4th National Symposium on Biosafety

Occupational Health and Safety Program in a Research Animal Facility

Rebecca Bascom, MD, MPH
University of Maryland
10 South Pine Street
Room 800
Baltimore, MD 21201
410-706-2169

The overall goal of an Occupational Health and Safety Program in a Research Animal Facility is to reduce to an acceptable level the risk associated with using materials or systems that might have inherent danger. The simplicity of the goal belies the complexity of the task.

Basic principles guide the development of an occupational health and safety program. At a worksite, knowing the hazard leads to good protection, and avoiding hazardous exposures in the best approach for risk reduction. For the workforce, trained employees are less vulnerable to risks, but rules are necessary, and consistency is vital to a good program. For the institution, good records are useful to measure program effectiveness, and commitment and coordination are necessary.

To accomplish the overall program goal, it is useful to enlist the collaborative participation of the five key institutional activities related to the care and use of research animals. These include the animal care and use activity, the research activity, the environmental health and safety activity, the administration and management activity, and the occupational health activity. The Institutional Animal Care and Use Committee may have value in developing these collaborations and sustaining interactions.

In successful programs, these five activities interact continually. Institutions may have diverse styles and solutions, but need unambiguous identification of responsibility and delegated chains of authority.

Five Key Activities

The research activity drives the risk profile by selecting protocols and methods needed to address the experimental questions. Researchers need access to specific, effective consultation at the time they develop protocols. They need to supply the occupational health and safety information with hazard information they acquire through their professional societies.

The animal care and use activity houses and husbands the research animals. While this activity controls the primary environment for the animals, animals may be in the facility who are in the midst of a protocol. Both hazards intrinsic to the animal and those arising from the experimental protocol may occur. Interaction with research is necessary to understand the hazards that will be introduced to the facility by the exprimental protocols.

The environmental health and safety activity leads the assessment and control of workplace hazards and risks and seeks the input of occupational health professionals, veterinary staff, research scientists, and the animal care activity.

The occupational health activity manages the occupational healthcare of the employees. They will identify employees at risk, perform timely evaluation and prompt inclusion of new employees in the ongoing surveillance program. The ?preplacement health evaluation" will identify susceptibility factors that may require special attention or accommodation. Interaction with administration including human resources and legal personnel will be needed. Environmental health and safety, researchers and animal care and use will need to interact with occupational health care services to ensure that the health assessment is appropriate for the anticipated risks, and that recommended accommodations are practical for the worksite.

The administrative and management activity provides resources, coordinates information systems and monitors program success. It tasks appropriate individuals with contributing human resource, legal, and worker compensation services to the occupational health and safety program. They need information about the presence and magnitude of risks, the regulatory requirements, and recommended control strategies.

Getting Started

The impetus to initiate or review an occupational health and safety program may derive from a serious, highly publicized workplace illness or injury, from the need to comply with government regulations, or from a desire to manage and reduce business risks. This initial impetus needs three supporting elements to result in sustained program development.

Institutional champion: The first need to identify an institutional champion who will organize and guide a task group. Group process skills are useful, since conflicts are inevitable, and efforts by one activity to dominate the occupational health and safety program undermine the collaborative nature of the task. However, equally problematic is the abdication of responsibility by one or more activity, or the absence of an institutional champion.

A committed senior official: The second need is to identify a senior official who will articulate a commitment to a safe and healthy workplace, will delegate the authority to commit and direct institutional resources, and will establish mechanisms to monitor program success. The success of the effort will relate closely to the authority, power, and influence of the senior official, and the priority of occupational health and safety relative to other institutional goals.

A priority list: The purpose of the priority list is to ensure that the greatest risks are addressed first. Typically the most costly, most common or most severe risks are managed first, followed by unacceptable cumulative risk. The first job of the task group, comprised of the five key activities around one table, is to establish the priority list.

The Priority List

Three question must be answered to establish a priority list. What are the hazards? What is the injury and illness experience of the institution? Who is currently at risk? The reason that all five activities must be present to develop the priority list is that the answers to these questions exist piecemeal throughout the organization. The collective knowledge and wisdom of the task group is far greater than a compilation or reports from each group would suggest.

First Question:

What are the hazards?

Hazard recognition is the first step in creating a risk priority list. Hazard is the inherent danger in a material or system, while risk is a measure of the likelihood of a consequence.

There is no single source of hazard information for a worksite. Rather, a compilation of hazard information from multiple sources is required. General sources of information include the Institute of Laboratory Animal Resources, professional associations, material safety data sheets or manufacturer's safety bulletins.

