Displaying items by tag: PPE

Safety should always be the first priorty when responding to a stranding. The following guidelines pertain to necropsy situations in the lab or field but remember that even collecting level A data can represent a hazard whether from the animal or from the environment.  Volunteer training should always discuss safety when lifting carcasses, when working near or in the ocean environment, as well as the following information for conducting more thorough exams including necropsies.

Below are current recommendations taken from the NMFS Marine Mammal Health and Stranding Response Program (MMHSRP) to protect the health of stranding network personnel when handling cetaceans or pinnipeds suspected of being infected with Brucella or other infectious, zoonotic diseases (i.e. coccidioidomycosis, cryptococcus, influenza, leptospirosis, Mycobacterium sp., Mycoplasm sp.).

Minimum Recommended Personal Protection Equipment (PPE) for Necropsy (field or laboratory)

• Gloves (disposable, preferably double-glove during necropsy)

• Rubber boots or closed footwear (that can be disinfected)

• Face shields (for field necropsies use if appropriate for environmental conditions)

• Tyvek suits, slickers, other coverall type clothing, waterproof aprons, and/or full wetsuits/skins as appropriate for environmental conditions including temperature and necropsy location.

Special Necropsy PPE for Procedures that Create Aerosols (Stryker Saw/High Pressure Hose Cleaning)

Wear Minimum Recommended Necropsy PPE as listed above with additional recommendations:

• Respiratory protection such as a NIOSH-certified N95 (or greater) filtering facepiece respirator or equivalent is recommended. All respirator users should be fit-tested before use and respirators should be used within the context of a complete respiratory program that meets the requirements in the OSHA Respiratory Protection Standard (29 CFR 1910.134)

• See CDC Safe Work Practices Guidelines-Appendix I for more information or check here.

General Protective Guidelines:

In general, precautionary measures to prevent skin and mucous membrane (eyes, nose, and mouth) exposure to fluids, excretions, and tissues from stranded marine mammals or aborted fetuses can decrease the risk of infection. The following recommendations are listed in order of importance.

• Hand hygiene. Proper hand washing is the most important element of infection control. Wearing gloves does not replace the need for proper hand washing with soap and water, or alcohol-based hand sanitizer if soap and water are not available.

• When appropriate for environmental conditions wear protective clothing during necropsy, including coveralls or coat, rubber or plastic apron, or rain slicker. Impermeable outer garments are recommended if potential exists for clothing to become soaked with animal fluids. Waterproof boots that can be cleaned and disinfected are recommended. Disinfect boots after each use. Examples of disinfectants (bleach, 70% alcohol, etc.) can be found in the following resource (Nasphv.org Vet Precautions2010 – Appendix II)

• Outer clothes worn when working with animals or tissues should be cleaned at work when feasible. Disposable items should not be reused, and wash and dry soiled clothing separately from other items.

• Disposable gloves are recommended when handling potentially infected animals, tissues, fluids, or excretions.

• Clean and treat cuts and scratches with an antiseptic and cover with a bandage. Report injuries to your supervisor and document appropriate medical treatment.

• A face shield that covers the entire face is recommended to be worn during all necropsy procedures and especially if splashes or sprays are anticipated. Full-face plastic shields are preferred over goggles as they provide additional protection for the mouth and nose. Should any potentially infectious material enter the eye, the eye should be flushed for at least 10 minutes with water under clean or aseptic conditions. Exposure should be documented and prompt medical attention is recommended.

• Activities that generate dust or aerosols should be avoided as much as possible to limit the potential for respiratory exposure. Wet mopping, High-Efficiency Particulate Air (HEPA) vacuums, and avoiding the use of high pressure water sprayers for cleaning is recommended. PPE as described above are recommended to be worn during necropsy and cleaning activities.

• If feasible, staff should consider participating in a medical surveillance program. Baseline serology should be considered for new staff before starting work. Staff are encouraged to report symptoms that could be compatible with potential infectious diseases. Any staff that develop disease are encouraged to seek prompt medical attention for diagnosis and treatment.

• People under 18 years of age, pregnant women and people with weakened immune systems are recommended to be excluded from handling potentially infected animals or tissues because these people are at higher risk for infection.

Personnel Health Monitoring:

• Brucella has never been documented in humans after direct exposure to marine mammals, though there has been a single case of occupational exposure in a laboratory worker that was obtained after working with isolates from an infected dolphin (Brew et al. 1999). Therefore, there is a low but possible risk of transmission of Brucella bacteria to animal care workers from infected animals at necropsy.

• Monitoring for clinical signs and symptoms of human illness are encouraged, and it is recommended that any human illness related to zoonotic disease exposure be reported to the stranding facility, the NMFS Regional Office, MMHSRP HQ, and the appropriate health officials.

Disposal of Carcasses:

• Carcasses with suspected coccidioidomycosis should be incinerated following post mortem examination.

• Carcasses with other suspected zoonotic diseases should be disposed of according to current practices for your facility, and local and state regulations, i.e. burying on the beach, rendering, incineration, or composting. Some guidelines on disposing of carcasses infected with influenza can be found in the USDA Draft Summary HPAI Plan, page 71.

Thanks to Dr. Katie Colegrove for compiling and reviewing these guidelines.