aaalac ohs (1)
TRANSCRIPT
-
8/12/2019 Aaalac Ohs (1)
1/98
Occupational Healthand Safety Programs: An AAALAC Perspective
-
8/12/2019 Aaalac Ohs (1)
2/98
Elements of anOccupational Health Program:
Deficiencies identified by AAALAC.
David DeLong, D.V.M.
Chief, Veterinary Medical UnitVAMC, Minneapolis, Minnesota
Section 1
-
8/12/2019 Aaalac Ohs (1)
3/98
Why does AAALAC assessoccupational health and safety programs?
Elements of an OHS program:Deficiencies identified by AAALAC
-
8/12/2019 Aaalac Ohs (1)
4/98
According to the Guide -
An occupational health and safety program must be part of the overallanimal care and use program."
Elements of an OHS program:Deficiencies identified by AAALAC
-
8/12/2019 Aaalac Ohs (1)
5/98
Working with animalscan be dangerous business!
Physical and chemical hazards
Protocol related hazards
Allergens
Zoonotic diseases
Elements of an OHS program:Deficiencies identified by AAALAC
-
8/12/2019 Aaalac Ohs (1)
6/98
How doesAAALAC assess an OHS program?
Prior to the site visit, review theProgram Description.
During the site visit, review facilities
and documents; interview personnel.
Elements of an OHS program:Deficiencies identified by AAALAC
-
8/12/2019 Aaalac Ohs (1)
7/98
-
8/12/2019 Aaalac Ohs (1)
8/98
Other documents:
Occupational Health and Safety in the Care and
Use of Research Animals. 1997. NRC, NationalAcademy of Sciences.
Biosafety in Microbiological and BiomedicalLaboratories. 1999. HHS Pub. No.
(CDC) 93-8395.
Miscellaneous AAALAC resource documents .
Elements of an OHS program:Deficiencies identified by AAALAC
-
8/12/2019 Aaalac Ohs (1)
9/98
What are the requiredcomponents 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.
Elements of an OHS program:Deficiencies identified by AAALAC
-
8/12/2019 Aaalac Ohs (1)
10/98
What are the hallmarksof a successful program?
Strong administrative support.
Sound implementation strategies.
Effective coordination of program components.
Elements of an OHS program:Deficiencies identified by AAALAC
-
8/12/2019 Aaalac Ohs (1)
11/98
What trends in OHS Program deficiencieshave been identified by AAALAC?
Elements of an OHS program:Deficiencies identified by AAALAC
-
8/12/2019 Aaalac Ohs (1)
12/98
0
20
40
60
80
100
120
1993 1994 1995 1996 1997 1998 1999*
MandatorySuggestion
Occupational Health and Safety of Personnel
Elements of an OHS program:Deficiencies identified by AAALAC
-
8/12/2019 Aaalac Ohs (1)
13/98
0
10
20
30
40
50
60
1993 1994 1995 1996 1997 1998 1999*
MandatorySuggestion
Hazard Identification and Risk Assessment
Elements of an OHS program:Deficiencies identified by AAALAC
-
8/12/2019 Aaalac Ohs (1)
14/98
0
10
20
30
40
50
60
1993 1994 1995 1996 1997 1998 1999*
MandatorySuggestion
Personnel Training
Elements of an OHS program:Deficiencies identified by AAALAC
-
8/12/2019 Aaalac Ohs (1)
15/98
Personal Hygiene/Protection
0
10
20
30
40
50
60
1993 1994 1995 1996 1997 1998 1999*
MandatorySuggestion
Elements of an OHS program:Deficiencies identified by AAALAC
-
8/12/2019 Aaalac Ohs (1)
16/98
Facilities, Procedures, and Monitoring
0
10
20
30
40
50
60
1993 1994 1995 1996 1997 1998 1999*
MandatorySuggestion
Elements of an OHS program:Deficiencies identified by AAALAC
-
8/12/2019 Aaalac Ohs (1)
17/98
-
8/12/2019 Aaalac Ohs (1)
18/98
More common deficiencies:
Hazard identification/risk assessment. Personal hygiene/protection.
