The Occupational Health Office of the Campus Health Service (CHS) conducts the medical surveillance portions of this program for the University, particularly focusing on items 1 and 6 as relates to immunizations, testing, and treatment and follow up of exposures. The Institutional Animal Care and Use Committee (IACUC) and University Animal Care provide support for items 2, 3, 4, and 5. However, the IACUC, University Animal Care and CHS are involved to some degree with all aspects of this program. Other University departments also provide assistance in meeting the requirements for occupational safety and training, including Risk Management Services, the Office of Radiation, Chemical and Biological Safety and others. Any regulatory penalties or medical costs resulting from noncompliance with this policy or established procedures will be charged in accordance with standard University policy.
Personnel required to participate in the Animal Hazards Program are those involved in the direct care of animals and/or their living quarters and/or those individuals who have direct or environmental contact with animals (live or dead), their viable tissues, body fluids, wastes or cell lines.
University Animal Care (UAC) staff
Investigators and their technical staff
Instructors and students involved with animal related work
Some personnel in Facilities Management (includes custodial staff) and security
Non-University of Arizona students, consultants, volunteers and visiting scholars who will be performing animal work as defined above at the University of Arizona must also comply with this policy.
Every lab/department must appoint one individual that serves as the OSD. This individual, along with the Principal Investigator (PI), is responsible for occupational safety concerns for their research group/department (see Figure 1). IACUC protocol forms provide a space for PIs to indicate their OSD. Occupational Health must be notified of the name and contact information of the protocol OSD. Any protocol submitted without a specified OSD cannot receive IACUC aprroval. The PI can serve as the OSD.
Risk is a statement of probability that harm, injury, or disease will occur in the occupational setting. The degree of risk can, and does, vary with an assortment of factors.
Risk assessment is the evaluation of scientific information on the hazardous properties of an agent and on the extent of human exposure that yields a qualitative or quantitative statement of the probability and degree of risk or harm estimated for individuals or populations.
Hazard is a recognized risk. Once a risk is recognized and assessed, appropriate adjustments can be made to modify the underlying factors that contribute to the risk, or behaviors can be modified to reduce exposure to those risks. The risks can be abated through engineering controls, personal protective equipment, and by administrative control to include: modifying practices and procedures, pre-placement and periodic examinations, training, etc.
Safe is the state of being free from risk or when an acceptable level of risk has been achieved.
Regular health and safety inspections are an effective tool in the hazard identification process. Together with accident investigation, these inspections form the main thrust in good occupational health and safety management. Not only do they provide an opportunity to identify the sources of potential hazards, but can be used to monitor occupational health and safety policies and procedures and determine how effectively these are translated into the workplace. The inspection process allows a full examination and report on the status of occupational health and safety performance in a work area.
Essentially, it allows one to:
Identify hazardous conditions and apply hazard control measures
Monitor behavior trends
Monitor and evaluate health and safety standards
Improve health and safety standards
Check new facilities, equipment, processes, etc.
Collect data for meetings, support of initiatives, etc.
Maintain interest in health and safety
Display supervisory commitment to health and safety
As a bonus, it has a noticeable effect on communication in the work area and thus helps to improve and facilitate industrial relations and enable the whole University community to play a more significant role in the maintenance of a healthy and safe work environment. However, it must be recognized that the full benefit of the inspection process cannot be realized if action is not taken based on the data collected.
To achieve the University's goal to provide and maintain the highest standard of health, safety and welfare for its staff, and in accordance with this Animal Hazards Program Policy, systems must be in place to identify hazards in the workplace in order to allocate appropriate resources and implement effective control strategies. The University recognizes that regular health and safety inspections are effective mechanisms for identifying workplace hazards. The Animal Hazards Program requires each animal use unit to:
Inspect the work area for hazards on a frequent and systematic basis, and document and evaluate the findings,
Analyze and monitor work practices, procedures and systems of work to identify hazards which may otherwise be overlooked, and
Develop and implement a priority action plan for hazard control.
These inspection reports will provide a monitoring system for OSD's of units.
The OHS is available for advice and assistance, but is not charged with the responsibility to accompany inspection parties. The following guidelines have been developed to assist Units in the inspection process and may be adapted to suit individual areas. In addition, the IACUC requires all participants to complete the OSD Certification module, which includes a segment on inspection procedures.
