* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
Download safety manual - The Wildlife Rehabilitation Center of Minnesota
Oesophagostomum wikipedia , lookup
Onchocerciasis wikipedia , lookup
Marburg virus disease wikipedia , lookup
Brucellosis wikipedia , lookup
Neglected tropical diseases wikipedia , lookup
Schistosomiasis wikipedia , lookup
Middle East respiratory syndrome wikipedia , lookup
Eradication of infectious diseases wikipedia , lookup
African trypanosomiasis wikipedia , lookup
Sexually transmitted infection wikipedia , lookup
provides quality medical care and rehabilitation for all injured, sick and orphaned wild animals, and shares its knowledge with the people who care about them. 2530 Dale Street, Roseville, MN 55113 651-486-9453 FAX 651-486-9420 www.wrcmn.org SAFETY MANUAL for Wildlife Rehabilitation Center of Minnesota Staff and Volunteers Reviewed and updated January, 2015 SAFETY MANUAL for Staff and Volunteers Table of Contents I. Introduction II. Emergency Situations 3 A. B. C. D. E. F. G. H. Emergency Exits/Fire Extinguishers Fire Emergency Tornado/Weather –Related Emergency Bomb Threat Emergency Bomb Threat Checklist Human-Related Emergency (Medical and Psychiatric) Maintaining a Safe Workplace Environment Minor Medical Emergencies 1. First Aid Kits 2. Puncture Wounds 3. Cuts and Bleeding 4. Splinters I. Reporting of Safety Incidents to Management 1. Incident Report Form 2. Sample Incident Report Form 4 6 7 8 9 10 11 12 13 14 15 III. Daily Operating Safety Procedures A. Exposure to Diseases and Parasites Carried in Wild Animals B. Rabies Immunization Policy C. Tetanus Immunization Policy D. Diseases Carried in Wild Animals E. Parasites Carried in Wild Animals F. Hand Washing G. Animal Handling H. Safe Handling/Storage of Medications/Medical Equipment I. Safe Handling of Chemicals J. Chemical Spills/Radiology/Medical Gases K. Enviro Care Material Safety Data Sheet (MSDS) L. ACCEL Material Safety Data Sheet (MSDS) 16 17 21 23 30 33 34 35 35 38 38 40 IV. Personal Safety A. Hygiene B. Eye Protection C. Physical Limitations D. Eating/Drinking E. Control of Personal Belongings to Control Theft F. Parking and Personal Safety G. Harassment/Misconduct H. Pregnancy 42 43 43 43 44 44 44 45 2 WRC Safety Manual I. INTRODUCTION The Wildlife Rehabilitation Center of Minnesota (WRC) is a unique facility: a wildlife hospital. The very work we do is unusual and poses some unique challenges to protecting the health and safety of all the persons who do this work. While the people who choose to be here have a care and concern for wild animals, that care must always be exercised with caution and good judgment for their own safety and for the safety of the people around them. It is not possible for any manual to be written in such a way as to anticipate all of the possible risks or variable ways in which circumstances could evolve on any given day. This manual is intended to set forth some general guidelines. Compliance with this manual is critical to the successful operation of WRC—AND TO THE SAFETY OF ALL WHO ARE HERE. This manual is not intended to serve as an all-inclusive framework that can guarantee safety. It is intended as a general guideline to minimize and reduce risks. At any given time, each individual must assess the circumstances and risks of performing certain tasks with and around wild animals. Therefore YOU are the key to a safe and successful experience at WRC. The safety of the staff, volunteers, visitors and guests in our building is the foremost priority of the WRC. After that comes the safety of the wild animals under our care. At no time should any individual risk injury or possible death to care for an animal. At no time should the safety of an animal take precedence over the safety of a person. 3 WRC Safety Manual II. EMERGENCY SITUATIONS A. WRC BUILDING – MAIN LEVEL X = Fire Extinguishers PPE = Personal Protective Equipment Station (gloves, masks, goggles, hand sanitizer) PPE PPE PPE 4 WRC Safety Manual A. WRC BUILDING – LOWER LEVEL X – Fire Extinguisher 5 WRC Safety Manual B. FIRE EMERGENCY CALL 911 immediately any time flames are seen. (if using a WRC phone dial 9 for an outside line) Fire extinguishers are located: Main Level: At Top of Staircase Nursery Hallway Main Lobby Lower Level: Volunteer/Staff Lounge Back Hallway Remain calm. Notify a staff member. Shut all doors if it is possible to do so safely. Leave the building by the nearest exit. The diagrams on the preceding two pages show the emergency exits as well as other exits to the building. Proceed to the south end of the parking lot (near the gazebo) and wait there with other staff and volunteers until everyone has been accounted for. It is important that everyone meets in this area so we can be assured all personnel have left the building. At no time should an individual risk injury or possible death to rescue an animal. Note: The building is equipped with a “dry sprinkler system.” It is an automatic sprinkler system with pressurized air in the piping, rather than water. This allows for the pipe to be installed in unheated, as well as heated areas, without the risk of freezing. The sprinkler heads have a small glass fixture which, when broken—either by heat or by direct contact—causes a loss of air pressure allowing the system to fill with water. Water will then flow from the open heads (but not from all the heads) to control the fire until the fire department arrives. In the absence of a fire or direct contact, if water should begin spraying from any sprinkler head, please contact a staff member immediately. 6 WRC Safety Manual C. TORNADO/SEVERE WEATHER EMERGENCY It is the responsibility of the staff to alert everyone in the building of a tornado or severe weather warning for the area. In the event of an imminent tornado or severe winds, everyone should stay indoors and away from windows and doors. Move quickly to the lower level and stay in the interior hallway between the lounge and the volunteer entrance door. Close the hallway door that connects to the lounge area. Do not attempt to leave the building; you could be in greater danger outside. Animals should be left in their cages and not removed from the building during a tornado, tornado watch or warning. AT NO TIME SHOULD AN INDIVIDUAL RISK INJURY OR POSSIBLE DEATH TO RESCUE AN ANIMAL. In the event of a temporary power outage, auxiliary lighting attached to the “EXIT” signs will turn on automatically. Flashlights are located in the fire extinguisher cabinets, with the fire extinguishers. 