Chapter 6: Occupational Health and Exposure Response

The goal of Occupational Health is to promote a safe and healthy workplace through pre-research personnel screening, medical monitoring, and exposure follow-up. Exposure Response develops appropriate, consistent, and thorough treatment plans should an exposure to a biohazard occur.

1.     DEFINITIONS:

1.1. Applicable Student: In the context of the exposure response, an applicable student is one who is paid through a university stipend, and therefore is covered by Occupational Medicine.

1.2. Infectious Agent Fact Sheet: An informative packet of information related to the infectious agent along with proper response to exposure.  It is necessary to ensure proper exposure response by the hospital Emergency Department.

1.3. Occupational Health Questionnaire: An annual health questionnaire, required by Office of Research Integrity and Compliance, which is used to determine if a person has a medical condition that would prevent them from safely working with animals, biohazards, and other hazards.

2.     PROCEDURE:

2.1. Occupational Health Questionnaire

Any faculty, staff, or student working at BSL2 or higher is required to fill out the Occupational Health Questionnaire prior to beginning research. The questionnaire must be completed annually and is located at: https://ohq.hsc.wvu.edu/

2.2. Medical Monitoring

West Virginia University Occupational Medicine provides medical monitoring services to WVU faculty, staff, and some applicable students. Their services include physicals, respiratory protection services including fit testing, and immunizations. Contact Occupational Medicine at (304)-293-3693 for consultation if your research requires medical monitoring.

2.3. Hepatitis B Vaccine

OSHA Bloodborne Pathogen Standard 1910.1030 requires employers to make the hepatitis B vaccine available, at no charge, to all employees who have the potential to have occupational exposure to hepatitis B. This is applicable to WVU faculty, staff, and some students who have the potential for occupational exposure. Contact Occupational Medicine at (304)293-3693 to determine eligibility in the program.

Following your initial bloodborne pathogen training, the trainees are required to sign the Hepatitis B Vaccination Acceptance or Denial Form. Contact the Biosafety Office or Occupational Medicine for a copy of the form. The link can also be found at https://www.ehs.wvu.edu/biosafety/bloodborne-pathogens

2.4. Exposure Response - Biohazard Exposure

Immediate, proper response to biohazard exposure is critical to minimize the potential for injury or infection. In most cases, the treatment for a biohazard exposure is very time sensitive. There are many potential modes of transmission of biohazards to personnel including:

• Skin puncture or injection
• Ingestion
• Contact with mucous membrane (eye, nose, mouth)
• Contact with non-intact skin
• Bite from a recently infected animal
• Aerosols/Inhalation
• Percutaneous contact with the body fluids from a recently infected animal
• Other

The initial response to a biohazard exposure must be first aid. Common first aid responses vary based on the exposure injury.

First Aid

Skin Exposure: Immediately go to the sink and thoroughly wash the skin area with soap and water.

Skin Wound: Immediately flush wound with running water while squeezing to express blood. Next, thoroughly was the wound and surrounding area with soap and water.

Splash to Mucous Membranes (eyes, nose, or mouth): Immediately flush the area with running water for at least 15 minutes.

Response Following First Aid

• The person involved must immediately report the incident to their supervisor or Principal Investigator (Pl).
• The exposed individual should take the Infectious Agent Fact Sheet (Figure 1) and go directly to WVUH Emergency Department.
• If the person could be potentially contagious, please call the WVUH Emergency Department for instructions on how to enter. The charge nurse phone number is (304)598-6122 and main ED phone number is (304)598-4172.
• Please try to call the charge nurse first.
• The Supervisor/Pl should fill out an incident report found on the EHS website within 24 hours of the incident: https://www.ehs.wvu.edu/general-safety/injury-illness
• Once the incident report has been sent, the individual can contact medical management (304)293-HURT(4878) for return to work questions or workers compensation questions.
• The exposed individual should call Occupational Medicine the next business day to inform them of the incident and schedule a follow-up appointment.
• The supervisor/Pl is responsible for reporting the incident to the biosafety officer (BSO) (304)293-7157, aaelliott@mail.wvu.edu.

          

Figure 1. Infectious Agent Fact Sheet

2.5. Exposure Response - Non-biohazard Exposure

For non-biohazard exposures, the following response should be followed. If you have an injury that does not involve an exposure (muscle sprain, cut from a sterile scalpel), you can call Occupational Medicine at (304)293-3693 during business hours (Monday - Friday 8am - 4:30pm). If it is after hours or on a holiday or weekend, please go to the WVUH Emergency Department. If it is a severe injury, go directly to the ED. Call WVU police if you need help with a severe injury (304)293-3136.

Reporting Requirements

All exposures involving biohazardous materials must be reported using a biohazard incident report form found on the EHS Biohazardous Incident Reporting website (https://www.ehs.wvu.edu/biosafety).

If the incident involves recombinant or synthetic nucleic acid molecules (r/sNA), material which falls under NIH Guidelines, the biosafety officer will work with the Pl to collectively complete the NIH Template for Reporting Incidents Subject to the NIH Guidelines for Research Involving Recombinant or Synthetic Nucleic Acid Molecules to the National Institutes of Health Office of Science Policy at https://osp.od.nih.gov/biotechnology/incident-reporting/

If the incident involved the following, then the report must be sent to the NIH Office of Science Policy (OSP) immediately:

• Personnel exposure at Biosafety Level 2 (BSL-2) and/or Animal Biosafety Level 2 (ABSL-2).

For all other incidents, reports must be sent to NIH OSP within 30 days. A few examples include:

• Needlestick or splash to mucous membranes with r/sNA
• Animal bite from an infected animal (including animals with recently introduced r/sNA molecules).

In conjunction with the IBC Chair, the BSO will submit the final incident report to the respective federal agency on behalf of the university. The final incident report will be reviewed by the IBC and corrective actions recommended and instituted as necessary.

2.6. Blood Borne Pathogen Exposure Control Plan

OSHA Blood Borne Pathogen Standard (1910.1030) mandates the employer to develop an exposure control plan document. The WVU BSO has posted the exposure control plan template document for your use. Intent of this plan is to provide the PIs and/or lab managers with an easy to use format that may be used as a template to develop a written exposure control plan for the laboratory. The document helps you to implement work procedure to prevent the exposure of bloodborne pathogens to the personnel that work in/for your laboratory.

The BBP Exposure Control Plan template can be found at: https://www.ehs.wvu.edu/biosafety/bloodborne-pathogens

2.7. Infectious Agent Fact Sheets

In order to provide appropriate and consistent response to biohazard exposure, Infectious Agent Fact Sheets were created by the Biosafety Office for all infectious agents utilized at BSL2 or higher. Each fact sheet is specific for individual PI’s laboratories and will include the following:

• PI name and contact information
• IBC protocol number
• Infectious agent/material name
• Biosafety level
• Description of infection risk
• Transmission mode
• Appropriate disinfectants
• Emergency response for exposure
• Any other pertinent information

The Infectious Agent Fact Sheets must be posted in the individual labs, in a conspicuous location, and the lab personnel must be trained where the sheets are located. See Appendix A of this chapter for an example of an Infectious Agent Fact Sheet.

The Infectious Agent Fact Sheet will have a fluorescent pink cover sheet and contain the title “Infectious Agent Fact Sheet” along with the name of the infectious agent.

4.     EXAMPLE OF INFECTIOUS AGENT FACT SHEET:

                      

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Version History:

Revision Control Table
Version	Changes	Revised by
1.0	Initial version	Matt Stinoski