Safety Office Guides and Publications Working with Animals

Health surveillance for workers with laboratory animals

Introduction

Allergens from laboratory animals are recognised respiratory sensitisers. Skin exposure to these may also precipitate irritation or dermatitis. The condition known as allergy to laboratory animals is summarised in Appendix 3. All workers with laboratory animals should be made aware of this information, either by a copy of the Appendix or by incorporation of this information into local safety documents.

Authorisation to work with laboratory animals for routine entry into animal houses is conditional upon the individual undergoing health surveillance as described in this circular. In the event of an individual failing to participate then admission to the animal house will be refused.

Health surveillance via Occupational Health will be provided for all workers with laboratory animals and all staff who need to routinely enter animal houses, e.g. maintenance and cleaning. The exception to this is undergraduate work with laboratory animals due to the much lower level of exposure. In respect of visiting workers then liaison will be required with the home institution to ensure that adequate arrangements have been made to provide health surveillance.

For the purpose of this guidance laboratory animals are those kept in relatively confined conditions, i.e. laboratories. Hence work with farm animals would be included when kept in a laboratory but not when on the farm. (Health surveillance tailored towards workers with farm animals will be provided). Similarly aquatic animals are excluded unless exposure to laboratory animal allergens is likely as a result of the location of the aquatic facility, for example within a general animal house.

Health surveillance will comprise both pre-employment screening and periodic surveillance. Occupational Health are equipped to visit Schools/Divisions to carry out screening and will make arrangements to do this where the numbers or location justify this.

Pre-employment and early employment health screening

The purpose of pre-employment health screening is to:

1. Identify those who have already developed occupational ill-health and for whom special precautions may be necessary;

2. Identify people who would be more vulnerable if they developed occupational ill-health;

3. Provide a baseline measurement for later periodic health surveillance;

4. Raise awareness of occupational ill-health and inform individuals where confidential medical advice can be sought if symptoms develop.

This screening involves completion of a questionnaire, a lung function test (spirometry) and health education by the Occupational Health nurse. If any queries arise from the screening, the individual will be referred to the Occupational Health Physician. After the initial screening by the nurse and doctor as necessary, a fitness for work certificate will be sent to the person's line manager or academic supervisor, with a copy to the animal house manager concerned. Individuals should not commence work with animals until these certificates have been issued.

Screening will be repeated at 6 weeks and 6 months (or any such interval which the Occupational Health Physician may recommend) after commencing work with laboratory animals. An appointment for screening at 6 weeks will be made at the initial appointment. It will be the responsibility of the individual to attend and the time for this should be allowed by both the individual and the School/Division.

Schools/Divisions intending to assign individuals to work with laboratory animals should send notification to the manager of the animal house concerned using the attached form.

Should pre-employment screening reveal that an individual would be at a risk to their health from the proposed work, then Occupational Health will inform the relevant School/Division.

Periodic health surveillance

Occupational Health will annually request an up to date list of employees who are exposed to Animal Laboratory Allergens (ALA) from the School/Divisional Safety Officer or other nominated person. The individual will be given an appointment for annual health surveillance and asked to complete a confidential health questionnaire. This will identify changes in respiratory function and skin condition. The OH Nurse will review the questionnaire, enquire of the individual if they have any chest problems and undertake spirometry where there is cause for concern.

The individual will have the opportunity to discuss any changes relating to their personal exposure to animal allergens.

The School/Divisional Safety Officer/nominated person will be informed of staff who have attended for annual health screening in order to maintain a register to comply with the Control of Substances Hazardous to Health Regulations (COSHH). The manager of the animal house will be sent a copy. Any individual who does not attend for health screening will be sent a reminder - if there is no response the School/Divisional Safety Officer/nominated person and the manager of the animal house will be informed and that individual will be refused admission to the animal house.

The nominated person will ensure that any employee who has been exposed to laboratory animals and is ceasing employment with the University of Nottingham, is given a confidential health questionnaire to be returned, by the individual, to Occupational Health. (Appendix 2).

Short term visitors to the animal laboratories (i.e. less than six weeks duration) must be advised of the risk to health from animal allergens. This will be done by the individual being issued with a copy of Appendix 3 at the animal house on their first visit. Their exposure time should be restricted to a minimum.

