Laboratory Animal Allergy Prevention Guidelines

Please note that compliance with University Guidelines is expected in normal circumstances, and any deviation from Guidelines – which should only be in exceptional circumstances – needs to be justifiable.

Purpose

To outline the occupational health surveillance process which protects staff and students working with laboratory animals by identifying those at increased risk, detecting early signs of allergy, and enabling timely intervention to reduce further exposure.

Organisational scope

All University of Otago animal facilities

Definitions

LAA

Laboratory Animal Allergy

SOP

Standard Operating Procedure

HVAC

Heating, Ventilation and Air Conditioning systems

PPE

Personal Protective Equipment

P2

Particulate 2 respiratory mask

PI

Principal Investigator

Content

Content

1. What is Laboratory Animal Allergy (LAA)?

   1. Laboratory Animal Allergy (LAA) is an inappropriate immune response to otherwise harmless proteins (allergens) in the urine, saliva, fur, and skin cells of laboratory animals such as rats and mice. LAA affects 10-50% of individuals who are exposed to these allergens. Symptoms include sneezing, running nose, eye inflammation, skin rash and, most seriously, asthma. In addition to a reduced quality of life for affected individuals, both employees and employers suffer due to absence from work and potentially, job loss. The allergenic proteins implicated in LAA are carried on microscopic dust particles that can remain airborne for considerable periods of time, and, unless contained, can migrate throughout a laboratory or animal facility. They can also be carried around a facility on clothing and hair.
   2. Although individuals who work directly with laboratory animals are most at risk of developing LAA, the migratory ability of the allergens means that LAA can also affect susceptible individuals who have no direct contact with animals. Some individuals have a greater chance of developing LAA than others, since risk factors include the amount of daily allergen exposure and the presence of pre-existing allergies. It is not currently known whether there is an acceptable upper limit for levels of laboratory animal allergens; the aim of LAA management must therefore be to reduce the levels to as low as possible.

2. Guidelines for prevention of LAA

   The Health and Safety at Work Act 2015 and regulations requires the identification of hazards and risks, and the management of hazards/risks by the hierarchy of elimination, minimisation.

   1. Engineering controls – working towards elimination
      1. The primary engineering control to be applied is ventilation and extraction of animal allergens to reduce the number of airborne allergens, thereby reducing exposure. The air levels of allergens are also monitored, however, there is no international standard on the minimum safe exposure (workplace exposure standard) for animal allergens.
      2. Room ventilation: the rate of room extraction, delivery of fresh air and downdraft created is designed to remove allergen loading in the air. The ventilation rates are based on international best practice guidelines at 10 – 15 fresh air changes per hour, with the animal rooms at negative pressure so that allergen laden air is not re-circulated to non-animal areas. The ventilation rates are monitored annually.
      3. Individually ventilated cage systems: exhaust ventilated cages, or individually ventilated cages, remove the air from the cages (the direct source) and vent it straight outside without re-entering the room. This greatly reduces the air-borne allergens. The University will consider the installation of individually/exhaust ventilated cages as a part of the upgrade process of animal facility areas.
      4. Cage change ventilation: cage emptying, or dumping, generates large volumes of airborne allergens. To reduce the hazard, cage dumping stations are used with an extraction unit directly behind the waste receptacle. This unit drags the air from around the operator, across the dumping space, and then vents it to the outside away from the breathing zone. It is important that any cage changing is done with a cage dumping station and for the individual to wear suitable PPE.
      5. The University of Otago has implemented the above engineering controls and monitoring of the environmental levels of allergens (e.g., in the Eccles building) below detectible levels. However, the risk cannot be completely eliminated and there is potential for animal dander and urine to contact or be inhaled during handling and manipulation of animals. The methods of isolation and minimisation must also be applied through the use of Personal Protective Equipment (PPE), and administration (reducing time with the animals).
   2. Isolation and minimisation: Personal Protective Equipment (PPE)
      1. Where possible, building design including ventilation and the use of extraction equipment (individually ventilated cages, change stations, etc.) are purchased and in use where animals are handled.
      2. Each animal facility will have rules and requirements for entering the building with an induction training requirement prior to accessing the facility. All staff and students must complete an Animal Welfare Office (AWO) 101 training course prior to commencing work with animals which includes a section on LAA.
      3. Masks (P2) are required to be worn in all rodent animal facilities. Individuals must be mask-fitted to ensure the mask provides sufficient protection. Gloves, gowns, foot covers and coveralls through to full clothing change may be required to enter the various facilities – check with specific facilities for the requirements.
      4. For those staff or students working with animals for significant periods of time and for high-risk activities (such as cage changing) an air fed respirator will provide effective and more comfortable protection.
      5. There are circumstances where additional PPE is required:
         • Direct skin contact
           Where the work involved requires direct skin contact (such as handling/picking up) with the animals, including surgery, gloves must be worn.
         • Soiled bedding
           Employees working with animals and/or soiled bedding must wear gloves (e.g., nitrile) and disposable lab coats or other coverings (e.g., scrubs). Gloves less prone to puncture (e.g., nitrile) along with proper animal handling and restraining techniques help to reduce the risk of bites. Hand washing and showering after exposure to allergens helps to dramatically remove allergens.
         • Risk of splash
           Where the work has a risk of splashing the arms or face, or high-risk activities such as cage changing, a face shield or goggles must also be worn.
      6. Supply of PPE
         PPE is provided in the animal facilities for authorised users and instructions for donning and doffing PPE will be described in the induction.
      7. Care of PPE
         PPE must be located close to the entrance/exit of the facility. On entering the facility, jackets etc. must be removed, and hands must be washed before putting on a gown and head covering. If individuals are required to handle animals during their visit (rather than just sight observation) they must wear gloves. The facility will have somewhere to store personal clothing items – either by hooks or lockers.
      8. Gloves
         Gloves should be readily available with the option of non-latex gloves. Gloves need to be put on before handling any animals and disposed of immediately after removal. Hand washing is required before putting gloves on and on removal, particularly as individuals exit the facility.
      9. Gowns
         Long sleeves are required to provide protection for the forearms from dander and urine and should be cuffed.  No gowns or other animal facility clothing is to be taken home.  Disposable gowns may be used, are for single use only and must be disposed of when exiting the facility. Check with specific facilities for the requirements.
      10. Hair covers
          Hair covers are to prevent the retaining of animal allergen particles in the hair which are then transferred to non-animal areas. Individuals wearing burqa or veils for religious reasons must ensure complete coverage.
      11. Respiratory protection/P2 masks
          All respirators/masks must meet the requirements of AS/NZS 1715 to ensure an adequate level of protection. Surgical or dust masks do not provide any protection against airborne animal allergens and must not be used. A Particulate 2 or N95 mask is required to prevent the inhalation of animal allergens. These masks may be with or without a valve.