Who Conducts Inspections
The inspection team should be comprised of at least two individuals. The OSD and one of the following:
The Principal Investigator
The manager of the unit
A management representative, e.g., the relevant supervisor
A workplace employee representative
The Principal Investigator of the unit should be immediately notified of any and all discrepancies noted during the inspection so that the appropriate corrective action may be taken.
When Inspections are Conducted
A joint inspection of the type described above must be done at least on a bi-annual basis before the semi-annual IACUC Fall and Spring inspections, and is recommended on a quarterly basis depending on the area. However, the OSD or supervisor should monitor the workplace on a daily basis (i.e., housekeeping, observation of behavior trends) and more formally on a weekly/biweekly routine, checking such things as environmental conditions, etc. Any identified hazardous situations should be closely monitored at all times, particularly while awaiting the implementation of effective control measures.
The times of the inspection should be varied to assure is capturing the true workplace behavior (i.e., unprepared).
How Inspections are Conducted
Using the Animal Hazards Checklist form (general laboratory or field study) from the IACUC Forms page as a guide, the inspection team should inspect all workplaces within the unit including office, storage, and maintenance areas. Previous Inspection Reports should be viewed prior to inspection.
The inspection party should use the inspection checklist to consider:
Workplace Design (i.e., the physical workplace)
Ensure it meets relevant legislative requirements
Ensure it has correct storage facilities
Assure ease of manual handling (a floor plan is helpful in preparing and recording findings)
Assure proper operation of chemical fume hoods and biological safety cabinets
Policy and procedures
Safe work procedures(written and accessible)
Information available to workers relating to hazards
Accident or injury data and reporting mechanisms
Proper waste disposal
Proper handling, transportation, and restraint of animals
Provision and use of personal protective equipment
Such as noise, lighting, ventilation, thermal conditions
Assure all standards and guidelines are met
Determine the effectiveness of systems in place
Identify the need for training and education programs
The inspection team should ask themselves:
What is wrong?
Why is it wrong?
What if... such and such happened?
Observations made during the inspection must be recorded on the Animal Hazards Checklist form. This ensures that issues raised are not forgotten and provides a valuable reference source for spot inspection and periodic checks by supervisors.
The Animal Hazards Checklist form must be kept at the work site to be available to IACUC, granting agency, and AAALAC site visitors.
Confirmation that the inspection has occurred at least twice a year is supplied by the Principal Investigator (PI) on the Annual Status Report for each active protocol held by the PI.
Review and Follow Up
The inspection team should immediately analyze the report and develop an action plan according to agreed priorities.
The information obtained from regular inspections should be reviewed carefully, not only to identify where immediate corrective action is needed, but also to identify trends as part of overall monitoring of the inspection program's effectiveness.
Analysis of inspection records over a period of time, for example:
Highlights the need for training in certain areas
Provides insight as to why accidents are occurring in particular areas
Establishes priorities for corrective action
Assists in improving or establishing healthy safe work practices
Indicates areas, equipment, etc. which may require more detailed hazard analysis
Remember that inspections are only successful in accident prevention if deficiencies receive prompt corrective action.
PIs who do not complete the Animal Hazards Checklist every six monrths will be in IACUC non-compliance. The IACUC will be notified and will decide on the appropriate corrective action.
Duty Site Surveillance of Work Related Injuries
Injury and Infection Log: Every animal holding facility and animal research laboratory will maintain an Injury and Infection Log to include the following categories:
Reporting Work Related Injuries: Every person working with animals should be aware of the potential danger from animal bites. Although an animal scratch or bite might not seem serious, its occurrence should be reported to one's supervisor or instructor so that proper measures may be taken. In addition, employees and students shall promptly report all suspected work related injuries and illnesses:
Weekdays between 8 a.m. and 4:30 p.m., Wednesdays between 9 a.m. and 4:30 p.m.: Report to the Urgent Care Center (621-4427) at the Campus Health Service.
After work hours: Report to any Urgent Care facility or Emergency Room and inform them that your Workers' Compensation Carrier is the Arizona Department of Administration, Risk Management Section.
Several of the agents responsible for viral, fungal, bacterial, and parasitic infections in laboratory animals are capable of infecting humans. Employees are counseled to report any gastrointestinal, eye, respiratory or skin illnesses that may resemble the signs or symptoms of infections in the animals for which they are caring.
All participants will be queried via the University of Arizona's Risk Assessment Questionnaire (RAQ) regarding anticipated exposure to animals. The OSD in each lab/department will complete the demographic and exposure sections; the participant will complete the confidential medical information. Both the OSD's portion and the participant's portion of the RAQ is available online and should be submitted electronically. The OSD generally submits their portion of the participant's form first, the participant will then be sent the link via email to complete their portion (or they may log on to the web site and initiate the form). For participants who are not able to submit their forms electronically, please contact the Occupational Health Program Coordinator at (520) 626-5735 or firstname.lastname@example.org.
