1. Occupational Health
and Safety Programs:
An AAALAC Perspective

2. Occupational Health Program:
Section 1
Elements of an
Occupational Health Program:
Deficiencies identified by AAALAC.
David DeLong, D.V.M.
Chief, Veterinary Medical Unit VAMC, Minneapolis, Minnesota

3. occupational health and safety programs?
Elements of an OHS program:
Deficiencies identified by AAALAC
Why does AAALAC assess
occupational health and safety programs?

4. “An occupational health and safety program must be part of the overall
Elements of an OHS program:
Deficiencies identified by AAALAC
According to the Guide -
“An occupational health and safety
program must be part of the overall
animal care and use program."

5. Working with animals can be dangerous business!
Elements of an OHS program:
Deficiencies identified by AAALAC
Working with animals can be dangerous business!
Physical and chemical hazards
Protocol related hazards
Allergens
Zoonotic diseases

6. How does AAALAC assess an OHS program?
Elements of an OHS program:
Deficiencies identified by AAALAC
How does AAALAC assess an OHS program?
Prior to the site visit, review the Program Description.
During the site visit, review facilities and documents; interview personnel.

7. The Guide is the basis for the review.
Elements of an OHS program:
Deficiencies identified by AAALAC
The Guide is the basis for the review.

8. Elements of an OHS program:
Deficiencies identified by AAALAC
Other documents:
Occupational Health and Safety in the Care and Use of Research Animals NRC, National Academy of Sciences.
Biosafety in Microbiological and Biomedical Laboratories HHS Pub. No. (CDC)
Miscellaneous AAALAC resource documents.

9. What are the required components of an OHS program?
Elements of an OHS program:
Deficiencies identified by AAALAC
What are the required components of an OHS program?
Risk assessment and hazard identification.
Training.
Personal hygiene and personal protective equipment.
Facilities, procedures, and monitoring.
Medical evaluation and preventive medicine.

10. What are the hallmarks of a successful program?
Elements of an OHS program:
Deficiencies identified by AAALAC
What are the hallmarks of a successful program?
Strong administrative support.
Sound implementation strategies.
Effective coordination of program components.

11. What trends in OHS Program deficiencies
Elements of an OHS program:
Deficiencies identified by AAALAC
What trends in OHS Program deficiencies
have been identified by AAALAC?

12. Occupational Health and Safety of Personnel
Elements of an OHS program:
Deficiencies identified by AAALAC
Occupational Health and Safety of Personnel

13. Hazard Identification and Risk Assessment
Elements of an OHS program:
Deficiencies identified by AAALAC
Hazard Identification and Risk Assessment

14. Personnel Training Elements of an OHS program:
Deficiencies identified by AAALAC
Personnel Training

15. Personal Hygiene/Protection
Elements of an OHS program:
Deficiencies identified by AAALAC
Personal Hygiene/Protection

16. Facilities, Procedures, and Monitoring
Elements of an OHS program:
Deficiencies identified by AAALAC
Facilities, Procedures, and Monitoring

17. Preventative Medicine for Personnel
Elements of an OHS program:
Deficiencies identified by AAALAC
Medical Evaluation/
Preventative Medicine for Personnel

18. More common deficiencies:
Elements of an OHS program:
Deficiencies identified by AAALAC
More common deficiencies:
Hazard identification/risk assessment.
Personal hygiene/protection.

19. Less common deficiencies:
Elements of an OHS program:
Deficiencies identified by AAALAC
Less common deficiencies:
Personnel training.
Facilities, procedures and monitoring.
Medical evaluation/preventive medicine.

20. Animal experimentation involving hazards
Elements of an OHS program:
Deficiencies identified by AAALAC
Animal experimentation involving hazards
This category reflects how OHSP components are implemented and coordinated to ensure safety in the face of a particular hazard.

21. Animal Experimentation Involving Hazards
Elements of an OHS program:
Deficiencies identified by AAALAC
Animal Experimentation Involving Hazards

22. Elements of an OHS program:
Deficiencies identified by AAALAC
OHSP expectations:
Individual components that are appropriate for the facility.
Evidence that the components work effectively together.