7 WRC Safety Manual D. BOMB THREAT EMERGENCY In the event a bomb threat is received: (Remember, all bomb threats must be considered real until proven otherwise.) DO NOT USE CELLULAR PHONES, TWO-WAY RADIOS, OR OTHER ELECTRONIC DEVICES AS THEY MAY INTERACT WITH RADIO-CONTROLLED DEVICES OR BOMBS. CALL 911 (do not use cell phone: call from a WRC phone, dial 9 for an outside line) Give this information: • Say “I have received a bomb threat” • Your name: • Our location: Wildlife Rehabilitation Center 2530 Dale Street North Roseville, MN 55113 • Our phone: 651-486-9453 DO NOT TOUCH ANY SUSPICIOUS OBJECTS Fill out the following information sheet to record pertinent information and have this information ready when law enforcement authorities arrive. Information sheets are found with the Incident Report forms in the upstairs First Aid cabinet and at the front desk. As soon as you have called the authorities, notify a staff member who will notify everyone in the building. Everyone should proceed quickly and calmly to the Harriet Alexander Nature Center to await further instructions from the authorities. It is important that everyone who leaves the building goes to this location so that all staff and volunteers can be accounted for. 8 WRC Safety Manual E. BOMB THREAT CHECKLIST 9 WRC Safety Manual F. HUMAN-RELATED EMERGENCY (accidents, medical, psychiatric) For accidents or medical emergencies involving staff, volunteers, or visitors • Determine if the person needs your help. Ask them if they are okay. • If the person is unresponsive, call 911 even if you must leave them (if using a WRC phone dial 9 for an outside line) Give this information: Your name: Location: Wildlife Rehabilitation Center 2530 Dale Street North Roseville, MN 651-486-9453 Phone: Describe the injury, illness or problem • Notify a staff member. • Do not move an injured or ill person. Try to make them comfortable. • Arrange for someone to meet the emergency response team. • Stay on the line to answer questions. For psychiatric emergencies involving staff, volunteers or visitors • Remain calm and proceed in a logical, rational manner. • Assess the situation in terms of the degree of threat, injury or damage. • If necessary, take shelter away from the individual, assisting others if necessary. • Notify a staff member. If there is actual or threatened physical harm to persons or property call 911 (if using a WRC phone dial 9 for an outside line) Give this information: Your name: Location: Wildlife Rehabilitation Center 2530 Dale Street North Roseville, MN 651-486-9453 Phone: Describe the problem 10 WRC Safety Manual G. Maintaining a Safe Workplace Environment It is WRC’s goal to provide a safe workplace environment on the premises of WRC for all staff and volunteers. Most of this manual deals with safety involving accidents or mishaps on the job at WRC. However, in today’s world, we acknowledge that we cannot control or anticipate physical or other threats that may occur, including crimes of violence, from unexpected sources beyond our premises or outside our control. Safety of staff and volunteers is our highest priority. ALWAYS! Human safety takes priority over animal safety at all times. In the event of some type of violent threat or behavior by an individual in or near our premises: IMMEDIATELY CALL 911 (on WRC phone, dial 9-911) FOLLOW INSTRUCTIONS FROM EMERGENCY RESPONDERS Remain calm and proceed in a logical, rational manner Notify a staff member if it is safe to do so Do not take undue risks to “be a hero” 11 WRC Safety Manual H. MINOR MEDICAL EMERGENCIES Accidents and injuries happen and it is important that everyone know the appropriate course of action to follow if there is risk of contact with any human body fluids. All human body fluids are considered potentially infectious and it is important to follow the safety precautions established by the Center for Disease Control and Prevention (CDC). 1. FIRST AID KITS are located in: • • Exam/Treatment Room, in cupboard above intake computer. Volunteer/staff Lounge, in cupboard above the sink. Simple first aid can be performed with the supplies contained in the First Aid kits remembering that all human body fluids are considered potentially infectious to other humans. To avoid unnecessary exposure it is recommended that anyone with a minor wound treat his or her own injury. Minor injuries can be treated with general first aid measures keeping in mind that your personal safety is important. If a staff member or volunteer chooses to assist an injured person, the CDC recommends wearing disposable, impervious gloves for protection whenever there is a chance of contact with blood, any other human body fluids or possible infectious material. Disposable gloves are located with the first aid kits in the above locations. If towels or paper products are used to absorb blood or fluids these are considered contaminated and need to be doubled-bagged in sealed plastic bags before being disposed of with the garbage. Any surface contaminated with human body fluids should be disinfected by flooding the area with a 1:10 dilution of bleach (sodium hypochlorite) followed by wiping of the area with disposable towels soaked with diluted bleach. Other suitable disinfectants can be also be used. These cleaning supplies also need to be doubled-bagged in sealed plastic bags before being disposed of with the garbage. Finally the area should be allowed to air dry. When there is no further risk of exposure to body fluids remove the gloves being careful not to touch the contaminated surfaces. Gloves should be removed prior to leaving the area and doubled-bagged in sealed plastic bags. Wash hands thoroughly after removing gloves. 2. Puncture Wounds For a shallow wound allow normal bleeding (dabbing the area occasionally). This enables the wound to cleanse itself. When bleeding subsides, wash the area well with soap and water and rinse thoroughly. Dry and inspect to make sure the wound is clear of glass, wood or dirt. Apply antiseptic cream or ointment and an absorbent, sterile bandage. For deep punctures, apply pressure with a clean or sterile cloth to control bleeding and see a doctor. A tetanus booster may be needed if the last immunization was five or more years before. 12 WRC Safety Manual 3. Cuts and Bleeding Cover the cut with clean gauze and press directly on the cut for 5-10 minutes. If bleeding continues, press on the pulse point near the groin or on the inside of the upper arm. Rinse the cut thoroughly with soap and warm water and remove dirt particles if they are easily loosened. If the cut is on a leg or arm, elevate the injured area above heart level to slow the flow of blood to the wound. When bleeding stops, cover the wound. A tetanus booster may be needed if the last immunization was five or more years before. 