical Surveillance: Scheduled periodic health evaluations are the key component of occupational health programs. Each medical surveillance program should be specifically tailored to the potential exposures. Medical surveillance should include both individual assessments and aggregate analysis of the data collected.
Episodic and Postexposure Health Evaluations: 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.
Recognition, Evaluation, Recording, and Follow-up of Adverse Health Outcomes: The incidence and prevalence of medical symptoms, injuries, or illnesses should be assessed periodically. "Near-miss" reports can be utilized as tool.
Medical Management of Injuries and Illness: Whenever possible, Occupational Medicine Departments should direct the management and treatment of workers compensation cases. Occupational medicine works with human resources and line management to determine whether the employee can be accommodated in their current position or whether other work is available.
Immunization: Immunization programs are an accepted method of protecting people from some infectious diseases. The Public Health Service Advisory Committee on Immunization Practices provides guidance for administration of specific vaccines and toxoids such as for hepatitis B, rabies, and tetanus.
Medical Record Keeping: It is the responsibility of the employer to maintain medical records related to an employee's participation in healthcare service activity.
Serum Banking: Serum banking is the collection and frozen storage of serum samples obtained from employees who may be at risk fro occupationally acquired infection. The CDC and NIH recommend serum banking and serological surveillance when a substantial risk of occupational illness is associated with an agent under study and methods are available to measure immunological response to the agent. The collection and storage of employee serum should not be performed in the absence of a functioning occupational health and safety program.
Exit Evaluations: An exit evaluation is a medical evaluation performed when an employee terminates employment or changes jobs so that he or she is no longer exposed to a specific hazard. Exit examinations should be part of the human resources checklist for employment termination.
Nonoccupational Health Care: Many companies have found that there is a role for nonoccupational health care to maximize employee productivity. Some employers choose to use the occupational health program to provide general health promotion such as blood pressure measurement, cholesterol screening, and education about healthy lifestyles.
Education and Training: Occupational health and safety objectives of an institution can be achieved only if employees know the hazards associated with their work activities; understand how the hazards are controlled through institutional policies, engineering controls, work practices, and personal protective equipment; and have sufficient skills to execute safe work practices proficiently. Successful programs have three common attributes:
(1) Occupational health and safety goals of the institution and how they will be achieved, including precise guidance on regulatory-compliance strategies, are clearly communicated to all employees.
(2) Employees are fully apprised of all relevant hazards and control strategies pertaining to their general work assignments.
(3) Supervisors and principle investigators in the animal care and research groups are responsible and accountable for ensuring that their employees have acquired the necessary training, skills, and attitudes to work safely.
Training is a continuous process. Training records are required to satisfy specific requirements of federal and state environmental health and safety regulations. A wide variety of mechanisms exist for evaluating the success of the education and training program. The approach should be carefully designed and applied to provide information useful for both institution officials and employees.
Emergency Procedures:
Every institution must have an emergency response plan. A rapid and appropriate response is not possible without an institutionally adopted written and tested plan. An emergency response plan provides a structure for effective response by defining employee responsibilities, interactions between responding personnel, and the sequence of response procedures, and availability of emergency equipment. All on-site employees should know their roles in responding to emergency situations. The planning process should follow a logical progression that begins with identification of the types of emergency situations that are most likely to occur. After adoption of the written plan it is important to conduct training to test its efficacy. The emergency response team for an animal facility should either include or have rapid access to health and safety, veterinary, and animal care personnel. Typically, the hierarchy for response will be to protect personnel, then animals, and finally the animal care facility and surrounding buildings. Medical personnel should have specific information on the unique hazards related to emergency response procedures in the animal facility.
Program Evaluation:
Evaluation of the adequacy of a healthcare service should focus on whether the healthcare providers meet legal requirements and ethical guidelines, accomplish the mission of the occupational health program, and deliver the appropriate components of the service.

Questions:

No questions