Complete instructions for OSDs and non-OSDs, and the log-in are available at the Animal Hazards Program website.
Notification by Animal Hazards Program Staff
An Occupational Health provider will review the RAQ when both portions are received. Participants are assigned a category(ies) that reflect the general surveillance needs of the individual based on real or potential occupational exposure to specific species of animals (Table 2).
The assessment of risk will also be based upon frequency of contact, intensity of exposure, hazards associated with the animals being handled, hazardous properties of agents used in research, the susceptibility of individual employees, the hazard-control measures available, and the occupational history of individual employees. After review, the participant will be sent an email acknowledging receipt and advising of any follow up that is needed. The OSD is copied on most correspondence.
The RAQ must be updated whenever an employee changes/adds protocols, exposures or animal species, or has a change in their health status. When the Animal Hazards Program office needs an update, you will receive an email request from the Occupational Health Animal Hazards Program office or from your OSD. You may also submit an update any time you feel your exposures or health in relation to animal work should be re-evaluated. Notify the Animal Hazards Program Coordinator that you need to update your RAQ and the link to the form will be emailed to you.
All persons participating on any IACUC reviewed and approved project must receive appropriate certification. For more information, see the IACUC Training and Certification page.
The OSD for each research group is responsible for assuring that all members of the research group are adequately informed of, and receive training in, Occupational Safety issues, and are in compliance with program requirements (Figure 1). The OSD will need to complete the CITI OSD Certification module. The PI and OSD may choose how best to train members of the individual research group in these issues. If the PI/OSD choose to provide training to staff, they must document content and attendees.
All persons should have completed the IACUC Certification modules as soon as possible and not longer than four months after their initial hire date. If a Principal Investigator has not received proper certification, their protocols will not be reviewed for approval. Researchers who are not properly certified will not be authorized to participate on protocols.
Training will be under the auspices of the IACUC. The Department of University Animal Care and the OHS will provide technical instruction and assistance, as required.
There are a number of personal hygiene issues that apply to all workers who are exposed to animals.
There should be no eating, drinking, smoking, or applying of cosmetics in areas where animals are housed or used.
Laboratory coats should be worn over street clothes when working with animals. This will minimize the contamination of street clothing. Laboratory clothes should be left in the lab and should not be worn when eating or in public eating areas. Laboratory clothing should be laundered routinely.
Careful hand washing should be done after handling of animals and prior to leaving the laboratory.
All work surfaces should be decontaminated daily and after any spill of animal related material.
Certain infections are transmitted from animals to humans primarily by the animal feces or urine contaminating someone's hands and then contaminating objects put into the mouth. Examples of organisms utilizing this mode of transmission are species of Salmonella, Shigella, and Entamoeba. Every precaution should be taken to avoid this mode of transmission by alertness and careful personal hygiene. Additional health problems are encountered when these organisms are carried home and children/family members are exposed.
Requirements and guidelines for establishing and maintaining an occupational health and safety program for those who work with field wildlife animals are found in the Guidelines of the American Society of Mammalogists for the Use of Wild Mammals in Research; the National Wildlife Health Center; and, occupational health and safety standards for all classification of animals are specified in the Occupational Health and Safety in the Care and Use of Research Animals.
Environmental Risk Factors
When working in a natural environment (e.g., woods, field, or water), the environment itself can present some unique risks. Examples consist of the following possibilities:
Adverse weather conditions or transportation failures may occur
The experiment itself may require the use of potentially hazardous chemicals
Exposure to contaminated soil and water
Animal bites, kicks, or scratches
Cuts or punctures from fins
Capture equipment injuries caused by tools like dart guns or traps
Ergonomic injuries caused by moving equipment in the field
Restraint device injuries
Hypodermic needle sticks
Accidental exposure to anesthetic or immobilizing agents
Equipment hazards such as rappelling, electrofishing, SCUBA equipment, or fires resulting from rocket-distributed capture nets
The animals themselves present risks such as:
Zoonotic infections can also become a serious risk. Personnel (including animal care staff, technicians, investigators, clinicians, students, maintenance workers, and security staff) who have contact with or an opportunity for contact with animals or their excreta, products, or tissues should be aware of hazards and risks that may be involved. Some examples are:
Intestinal parasites such as Giardia and Cryptosporidia spp.