          All P2 masks are required to be fit tested – contact Occupational Health (email ohn@otago.ac.nz) to arrange a mask fitting. Once it is known which mask fits, ensure it is readily available. Only wear the mask that you have been fitted with. If you have any concerns regarding your mask or fit please contact Occupational Health.

      12. Air-fed respirators
          Air-fed respirators or Positive Air Pressure Respirators (PAPR) may be required to reduce exposure if you suffer from allergies to a species you work with. These respirators supply clean filtered air through a mask to the wearer, eliminating animal allergens to the breathing zone.  Such respirators must be trialed and purchased in consultation with Occupational Health. These respirators require full fit testing and on-going monitoring.

3. Health surveillance

   Health surveillance or monitoring is a part of the minimisation process, as allergens cannot be completely eliminated from the environment, and some exposure is possible, so the potential health effects from the exposure must be monitored.

   1. Identifying those requiring surveillance
      1. All staff and students who will be handling animals or exposed to the animal housing environment should be enrolled in the health surveillance programme. All animal related staff appointments, such as technician staff, are enrolled in the health surveillance programme.
      2. Staff and students identified on Animal Ethics approvals through the Animal Ethics Committees who are required to complete module 1, are automatically notified to ohn@otago.ac.nz, or may be identified by access to the animal facility swipe card records.
      3. New staff employed in animal facilities or housing should have the hazard of LAA clearly defined in their job description. Once an appointment has been made, the details of the position and individual are to be forwarded to ohn@otago.ac.nz for enrolment in the health surveillance programme.
   2. Pre-placement health assessments
      1. Where a position/job description clearly identifies that the position requires monitoring based on the criteria above, then pre-placement assessments will be required. The position descriptions must be sufficiently detailed for people with a pre-existing allergy to make an informed decision on whether to apply.
      2. As it is potentially damaging to the health of people with pre-existing conditions to be exposed to animal allergens, it is a condition of employment that a satisfactory health clearance is obtained by Occupational Health before the individual starts work. This includes the transfer of staff between positions. Please contact ohn@otago.ac.nz for further information.
   3. Health Surveillance Programme
      1. The health surveillance system consists of an annual blood test. This test is called a RAST test for Allergen-Specific Immunoglobulin E (IgE). This test measures the levels of different IgE antibodies. If antibodies are increased on testing, it may be an indication that the body is exhibiting an allergic response. A blood form will be sent to staff via their staff email advising to get the blood test. The results will be returned to the occupational health team. If results are normal, staff will not be contacted. If the results are positive, staff will be contacted for a review of their work with animals and further assessment. Individuals can be asymptomatic with an increased IeG but by intervening and increasing protection, further development of allergy can be prevented.
   4. Diagnosed cases of LAA
      1. Where LAA is diagnosed, the ACC processes of determining a work-related illness will be initiated. The decision on the claim and entitlements will follow ACC policies and procedures. Staying at work or returning to work will be managed by the ACC Case Management team.

4. Health monitoring process

   1. The Occupational Health Nurse (OHN) will capture staff members working with animals/in animal facilities within the University. This can be done either by the department informing OHN via email (ohn@otago.ac.nz) when a staff member commences employment, via a departmental training session with OHN, or through onboarding information obtained from Human Resources.
   2. The Principal Investigator (PI) will contact OHN via email (ohn@otago.ac.nz) prior to the commencement of research with details on staff/students participating and their exposure levels.
   3. The OHN will record the details provided by the PI and will provide information on LAA and the monitoring process.
   4. For staff:
      1. the level of exposure will be assessed by the OHN;
      2. a LAA (IgE) blood test will be offered annually;
      3. a blood test form will be provided by the OHN to staff members via their university email. Staff are to visit the nearest testing centre with the completed forms to obtain the blood test.
   5. For students:
      1. the OHN will offer to fit test appropriate PPE if required.
      2. If symptoms develop, the student should contact the OHN by email (ohn@otago.ac.nz) to discuss the reaction. A blood test will also be offered at this time.
   6. Negative result: monitor annually or contact OHN by email (ohn@otago.ac.nz) if symptoms develop.
   7. Positive result: arrange an appointment with the University Occupational Health Physician who will review, recommend PPE and arrange a follow-up blood test in 3-6 months.

   Related policies, procedures and forms

   • Health, Safety and Wellbeing Policy
   • Laboratory Animal Allergy and Zoonosis Prevention Policy
   • The Tertiary and International Learners Code of Practice

   Contact for further information

   If you have any queries regarding the content of this policy or need further clarification, contact:

   Email ohn@otago.ac.nz