Elements of an OHS program:Deficiencies identified by AAALAC
-
8/12/2019 Aaalac Ohs (1)
19/98
Less common deficiencies:
Personnel training.
Facilities, procedures and monitoring.
Medical evaluation/preventive medicine.
Elements of an OHS program:Deficiencies identified by AAALAC
-
8/12/2019 Aaalac Ohs (1)
20/98
Animal experimentation involving hazards
This category reflects how OHSP components areimplemented and coordinated to ensure safety in theface of a particular hazard.
Elements of an OHS program:Deficiencies identified by AAALAC
-
8/12/2019 Aaalac Ohs (1)
21/98
-
8/12/2019 Aaalac Ohs (1)
22/98
OHSP expectations:
Individual components that are appropriatefor the facility.
Evidence that the components work effectivelytogether.
Elements of an OHS program:Deficiencies identified by AAALAC
-
8/12/2019 Aaalac Ohs (1)
23/98
Issues in OHSPImplementation and Participation
Christian E. Newcomer, V.M.D., DACLAMResearch Professor and DirectorPathology and Laboratory MedicineThe University of North Carolina at Chapel Hill
Section 2
-
8/12/2019 Aaalac Ohs (1)
24/98
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?
Issues in OHSPimplementation and participation
-
8/12/2019 Aaalac Ohs (1)
25/98
OHSP implementation issues:
What mandates the creation of an OHSP?
PHS Policy: The Guide
OSHA: CFR 29
ILAR: Occupational Health and Safetyin the Care and Use of Research
Animals
Issues in OHSPimplementation and participation
-
8/12/2019 Aaalac Ohs (1)
26/98
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.
Issues in OHSPimplementation and participation
-
8/12/2019 Aaalac Ohs (1)
27/98
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!
Issues in OHSPimplementation and participation
-
8/12/2019 Aaalac Ohs (1)
28/98
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?
Issues in OHSPimplementation and participation
-
8/12/2019 Aaalac Ohs (1)
29/98
OHSP design team members:
Animal Care and Use Staff
Research Staff
Environmental Health and Safety
Occupational Health/Medicine
Administration and Management
Issues in OHSPimplementation and participation
-
8/12/2019 Aaalac Ohs (1)
30/98
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 andimprove outcomes.
Are participants clear on the availableOHSP services?
Issues in OHSPimplementation and participation
-
8/12/2019 Aaalac Ohs (1)
31/98
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?
Issues in OHSPimplementation and participation
-
8/12/2019 Aaalac Ohs (1)
32/98
Issues in OHSPimplementation and participation:
Who reviews OHSP scope and participation?
IACUC OHSP Coordinator
Senior Official AAALAC International
Issues in OHSPimplementation and participation
-
8/12/2019 Aaalac Ohs (1)
33/98
Hazard Controland Risk Assessment
Ron E. Banks, D.V.M.University Veterinarian & DirectorOffice of Laboratory Animal ResourcesUniversity of Colorado Health Sciences Center
Section 3
-
8/12/2019 Aaalac Ohs (1)
34/98
What is the principalobjective of an OHSP?
To reduce to an acceptable level, the risk associatedwith using materials or systems that haveinherent danger by controlling or eliminating hazards.
Hazard controland risk assessment
-
8/12/2019 Aaalac Ohs (1)
35/98
How does risk assessmentrelate to the greater OHSP?
Risk Assessment is the foundation for progressive OH&S
Risk Assessment is prerequisite to selecting an appropriatehealth-care service for employees!
Hazard controland risk assessment
-
8/12/2019 Aaalac Ohs (1)
36/98
What is risk?
The likelihood of a consequence.
Hazard controland risk assessment
-
8/12/2019 Aaalac Ohs (1)
37/98
-
8/12/2019 Aaalac Ohs (1)
38/98
What issues enter into risk assessment?