Bite or scratch wounds, which can become infected with Bartonella henselae, Capnocytophaga canimorsus, or Yersinia pestis (in addition to aerosol transmission)
Oral infectivity of Salmonella spp.
Animals may harbor disease vectors such as ectoparasites (e.g., fleas and ticks
Unplanned exposures such as to rabid animals or venomous snakes
Potential hazards from field work are summarized in Table 3.
Medical evaluation and preventative medicine
Completion and submission of the Risk Assessment Questionnaire is required in order for the Occupational Health professional to analyze and prevent hazards that are based on the individual’s unique health profile and by providing preventative medications, such as vaccines.
Recognize, treat, and manage illnesses or injuries
Standard operating procedures (SOP) should be developed that cover the following items:
Equipment safety (inclusive of firearms)
Emergency medical kits that should include: antiseptics, bandaging materials, topical antibiotics, tourniquets, fluids, IV sets, and antivenom
Evacuation plans in case of extensive injuries such as bites, kicks, and scratches which can cause extensive, life-threatening trauma or disease exposures
Field teams should have emergency contact phone numbers for medical professionals.
At least one member of the team should have basic training in first aid techniques.
To aid the health care professional, the team should record the following information:
Map of the geographic location
Time of event
Circumstances of event
Medical responses already initiated (e.g., provide package insert)
If possible, a picture to help identify the plant or animal exposure
Personal protective equipment (PPE), personal hygiene, and other equipment
PPE required for field studies can range from nonexistent (e.g., for a study of the migratory patterns of hawks) to comprehensive (e.g., a project evaluating the presence of Ebola virus in cave-dwelling bats). Recommended PPE are:
Gloves: thick (biohazard strength) neoprene or latex gloves or leather to provide appropriate protection from animal scratches and bites.
Face shields, netting, and goggles: these items are needed to protect against pervasive on-site insects, splashed polluted water, animals that spray noxious or irritating chemicals, or birds that peck the face.
Face masks and respirators: allergies constitute health hazards for individuals working with field study animals. Observational studies in forests or grasslands may expose personnel to allergenic pollen, excursions into caves may require special filters for gases or even oxygen, and face masks may be necessary to prevent inhalation of viral particles such as Hantavirus.
Clothing: clothing worn should be planned to protect from infectious agents, prevent contact with contaminated water, protect the researcher from the sun or extreme cold temperatures, and prevent puncture wounds from snakebites or plant spines and needles.
PPE should be disposed or disinfected and laundered after use.
Personal hygiene is a critical component of infection control
Wash-up in clean water may only be available via stored water in the transport vehicle
Hand-cleaning compounds (e.g., Purell® Instant Hand Sanitizer) are ideal
Limit animal contact congruent with drinking or eating
Recommended equipment: first aid kits, flashlights, insect repellent, cell or satellite phones, and global positioning systems
When personnel have the potential of being exposed to noise exceeding federal standards, appropriate protection equipment should be provided (CFR, 2008)
The appropriate type of personal protective equipment (PPE) depends on the nature of the research and is specific to each laboratory or work area. Each laboratory or department should have Standard Operating Procedures (SOPs) to address the required types of PPE that are to be used during various activities.
Resources are available to help OSDs and Supervisors assess their areas for risks and determine the PPE that is needed. You can contact the Risk Management and Safety Office or the Occupational Health Office (520) 626-5735 or email@example.com).
The following exemptions may be granted after submission of the RAQ:
Personnel who work solely with standard animal biological products obtained from vendors, such as organs, tissues, cells, or antibodies, may be exempt from program participation. A written request and current animal health report from the vendor must be provided to the University Animal Care clinical veterinarian for review and approval in order to qualify for this exemption.
Personnel who will have no contact with animals, animal tissues, fluids or wastes, nor will they enter animal areas, are generally exempt. Typically, these are administrative personnel who are listed on a protocol.
Personnel whose contact is limited to in-vitro work with animals, tissues, fluids or wastes that have been sterilized chemically or via autoclaving.
Provider recommendations for immunizations/tests will be based on the functional requirements of the position, the type of animal contact, and the individual's medical history. Any person declining to obtain recommended immunizations, PPE or testing that have been recommended by Occupational Health is required to sign a declination form.
In some cases, immunizations or tests are required for a position and cannot be declined. For example, those working with (or in the rooms with) nonhuman primates must have annual TB screenings (TST). Also, those working with, or who have the potential of contacting, the rabies virus must have the rabies immunizations and subsequent titers.
