Occupational Health

Female doctor writing in patient chart, mid section

Important Occupational Health Announcement for all investigators using lab animals!

IMPORTANT NOTICE

  • Please be advised that the turn around time for review of health history surveys and clearance of personnel MAY take as long as two weeks.
  • Surveys submitted less than two weeks prior to an IACUC Meeting, where a protocol is on the agenda, cannot be guaranteed to be acted upon in time for that meeting. This may result in the delay of protocol approval.

Occupational Health Program For Research Personnel With Animal Contact

Individuals who work with or near animals in a modern research setting are at risk for animal-related allergy, injury, and infectious disease.  The risks are variable depending upon the species being used, the source of the animals, the quantity and quality of contact with or exposure to the animals and other factors.

The quality of today’s research animals greatly limits the chance of acquiring an infectious disease from research animals housed at GUMC. This is particularly true for anyone using purpose bred rodents or rabbits. The other animals used pose slightly higher, but still very small, risks of infectious disease. The Division of Comparative Medicine (DCM) maintains a library with information on zoonotic diseases. Anyone desiring further information can contact the DCM Director.

Allergies are common in people working with or near laboratory animals. These include both inhalant and contact allergies. Nearly every species housed in the DCM has the potential to cause allergic reactions in susceptible individuals. In many cases, the allergies develop after employment begins. Symptoms can vary but can include conjunctivitis, dermatitis, respiratory problems, and anaphylaxis.  Prevention of animal allergy depends on control measures in place within the work environment.  A combination of methods to combat or limit allergen exposure, including administrative controls, training and education and the utilization of personal protective equipment has been implemented at Georgetown University.

Injuries are the most common occupational hazard for DCM staff members. Most of these are related to equipment, lifting, repetitive motion, wet floors, etc. Investigators, their staff, and other individuals entering the animal facility should be watchful for wet floors and practice proper lifting techniques, as necessary. In addition, staff members are at risk of animal bites and scratches. Proper animal handling greatly reduces the potential for a bite or scratch.

Training

All Animal Research Personnel working in a laboratory setting must attend training sessions in chemical and biohazard safety, emergency preparedness, basic laboratory safety, accident investigation, bloodborne pathogens, and fire /electrical safety.  Radiation safety training is required if personnel will be working in a lab authorized to use radioactive materials.  Environmental Health and Safety (EH&S) provides additional retraining as necessary.

The DCM provides hands-on training, in humane and safe methods of restraint and laboratory procedures with emphasis on injury prevention for both personnel and animals.

Personnel also is required to complete a course in the AALAS Online Learning Library regarding laboratory animal allergy risks in animal care and use environment.

A DCM clinical veterinarian provides training to employees working with nonhuman primates on the disease, history, clinical signs and zoonotic potential for B virus (Macacine herpesvirus 1), required PPE, location and proper use of Bite and Scratch Kits, and appropriate post-exposure medical and administrative follow-up.  This training is mandatory for all individuals working with nonhuman primates.

Medical Clearance Procedures

1. Risk Assessment – Health History Survery

All Animal Research Personnel who are listed as participants on an approved IACUC protocol must complete a Health History Survey, receive health risk assessment, and obtain medical clearance, annually and prior to IACUC protocol renewal.  All Animal Research Personnel, who will be listed as a participant and will work with animals on an IACUC protocol, must obtain medical clearance through the Occupational Health Program before the IACUC protocol can be approved or renewed.  Find the Health History Survey. Animal Research Personnel also receive the form during their required DCM orientation.

All completed surveys are sent directly to the Occupational Health Program Coordinator (“Coordinator”), who logs and forwards the form to the Medical Director.  The Medical Director completes his risk assessment review – evaluating the following:

  • Tetanus vaccination – Tdap if not received as an adult and Td booster every 10 years unless medically contraindicated. Personnel may decline vaccine by indicating this choice on the Td/Tdap Vaccine Declination form;
  • TB screening – Personnel working with nonhuman primates who do not have prior history of a positive TST (tuberculin skin test) receive a TST on enrollment.  If the participant has received the Bacille Calmette-Guerin (BCG) vaccine, an interferon-gamma release assay (IGRA) blood test is ordered. If a participant is found to have a positive TST or IGRA, a TB Questionnaire is administered and chest x-ray is obtained.  Participant with prior history of positive TST or IGRA does not receive further testing;
  • Hepatitis B – 3 doses of vaccine will be offered unless an individual has had prior doses of the vaccine.  If prior doses of the vaccine were administered, the vaccine series will resume from the last dose received – the series does not need to be restarted. Employees may decline vaccine by indicating this choice on the Hep B Vaccine Declination Form;
  • Measles (MMR) – Personnel working with nonhuman primates who have not had previous exposure to measles (e.g. had a natural case or been previously vaccinated and have laboratory evidence of immunity) will be offered the vaccine. Personnel may decline vaccine by indicating this choice on the Measles Vaccine Declination Form.  If measles vaccine is declined or medically contraindicated, employee WILL NOT be cleared to work with nonhuman primates;
  • Allergy assessment;
  • Evaluation for respiratory protection, if indicated or requested;
  • Pulmonary function studies, and/or chest x-ray, if indicated;
  • Appropriate specialty and subspecialty consultation where indicated

2. Medical Clearance

If additional tests, physical exams or health surveillance are needed, the Medical Director completes a “Medical Authorization and Order Form” and forwards it to the Coordinator.  The Coordinator forwards an electronic copy of this form to the animal research personnel and assists in setting up appointments, as necessary, with the Clinical Research Unit (CRU).  After the individual has received his/her examination, testing and/or assessment, the Coordinator retrieves the Patient Encounter Form and completed Medical Authorization and Order Form from the CRU and forwards to the Medical Director for final review.