Known /
unknown
Work
Assignment
Species Facility
EngineeringExperimentalConditions
Duration ofStudy
Specific AgentProperties
Current HealthStatus
Outside Work /
Play
Frequency of
Exposure
Intensity of
Exposure
Required
EquipmentFacility History Regulatory
RequirementsPrevalence Personnel
Experience
Hazard controland risk assessment
-
8/12/2019 Aaalac Ohs (1)
39/98
When can I stop defining and quantifying hazards? Dynamic process never completed!
Hazard controland risk assessment
-
8/12/2019 Aaalac Ohs (1)
40/98
How important is risk assessment?
Undetected / undefined hazards pose themost significant problem to research staff
Undetected and unrelated hazards are themost worrisome.
You cant protect staff from the unknown
Hazard controland risk assessment
-
8/12/2019 Aaalac Ohs (1)
41/98
Whose responsibility is itto identify hazards?
The researcher
The facility management team
The care provider
In short . EVERYONE!
Hazard controland risk assessment
-
8/12/2019 Aaalac Ohs (1)
42/98
How should risk assessment be used in the laboratory?
To manage the hazard
To avoid / control exposure
To provide therapy when exposure occurs
Hazard controland risk assessment
-
8/12/2019 Aaalac Ohs (1)
43/98
What must you know to performrisk 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
Hazard controland risk assessment
-
8/12/2019 Aaalac Ohs (1)
44/98
What must you know to perform riskassessment for infectious diseases?
Dose-response relationship Virulence Communicability Prevalence Route of exposure Shedding patterns Stability Availability of prophylaxis / therapy
Hazard controland risk assessment
-
8/12/2019 Aaalac Ohs (1)
45/98
Does the IACUC have a roleto play in risk assessment?
Yes!
Protocol review can (and should) include requestsfor information on the potential hazardsof a particular study.
Hazard review can be performed by: A committee member A H&S committee or board The IACUC
Hazard controland risk assessment
-
8/12/2019 Aaalac Ohs (1)
46/98
Where can you find informationto assist in risk assessment?
Scientific literature Other scientists MSDS The researchers themselves Your own staff!
Hazard controland risk assessment
-
8/12/2019 Aaalac Ohs (1)
47/98
-
8/12/2019 Aaalac Ohs (1)
48/98
Hazard controland risk assessment
How can I assure AAALAC site visitorswe 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 visitorinquiry of why they do something a certain way (PPE / process).
-
8/12/2019 Aaalac Ohs (1)
49/98
Training andInformation Management
Barbara Garibaldi, D.V.M., ACLAMDirector, Animal Research FacilityBeth Israel Deaconess Medical CenterBoston, Massachusetts
Section 4
-
8/12/2019 Aaalac Ohs (1)
50/98
-
8/12/2019 Aaalac Ohs (1)
51/98
An institutions approach for providingeducation and training depends on its:
Size
Resources
Animal species used
Research activities
Staff experience and technical expertise
Training andinformation management
-
8/12/2019 Aaalac Ohs (1)
52/98
Information provided to employees should bedeveloped through the interaction of severalkey people:
A veterinarian
A health and safety professional
A research scientist
Training andinformation management
-
8/12/2019 Aaalac Ohs (1)
53/98
What types of occupational health and
safety training should be provided?
Training andinformation management
-
8/12/2019 Aaalac Ohs (1)
54/98
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, biohazardousmaterial safety, and bloodborne pathogens may be
provided by experts in the appropriate department.
Training andinformation management
-
8/12/2019 Aaalac Ohs (1)
55/98
Personnel who have contact withexperimental animals should receive trainingin the proper handling of the animals that
they will work with.
Personnel should be instructed to avoidunnecessary risk when working with
animals, and to seek expert assistance whenin doubt.
Training andinformation management
-
8/12/2019 Aaalac Ohs (1)
56/98
Most animal inflicted injuries occur becauseof inadequate training and experience, or
because of carelessness.