For participants who do not wish to utilize any of the medical services offered by the program, and are not required by their position to obtain immunizations/testing, a Medical Surveillance Program Declination form is available. This form allows them to opt out of the program completely. Even though individuals may decline to participate in the Animal Hazards Program, they must complete a RAQ. The Occupation Health provider will determine whether declination is an option, based on review of the RAQ. They will determine if the declination places the participant at increased risk of illness or injury and will address that issue directly with the participant. The IACUC, OSD or supervisor will be notified of all medical surveillance program declinations.
Refusal to comply with the requirements of the Animal Hazards Program is considered IACUC non-compliance. The IACUC will be notified and will decide on the appropriate corrective action.
Basic Occupational Health Care (BOHC)
After reviewing the RAQ, the Occupational Health provider may request a clinic visit, depending on level of risk or in accordance with specific job requirements, to address health issues listed, or if immunizations/tests are needed. If not specifically required in their position, individuals may decline the clinic visit, but must file a formal Medical Surveillance Program Declination with Occupational Health. This information will be forwarded to IACUC, the OSD and/or supervisor for their records.
The recommendations made by the provider at the visit will be based on the functional requirements of the position, the type of animal contact, and the individual's medical history. Anyone declining to obtain recommended immunizations or testing will be required to sign a Medical Surveillance Program Declination form. IACUC and the OSD or supervisor will be notified of all declinations. Participants, depending on their specific exposures, will have the following vaccinations documented:
The Public Health Service Advisory Committee on Immunization Practices (ACIP) recommends immunization against tetanus every 10 years for everyone. It is also recommended if a particularly tetanus-prone injury occurs in an employee where more than five years has elapsed since the last immunization. Every employee should have up-to-date tetanus immunizations.
Any wound may potentially serve as a source from which tetanus may result. A trained health care provider will evaluate all wounds to assess contamination and likelihood of infection, as well as determine proper treatment. If a wound occurs, persons who have previously received a full primary series of tetanus immunizations may not require a booster if less than 5 years has elapsed since the last immunization. This is dependent, however, upon severity of the wound, degree of contamination, and circumstances surrounding the injury. It is strongly recommended that all wounds be seen and treated despite the person's status of tetanus immunization.
All individuals require at dose of Tdap vaccine at some point in their adult life. Unless the individual has already received the Tdap vaccine, this should be substituted for tetanus vaccine when there is a need for a tetanus booster.
Rabies is a relatively rare and devastating viral disease that can result in severe neurological problems and death. Most cases of rabies occur in wild animals although any mammal can contract the disease. The disease is virtually unheard of in common laboratory animals. All bites of any type must be reported immediately to your supervisor.
Rabies is an endemic disease in Arizona, especially in skunks, foxes, and bats. Sporadic cases have been well documented in other species of wildlife, as well as domestic animals. Animals and animal tissue field-collected in Arizona should be handled with care. Precautions should take into account that infected animals may shed the virus in the saliva before visible signs of illness appear, that a bite is not required to contract rabies - contact with saliva may be sufficient, and that rabies virus can remain viable in frozen tissues for an extended period.
Based on current ACIP recommendations, rabies pre-exposure prophylaxis (Table 4) human diploid cell rabies vaccine (HDCV) is provided to the following employee groups:
Those working directly with the rabies virus
Those having random source dog and cat contact
Those having direct contact with Category 4 and 5 (Table 2) animals * or in
Those having exposure to potentially infected animal body organs or performing post mortem examinations on animals with a history of poorly defined neurological disorders (Category 8; Table 2)
Those having responsibility for capturing or destroying wild animals on University of Arizona property (excluding birds and rodents)
Wildlife mammalogists and students engaged in the handling and/or capture of susceptible species
Anyone doing extensive field (includes Category 6 and 7; Table 2)
Category of risk is determined by the category of animal contact you have been assigned to and review of the animal protocol you have submitted to IACUC. Anyone having exposure, or suspected exposure, to a rabies positive animal or tissues; or contact from a suspect animal that cannot be tested, or quarantined, for rabies, will undergo post exposure prophylaxis therapy.
It is the responsibility of the OSD to monitor the risk to students, student teachers, and lab workers and obtain the appropriate immunizations for them BEFORE exposure occurs.
If there is any question as to whether someone should be immunized, contact the OHS. Table 5 has information on post-exposure prophylaxis.