The Medical Director completes a “Medical Clearance to Work with Laboratory Animals” letter (Medical Clearance) and forwards to the Coordinator for distribution and logging into the program database.  The Coordinator sends an electronic copy of the Medical Clearance letter to the individual and his/her PI, enters the medical clearance information into the program database and files the hard copy of the forms.

The Coordinator provides the IACUC the names of all animal research personnel who have obtained medical clearance.  All medical history information is maintained securely by the Coordinator.

The GUMC Occupational Health Program maintains strict confidentiality of patient information and records, in full compliance with HIPAA.  Except for “Clearance to Work with Laboratory Animals” letters, no medical information is released to any agency without written consent from the examinee.

3. Annual Health Evaluation Assessment

Research personnel are required to complete and submit an Annual Health Evaluation form for review and approval by the Medical Director. The status of medical clearance of all personnel listed on an IACUC protocol is checked at the time of initial protocol submission, annual/triennial renewal and prior to amendment approval. Protocols will not receive approval unless all participants listed have full medical clearance to work with animals.

4. Respirator Certification

The Respiratory Protection Program is jointly managed by Occupational Health and Environmental Health & Safety.  This portion of the program is implemented in accordance with OSHA regulations on respiratory protection; 29 CFR 1910.134 for personnel who are presented for their baseline or annual assessments. It includes review of questionnaire, possible further medical evaluation to include pulmonary function test and chest x-ray (if indicated) and fit testing.  Fit testing must be performed annually per OSHA regulations.

Prevention Procedures

The DCM and research laboratories must make available personal protective equipment (e.g. lab coats, face masks, gloves, scrubs) in areas where animals may be present.

If research animals are transported outside the DCM, they must be moved in a filtered container (e.g. cages with microisolator filter tops for rodents). The outside of the container must be covered so that animals are not visible.

In the laboratory, animals should be maintained and handled in a local exhaust system such as a biological safety cabinet, fume hood or downdraft table.  In areas where local exhaust systems are not feasible, laboratory ventilation is maintained in a negative pressure environment.  Appropriate personal protective equipment is always required.

As applicable, research personnel are instructed to:

  • Wear personal protective equipment in all locations where animals are housed or where exposure to animal allergies may occur;
  • Wear disposable gloves when handling animals, animal tissues or animal fluids;
  • Wear a surgical mask and face shield in all nonhuman primate housing areas;
  • Keep hands away from mouth, nose and eyes;
  • Refrain from eating, drinking, smoking, handling contact lenses, applying cosmetics or taking or applying medicine in areas where research animals are located;
  • Wash hands thoroughly after handling animals, animal tissues or animal fluids and;
  • Use and dispose of sharps properly and in accordance with GUMC regulated medical waste guidelines.

Allergies to animal dander and other allergens are common and may increase with long term exposure to animals.  Occupational Health will assess an individual’s needs and determine if wearing a respirator  (e.g., N-95 mask, powered air purifying respirator or other type) or face mask and gloves will help alleviate allergy symptoms.  Use of a respirator without clearance is prohibited.  Occupational Health provides medical clearance and communicates as needed to EH&S who provides the required training and fit testing annually.

Bite and Scratch Procedures

Personnel who receive an animal bite that punctures the skin or a needle stick should:

  • Identify the animal species and ID #
  • Clean the wound
  • Report to the GU Hospital Emergency Room or his/her private physician.  An incident report will be completed by the injured party’s supervisor

Personnel bitten by a nonhuman primate, scratched by a nonhuman primate or by nonhuman primate equipment, or who has any mucous membranes exposed to nonhuman primate secretions (e.g. urine, saliva, feces) are instructed to:

  • Apply first aid immediately, follow the instructions for wound care management found in the “Bite/Scratch/Splash Kit” located adjacent to the animal rooms;
  • Report incident to a DCM veterinarian or veterinary technician;
  • Report to the GU Hospital Emergency Room or his/her own private physician for evaluation for Herpes B exposure. The potentially exposed person will take with him/her a copy of the B-Virus Exposure Management Protocol.  An incident report will be completed by the person’s supervisor and other documentation will be completed by the treating physician.

Reporting/CONSULTING Procedures for Animal-Related Illness or Injury

In the event of an injury or potential exposure, the employee and the employee’s supervisor must complete a  Supervisor’s Report of Injury form and forward it to the  Department of Risk Management.

Research personnel may seek care for illness or injury by reporting to the GU Hospital Emergency Room, private practitioner or any other health agency.

Research personnel should immediately report to Occupational Health any health complaints that they suspect may be related to animal contact or animal allergen exposure and inform his/her primary care physician about his/her occupational exposure to animals. Where appropriate and indicated, specialty consultation will be obtained.

For More Information

For additional information about the Occupational Health Program, please contact the Medical Director, through the Program Coordinator, at 202-687-1734.