23. Implementation and Participation
Section 2
Issues in OHSP
Implementation and Participation
Christian E. Newcomer, V.M.D., DACLAM
Research Professor and Director
Pathology and Laboratory Medicine
The University of North Carolina at Chapel Hill

24. OHSP implementation: first steps
Issues in OHSP
implementation and participation
OHSP implementation: first steps
What mandates the creation of an OHSP?
Who authorizes the OHSP?
Who funds the OHSP?
Who designs the OHSP?
Who coordinates the OHSP?

25. OHSP implementation issues:
Issues in OHSP
implementation and participation
OHSP implementation issues:
What mandates the creation of an OHSP?
PHS Policy: “The Guide”
OSHA: CFR 29
ILAR: “Occupational Health and Safety in the Care and Use of Research Animals”

26. OHSP implementation issues:
Issues in OHSP
implementation and participation
OHSP implementation issues:
Who authorizes the OHSP?
The senior official must:
Understand the issues.
Provide guidance.
Establish and support policies.
Have resource authority.
Assemble the team.

27. OHSP implementation issues:
Issues in OHSP
implementation and participation
OHSP implementation issues:
Who funds the OHSP?
The Senior Official is accountable.
By what funding mechanism?
The funding mechanism is not of concern to the AAALAC peer review process!

28. OHSP implementation issues:
Issues in OHSP
implementation and participation
OHSP implementation issues:
Who designs the OHSP?
Who or what qualifies the OHSP designers?
Does one design fit all or are there various successful models?
Opportunities for cost containment?

29. OHSP design team members:
Issues in OHSP
implementation and participation
OHSP design team members:
Animal Care and Use Staff
Research Staff
Environmental Health and Safety
Occupational Health/Medicine
Administration and Management

30. OHSP implementation issues:
Issues in OHSP
implementation and participation
OHSP implementation issues:
Who coordinates the OHSP?
Single point coordination of OHSP.
Team management of OHSP.
Interaction and communication among team members to refine approach, measure results and improve outcomes.
Are participants clear on the available OHSP services?

31. OHSP participation issues:
Issues in OHSP
implementation and participation
OHSP participation issues:
What is participation in the OHSP?
Who participates in the OHSP?
Can personnel waive OHSP participation?
How are participants identified/enrolled?
Who tracks OHSP enrollment?
What are the enrollment recall provisions?
Periodic? Status change?

32. Issues in OHSP implementation and participation:
Who reviews OHSP scope and participation?
IACUC
OHSP Coordinator
Senior Official
AAALAC International

33. Hazard Control and Risk Assessment Ron E. Banks, D.V.M.
Section 3
Hazard Control
and Risk Assessment
Ron E. Banks, D.V.M.
University Veterinarian & Director
Office of Laboratory Animal Resources University of Colorado Health Sciences Center

34. What is the principal objective of an OHSP?
Hazard control
and risk assessment
What is the principal objective of an OHSP?
To reduce to an acceptable level, the risk associated with using materials or systems that have inherent danger by controlling or eliminating hazards.

35. How does risk assessment relate to the greater OHSP?
Hazard control
and risk assessment
How does risk assessment relate to the greater OHSP?
Risk Assessment is the foundation for progressive OH&S
Risk Assessment is prerequisite to selecting an appropriate health-care service for employees!

36. The likelihood of a consequence.
Hazard control
and risk assessment
What is risk?
The likelihood of a consequence.

37. What is risk assessment?
Hazard control
and risk assessment
What is risk assessment?
A measure of the likelihood of a consequence.
Defining and quantifying a hazard.

38. What ‘issues’ enter into risk assessment?
Hazard control
and risk assessment
What ‘issues’ enter into risk assessment?
Known / unknown
Work Assignment
Species
Facility Engineering
Experimental Conditions
Duration of Study
Specific Agent Properties
Current Health Status
Outside Work / Play
Frequency of Exposure
Intensity of Exposure
Required Equipment
Facility History
Regulatory Requirements
Prevalence
Personnel Experience

39. When can I stop defining and quantifying hazards?
Hazard control
and risk assessment
When can I stop defining and quantifying hazards?
Dynamic process – never completed!

40. How important is risk assessment?
Hazard control
and risk assessment
How important is risk assessment?
Undetected / undefined hazards pose the most significant problem to research staff…
Undetected and unrelated hazards are the most worrisome.
You can’t protect staff from the unknown …

41. Whose responsibility is it to identify hazards?
Hazard control
and risk assessment
Whose responsibility is it to identify hazards?
The researcher
The facility management team
The care provider
In short …. EVERYONE!