Training should be provided that injuries,splashes, animal bites and/or scratches, andcuts sustained while working with animalsshould be promptly reported and the employeereferred to employee health service.
Training andinformation management
-
8/12/2019 Aaalac Ohs (1)
57/98
What type of documentationdoes AAALAC look at?
Training andinformation management
-
8/12/2019 Aaalac Ohs (1)
58/98
Training andinformation management
Training logs
Informational Newsletters
Written Guidelines
Websites
-
8/12/2019 Aaalac Ohs (1)
59/98
-
8/12/2019 Aaalac Ohs (1)
60/98
Utilize human resources (HR) to obtain a listof graduate students, and new employees.
Name a designee from each approved protocol responsiblefor listing new employees on the protocol and contacting theIACUC 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.
Training andinformation management
-
8/12/2019 Aaalac Ohs (1)
61/98
Approaches to achieving investigator/scientist participation?
Training andinformation management
-
8/12/2019 Aaalac Ohs (1)
62/98
-
8/12/2019 Aaalac Ohs (1)
63/98
Occupational health and safety goals and howthey will be achieved must be clearlycommunicated to all employees through:
Formal orientation.
Distribution of written guidelines.
And periodic refresher training.
Training andinformation management
-
8/12/2019 Aaalac Ohs (1)
64/98
-
8/12/2019 Aaalac Ohs (1)
65/98
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.
Training andinformation management
-
8/12/2019 Aaalac Ohs (1)
66/98
What would lead AAALAC to conclude
that training is inadequate?
Training andinformation management
-
8/12/2019 Aaalac Ohs (1)
67/98
Have you been offered participation
in the OHS program?
Training andinformation management
-
8/12/2019 Aaalac Ohs (1)
68/98
"Details of OHS training program were not providedto employees and did not include foreseeable hazards such
as exposure to animal allergens."
"Several procedures described in the occupational healthand safety program (OHSP) brochure, used to train
employees, were not being practiced."
Training andinformation management
-
8/12/2019 Aaalac Ohs (1)
69/98
-
8/12/2019 Aaalac Ohs (1)
70/98
Training provided to researchers using animals consistedof general print-outs and dated booklets and was notwell-matched to the scope of the program of animal care anduse a training program covering subjects relevant to theneeds of the institution must be developed andimplemented."
The communication of the potential hazards of workingwith macaques had been done verbally between theveterinarian and the investigator but had not been formallydocumented."
Training andinformation management
-
8/12/2019 Aaalac Ohs (1)
71/98
How are oversight mechanisms reviewed?
Training andinformation management
-
8/12/2019 Aaalac Ohs (1)
72/98
An effective education and training program requires:
Resources Administrative record keeping A mechanism for monitoring its efficiency
Training andinformation management
-
8/12/2019 Aaalac Ohs (1)
73/98
-
8/12/2019 Aaalac Ohs (1)
74/98
How is information managed?
Training andinformation management
-
8/12/2019 Aaalac Ohs (1)
75/98
Record keeping is essential.
Training records are necessary to satisfy specificrequirements of federal and state environmental health andsafety regulations.
Establish a simple system with minimal administrative
burden. A computer based system may facilitate such an approach.
Training andinformation management
-
8/12/2019 Aaalac Ohs (1)
76/98
Rapid access to employee-specificexposure information is vital.
The following documentation should be available:
Occupational exposures Safety training
Medical surveillance Work-related injury and illness
Training andinformation management
-
8/12/2019 Aaalac Ohs (1)
77/98
On-line access to healthand safety information could:
Improve the management and performance of an occupational healthand 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 safetyinformation.
Safety bulletin boards should be available for communicatingwith other health professionals.