Serologic monitoring and booster doses:
Serologic monitoring will be performed every two years.
Booster doses are administered to employees with inadequate titer. Inadequate titer is defined by the Centers for Disease Control and prevention as <1:5 by the rapid fluorescent focus inhibition test.
At the University of Arizona, the "CDC Frequent Exposure" classification is applied to all members of these categories. In reality, many or most have only "Infrequent Exposure". These exposures are based more on the prevalence of rabies in the Southern Arizona fauna than on actual human exposure to the virus. Field workers are occasionally exposed to rabies, but laboratory and animal care workers are not. Dogs and cats used in research are vaccinated. Bats and certain other wild animals transmit the vast majority of rabies. Only under exceptional circumstances is a wild animal present in a University of Arizona facility.
Farm animals are monitored, protected and in some cases vaccinated, however are subject to attack by bats as well as other wild and domestic rabid species. Field researchers, while not always working directly with rabies prone species, are at increased risk due to greater environmental exposure. Veterinary Diagnostic Laboratory workers, veterinarians and researchers that utilize the rabies virus in their protocols are at "Frequent or Continuous" risk of rabies exposure. These groups need to be immunized against rabies.
For these reasons, the Animal Hazards Committee, in its January 24, 2007 meeting, elected to suspend routine rabies immunization and serology for all participants except:
Field researchers that closely handle, study or trap rabies prone species
Other field or agriculture researchers who spend sufficient time in the field, or overnight, so as to be at risk for random exposure from indigenous rabies prone animals
Veterinary Diagnostic Laboratory workers
Any participant working in a laboratory where the rabies virus is present
Occasional others with individual situations/needs
In adherence to the Americans' With Disabilities Act, and Arizona law, no individual will be required to receive rabies immunization. Declination of the vaccination, may, at the discretion of their supervisor, preclude employment in certain positions and assignment to certain duties
Based on CDC recommendations, all individuals who will have contact with birds or poultry, or who will be working with the influenza virus in a laboratory setting, should receive the annual influenza immunization.
For those working with birds or poultry, currently available "Flu" vaccines do not directly protect humans from acquiring avian influenza. However, individuals that work with birds could acquire both avian flu and human flu, concurrently. The result could be potentially life threatening AND the affected individual could become a human incubator offering the two viruses the opportunity to combine into a new, devastating human influenza.
Tuberculosis (TB) Testing
Participants in categories 3, 5, 6, 8 and 10 (and potentially 2) of Table 2 will have either biannual or annual TB testing documented. To avoid misinterpretation of what is known as a "boosted reaction", a two-step TST may be required for those beginning a tuberculosis screening program or who have not had a TST within 24 months.
A gamma interferon (IGRA blood test is performed at an initial positive TST reading and a Positive TB Questionnaire is completed at this time. If there is symptomology, a chest X-Ray is also performed. If not, the chest X-Ray is delayed until the IGRA report is received. If the IGRA is negative, the participant will no longer receive a TST, but will complete the Positive TB Skin Testing Questionnaire on either the biannual or annual schedule, as appropriate. The participant is considered to be free of TB infection and is cleared to work without restrictions. They should report any health changes to the Occupational Health provider as soon as possible. If the IGRA is positive, a chest X-ray will be ordered to clarify if there is active TB in the lungs. If the chest X-ray is positive, i.e.”suspicious for pulmonary TB”, the results of the IGRA blood test, whether positive or negative will not be a consideration. All workers with chest X-rays that are read as suspicious for TB, will be referred to a Pulmonary or Infectious Disease doctor and reported to the Pima County Health Department. They may not return to work until cleared by the Occupational Health provider EVEN THOUGH THEY MAY PRESENT A NOTE FROM ANOTHER DOCTOR THAT RELEASES THEM TO WORK. There are many work factors that must be considered once an employee’s physician has “cleared” them to work.
In all cases where an employee has a documented positive TB test (TST, IGRA, CXR), no further TST will be administered and the participant will provide information through the Positive TB Questionnaire either biannually or annually, as appropriate.
Other Immunizations and Testing
Other immunizations and tests may be recommended as determined to be needed by the Occupational Health provider.