A central event in establishing an occupational health and safety program is the "walk-through". A walk-through is a tour of the functioning worksite in the presence of knowledgeable health and safety professionals. Individuals from the environmental health and safety activity leads the walk-through because of their expertise of in the recognition, measurement and control of workplace hazards. Consulting industrial hygienists may be enlisted for this key step. The walk-through team should understand the operations well enough to imagine scenarios that might result in injury or illness.

Researchers can describe the nature of the research protocols, while veterinarians or animal care technicians can describe the work of animal husbandry. Individuals from the occupational health care activity provide a complementary perspective, having taken occupational histories from workers. The administration activity can consider the identified hazards in the context of long term facilities planning as well as short-term resource allocation. Workers are an indispensable source of information about hazards. Consultation with workers can occur during the walk-through, or at the time of workplace monitoring or healthcare visits.

Institution-specific hazard information also derives from protocol reviews, the chemical inventory, accident reports, Occupational Safety and Health Administration (OSHA) logs, safety committee reports, and consultant and audit reports.

The Second Question:

Institutional trends for occupational health and safety may be estimated from several sources. First aid logs, maintained at the worksite, list minor (nonrecordable) nonrecordable illnesses. Care for events such as eye injuries may be sent directly to subspcialists, and thus be outside the occupational health center database. The occupational health center log lists all visits to the health center. Visits to the center occur either for scheduled monitoring due to a recognized hazard (so-called periodic visits) and other visits that are necessary to evaluate health symptoms(so-called episodic visits). Adverse reaction reports, typically maintained by the environmental health and safety office, record unplanned exposures ("excursions") or unexplained symptoms.

An additional source of information is the OSHA 200 log. An injury is "recordable" if it causes death, loss of consciousness, lost worktime, restricted duty or requires medical treatment beyond first aid. All illnesses (non instantaneous events) are "recordable." This log is maintained by the environmental health and safety activity, with input from administration and management. For each entry, a detailed supplementary form (OSHA 101) is completed. The number of entries for an institution can be compared with previous years, with an OSHA compliance database, and a National Safety Council Accident Book. The OSHA compliance database summarizes information on inspections during which a citation was issued. Its utility is in understanding what issues are receiving particular attention from OSHA inspectors.

National sources of information about similar industries or institutions are worker compensation insurance companies and reference data. The SIC 0740 for veterinary services lists 74 compensable injuries and illnesses. Of these, 34 occurred among animal caretakers, 54% were due to cuts, punctures and bites, and 30% were due to overexertion due to lifting.

The Third Question:

Who is currently at risk?

Institutions may use employment status as a surrogate for assessment of risk, but this practice should be strongly discouraged. Risk is determined by the functions of the individual at the worksite. Therefore, institutions are encouraged to provide for the participation of all personnel involved in the care and use of research animals on the basis of the risks encountered, regardless of their employment status.

A functional definition of the term "employee" is "all personnel involved in the care and use of research animals, regardless of their employment status." The need for healthcare services is then based on the nature of the hazards, and the intensity and frequency of exposure.

Previously, "employees with substantial animal contact" were understood to be the at-risk group. Unfortunaely this catchy phrase proved to be misleading. For example, employees with insubstantial contact with whole, live animals may hanlde infectious tissues or fluids derived from the animal.

The phrase "employees with substantial risk from animal-related research" best describes the group of concern. Assessment of risk includes consideration of the frequency of contact with animals in the reseach settings as well as to their derived tissues and products, Also important are the intensity of the exposures, hazards intrinsic to the animals, hazards present in the research agents, current and potential hazard control technology, the worksite health experience, and an employee's individual susceptibility and occupational history.

The Work Plan

After its completion, the priority list will be turned into a work plan, which will require resources for implementation. The essence of the message to sell an occupational health and safety program is as follows. A trained workforce working at a location that maximizes the use of passive protection is perhaps the greatest resource that an institution can develop. Resources provided by the institution will be used to train workers in hazard recognition and avoidance, to correct workplace conditions, to simplify protection practices, and to monitor health.

The development and implementation of a workplan requires periodic meetings of the five activities of research, administration, animal care and use, environmental health and safety, and occupational health care services. The simultaneous presence of the five activities will promote the necessary coordination. The frequency of the meetings will be determined by the magnitude and complexity of the task. Weekly or even daily meetings may be necessary to launch the program in at atmosphere of crisis.