42. How should risk assessment be used in the laboratory?
Hazard control
and risk assessment
How should risk assessment be used in the laboratory?
To manage the hazard
To avoid / control exposure
To provide therapy when exposure occurs

43. What must you know to perform risk assessment for chemical agents?
Hazard control
and risk assessment
What must you know to perform risk assessment for chemical agents?
Toxic doses
Stability
Form (gas/liquid/solid)
Type of toxicity (irrit/corrosion/carcin/narcosis/lethality)
Severity of reaction
Mode of action
Metabolic products

44. What must you know to perform risk assessment for infectious diseases?
Hazard control
and risk assessment
What must you know to perform risk assessment for infectious diseases?
Dose-response relationship
Virulence
Communicability
Prevalence
Route of exposure
Shedding patterns
Stability
Availability of prophylaxis / therapy

45. Does the IACUC have a role to play in risk assessment?
Hazard control
and risk assessment
Does the IACUC have a role to play in risk assessment?
Yes!
Protocol review can (and should) include requests for information on the potential hazards of a particular study.
Hazard review can be performed by:
A committee member
A H&S committee or board
The IACUC

46. Where can you find information to assist in risk assessment?
Hazard control
and risk assessment
Where can you find information to assist in risk assessment?
Scientific literature
Other scientists
MSDS
The researchers themselves
Your own staff!

47. Risk assessment provides a touch of reality to life!
Hazard control
and risk assessment
Risk assessment provides a touch of reality to life!
The likelihood of occupationally acquired zoonoses is MUCH lower than is popularly perceived.
The likelihood of occupationally acquired immune response to chemical is MUCH higher than is popularly perceived.
‘Substantial animal contact’ IS NOT a sufficient indicator of the need for enrollment in OH&SP!

48. Hazard control
and risk assessment
How can I assure AAALAC site visitors we have a risk assessment based OHSP?
OHS ‘Committee’ minutes showing program formation / review.
Note in semiannual review of OHSP assessment (program review).
Occasional changes in OHSP process (dynamic process).
Common sense subtle differences (consistent inconsistencies) in the OHSP between care facilities.
A suggestion process involving employees (program enhancements).
Ready explanations (consistent between employees) to site visitor inquiry of why they do something a certain way (PPE / process).

49. Information Management
Section 4
Training and
Information Management
Barbara Garibaldi, D.V.M., ACLAM
Director, Animal Research Facility Beth Israel Deaconess Medical Center
Boston, Massachusetts

51. Training and
information management
An institution’s approach for providing education and training depends on its:
Size
Resources
Animal species used
Research activities
Staff experience and technical expertise

52. Training and
information management
Information provided to employees should be developed through the interaction of several key people:
A veterinarian
A health and safety professional
A research scientist

53. What types of occupational health and
Training and
information management
What types of occupational health and
safety training should be provided?

54. The use of personnel protective equipment (PPE).
Training and
information management
The use of personnel protective equipment (PPE).
Good hygiene practices and universal precautions.
Laboratory animal allergies.
Zoonotic agents.
Ergonomics; Physical Hazards; Noise.
Training sessions in chemical, radiation, biohazardous material safety, and bloodborne pathogens may be provided by experts in the appropriate department.

55. Training and
information management
Personnel who have contact with experimental animals should receive training in the proper handling of the animals that they will work with.
Personnel should be instructed to avoid unnecessary risk when working with animals, and to seek expert assistance when in doubt.

56. Training and
information management
Most animal inflicted injuries occur because of inadequate training and experience, or because of carelessness.
Training should be provided that injuries, splashes, animal bites and/or scratches, and cuts sustained while working with animals should be promptly reported and the employee referred to employee health service.

57. What type of documentation does AAALAC look at?
Training and
information management
What type of documentation does AAALAC look at?  

58. Informational Newsletters Written Guidelines Websites
Training and
information management
Training logs
Informational Newsletters
Written Guidelines
Websites

59. How do you ensure that all individuals have received OHS training?
Training and
information management
How do you ensure that all individuals have received OHS training?

