Building A Research Occupational Health Program

Building a ResearchOccupational Health ProgramOLAW Online SeminarMarch 12, 2020Ted Myatt, Sc.D., University of Rhode IslandEileen Morgan, NIH, Office of Laboratory Animal Welfare

OLAW FAQ G.9.: olaw.nih.gov/guidance/faqs#G2

Building a ResearchOccupational Health ProgramOLAW Online SeminarMarch 12, 2020Ted Myatt, Sc.D., University of Rhode IslandEileen Morgan, NIH, Office of Laboratory Animal Welfare

Occupational Healthand Safety ProgramsEileen MorganDirector, Division of AssurancesOffice of Laboratory Animal WelfareNational Institutes of Health (NIH)4

ObjectivesIdentify Occupational Health and SafetyProgram (OHSP) requirements perPHS Policy and GuideIndicate who is responsible for the OHSPIdentify essential components of aneffective OHSP5

RequirementsPHS Policy IV.A.1.f.For institutions with an Animal WelfareAssurance, the Institutional Program for AnimalCare and Use must include a description of “the health program for personnel who work inlaboratory animal facilities or have frequentcontact with animals”6

RequirementsGuide for the Care and Use ofLaboratory Animals, 2011 (p 17-23)“Each institution must establish and maintain anoccupational health and safety program (OHSP)as an essential part of the overall Program ofanimal care and use.”7

RequirementsMedical Evaluation and PreventativeMedicine for Personnel “ development and implementation of aprogram of medical evaluation and preventivemedicine should involve input from trainedhealth professionals, such as occupational healthphysicians and nurses.” “Confidentiality and other medical and legalfactors must be considered ”8

Polling Q19

Componentsof an OHSP Personnel Training Disaster Planning/Emergency Preparedness Risk Assessment Medical Treatment Facilities, Equipment & Monitoring Hazard Identification Health Assessment Personal Protection10

Risk Assessment is anEssential ComponentTwo parts to the risk assessment processinclude: Identifying hazards associated with risks ofthe job Identifying risks of the individualOccupational Health and Safety in the Care and Use ofResearch Animals, National Research Council, 199711

OLAW FAQ G.2. What is Required?Pre-placement medical evaluationIdentification of hazards to personnel and safeguardsappropriate to the risks associated with the hazardsAppropriate testing and vaccinationsTraining of personnel regarding their duties, any hazards,and necessary safeguardsPersonal protective equipment (PPE)12

OLAW FAQ G.2. What is Required?Policies and facilities that promote cleanlinessProvisions for treating and documenting job-relatedinjuries and illnessesFacilities, equipment and procedures designed, selectedand developed to reduce the possibility of physical injuryor health risk to personnelGood personal hygiene practices, prohibiting eating anddrinking, use of tobacco products, and application ofcosmetics and contact lenses in animal rooms andlaboratories13

The institution is responsible forestablishing and maintaining an effectiveOHSPSummary The nature of the OHSP will depend on thefacility, research, hazards, and speciesinvolved beginning with an identificationof those hazards and assessment of theassociated risks An effective OHSP requires evaluation ofprogram components and the coordinationof various research, program,administrative, and facility personnel14

Building an Effective ResearchOccupational Health ProgramTed Myatt, Sc.D.Associate Vice President for Research AdministrationUniversity of Rhode Island15

Requirements for an Occupational Healthand Safety Program (OHSP)PHS Policy IV.A.1.f. For institutions with an Animal Welfare Assurance, the InstitutionalProgram for Animal Care and Use must include a description of “thehealth program for personnel who work in laboratory animalfacilities or have frequent contact with animals.”Guide for the Care and Use of Laboratory Animals (p. 17) “Each institution must establish and maintain an occupational healthand safety program (OHSP) as an essential part of the overallProgram of animal care and use.”16

Health Risks of Animal Care StaffVeterinary services rank 2nd in incidence rates fornon-fatal occupational injuries and illnessesTypes of injuries or illnesses: Laboratory animal allergies, with progression to asthma 10-46% of exposed develop allergies Needlestick/sharps injuries Musculoskeletal disorders (MSDs) Compassion fatigue, stress, burnout Zoonotic infectious disease17

Topics for TodayConfront the barriersImprove upon what you haveBe inclusive Go beyond the Guide Consider the broader research community18

Challenges and Barriers to an Effective OHSPLack of expertiseLack of resourcesInstitutional barriers On-campus health services focused on student health only OHSP focused on clinical care, not research environment19

Polling Q220

What Does Your OHSP Need to be?“The nature of the OHSP will depend on the facility,research, hazards, and species involved.” (Guide, p. 17) Start by evaluating the risks Conduct an assessment of all activities involvinganimals21

Building an Effective ProgramHallmark of anEffective Program?Sound ImplementationStrategiesFocus on developing sound,realistic policies andproceduresBased on your risks, understandprogram needs (i.e., time, resources) It’s OK to start small Utilize outsourced expertise wisely Build in training opportunitiesProgram needs champions Leadership and doersRegardless of size, a successfulprogram requires a team approach22

Engage LeadershipHallmark of anEffective Program?Strong AdministrativeSupportGain SupportEngageProactively discuss regulatory requirementsand risks with senior leadershipData – conduct a gap assessment Internal or external Compare against requirements andpeer institutions Survey program users Rate status of program areas(e.g., not present, developing, mature)23