4. Splinters Grasp the splinter with sterile tweezers and gently pull it out in the same direction that it entered. Wash the area with soap and water and apply antiseptic cream and a sterile bandage. A tetanus booster may be needed if the last immunization was five or more years ago. I. REPORTING OF SAFETY INCIDENTS TO MANAGEMENT All safety incidents must be reported promptly and in writing to the management and/or medical staff by completing an Incident Report (see examples that follow). Reportable incidents are injuries sustained by anyone while on the premises of WRC. Injuries relating to handling animals (scratch, bite, puncture wound) are the most likely injuries to occur at WRC, but other types of injuries (e.g. slip and fall, undue exposure to known diseases or hazardous chemicals, etc.) should also be reported. Sample “Incident Reports” follow this page. The completed and signed form must be submitted to the staff before the injured person leaves the premises on the day of the incident. 13 WRC Safety Manual 1. WRC Incident Report Form INCIDENT REPORT Name Date & Time incident occurred Volunteer activity/shift Phone (home) Was an animal involved? Yes (work/cell) No If yes, give species case number Please give a detailed description of the incident including immediate action taken Give name and phone of anyone who witnessed the incident: Signature of person completing report Date To be completed by staff veterinarian: Describe action taken with animal, if applicable: _____ animal was euthanized _____ euthanized and submitted for rabies testing _____ cautionary statements placed on animal's cage, treatment sheet and hardback _____ other, please describe: _____________________________________________________ _____________________________________________________________________________ Was injured advised to seek medical advice and check on status of tetanus immunization? ____ Was a follow-up phone call made? Veterinarian’s signature Date _____________________________________ 14 WRC Safety Manual ________ 15 WRC Safety Manual III. DAILY OPERATING SAFETY PROCEDURES A. EXPOSURE TO DISEASES & PARASITES CARRIED IN WILD ANIMALS Animals admitted to the Wildlife Rehabilitation Center (WRC) can carry a wide range of infectious diseases that can be transmitted to humans (called zoonoses or zoonotic diseases). Employees and volunteers must have a basic understanding of zoonotic diseases to help decrease their risk of contracting such diseases. Multiple bacterial, viral, fungal, and parasitic infections can be associated with animal contact, and the infecting organisms are transmitted through various modes. The methods for direct transmission include (but are not limited to): Inhalation: inhaling air contaminated with aerosolized body fluids and feces (droppings) and/or splashing of body fluids from infected animals. Direct Exposure: contact from infected animals’ body fluids, including saliva, with abrasions and/or cuts in the skin or mucous membranes (eyes, nose, or mouth). Puncture Wounds: cuts from claws, beaks, contaminated broken bones, and/or punctures and cuts from contaminated equipment (needles, scissors, scalpels, etc.). The precautions discussed should be followed when handling all wildlife, especially those that appear sick. Handling wild animals can increase the opportunity for exposure to many diseases. Depending on the circumstances, some or all of the personal protective measures listed should be used to reduce the possibility of direct exposure to zoonotic diseases. Barrier protection (disposable gloves, masks, and goggles or safety glasses) should be used anytime there is a possibility of contact with body fluids. Other protective measures include washing hands, wearing long pants, and wearing boots or closed-toe shoes. The recommendation to wash hands frequently is the single most important prevention step for reducing the risk for disease transmission. The zoonotic diseases that are most likely to be encountered at the WRC are discussed on the following pages. Other possible diseases and/or parasites volunteers and staff could be exposed to include Cryptosporidiosis, Giardia, Listeriosis, Psittacosis, Toxoplasmosis and Tularemia. These conditions occur very rarely in Minnesota wild animals and chances are extremely low a volunteer or staff member would contract any of these diseases, but everyone needs to be aware of the possibility of exposure. Employees and volunteers should discuss the potential for zoonotic disease transmission with their physician. Extra care should be exercised by anyone with open sores or wounds. For a person with a compromised immune system due to immunosuppressive drugs, chronic disease, pregnancy, splenectomy, HIV infection, chemotherapy, radiation, hemodialysis, age, etc., it may not be appropriate to work with wild animals. Consultation with your physician is recommended. Staff and volunteers should also consult a physician if they are bitten or scratched by an animal at WRC. Additionally all injuries need to be reported to WRC personnel along with a completed Incident Report. 16 WRC Safety Manual One of the more significant safety risks at the WRC is exposure to rabies. Because of this risk and because rabies is a fatal disease, no one is permitted to work with, or in the vicinity of, wild rabies-vector mammals unless they are adequately immunized against rabies. All volunteers and employees working with rabies-vector mammals are REQUIRED to have rabies preexposure immunizations followed by written rabies titer results showing an adequate protective titer from the rabies vaccination. The only exceptions are those volunteers working with nonrabies vector species in the Avian, Waterfowl and Mammal Nurseries. Vaccinated staff will admit rabies-vector mammals for non-immunized Intake volunteers. The Rabies Immunization Policy, along with detailed information about the required process for immunizations and testing follows. B. RABIES IMMUNIZATION POLICY PURPOSE: WRC treats thousands of wild animals annually. Because rabies is a fatal disease, immunization against rabies is required to protect our staff and volunteers against the virus. POLICY: All volunteers and employees working with rabies-vector mammals are REQUIRED to have rabies pre-exposure immunizations followed by written rabies titer results showing an adequate protective titer to the rabies vaccination. The following information clarifies this policy. What is rabies? Rabies is an infectious, deadly viral disease that affects the central nervous system. It is a fatal disease. The rabies virus is most