Feedback from health surveillance

Any information concerning the state of an individual's health resulting from screening carried out at Occupational Health is medically confidential. One of the objectives of health surveillance however is to enable the adequacy of existing controls to be evaluated. If the health surveillance programme indicates that certain categories of worker or certain areas might involve significant exposures to respiratory sensitisers, then indicative feedback to the animal house concerned will be provided to enable the control measures in place to be re-evaluated. Confidential medical information will of course not be included in such feedback. Where the provision of confidential medical information may be necessary in order to further protect the health of the worker, then this will only be provided with the written consent of the individual.

Health education

Health education involves:

1. Explanation of a ALA, its symptoms and latency period;

2. The importance of good hygiene practices, e.g. changing clothes after work and washing hands;

3. Importance of using control measures such as extraction fans and ventilation units and also wearing appropriate protective equipment which should be properly maintained;

4. The symptoms of skin and respiratory sensitisation which the individual should be looking out for and the importance of the procedures for reporting these;

5. The hazards to health of smoking, if relevant.

Dr J A Sutherland

Safety Officer

Appendix 1

Health surveillance request for intended laboratory animal workers

This form should be used to notify the Manager of animal house of the intention to appoint someone whose work will involve laboratory animals at or from that animal house.

To be completed by the prospective worker and countersigned by the manager/academic supervisor once an appointment for initial screening has been made with Occupational Health.

Name of intended worker:

School & Division:

Status (UG/PG/employee):

Location of work:

Appointment for screening by

Occupational Health Unit arranged

for (time and date):

Intended starting date:

Approximate duration (if known):

Name of Manager/Academic

Supervisor:

Signature:

Date:

Appendix 2

Nottingham Occupational Health

Termination of Employment Health Questionnaire For Persons Working with Animal Allergens

Please complete this confidential questionnaire as soon as possible and return it to Nottingham Occupational Health, Cripps Health Centre, University Park, University of Nottingham.

NAME

D.O.B

EXT NO.

Since commencing work in your present post and follwoing initial health screening with Nottingham Occupational Health have you experienced any of the following symptoms either at work or home (not attributed to colds,flu, etc.)

1. Recurring soreness or running eyes Yes No

2. Recurring blocked or running nose Yes No

3. Dry, persistent, irritating cough Yes No

4. Tightness of the chest Yes No

5. Wheezing Yes No

6. Breathlessness or breathing problems Yes No

7. Skin problems - eczema, dermatitis, dry cracked skin, rash Yes No

8. Have you consulted your doctor about a chest or skin condition in the last year Yes No

I confirm that the above information is accurate

Signature :

Date :

For official use only :

Date recevied :

No action/send appointment :

Appendix 3

Allergy to Laboratory Animals

Any person exposed to animal allergens at work may develop a condition known as Allergy to Laboratory Animals (ALA). ALA is a hypersensitivity or allergic response which may develop as a response to repeated exposure to allergens. The common allergens in animal units are proteins from body tissue, excretions and secretions from mammals, insects and birds. The symptoms can be provoked by inhalation of allergens or by allergens being introduced into a break into the skin.

Many of the symptoms of ALA are similar to those of hay fever. They include rhinitis (sneezing and running nose), conjunctivitis (sore and runny eyes), skin rashes such as urticaria (hives or nettle rash), weals on the skin around bites and scratches and asthma (tightness of the chest and wheezing). In rare cases, an anaphylactic shock (a severe form of shock and collapse) may also occur. The commonest symptom relating to animal exposure is running eyes and nose although the most important health problem it may cause is occupational asthma, as this may develop into a disabling condition with recurrent episodes of wheezing and breathing problems. For those individuals who develop occupational asthma, symptoms may occur during working hours or may be delayed until several hours after exposure has ceased when the employee is away from the workplace. A temporary improvement can occur following longer breaks from work, e.g. weekends and vacations.

ALA symptoms commonly develop within six months of first starting work with animals and in most cases within a two year period. Occasionally symptoms occur for the first time after many years of working with laboratory animals.

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