60. Some institutions choose to link training to facility access.
Training and
information management
Utilize human resources (HR) to obtain a list of graduate students, and new employees.
Name a designee from each approved protocol responsible for listing new employees on the protocol and contacting the IACUC coordinator to set up training.
This individual can serve as a source of information, guidance, and instruction for their colleagues.
Some institutions choose to link training to facility access.

61. Approaches to achieving investigator/ scientist participation?
Training and
information management
Approaches to achieving investigator/ scientist participation?

63. Training and
information management
Occupational health and safety goals and how they will be achieved must be clearly communicated to all employees through:
Formal orientation.
Distribution of written guidelines.
And periodic refresher training.

64. Training and
information management
One option is a mandatory course offered several times during the year:
“Live" organized class.
Distance learning i.e. teleconferencing or video.
Online training/Web site.
Individual may be asked to take a test verifying that the information was understood.

65. Training and
information management
Training may be conducted in individual investigator laboratories, instead of organized classes.
One-on-one training offered by a veterinarian, occupational health professional, or designee (smaller institutions).
Written guidelines appropriately designed to the scope of the institution's animal care and use program.
Brochures/pamphlets.

66. What would lead AAALAC to conclude that training is inadequate?
Training and
information management
What would lead AAALAC to conclude that training is inadequate?

67. Have you been offered participation in the OHS program?
Training and
information management
Have you been offered participation in the OHS program?

68. Training and
information management
"Details of OHS training program were not provided to employees and did not include foreseeable hazards such as exposure to animal allergens."
"Several procedures described in the occupational health and safety program (OHSP) brochure, used to train employees, were not being practiced."

70. Training and
information management
“Training provided to researchers using animals consisted of general print-outs and dated booklets and was not well-matched to the scope of the program of animal care and use … a training program covering subjects relevant to the needs of the institution must be developed and implemented."
“The communication of the potential hazards of working with macaques had been done verbally between the veterinarian and the investigator but had not been formally documented."

71. How are oversight mechanisms reviewed?
Training and
information management
How are oversight mechanisms reviewed?

72. An effective education and training program requires:
Training and
information management
An effective education and training program requires:  
Resources
Administrative record keeping
A mechanism for monitoring its efficiency

73. A wide variety of mechanisms exist for
Training and
information management
A wide variety of mechanisms exist for
evaluating the success of the education
and training program.
Site inspections
Personnel reviews
Injury and illness records
Regulatory-compliance citations
Periodic questionnaires

74. How is information managed?
Training and
information management
How is information managed?

75. Record keeping is essential.
Training and
information management
Record keeping is essential.
Training records are necessary to satisfy specific requirements of federal and state environmental health and safety regulations.
Establish a simple system with minimal administrative burden.
A computer based system may facilitate such an approach.

76. Rapid access to employee-specific exposure information is vital.
Training and
information management
Rapid access to employee-specific exposure information is vital.
The following documentation should be available:
Occupational exposures
Safety training
Medical surveillance
Work-related injury and illness

77. On-line access to health and safety information could:
Training and
information management
On-line access to health and safety information could:
Improve the management and performance of an occupational health and safety program.
Make it practical to develop records that are specific for each research protocol.
Computer links with other institutions through external networks, such as electronic mail, are useful for obtaining current health and safety information.
Safety bulletin boards should be available for communicating with other health professionals.

78. Training should be a continuing process
Training and
information management
Training should be a continuing process
A well-informed staff with safe work habits will:
Minimize injuries and illnesses
Reduce costs related to:
Labor time
Insurance
Health care
And legal actions

80. and Preventative Medicine
Section 5
Medical Evaluation
and Preventative Medicine
Dale G. Martin, D.V.M., Ph.D., ACLAM, ACVPM
Director, Laboratory Animal Science and Welfare Aventis Pharmaceuticals
Bridgewater, New Jersey

81. Physicians should not practice veterinary medicine.
Medical evaluation
and preventative medicine
Martin’s Observation #1:
Physicians should not practice veterinary medicine.
Martin’s Rule #1:
Veterinarians must not practice human medicine.

82. The Guide states – Input from trained health professionals
Medical evaluation
and preventative medicine
The Guide states –
Input from trained health professionals
Pre-employment risk assessment
Periodic medical evaluations
Appropriate immunizations
Zoonoses surveillance
Incident reporting
Primates (special considerations)

83. Who is the appropriate health professional?
Medical evaluation
and preventative medicine
Who is the appropriate health professional?
Occupational health physician
Occupational health nurse?
General practitioner?
Contract nurse?
Attending veterinarian?
Senior animal caretaker?