Training andinformation management
-
8/12/2019 Aaalac Ohs (1)
78/98
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
Training andinformation management
-
8/12/2019 Aaalac Ohs (1)
79/98
-
8/12/2019 Aaalac Ohs (1)
80/98
Medical Evaluationand Preventative Medicine
Dale G. Martin, D.V.M., Ph.D., ACLAM, ACVPMDirector, Laboratory Animal Science and Welfare
Aventis PharmaceuticalsBridgewater, New Jersey
Section 5
-
8/12/2019 Aaalac Ohs (1)
81/98
Martins Observation #1:
Physicians should not practiceveterinary medicine.
Martins Rule #1:
Veterinarians must not practicehuman medicine.
Medical evaluationand preventative medicine
-
8/12/2019 Aaalac Ohs (1)
82/98
The Guide states
Input from trained health professionals
Pre-employment risk assessment Periodic medical evaluations Appropriate immunizations Zoonoses surveillance Incident reporting Primates (special considerations)
Medical evaluationand preventative medicine
-
8/12/2019 Aaalac Ohs (1)
83/98
Who is the appropriate health professional?
Occupational health physician
Occupational health nurse? General practitioner? Contract nurse? Attending veterinarian? Senior animal caretaker?
Medical evaluationand preventative medicine
-
8/12/2019 Aaalac Ohs (1)
84/98
What services should be provided?
The occupational health services are often the most
difficult for an institution to plan or carry out becauseconsensus on what needs to be done has not yet beenestablished.
ILAR, NRC Occupational Health and Safetyin Research Animal Facilities.
Medical evaluationand preventative medicine
-
8/12/2019 Aaalac Ohs (1)
85/98
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
Medical evaluationand preventative medicine
-
8/12/2019 Aaalac Ohs (1)
86/98
-
8/12/2019 Aaalac Ohs (1)
87/98
For pre-employment or periodic evaluations,
should it include a questionnaire and/ora physical?
Ideal- questionnaire + physical
Medical evaluationand preventative medicine
-
8/12/2019 Aaalac Ohs (1)
88/98
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 workingwith animals (zoonoses)?
Do you have back problems, etc.?
Medical evaluationand preventative medicine
-
8/12/2019 Aaalac Ohs (1)
89/98
Symptoms of allergy and asthma:
Allergy- Sneezing Nasal congestion Itchy eyes Cough
Medical evaluationand preventative medicine
Asthma Coughing Wheezing Chest tightness Shortness of breath
-
8/12/2019 Aaalac Ohs (1)
90/98
Components of oneallergy program:
Screening Management of the sensitized patient Management of the allergic and/or asthmatic patient Management of the anaphylactic patient
Medical evaluationand preventative medicine
-
8/12/2019 Aaalac Ohs (1)
91/98
Components of one allergy program:
Screening
Questionnaire- family/personal history
Testing
Skin RAST- IgE ELISA- IgE
Medical evaluationand preventative medicine
-
8/12/2019 Aaalac Ohs (1)
92/98
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
Medical evaluationand preventative medicine
-
8/12/2019 Aaalac Ohs (1)
93/98
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)
Medical evaluationand preventative medicine
-
8/12/2019 Aaalac Ohs (1)
94/98
What immunizations or screening programs should be included?
Tetanus ( Guide ) Rabies? Hepatitis B? Other immunizations? TB testing? Serum banking?
Medical evaluationand preventative medicine
-
8/12/2019 Aaalac Ohs (1)
95/98
-
8/12/2019 Aaalac Ohs (1)
96/98
Special precautions for primates:
TB testing
Herpes B program
Pre-arrangement with health professionals Bite/scratch kits
SOPs for sampling/testing
Medical evaluationand preventative medicine
-
8/12/2019 Aaalac Ohs (1)
97/98
Martins Observation #1: Physicians should not practice Veterinary Medicine.
Martins Rule #1:
Veterinarians must not practice Human Medicine.
Martins Advice #1:
Obtain and retain appropriate health professionals to set up
and administer the Medical Evaluation and PreventiveMedicine aspects of your Occupational Health and Safety
program.
Medical evaluationand preventative medicine
-
8/12/2019 Aaalac Ohs (1)
98/98
Occupational Healthand Safety Programs:
An AAALAC Perspective