Reducing Risk: Hierarchy of Control

Occupational health and safety professionals recognize a hierarchy of control strategies which will fundamentally influence the work plan. Implicit in the control hierarchy is a recognition of the high cost of worker illness or injury, an a consequent emphasis on prevention. A primary control strategy such as reducing, modifying or eliminating the hazard is the strategy of choice. A secondary control strategy is to perform premorbid case detection, and to thus prevent overt disease. A third control strategy is to engage in case-finding for the purpose of disease management, and mitigation of adverse effects.

Measuring Program Effectiveness

During the development of the work plan, an important task of the work group is to agree on measures and schedules to track program effectiveness. These could include reductions in exposure levels, in pecific illnesses or injuries, of damaged-material costs or loss of work due to damaged equipment, or in program costs per covered employee.

Team Building: Common Conflicts

Conflict is inherent to the occupational safety and health effort. The purpose of the work group is to move forward while recognizing and balancing competing pressures. Characteristic conflicts are sketched below.

When an occupational health and safety program begins, case finding may initially increase the frequency of work-related illness. Many successful control efforts, (even worldwide small pox eradication), have stories of administrators wanting to shut down programs because of perceived ineffectiveness at this initial phase. Costs savings result later as case severity, if not incidence, decreases.

Programs struggle with the difficulty in measuring avoided costs. The occupational health care service may balk at choosing control strategies, preferring to initiate all available control strategies to address a workplace health concern. Alternatively, they may shy away from recommending necessary, but costly control strategies for fear of administration hostility.

The success of the environmental health and safety(EHS) activity is based on a control program designed after quantifying exposure (e.g. air sampling). The EHS group typically feels ownership of the control program. The occupational health care service (OHCS) documents worker injury and disease, events that occur when the EHS control program fails, and the EHS unit may resent the evidence of failure.

The EHS team may think that the OHC team is eternally second-guessing and micro managing their program. Clinical medicine focuses on the individual and many clinicians are weak when it comes to devising solutions for populations. It is the tendency of the clinician to suggest the use of limited resources in understanding details of a single case, rather than to use resources to reduce risk in the workplace as a whole.

Conflict also occurs when there is uncertainty about the relationship between a workplace exposure and worker disease. The occupational health care service tends to "believe the patient" despite the well-known risk of improper attribution. The environmental health and safety tends to "believe the sampling", despite well-recognized limitations in sampling technology.

Researchers, as a group, are wary of any occupational health and safety program. Their questions about health and safety are often more specific than the general expertise of the occupational health and safety practitioners, and their knowledge of their discipline is unequaled. Protocols often develop under time pressures from grant deadlines. As a result, the researcher may view an occupational health and safety program as a useful institutional support service, but possibly as a necessary nuisance, or even as a hindrance to their work and a drain on limited resources.

Veterinarians administer the animal care facility, and their knowledge of zoonoses exceeds that of many human health practitioners. In the absence of occupational health care practitioners, they may be called upon to provide health care services to employees. A vigorous occupational health and safety program may be seen as an incursion of their turf.

Administrators prefer to direct institutional resources to high return, high profile programs. Occupational health and sfety is only high profile when the news is bad. At best, it is understood to be part of the cost of doing business, at worst it is considered overhead to be slashed. It is necessary for occupational health and safety work groups to continually consider the value of their services, and to inform the administrators of that value.

Staying Current

The information base that guides workplace hazard assessment and risk management is constantly changing. The work group needs to agree on a plan to review and update its program. The need for a focused review can be triggered by changes in regulations, information about workplace hazards, or a change in the illness and injury experience at the workplace. In addition, a general review every 5-7 years, even in a static workplace, can ensure that the goals, activities and functions are appropriate.

Summary

A concerted institutional effort is needed to address the health and safety hazards in research animal facilities, to broaden occupational health and safety programs where indicated, and to measure risk reduction. A successful effort results in focused and effective programs that help researchers in their work. An unsuccessful effort wastes valuable institutional resources, costs research productivity and engenders ill will.

The work of an occupational health and safety program is accomplished by people with a detailed knowledge of the particular workplace. Five activities contribute to the program: research, animal care and use, environmental health and safety, occupational health care services, and administration and management. Clear goals, constant interaction among the five activities, and periodic updates are the most important features of a successful program.

Office of Health and Safety, Centers for Disease Control and Prevention, 1600 Clifton Road N.E., Mail Stop F05 Atlanta, Georgia 30333, USA Last Modified: 1/2/97
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