often spread by a bite and saliva from an infected (rabid) animal such as a raccoon, fox, coyote, skunk or bat. . Other mammal species, such as muskrat, opossum, and woodchuck can also harbor the rabies virus, although the incidence is much lower. Natural immunity to rabies in humans is unknown. Prompt wound care and the administration of post-exposure prophylactic vaccine are highly effective in preventing human rabies following exposure. What is rabies pre-exposure immunization? There is no treatment for rabies after symptoms of the disease appear. In 1980 an extremely effective rabies vaccine regimen was developed for use before an exposure occurs. This preexposure vaccination against rabies simplifies the rabies post-exposure treatment and may provide protection in cases of unrecognized rabies exposure or when post-exposure treatment is delayed. Pre-exposure prophylaxis is not meant to offer complete protection from rabies infection; two additional injections will still be needed after a known rabies virus exposure for pre-immunized persons. The main benefit of pre-exposure prophylaxis is the rapidity with which immunity develops. Pre-immunized persons still must receive booster shots after an exposure. Currently two types of vaccine; Imovax (HDCV - Human diploid cell vaccine) and RabAvert (Purified chick embryo cell vaccine - PCECV), are available and both are equally effective if given according to the recommended route and schedule. Pre-exposure immunization is provided by a series of three, relatively painless injections of vaccine. Intramuscular injections must be given in the deltoid area (upper arm) on days 0, 7, 21 or 28. This series of three injections can be expected to produce protection (neutralizing antibodies) in 100% of those vaccinated. 17 WRC Safety Manual What if I get the first injection, but can’t get the second and third on the appropriate days? Since three appropriately timed injections are necessary for the immunization to be effective, you should carefully schedule the first injection at a time when your schedule will permit you to complete all three within the appropriate time frame. Call your doctor’s office or the Minnesota Department of Health (651-201-5414) for advice. Rabies prevention is a serious matter and changes should not be made in the schedule of doses. Who is required to have the pre-exposure rabies vaccination series? All staff employees are required to have the vaccination series. All volunteers who: •work on an Animal Care Crew •work in a Mammal Nursery with rabies-vector animals •are professional visiting veterinarians •are Interns or Externs or students working in the treatment room •release or handle rabies-vector mammals What are possible side effects from the vaccine? Tenderness, redness, swelling or itching at the injection site may occur. Minor reactions such as headaches, nausea and a slight fever have been reported. Usually, such reactions can be successfully managed with anti-inflammatory and antipyretic medications such as ibuprofen or acetaminophen. Major reactions are very rare. How do I know if I received an adequate response from the vaccination? The Wildlife Rehabilitation Center requires a blood (serum) test, called a rabies titer, to be done after your last immunization. The blood sample is taken in your doctor’s office and mailed to one of several labs around the country that perform this specialized testing. WRC requires a copy of the satisfactory titer results and repeat titers every two years to confirm a continued adequate response. Who should not receive the rabies vaccine? The following people should not receive the vaccine without prior approval from their physician: • anyone who is pregnant. • anyone taking oral or injected cortisone. • anyone who is ill and/or has a fever. • anyone who has previously had reactions to this vaccine. • anyone with a health problem affecting their immune system. • anyone taking or planning to take malaria medication in the next eight weeks. • anyone unable to receive the injections on each date indicated. • anyone with a health condition that might be adversely affected by receiving the vaccination. 18 WRC Safety Manual Who pays for the immunization series? Each employee and volunteer is required to pay for their own immunizations and titer. Contact your health plan or physician prior to the first immunization to determine insurance coverage. Health plans often will pay all or part of the cost. Are boosters required? Rabies immunization lasts for an unknown period of time so the Wildlife Rehabilitation Center requires repeat titers every two years to confirm a continued adequate response. Booster(s) immunizations may be required depending on the results of the titer test. Who does not have to go through the pre-exposure rabies vaccination series? Volunteers who are involved with activities such as clerical, computer, education, or whose involvement does not include animal contact of any kind do not need to be immunized. Anyone who has not been vaccinated is restricted to the public or downstairs office areas, with the exception of Nursery volunteers who do not work with rabies-vector mammals. Vaccinated staff will admit rabies-vector mammals for non-immunized Intake volunteers. Vaccination is strongly recommended for everyone working at WRC to prevent against unintended exposure. How soon should new volunteers be immunized? It is our desire to have everyone vaccinated before they start orientation, however, most volunteers start their immunizations at the time they start volunteering. We require that volunteers not enter the mammal ward, the treatment room, or the front lobby any time a mammal is out of its cage, being treated, or being admitted until they have finished the series and received titer results showing an adequate response. There are no exceptions to this policy. What should you do if you are bitten or scratched by an animal? It is the responsibility of everyone to make others aware when a mammal is at large, loose, or being examined so that the incidence of potential contact is reduced. If you are bitten or scratched by any animal (no matter how small the injury appears) notify your Crew Leader and the staff veterinarian or a staff member if the veterinarian is not available. Wash the wound thoroughly with povidone-iodine solution (Betadine®) located with the FirstAid kits, or another virucidal and/or anti-microbial soap and hot water for several minutes, and call your personal physician, ER, or Urgent Care Center within 24 hours for advice. In every instance an Incident Report, located by the First Aid Kit in the treatment room, must be completed. Pre-exposure vaccination does not eliminate the need for additional medical attention after a rabies exposure, but it simplifies post-exposure prophylaxis by eliminating the need for human rabies immune globulin (HRIG) and decreasing the number of vaccine doses needed. Administration of post-exposure vaccine is considered a medical urgency, not a medical emergency. Current vaccines are relatively painless and are given in your arm, like a flu or tetanus vaccine. According to the Center for Disease Control and Prevention website, there have been no vaccine failures (where someone developed rabies) in the United States when post-exposure prophylaxis was given promptly and appropriately after an exposure. 