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SM 445-2-H CHAPTER 24

Occupational Medicine – Prevention of Zoonotic and Vector-Borne Diseases in the Field

Instruction: Chapter 24 was revised to incorporate requirements for awareness, recognition, and prevention of zoonotic and vector-borne diseases encountered in the field. The requirement for a Lyme Disease Protection Program and Appendices 24-1, 24-2, and 24-3 were removed. Appendices 24.A and 24.B were added.

1. Purpose. To specify the minimum Occupational Safety and Health Program requirements for protecting U.S. Geological Survey (USGS) employees engaged in activities where there is an increased risk of exposure to zoonotic and vector-borne diseases when conducting work in the field, including transporting biological materials in vehicles and storing biological materials in non-laboratory facilities. This chapter does not apply to incidents involving outbreaks and emergency response and management of outbreaks.

2. References.

A.  Occupational Safety and Health Act 1970, Public Law 91-596 Section 19, Federal Agency Safety and Health Program.

B.  Executive Order 12196, Occupational Safety and Health Programs for Federal Employees.

C.  29 CFR 1960, Basic Program Elements for Federal Employees, Occupational Safety and Health Programs.

D.  U.S. Department of the Interior Occupational Medicine Program Handbook, latest revision.

E.  Guidelines for Handling Birds to Prevent Spread of West Nile Virus, USGS National Wildlife Health Center.

F.  Department of Interior, Memorandum, and Subject: Updated Employee Health and Safety Guidance for Avian Influenza Surveillance and Control Activities in Wild Bird Populations, 2014, dated July 17, 2014.

G.  Environmental Protection Agency (EPA), Insect Repellents: Reducing Insect Bites http://www2.epa.gov/insect-repellents.

H. Centers for Disease Control and Prevention (CDC), Division of Vector-Borne Diseases .

I.  CDC, “Diseases That Can Be Spread from Pets to People” http://www.cdc.gov/healthypets/diseases/index.html.

3. General Requirements.

A.  Employees working in the field shall be protected from zoonotic (direct animal to human) and vector-borne diseases (transferred for example by ticks and mosquitos) by employing safe work and hygienic practices, use of personal protective equipment (PPE), and receipt of immunizations, as appropriate. Field employees shall also have training to reduce exposures, inclusive of preve ntion measures detailed in Appendix 24.A, Recommended Practices for Preventing Infectious Diseases in Field Work, SM 445-3-H Safety and Health for Field Operations, and on the CDC Web sites in 2.H and 2.I above.

B. Work Practices. Work practices shall include, but are not limited to:

(1) Use proper wildlife handling practices; rodent, wildlife, and pest control practices in field housing and other occupancies.

(2) Use EPA-registered insect repellent such as those containing N,N-diethyl-meta-toluamide (DEET), pyrethrin, or picaridin to repel ticks, mosquitoes, and other biting insects. (Click here for the EPA-registered insect repellent tool.)

(3) Cover exposed skin to prevent insect bites and stings. Tuck pant legs into boots or socks and sleeves into gloves and wear hats. Use of permethrin treated clothing and tick gaiters is recommended.

(4) Perform daily check on oneself for the presence of ticks. Remove attached ticks as soon as possible.

(5) Proper cleanup of rodent, bat, and bird droppings and urine and nesting debris, using wet methods with disinfection. Do not dry sweep or brush to clean. Use a scraper instead.

(6) Clean and disinfect cages, equipment, and surfaces.

(7) Discard disposable gloves and protective clothing in an appropriate receptacle. Wash reusable gloves and other protective clothing.

(8) Avoid creating dust or mists when handling animals or contaminated surfaces and equipment. Work upwind of dust and, where possible, use water to keep dust levels down.

(9)  Do not open carcasses in the field, where it can be avoided. Instead, perform this task in a facility designed for these procedures.

(10)  Discard sharps such as contaminated needles, syringes, and scalpels into a sharps container.

(11)  Where feasible, use surgical scissors or other manual cutters instead of knives to minimize the risk of cutting oneself.12) Minimize direct contact with wildlife, their secretions, and dander.

(13) Minimize direct contact with the carcass when bagging it.

(14) Wash hands with soap and water for 30 seconds immediately after handling wildlife.

(15)  When transporting biological specimens, specimens shall be packaged in primary watertight, leak-proof containers and placed inside a secondary leak-proof container with sufficient absorbent material between containers to absorb spillage from the primary container.

(16) When transporting known infectious substances (etiological agents) or clinical (diagnostic) specimens by vehicle on public roads or by commercial carrier, packaging, labeling, transporting, or shipping shall comply with Department of Transportation hazardous materials regulations. Contact the recipient laboratory or the commercial carrier for packaging and shipping instructions prior to collecting the specimens.

(17) Refrigerators and freezers where biological specimens are stored shall be able to contain leaking fluids from specimens, including when the unit door is opened.

(18)  A spill kit to clean up blood, secretions, excreta, and other biological liquids shall be maintained at facilities where specimens are stored and handled and in vehicles where biological liquids are transported.

