Section VII – Occupational Health and Immunoprophylaxis

Section VII:  Occupational Health and Immunoprophylaxis (Occupational Health Support Service elements, Occupational Health in the BSL-4 setting)

To comment on this section of the BMBL 5th edition, enter your responses below in the “leave a reply” box. In your comment, please specify what information/table/figure you would suggest to be deleted, modified (how?), or added in this section.

Your comments will be posted on this page for the committee and public to view and respond.

3 Comments

  1. Anonymous's Gravatar Anonymous
    May 20, 2016    

    The first paragraph of this section states that “The health provider should design medical support services in consultation with representatives from the institutional environmental health and safety program and the principal investigators.” Perhaps you could add using the best practice standards recommended, and generally implemented nationally. Following potential exposures or incidents, workers should also be able to seek further information from outside of their institutions without fear of retribution, so that they can inform themselves and their own physicians fully with regard to any future or long-term health care issues.

    (This is based on experience with individuals who are discouraged from seeking addtiional information or speaking directly with subject matter experts)

    Also, it would be beneficial to all if there is some recommendation to institutions to discuss their occupational experiences freely so that others can learn from knowledge gained. (There tends to be a reluctance of institutions to be forthcoming about exposures and incidents, as if they are embarrassed or afraid of legal repercusions. Overcoming this mentality would benefit many.

  2. ABSA Member's Gravatar ABSA Member
    May 10, 2016    

    There is a sentence in the fifth paragraph that should be changed to, “Medical support services for biomedical research facilities should be evaluated annually or whenever there is a change in potential risk”.

    Occupational Health Support Services

    Pre-placement Medical Examinations

    There is a statement, “The health provider should review the worker’s previous and ongoing medical problems, current medications, allergies to medicines, animals and other environmental proteins, and….”

    Comment: This statement should read, “The health provider should review the worker’s previous and ongoing medical problems, current medications, allergies to medicines, animals and other environmental allergens, and….”

    Vaccines

    The last sentence of the third paragraph states, “ Receipt of such vaccines is rarely justified as a job requirement. “ This statement is an opinion which may or may be applicable in any given situation. Since it is an opinion and not specific guidance, the need for this statement is questionable, and its removal should be considered.

    Medical Support for Occupational Illness and Injuries

    The fifth paragraph discusses post-exposure prophylaxis. It is suggested to add the sentence, “If the potential for any post-exposure prophylaxis exists, the worker should be fully informed prior to beginning the work and a course of action determined for each worker taking into account the possibilities of such issues as pregnancy, co-morbid disease state, a significant immunocompromised state, etc.” This pre-defined course of action is especially important if the exposed person is unable to communicate to medical responders at the time of incident.

    The list of items that the medical provider’s description of injuries should include in this section should also include the following items:
    • The possible amount of the potentially infectious agent received by the patient
    • The task being undertaken when the incident occurred.

    Occupational Health in the BSL-4 Setting

    The fifth sentence states, “Thus, SOPs for BSL-4 settings require special attention to management of unexplained worker absence, including protocols for monitoring, medical evaluation, work-up, and follow-up of workers with unexplained absences.” These SOP’s should be required for BSL-3 settings as well. Both BSL-3 and BSL-4 facilities would be working with infectious agents which are transmissible via the aerosol route. Infection from these agents via this route would therefore not always be apparent. Some of these infectious agents may have not have unique signs and symptoms which could be readily recognized and tracked, which places a greater reliance of more passive surveillance via the general indicators of illness noted in this statement.

  3. CSHEMA Biosafety Community of Practice's Gravatar CSHEMA Biosafety Community of Practice
    May 9, 2016    

    Currently, there is no clarity on the re-vaccination timeline for smallpox vaccine for people working with Monkeypox viruses within the laboratory versus infected animals. There is a discrepancy between the recommendations of the BMBL (see section VII, p 118 and VIII-E, p. 219), World Health Organization (WHO) and the most current (2003) CDC Immunization Practices Advisory Committee (ACIP) on the frequency (every 3 or 10 years) of re-vaccination. Vaccination is advised every 3 years for monkeypox virus and every 10 years for cowpox and vaccinia virus. A clear statement on requirements for in vitro, in vivo and working with clinical samples would be helpful.