19 WRC Safety Manual What is the risk of contracting rabies from squirrels, mice, and other rodents? While all warm-blooded animals are susceptible to rabies, small rodents (such as squirrels, mice and chipmunks) and lagomorphs (rabbits) are almost never found to be infected with rabies and have not been known to cause rabies among humans in the United States. The following are “species of special concern” and they must be euthanized and sent for rabies testing if they bite and break the skin. Extra care should be taken when handling these animals so as not to put you or the animal at risk. The animals that must be euthanized if they bite someone are: Badger Fox Otter Woodchuck Bat Mink Porcupine Skunk Beaver Muskrat Raccoon Bobcat Coyote Opossum Weasel Rabies is a lethal disease. COMPLIANCE WITH THIS POLICY IS MANDATORY - YOUR LIFE AND THE LIFE OF THE ANIMAL MAY DEPEND UPON IT! Please use care and caution to protect yourself and the animals. If you cannot be vaccinated for medical reasons, but would still like to help wildlife, we have many other areas at the WRC that need your help. ADDITIONAL RESOURCES: Boynton Health Service Immunization Clinic at the University of Minnesota: East Bank Clinic (Minneapolis) 612-625-3222 (appointments) West Bank Clinic (St. Paul) 612-624-7700 (appointments) Boynton Health Clinics serve University of Minnesota students, staff and faculty, however those not affiliated with the University can obtain immunizations at either of the Boynton locations on a fee-for-service arrangement. The rabies titer blood test is much less expensive than the injections and can be drawn at the same time as other blood work. Travel clinics throughout the metropolitan clinic also offer rabies immunizations and titers. Sources: National Wildlife Health Center: http://www.nwhc.usgs.gov Centers for Disease Control and Prevention (CDC): www.cdc.gov/ncidod/dvrd/rabies Centers for Disease Control and Prevention (CDC) http://www.cdc.gov/rabiesandkids/ National Network for Immunization Information (NNii): www.immunizationinfo.org Boynton Health Service at the University of Minnesota: www.bhs.umn.edu Minnesota Department of Health – 651-201-5414: www.health.state.mn.us 20 WRC Safety Manual C. TETANUS (LOCKJAW) IMMUNIZATION POLICY What is tetanus? Tetanus (lockjaw) is an acute disease characterized by intermittent spasms of the muscles and/or convulsions. The spores that cause tetanus usually enter the body through a wound. In the presence of low oxygen conditions (such as found in a puncture wound) the spores produce toxins. The tetanus toxins then interfere with the function of the nervous system which, in turn, causes spasms of the jaw, neck, abdomen, and back muscles. An average of 30 cases a year has occurred in the U.S. since 1996 and death results in about 1 in 10 cases according to the CDC. Because this is a serious disease, everyone at WRC needs to be immunized against tetanus. The following information clarifies this policy. Who is at risk? Volunteers and staff members who care for mammals are more likely to be exposed to the spores that cause tetanus than the general public. The successful decline in cases and deaths is the result of years of mandatory childhood immunizations. How is tetanus transmitted? The spores that cause tetanus are widely distributed in soil and in the intestinal tracts and feces (droppings) of many animals. Transmission occurs primarily through contaminated wounds, whether large or small. Tetanus infection is most often the result of wound contamination in an unimmunized person or someone who has not had a vaccine booster in many years. What is tetanus immunization? Due to mandatory childhood immunization laws, most people had the initial (primary) series of three tetanus/diphtheria (Td) immunizations as children. Following a properly administered primary series, virtually everyone develops a protective level of antitoxin (immunity) to both diseases. However, antitoxin levels fall over time and, while some people may be protected for life, most will have antitoxin levels that approach a minimal protective level by 10 years after the last dose. Emergency booster doses are unnecessary if the wound is clean and minor (not tetanus prone) and primary or booster immunizations against tetanus have been given in the last 10 years. However, an emergency booster is necessary in individuals with a clean, minor wound if the primary series was incomplete, or if more than 10 years has elapsed since the primary or last booster dose. In a small percentage of people, antitoxin levels fall below the minimal protective level before 10 years. To ensure adequate protection in individuals who sustain a wound that is tetanus prone, a booster is recommended if more than 5 years have elapsed since the last dose. 21 WRC Safety Manual Tetanus vaccination is virtually 100% effective in preventing the disease after completion of the initial three-dose series and with the administration of boosters every 10 years in the deltoid muscle (upper arm). Several formulations of tetanus vaccine are available for use depending on age, previous vaccination status and the use of combination vaccines. Tetanus vaccine is safe in pregnancy if given under the guidance of a primary care provider. Are there side effects from the vaccine? Local reactions, such as fever, redness and swelling at the injection site are not uncommon and are usually self-limiting and require no therapy. Routine boosters can be deferred in case of illness, but a booster required at the time of an injury should not be deferred except in cases of moderate or severe acute illness. Who does not need tetanus immunization? Immunization is strongly recommended for all staff and volunteers regardless of whether or not their work is in the animal care area. Anyone who has a moderate or severe illness on the day the shot is scheduled should usually wait until they