Challenge – Lack of a Broader OHSPNo on-site occupational health program List of providers as opposed to an occupational program to“integrate” into Urgent care is first line of treatment State-run programs Connect with institutional risk management24

Example SituationGrowing Research InstitutionNo on-site occupational health service No occupational health expertise in-house Used biomedical research focused occupational health consultantto provide remote support (i.e., medical evaluations) Used consultant to train in-house staffGradually expanded in-house programs25

Be Efficient Use available capabilitiesand services Use Health Serviceselectronic medicalrecords system for animalcontact medicalsurveillance andrespiratory protectionmedical evaluation26

Improve Your OHSP – Learn, Grow, EvolvePrograms should be ever changing Semiannual IACUC program review is a good mechanism forself-evaluationIdentify funds for training opportunitiesImprove your logistics Make interacting with the program as easy as possible – consider theresearcher’s perspective Can communication between offices be improved? Interact with Human Resources to connect immediately with new hires Interact with Enrollment Services to obtain student rosters for classesthat involve animal contact27

Be Inclusive – Go Beyond the GuideNIH Guidelines for Research Involving Recombinant or SyntheticNucleic Acid MoleculesOSHA Standards 29 CFR 1910.1030 Bloodborne Pathogens 29 CFR 1910.95 Occupational Noise Exposure 29 CFR 1910.1048 Formaldehyde 29 CFR 1910.1450 Laboratory StandardNuclear Regulatory Commission Standards and Regulations28

Include EveryoneProtections for: pregnant women; immunocompromisedindividuals; and People not involved with theanimal care and use program(e.g. visitors, students,maintenance workers,emergency workers) Ensure yourinstitution does notlimit services tothose with animalcontact What about staff orstudents that do nothave contact withanimals?29

What Does a Program Look Like?Animal Exposure Medical surveillance program, health history questionnaire,tetanus vaccination Employees who handle wild animals will be provided rabiesvaccinationsBiological Materials Laboratory workers who handle pathogens for which there is aneffective vaccine available will be provided vaccinations for thoseagents30

What Does a Program Look Like?Reproductive Concerns Laboratory workers who handle materials for which exposure mayresult in potential reproductive and developmental concerns will beprovided risk evaluation and medical adviceRespiratory Protection Laboratory staff may necessitate the use of a respirator due to medicalconsiderations or exposure to allergens or hazardous materials Connect with EH&S to provide fit testingOther Occupational Injuries31

Example SituationClinical Care Focused Occupational Health ProgramRobust clinical care occupational health program Large research program Beyond basic support for animal care staff (i.e., allergen exposures),there was a lack of understanding of other occupational risksWork to incorporate research issues into larger occupationalhealth program Engaged OHSP team to participate in research-related functions tolearn about research health risks (e.g., attending IBC, IACUC) Established lines of communication with local emergencydepartment to facilitate care the event of exposures32

Improve Your OHSPHallmark of an EffectiveProgram?Ensure Coordination ofProgram ComponentsMeet regularly withstakeholdersContinue to develop resources Medical SOPs for healthproviders Agent specific training, hazardspecific trainingExpand to new areas Ergonomic evaluations33

Build AwarenessIACUC policy requires participation IACUC research protocols and coursesthat involve exposure to animalsIBC policy Communications with faculty, staff,and students Website, flyers, and magnets34

Involve the CommunityGain SupportDemonstrate the value of the OHSP Publish annual progress reportsAsk for feedback35

QuestionsSubmit to the chat box in theGoToMeeting control panel36

Question 1Can you provide possibleapproaches or options that AssuredInstitutions may implementregarding completion of a medicalevaluation?37

Question 2My institution involves usinganimals in teaching. What is theexpectation for the oversight of thestudents in an OHSP?38

Question 3Part IA PI considering writing his own IACUCtraining protocol for rodents. It involvesparticipants who will observe the procedureand others who will have an opportunity toperform hands-on surgical procedures.What are the Occupational Healthrequirements for participants observinganimal procedures and for participantsmanipulating or performing the animalprocedures?39

Question 3Part IIWhat is the most effectivecomposition of the OccupationalHealth Program that would beamenable for a small university withfew resources (e.g., no adjunctmedical school)?40

Question 3Part IIIWhat are the different models thatuniversities use to fulfill NIHrequirements (e.g., externalcontracts, relationship withhospitals)?41

Question 3Part IVWho is responsible for ensuringthat there is an OccupationalHealth Program and where doesthis program fit in the structuralorganization of the institution?42

Question 4How can institutions and theirIACUCs best prepare for acoronavirus pandemic?43

Question 5Part ICan OLAW provide guidance toinstitutions that are unable toconduct semiannual facilityinspections at least once every 6months as a result of a completeshutdown due to COVID-19 and/orwhere only essential personnel areallowed into facilities?44

Question 5Part IIIf OLAW authorizes a waiverregarding conducting semiannualfacility inspections within the 6month timeframe as a result ofCOVID-19, will institutions beallowed to “pick up where they leftoff” or will they be required to“catch up”?45

Question 6If procedures on an IACUC-approvedactivity cannot be performed (e.g.,administration of post proceduralanalgesia) as a result of a facility closuredue to COVID-19, would that beconsidered reportable noncomplianceto OLAW?46