Allergy to animal urine, saliva, hair and dander is common and therefore one of the more important occupational problems occurring in workers exposed to animals. Allergies can be manifested in a number of ways, including: allergic rhinitis (a condition characterized by runny nose and sneezing similar to hay fever); allergic conjunctivitis (irritation and tearing of the eyes); asthma; or atopic dermatitis (a skin condition which is caused by contact with a substance to which an individual is allergic). Allergy to animals is particularly common in workers exposed to animals such as cats, rabbits, mice, rats, gerbils, and guinea pigs. Allergic reactions can be caused by exposure to dander and debris from the skin and fur of an animal, urine, saliva, or fecal matter. Exposure to animal urine or feces may occur either through direct urine contact with skin or more commonly by inhaling dust from the bottom of a cage that has been contaminated with urine or fecal material.
People who have a prior personal history or family history of hay fever or eczema will be more likely to develop asthma after contact with animals. These people do not seem any more likely to develop rhinitis and conjunctivitis than do those without such personal or family history. Everyone should exercise certain precautions to attempt to prevent animal allergy. These attempts should not be focused only on people with an atopic or allergy history. Symptoms can develop anywhere from months to years after a person begins working with animals. However, a majority of the individuals who are going to develop symptoms will do so within the first year. It is extremely unusual to develop symptoms after more than three years of animal contact. Certain procedures should be routinely followed in order to prevent the development of animal allergy. Animals should be worked with in well-ventilated areas to prevent buildup of various particles in the air.
Workers may want to wear gloves to prevent direct exposure to animals - this applies to animal urine and feces as well as to animal dander. In order to prevent inhaling contaminated material, cages will be changed frequently and within an exhausted enclosure. If an enclosure is not available respirators should be worn during the changing of cages. Dumping of bedding is not allowed in a lab. Dirty cages will be taken to UAC and exchanged for clean cages. If an enclosure is not available for cage changes, respirators will be worn during cage changes.
Workers with frequent animal exposures should be cognizant of their potential to carry animal proteins out of the laboratory and in to their personal vehicle, bedroom, laundry room, etc... Each worker needs to make an individual effort to protect their friends and family, some of whom may be quite allergic to some animals or may become sensitized by repeated contact with the individual. For this reason, lab coats and ideally scrubs, should be left at work and street clothes should be worn when the worker leaves the building. Head and body hair are particularly effective at trapping animal proteins, so long hair should be worn up so as to minimize the exposed area. Surgical caps are supplied to assist employees in this effort. Some highly exposed workers may find showering to be the most effective way to decontaminate for re-entry to the non-work world.
Smokers are strongly advised to take advantage of the UA Benefits provided for smoking cessation. Animal care workers who are smokers have much higher levels of sensitization to animal proteins. This is due to animal materials that may be transferred from hands or pockets to cigarettes. The normal mucosal and ciliary function of the respiratory tree is compromised in smokers resulting in less ability to clear animal proteins from their lungs.
Despite the best preventive techniques some individuals will develop an allergy after contact with laboratory animals. Rarely, this will be so severe that a person needs to work with Occupational Health and their supervisor and Human Resources in order to seek accommodation. It is not always possible to accommodate medical problems, but the University of Arizona will make a good faith effort to do so. Rarely, a worker has to apply for a different position, but only after medical and work site engineering work has accomplished as much as possible. Commonly, sensitization can be prevented or controlled with the increased use of respirators while working with animals and possibly medication. Desensitization therapy (allergy shots) has been successful for some individuals. Employees will be queried on allergy risk.
Employees at increased risk for developing work related allergies include those with a history of pre‑existing allergies, asthma, seasonal rhinitis, or eczema. These individuals may be referred to Risk Management for the Respiratory Protection Program.
Enrollees with suspected allergies will be encouraged to seek evaluation through the OHS.
Referral for allergy testing will be provided to employees at the discretion of the OHS and with the employee's consent.
Q fever is a disease caused by the microorganism Coxiella burnetii which can be acquired by exposure to placental membranes and fetuses from infected sheep or goats. There is an especially high concentration of these infected materials in animals at the time that the animals give birth, so particular care needs to be used in handling newborn animals, placental tissues, and other products of conception. This would include the placenta, amniotic fluid, and blood or soiled bedding. In addition, individuals who handle young sheep or goats up to six months of age are at higher risk, as are individuals who participate in the routine care of sheep or goats such as the animal care workers. This infection is extremely contagious and is reportedly spread by aerosol.
It is extremely important that, should an employee who works with sheep or goats develop an influenza type infection, he/she mention to their physician the possibility of Q fever. Q fever is something that would not routinely be thought of and this diagnosis is often missed. In addition, Q fever places friends and family who may be pregnat at increased risk of an adverse prenancy outcome.