recover, however a person with a mild illness or low fever can usually be vaccinated. How soon should new volunteers be immunized? New staff and volunteers who do not know the date of their last booster should contact their primary care provider for this information and obtain a booster if more than 10 years have elapsed since the previous immunization. Who pays for the immunization? Each volunteer is required to pay for their own immunization. Most health plans will pay all or part of the cost since this is considered preventative care. What should you do if you are bitten/scratched by an animal or otherwise injured? If you are bitten or scratched by any animal (no matter how small the injury appears), or are injured in any other way, notify your crew leader and have a staff member inspect the wound. Wash the wound thoroughly with povidone-iodine solution (Betadine) located with the First-Aid kits, or another virucidal and/or anti-microbial soap and hot water for several minutes, and call your personal physician, ER, or Urgent Care Center within 24 hours for advice. In every instance an Incident Report, located by the first aid kit in the treatment room, must be completed. Sources: Center of Disease Control and Prevention http://www.cdc.gov/vaccines/vpd-vac/tetanus/ National Network for Immunization Information (NNii) http://www.immunizationinfo.org/vaccines/tetanus 22 WRC Safety Manual D. DISEASES CARRIED IN WILD ANIMALS What is Campylobacter? Campylobacter jejuni is a bacterium that causes a diarrheal illness called campylobacteriosis and is one of the most common bacterial foodborne diseases in the United States. Most people who become ill with campylobacteriosis have diarrhea, cramping, abdominal pain and fever within two to five days after exposure to the organism. The diarrhea may be bloody and can be accompanied by nausea and vomiting. The illness typically lasts about one week. How Does a Person Get Campylobacter? Campylobacter lives in the intestines of birds (primarily poultry) and other animals. It can be found in water, food, soil or on surfaces that have been contaminated with the feces of infected humans or animals. Campylobacter bacteria are carried in the intestines and shed in the droppings of birds contaminating their environment, their drinking water and the entire body of the animal which can then spread the bacteria to people. Food becomes contaminated by an infected food handler whose hands are contaminated with Campylobacter. It only takes a few Campylobacter organisms (fewer than 500) to make a person sick. Even one drop of juice from raw chicken meat can have enough Campylobacter in it to infect a person. What Animals can Spread Campylobacter to People? Campylobacter jejuni grows best at 37°C to 42°C, the approximate body temperature of a bird (41°C to 42°C), and seems to be well adapted to birds, who carry it without becoming ill. Campylobacter can be easily spread from bird to bird through a common water source or through contact with infected feces. How Can Campylobacter be Prevented? WRC strongly recommends wearing disposable gloves when cleaning, feeding or handling any of the wildlife, but particularly when working with species that are known to carry communicable diseases. Disposable gloves provide a protective barrier between body fluids and your skin. Leather or cotton gloves can be worn over disposable gloves when heavy gloves are needed, but these absorbent gloves are not protective against campylobacter when worn alone. ALWAYS wash your gloves or hands thoroughly with soap and warm water immediately after contact. Hand sanitizer (at least 60% alcohol) can be used, but soap and water is preferred. Hands should also be washed with soap and water after removing gloves and again before leaving the building. In addition, WRC suggests wearing dedicated footwear and clothing while at WRC and storing shoes/boots in a plastic bag in your car or at home. Clothing worn at WRC should be washed before being worn again. 23 WRC Safety Manual Sources: CDC: Center for Disease Control and Prevention www.cdc.gov/nczved/divisions/dfbmd/diseases/campylobacter NIH: National Institute of Allergy and Infectious Diseases http://www.nlm.nih.gov/medlineplus/ency/article/000224.htm MDH: Minnesota Department of Health http://www.health.state.mn.us/divs/idepc/diseases/campylobacteriosis/index.html What is Leptospirosis? Leptospirosis is an infectious bacterial disease that affects humans and animals. In humans, it can cause a wide range of symptoms and without treatment it can lead to potentially fatal infections of the kidney, liver, brain, lung or heart. How Does a Person get Leptospirosis? Leptospirosis can be spread by exposure to the urine or body fluids (except saliva) of infected animals. The bacteria can enter the body through mucous membranes (eyes, nose, or mouth) or skin, especially if the skin is broken from a cut or scratch. The bacteria that cause leptospirosis can get into water or soil and can survive there for weeks to months. Which Animals can Spread Leptospirosis to People? Animals that commonly develop or spread leptospirosis include rodents (mice, squirrels, chipmunks, woodchucks, beavers, raccoons, and opossums). When these animals are infected, they may have no symptoms of the disease. Leptospirosis may also occur in other animals not listed. How can Leptospirosis be Prevented? WRC strongly recommends wearing disposable gloves when cleaning, feeding or handling any of the wildlife, but particularly when working with species that are known to carry communicable diseases. Disposable gloves provide a protective barrier between blood and/or body fluids and your skin especially if you have cuts or abrasions. ALWAYS wash your gloves or hands thoroughly with soap and warm water immediately after contact with any potentially infectious animal. Alternatively hand sanitizer (at least 60% alcohol) can be used, but soap and water is preferred. Gloves should be changed between animals. Hands should also be washed with soap and water after removing gloves and again before leaving the building. EnviroCare® disinfectant (unless otherwise specified) should be used to disinfect surfaces that could be contaminated with an animal’s urine or body fluids. The solution must soak or at least 5 minutes to be fully effective against killing organisms. 