C. Personal Protective Equipment (PPE).

(1) In areas presumed or confirmed to be endemic to zoonotic disease, employees shall wear PPE when handling live, dead, or sick wildlife and their biological materials such as tissue, blood, and secretions to protect against splashes and spraying of these materials. The amount and type of PPE is determined by the amount of potential contact with biological materials, animal dander, feathers, and excretions. PPE may include goggles and a face shield, impermeable rubber gloves, puncture-resistant gloves, impermeable coveralls, impermeable aprons, hip waders, rain gear, and impermeable boots or boots coverings.

(2) Wear at least a respirator (either half-face elastomeric respirator with N-95 filter cartridges or a disposable N-95 filtering face piece respirator [dust mask]) when there is a potential for creation of dust or aerosols when handling live, dead, or sick wildlife and their biological materials, and when cleaning up or handling animal bedding and droppings. See SM 445-2-H.18, Respiratory Protection Program for respirator program requirements. The type of respiratory protection will depend on the task and the risk of airborne hazard with infectious or contaminated materials to the employee.

D. Medical Services.

(1) Immunizations and screening, if available, shall be provided to employees who are at increased risk due to handing wildlife or biological specimens, or are assigned to field work in endemic areas. Refer to Appendix 24.A, Recommended Practices for Preventing Infectious Diseases in Field Work, the U.S. Department of the Interior Occupational Medicine Program Handbook and CDC Web sites in 2.H and 2.I for immunizations recommendations.

(2) Where available, vaccinations will be made available within 10 days of initial assignment of the employee to duties with potential occupational exposure to vector-born and zoonotic infections. An employee opting to not receive a vaccination should document the declination using the form contained in Appendix 24.B.

(3) Employees should seek first aid and medical treatment immediately after an exposure mishap, (e.g., animal scratch, puncture or bite, splashing liquids into eyes or mouth, knife cut, needle stick) and when employees display signs and symptoms of illness.

E. Labeling. All containers including refrigerators and freezers in which biological specimens are contained shall be labeled with the biohazard label.

F. Training. Employees who are at an increased risk of exposure or handle biological specimens shall be trained in recognition and prevention of zoonotic and vector-borne diseases. Training should include:

(1) Modes of transmission.

(2) Signs and symptoms of illness.

(3) Use of proper clothing and covering exposed skin.

(4) Use of PPE.

(5) Availability of immunizations.

(6) Other preventive measures such as use of proper insect repellent.

(7) Proper containerization, bagging, labeling, and storage of biological specimens.

(8) Proper transport and shipping of biological specimens in accordance with DOT Hazardous Materials shipping requirements.

4. Responsibilities.

A. Director. Directs prevention of zoonotic and vector-borne diseases program activities through the Designated Agency Safety and Health Official.

B. Associate Directors and Regional Directors.

(1) Ensure that financial resources are provided to local sites to implement zoonotic and vector-borne disease prevention practices.

(2) Ensure that managers and supervisors are accountable for implementing zoonotic and vector-borne disease prevention practices.

(3) Ensure that regional and local program deficiencies are abated in a timely manner.

C. Designated Agency Safety and Health Official. Assigns authority to the Chief, Office of Management Services, to implement zoonotic and vector-borne disease prevention practices.

D. Chief, Office of Management Services.

(1) Assigns program management, administration, and operational program support responsibilities to the Occupational Safety and Health Program Manager.

(2) Ensures that safety staff has sufficient authority, resources, and qualifications to effectively support national capabilities and regional program needs.

E. Occupational Safety and Health Program Manager.

(1) Provides policy development and guidance for the implementation of zoonotic and vector-borne disease prevention practices and provides technical advice to regions, mission areas, and offices.

(2) Conducts program evaluations, in accordance with SM 445-2-H.5 Program Evaluations, to assess the implementation of requirements of this chapter within regions, mission areas, and offices.

F. Regional Safety Managers.

(1) Provide region-wide direction and oversight for the administration of zoonotic and vector-borne disease prevention practices, serving as the focal point for development of local procedures and providing technical advice to field Collateral Duty Safety Program Coordinators (CDSPCs).

(2) Assist CDSPCs as required in establishing and coordinating employee training.

G. Science Center Directors, Cost Center Managers, and Project Chiefs.

(1) Ensure that work practices and PPE are available to and utilized by employees for prevention against zoonotic and vector-borne diseases, and that employees are provided training in recognition and prevention of zoonotic and vector-borne diseases.

(2) Ensure that immunizations, when available, are provided to employees at risk.

(3) Report animal handling mishaps, medical diagnoses of zoonotic and vector-borne illnesses, and tick bites in the Safety Management Information System (SMIS) and investigate the SMIS report.

H. Collateral Duty Safety Program Coordinators.

(1) Assist managers and supervisors with implementation of zoonotic and vector-borne disease prevention practices and training.

(2) Provide assistance to managers and supervisors in coordinating immunizations with health care providers.

I. Employees.

(1) Participate in all required training programs.

(2) Seek prompt medical treatment by health care providers if bitten, scratched, or liquids are splashed into eye or mouth, or if experiencing signs or symptoms of illness.

(3) Report any exposure event (examples include tick bites, animal bites, scratches, or liquid splashes into eye or mouth), or illnesses to the supervisor.

/s/ Jose R. Aragon                                                                June 13, 2016
_____________________________________               ____________                      
Jose R. Aragon                                                                             Date
Associate Director for Administration


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Last modification: 07-Sep-2016@16:28 (kk)