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Chapter 24 : Occupational Medicine in a Biomedical Research Setting

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Abstract:

The principal goal for an occupational medicine program is to promote a safe and healthy workplace through the provision of work-related medical services. In a biomedical research setting that involves biohazardous materials, those services should include a preplacement interview and counseling, a practical plan for responding to suspected exposures and infections, and occasionally the provision of medical surveillance for suspected health hazards in the work environment. A preplacement medical evaluation is recommended for individuals who may be exposed to potential human pathogens, including zoonotic agents. This chapter focuses on medical care for occupational injuries and illnesses. Medical surveillance is an important component of occupational medical support services. The practice of occupational medicine is unique in that the practitioner is responsible to both the employee-patient and the worker's employer. Participation in a serum storage program is generally voluntary, although it should be strongly recommended by the health care provider. Sera should be preserved for the workers’ benefit at -20°C or lower in a non-self-defrosting freezer. The importance of the basic principles for designing medical support services for a workplace—a proper risk assessment and thoughtful advance planning for work-related medical needs—cannot be overemphasized when the workplace is a maximum containment laboratory. Specialized medical surveillance programs and immunization regimens may be necessary. Strict adherence to postexposure monitoring protocols is needed, and provisions for adequate medical facilities in the event of an exposure and/or subsequent infection should be made prior to undertaking biosafety level 4 work.

Citation: Wilson D, Schmitt J. 2006. Occupational Medicine in a Biomedical Research Setting, p 437-444. In Fleming D, Hunt D (ed), Biological Safety. ASM Press, Washington, DC. doi: 10.1128/9781555815899.ch24

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Figures

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FIGURE 1

Injury reports categorized by type over a 7-year period at the NIH.

Citation: Wilson D, Schmitt J. 2006. Occupational Medicine in a Biomedical Research Setting, p 437-444. In Fleming D, Hunt D (ed), Biological Safety. ASM Press, Washington, DC. doi: 10.1128/9781555815899.ch24
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Image of FIGURE 2
FIGURE 2

Illness reports categorized by type over a 7-year period at the National Institutes of Health. Illnesses are defined as those conditions requiring more than one visit to the occupational medical clinic or ongoing medical treatment.

Citation: Wilson D, Schmitt J. 2006. Occupational Medicine in a Biomedical Research Setting, p 437-444. In Fleming D, Hunt D (ed), Biological Safety. ASM Press, Washington, DC. doi: 10.1128/9781555815899.ch24
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References

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1. Advisory Committee on Immunization Practices, Centers for Disease Control and Prevention. 2003. Recommended adult immunization schedule by age group and medical conditions—United States, 2003–2004. Morb. Mortal. Wkly. Rep. 52:965969.
2. Baker,, E. L.,, and T. P. Matte. 1992. Surveillance of occupational illness and injury, p. 178–194. In W. Halpern,, E. L. Baker, and, R. R. Monson (ed.), Public Health Surveillance. Van Nostrand Reinhold, New York, N.Y.
3. Bush, R. K., R. A. Wood, and, P. A. Eggleston. 1998. Laboratory animal allergy. J. Allergy Clin. Immunol. 102:99112.
4. Centers for Disease Control and Prevention and National Institutes of Health. 1999. Biosafety in Microbiological and Biomedical Laboratories, 4th ed. U.S. Government Printing Office, Washington, D.C.
5. Gordon, S. 2001. Laboratory animal allergy: a British perspective on a global problem. ILAR J. 42 (1):37–46.
6. Institute for Laboratory Animal Research. 1997. Occupational Safety in the Care and Use of Research Animals. National Research Council, National Academy Press, Washington, D.C.
7. Institute for Laboratory Animal Research. 2003. Occupational Safety in the Care and Use of Nonhuman Primates. National Research Council, National Academy Press, Washington, D.C.
8. Koh, D., and, T. C. Aw. 2003. Surveillance in occupational health. Occup. Environ. Med. 60:705710.. [Online.] http://www.oem.bmjjournals.com.
9. Rusnak,, J. M.,, M. G. Kortepeter,, J. Aldis, and, E. Boudreau. 2004a. Experience in the medical management of potential laboratory exposures to agents of bioterrorism on the basis of risk assessment at the United States Army Medical Research Institute of Infectious Diseases (USAMRIID). J. Occup. Environ. Med. 46:801811.
10. Rusnak,, J. M.,, M. G. Kortepeter,, R. J. Hawley,, E. Bosenge,, J. Aldis, and, P. R. Pittman. 2004b. Management guidelines for laboratory exposures to agents of bioterrorism. J. Occup. Environ. Med. 46:791800.
11. Wood, R. A. 2001. Laboratory animal allergens. ILAR J. 42(1):1216.

Tables

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TABLE 1

Summary of recommended adult immunizations

Citation: Wilson D, Schmitt J. 2006. Occupational Medicine in a Biomedical Research Setting, p 437-444. In Fleming D, Hunt D (ed), Biological Safety. ASM Press, Washington, DC. doi: 10.1128/9781555815899.ch24
Generic image for table
TABLE 2

Hazardous materials for which OSHA requires medical surveillance

Citation: Wilson D, Schmitt J. 2006. Occupational Medicine in a Biomedical Research Setting, p 437-444. In Fleming D, Hunt D (ed), Biological Safety. ASM Press, Washington, DC. doi: 10.1128/9781555815899.ch24

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