24 WRC Safety Manual In addition, WRC suggests wearing dedicated footwear and clothing while at WRC and storing shoes/boots in a plastic bag in your car or at home. Clothing worn at WRC should be washed before being worn again. Source: Centers for Disease Control and Prevention: www.cdc.gov/leptospirosis What is Lyme Disease? Lyme disease is a potentially serious bacterial infection that may develop after a bite from a Lyme-infected deer tick and can affect the skin, joints, nervous system, heart, and other areas of the body. Typical symptoms include fever, headache, fatigue, joint pain and a characteristic bull’s-eye skin rash – a red ring with a central clearing - that occurs about 60 - 70% of the time. How Does a Person get Lyme Disease? The Lyme disease bacterium, Borrelia burgdorferi, is spread through the bite of an infected deer tick (Ixodes scapularis). In 2011, about 20% of deer ticks were infected in the Minnesota/Wisconsin region. The risk of acquiring Lyme disease from any given bite is related to the duration of tick attachment (risk increases at 36-48 hours) and the infection rate (about 20%) among ticks in the area. Not all people bitten by a deer tick will get Lyme disease. Not all deer ticks carry Lyme disease. Which Animals can Spread Lyme Disease to People? Typical hosts for the deer tick include mice, squirrels, rabbits, ground-feeding birds and deer. Deer ticks may also be found on other animals not listed. How can Lyme Disease be Prevented? The risk to volunteers and staff at WRC is very low as all animals with ticks and/or fleas are treated upon admission, however ticks may persist after treatment. Volunteers and staff members are encouraged to check themselves for ticks after leaving WRC. Volunteers may occasionally be asked to release animals back into the wild after recovery and should be aware that most releases occur in tick habitat so appropriate preventative measures should be used. Primary prevention of Lyme disease is avoidance of tick bites. The risk of infection may be reduced by avoiding known tick habitat, wearing long-sleeved shirts and pants, using insecticides (pre-treating clothing with permethrin) and/or repellents (DEET 20-30% or Picaridin 20% on the skin), and performing body-wide tick checks to find and remove ticks after spending time in known tick habitat. Sources: Minnesota Lyme Association: www.mnlyme.com Centers for Disease Control and Prevention: 25 WRC Safety Manual http://www.cdc.gov/Lyme Minnesota Department of Health: National Wildlife Health Center: www.health.state.mn.us/lyme http://www.nwhc.usgs.gov Wisconsin Medical Journal: http://www.wisconsinmedicalsociety.org/_WMS/publications/wmj/pdf/110/2/78.pdf What is Salmonellosis? Salmonellosis is an infection with bacteria called Salmonella and is the most common cause of foodborne illness. Most people infected with Salmonella develop diarrhea, fever, and abdominal cramps 12 to 72 hours after infection. The illness usually lasts 4 to 7 days, and most people recover without treatment. How Does a Person Get Salmonella? Contact with reptiles (turtles, snakes, and lizards) and amphibians (frogs and toads), and adult pigeons can be a source of human Salmonella infections. Salmonella bacteria are shed in the droppings of reptiles and amphibians and can easily contaminate their bodies and the water in tanks or aquariums where they live, which can then spread to people. Salmonella carried in the intestines of young birds and ducklings contaminates their environment and the entire body of the animal. Young birds and ducklings and the feces (droppings) of some animals (especially those with diarrhea) can also be a source of human Salmonella infections. Food becomes contaminated by an infected food handler whose hands are contaminated with Salmonella from animal feces. Any food may become contaminated; however, thorough cooking will kill Salmonella. Hands/gloves should always be washed immediately after handling a reptile, amphibian, bird or duckling even if the animal appears healthy. Which Animals can Spread Salmonellosis to People? Reptiles (turtles, snakes, and lizards), amphibians (frogs and toads), adult pigeons, young birds and ducklings can all be a source of human Salmonella infections. Salmonella may also occur in other animals not listed. How can Salmonellosis be Prevented? WRC strongly recommends wearing disposable gloves when cleaning, feeding or handling any wild animal, but particularly when working with species that are known to carry communicable zoonotic diseases. ALWAYS wash your gloves or hands thoroughly with soap and warm water immediately after touching a reptile, amphibian, adult pigeon, young bird or duckling, their aquarium or cage or any area where they have been. Alternatively hand sanitizer (at least 60% alcohol) can be used, but soap and water is preferred. Gloves should be changed between. Hands should also be washed with soap and water after removing gloves and again before leaving the building. 26 WRC Safety Manual In addition, WRC suggests wearing dedicated footwear and clothing while at WRC and storing shoes/boots in a plastic bag in your car or at home. Clothing worn at WRC should be washed before being worn again. Sources: NIH: National Institute of Allergy and Infectious Diseases http://www.nlm.nih.gov/medlineplus/salmonellainfections.html CDC: Centers for Disease Control and Prevention http://www.cdc.gov/salmonella/ 27 WRC Safety Manual What is MRSA (Methicillin-Resistant Staphylococcus Aureus)? MRSA is a “staph” bacterium that does not resolve with the first-line antibiotics that usually cure staph infections. When this occurs, the MRSA bacterium is “resistant” to the antibiotic. In the community (as opposed to healthcare settings like hospitals and nursing homes), most MRSA infections are skin infections. Volunteers and staff members will be notified of animals with diagnosed or suspected MRSA and safety precautions will be posted. How Does a Person Get MRSA? MRSA infections are usually spread by contact with a skin infection or items that touched the infected area like towels or bandages. MRSA can get on objects (food & water dishes), surfaces (cages) & linens if they touch the infected area. Touching a surface with MRSA does not mean you will become infected. People who are immuno-compromised or have cuts, scrapes or small cracks on their hands should not care for animals with MRSA. Which Animals can Spread MRSA to People? MRSA is an important human pathogen that is an emerging concern in veterinary medicine. It is known to be present in a wide range of animal species, including, but not limited to, dogs, cats, rabbits, horses, cattle, pigs, poultry, and exotic species, both as a cause of infection and as healthy carriers. It is unknown how prevalent it is in wildlife. One case of MRSA was diagnosed in a squirrel at WRC in 2011. Not all animals with active infections at WRC are tested for MRSA so staff and