84. What services should be provided?
Medical evaluation
and preventative medicine
What services should be provided?
“The occupational health services are often the most difficult for an institution to plan or carry out because consensus on what needs to be done has not yet been established.”
ILAR, NRC Occupational Health and Safety
in Research Animal Facilities.

85. What services can be provided?
Medical evaluation
and preventative medicine
What services can be provided?
Pre-employment medical evaluation
Periodic health evaluations
Episodic health evaluations
Analysis of adverse outcomes
Medical management of worker compensation cases

86. What services can be provided? (continued)
Medical evaluation
and preventative medicine
What services can be provided? (continued)
Immunizations/serum banking
Hearing conservation program
Ergonomic program
Allergy program
Respiratory protection program
Reproductive counseling
Non-human primate exposure program

87. For pre-employment or periodic evaluations,
Medical evaluation
and preventative medicine
For pre-employment or periodic evaluations,
should it include a questionnaire and/or
a physical?
Ideal- questionnaire + physical

88. What questions should be asked?
Medical evaluation
and preventative medicine
What questions should be asked?
Do you have any allergies?
Are you allergic to animals?
What hazards were you/will you be exposed to?
What animals do you/you work with?
Have you had illnesses associated with working with animals (zoonoses)?
Do you have back problems, etc.?

89. Symptoms of allergy and asthma:
Medical evaluation
and preventative medicine
Symptoms of allergy and asthma:
Allergy-
Sneezing
Nasal congestion
Itchy eyes
Cough
Asthma
Coughing
Wheezing
Chest tightness
Shortness of breath

90. Components of one “allergy” program:
Medical evaluation
and preventative medicine
Components of one “allergy” program:
Screening
Management of the sensitized patient
Management of the allergic and/or asthmatic patient
Management of the anaphylactic patient

91. Components of one “allergy” program:
Medical evaluation
and preventative medicine
Components of one “allergy” program:
Screening
Questionnaire- family/personal history
Testing
Skin
RAST- IgE
ELISA- IgE

92. Components of one “allergy” program:
Medical evaluation
and preventative medicine
Components of one “allergy” program:
Screening
Management of the sensitized patient
Avoid exposure (PPE, procedures)
Questionnaire (symptom progression)
Enrollment in respiratory protection program
Pulmonary function testing

93. Components of one “allergy” program:
Medical evaluation
and preventative medicine
Components of one “allergy” program:
Screening
Management of the sensitized patient
Management of the allergic and or asthmatic patient
Periodic pulmonary function testing
Emmunotherapy?
Management of the anaphylactic patient
Emergency (Epi)

94. What immunizations or screening programs should be included?
Medical evaluation
and preventative medicine
What immunizations or screening programs should be included?
Tetanus (Guide)
Rabies?
Hepatitis B?
Other immunizations?
TB testing?
Serum banking?

95. Should serum banking be a part of an Occupational Health program?
Medical evaluation
and preventative medicine
Should serum banking be a part of an Occupational Health program?
“Only when there is a clear reason for obtaining the specimens AND there is a plan to analyze the data as a part of a risk assessment strategy. …..substantial issues should be considered in advance of instituting a serum banking program including chain of custody, confidentiality, identification and handling of samples, retention, potential deterioration of sample quality over time, and cost.”
ILAR, NRC Occupational Health and Safety in the Care and Use of Research Animals.

96. Special precautions for primates:
Medical evaluation
and preventative medicine
Special precautions for primates:
TB testing
Herpes B program
Pre-arrangement with health professionals
Bite/scratch kits
SOPs for sampling/testing

97. Physicians should not practice Veterinary Medicine.
Medical evaluation
and preventative medicine
Martin’s Observation #1:
Physicians should not practice Veterinary Medicine.
Martin’s Rule #1:
Veterinarians must not practice Human Medicine.
Martin’s Advice #1:
Obtain and retain appropriate health professionals to set up and administer the Medical Evaluation and Preventive Medicine aspects of your Occupational Health and Safety program.

98. Occupational Health
and Safety Programs:
An AAALAC Perspective