Pregnant women, individuals with congenital heart disease, prior valvular heart disease, or who have a chronic immunocompromised state should not work with infected animals at the time of animal parturition (birth process), and it is best that they not work with sheep and goats at all (determined on a case-by-case basis). Immunocompromised individuals would include those with AIDS or a positive blood test for the AIDS virus (HIV), or immunocompromised because of medications or certain chronic diseases.
If a new employee does not decline to participate in the Animal Hazards Program, their initial contact or examination at Occupational Health will involve an assessment for their likelihood of developing chronic sequellae should they acquire Q Fever. Those employees who are pregnant, or with valvular or congenital heart defects, or those who are receiving immunosuppressant drugs, or who have been splenectomized, are advised of the potential risks involved. Such employees are strongly encouraged to self-identify to their supervisor or Occupational Health so that appropriate job precautions can be instituted.
Pregnant women should be cautioned about working with cats in the laboratory setting. Pregnant animal technicians who have been assigned to cat husbandry duties should be reassigned to other jobs during pregnancy unless titers are sufficient. Pregnant women who are exposed to cats in other ways would be best to avoid this exposure. There is no vaccine to protect humans.
Toxoplasmosis antibody titers are determined on any female employee of childbearing capacity who is occupationally exposed to cats or their feces. Females of childbearing capacity who lack immunity and plan to work with cats are informed of their susceptibility and provided additional educational information on toxoplasmosis. Their supervisor will be advised (if requested by the employee) to consider arranging a temporary job reassignment while a susceptible employee is pregnant. When this is not possible, consultation with the OHS will be encouraged to identify alternative methods of employee protection.
A large number of illnesses can be passed from nonhuman primates, such as monkeys, to humans and from humans to nonhuman primates. Because of this, it is extremely important that employees exposed to or handling monkeys exercise particular caution. Protective clothing should always be worn, especially when confronting primates. Awake animals (not used to being handled) should be handled only while wearing bite proof gloves. Ideally, animals should be sedated before procedures are performed.
Employees who are ill should not work with monkeys since they may transmit diseases to the monkey. Personal hygiene must be scrupulously maintained by all those exposed to nonhuman primates. Any scratch, bite or eye exposure must be immediately treated in accordance with instructions contained in monkey exposure kits in the lab or animal room and then reported to the supervisor.
Tuberculosis: Tuberculosis can be devastating in a monkey colony - special precautions are taken for individuals working with non-human primates, their products, or care devices. Testing for TB is described above.
Rubeola (measles): Measles is a deadly disease in nonhuman primates and has become more common. Nonhuman primates are vaccinated against this disease to prevent transmission from humans. Persons with active cases of measles will be prohibited from any primate facility.
Cercopithecine herpesvirus 1 (Herpesvirus simiae or B‑virus): Herpes B or Herpes simiae causes a very minor illness in macaque monkeys, but can cause a fatal illness in humans who contract the disease. In humans, it causes severe neurological disease that is most frequently followed by death. Fortunately, transmission of this disease to humans is quite rare. As mentioned above, it is mandatory that caution be exercised and that a supervisor is notified immediately regarding any bites, scratches, or exposure of monkey excretions to mucous membranes or the eyes. Medical care must be obtained immediately. Any wound should be carefully cleaned. Once a wound has been acutely managed, any unusual manifestations that develop later also need to be promptly reported. Symptoms of Herpes B infection at a wound include pain radiating away from the bite wound or blisters at the site of the wound. Again, it must be emphasized that careful adherence to safe handling procedures is the most important step in preventing illnesses.
Since there is no vaccine for this disease, training in proper primate handling and care is essential. Additionally, wound management procedures will be reinforced during primate training sessions. These procedures are posted in the animal room and inside Monkey Exposure Kits.
Injury and Infection Log: Record all traumas (animal or cage) in the "Injury and Infection Log", which is maintained by the facility supervisor.
The University of Arizona adheres to the guidelines found in the publication Recommendations for Prevention of and Therapy for Exposure to B Virus, CID 2002:35; 1191-1203.
Final recommendations for BOHC will be based upon individual risk assessment and may vary from the above.
Participants are periodically recalled for medical follow-up depending on the specific type of animal exposure and their particular BOHC protocol. Employees and students (participants) who are enrolled in the Animal Hazards Program are periodically recalled for medical follow-up depending on the specific type of animal exposure. See Table 2 for basic recall schedule. Email notices for recall appointments (or questionnaire completion) are sent to the employee with a copy to the OSD or supervisor.