volunteers should be aware of the possibility of undiagnosed MRSA and use appropriate safety precautions when caring for all animals. How can MRSA be Prevented? Healthy people are at low risk of getting infected. The key to preventing MRSA infections is to practice good hygiene. WRC strongly recommends wearing disposable gloves when cleaning, feeding or handling any wildlife with diagnosed or suspected MRSA. Towels can also be used as an additional barrier between you and any infected animal or contaminated area. Due to the infectious nature of MRSA, any animal with diagnosed or suspected MRSA should be cared for last to avoid the possibility of spreading MRSA to other animals. Linens used in caring for the animal should be used once and put into a washing machine, but they do not need to be laundered separately or bleached. Dishes should be washed at the sink in the room and reused. The counter, sink and faucet handles should be cleaned and sprayed with EnviroCare® until wet and allowed to air dry for at least 5 minutes to be fully effective. Large surfaces such as cupboards, walls, and floors do not need any special cleaning and have not been directly associated in the spread of MRSA. When finished, the disposable gloves should be removed and put in the wastebasket provided in the room, hands should be washed with soap and warm water for at least 20 seconds and dried with paper towels. Alternatively hand sanitizer (at least 60% alcohol) can be used, but soap and water is preferred. If cloth towels are used they should be used only once and taken directly to the laundry. Hands should also be washed again before leaving the building. Sources: Centers for Disease Control and Prevention: www.cdc.gov/mrsa/ Minnesota Department of Health: www.health.state.mn.us/ 28 WRC Safety Manual MedlinePlus Medical Encyclopedia:http://www.nlm.nih.gov/medlineplus/ency/article/007261.htm What is West Nile Virus (WNV)? West Nile virus (WNV) is mainly a mosquito-transmitted virus. Most human infections (about 80%) cause no symptoms, about 20% cause flu-like symptoms (fever, fatigue, headache and muscle or joint pain) and fewer than 1% of infected humans become severely ill with encephalitis or meningitis (inflammation of the brain and/or spinal cord). Most West Nile virus infections occur during warm weather when mosquito populations are active. How Does a Person Get West Nile Virus? Researchers believe WNV is spread when a mosquito bites an infected bird or animal, becomes infected and then bites a person. Fecal material, saliva and blood are the most likely sources of virus infection and are more likely to cause infection if the skin is broken from a cut or scratch. Puncture wounds from beaks and claws and cuts from contaminated equipment (needles, scissors, scalpels, etc.) can also transmit WNV. People over age 50 and individuals with compromised immune systems have the highest risk of severe illness from WNV, however people of all ages can be become severely ill. Which Animals can Spread West Nile Virus to People? Since 1999, WNV has been detected in over 326 wild and captive bird species. Current information indicates that all birds should be considered as potential hosts of WNV. Crows, blue jays and robins are highly susceptible to lethal WNV infection. Bats, squirrels and chipmunks have also been found to have WNV and WNV may also occur in other animals not listed. How can West Nile Virus be Prevented? WRC strongly recommends wearing disposable gloves when cleaning, feeding or handling any of the wildlife, but particularly when working with species that are known to carry communicable diseases. Disposable gloves provide a protective barrier between body fluids and your skin. Leather or cotton gloves can be worn over disposable gloves when heavy gloves are needed, but these absorbent gloves are not protective against WNV when worn alone. Prevention of WNV includes avoiding contact with an animal’s body fluids through skin, especially if the skin is broken from a cut or scratch or mucous membranes (eyes, nose, or mouth). Barrier protection (gloves, masks, and safety glasses or goggles) should be worn if there is a possibility of contact with body fluids. ALWAYS wash your gloves or hands thoroughly with soap and warm water immediately after contact. Hand sanitizer (at least 60% alcohol) can be used, but soap and water is preferred. Leather or cotton gloves should be washed after each use. Volunteers may occasionally release animals back into the wild after recovery and should take preventative measures to avoid mosquito bites by wearing long-sleeved shirts and pants, using insecticides (pre-treating clothing with permethrin) and/or repellents (DEET 20-30% or Picaridin 20% on the skin) and avoiding the peak feeding time for mosquitoes (dawn & dusk). Sources: National Institutes of Health: www.ncbi.nlm.nih.gov National Wildlife Health Center: http://www.nwhc.usgs.gov/ Minnesota Department of Health: www.health.state.mn.us/ 29 WRC Safety Manual National Institute for Occupational Safety and Health: www.cdc.gov/niosh E. PARASITES CARRIED IN WILD ANIMALS What is Alveolar Echinococcosis (AE)? Alveolar echinococcosis is a parasitic disease caused by infection with tiny tapeworms (the larval stage of Echinococcus multilocularis), found primarily in fox, wolves and coyotes. Although cases of AE in animals in endemic areas are relatively common, human cases are rare. AE can cause parasitic tumors that can form in the liver, lungs, brain and other organs and, if left untreated, can be fatal. How Does a Person Get Alveolar Echinococcosis? Infection is transmitted to people through ingesting food items contaminated with stool from fox or coyotes containing tapeworm eggs. This might include herbs, greens, or berries gathered from fields. Animals infected with Echinococcus tapeworms pass eggs in their feces and humans are exposed to these eggs by "hand-to-mouth" transfer. Indirect transmission of eggs, either through contaminated water, uncooked food or through the intermediary of flies, can also result in infection of humans. Which Animals can Spread Echinococcus multilocularis to People? Echinococcus multilocularis is found primarily in the feces of fox, wolves and coyotes, but may also occur in other animals not listed. How can Alveolar Echinococcosis be Prevented? All foxes and coyotes are dewormed on admission decreasing the chance of infection; however deworming may not provide a 100% cure. WRC strongly recommends wearing disposable gloves when cleaning, feeding or handling any of the wildlife, but particularly when working with species that are known to carry communicable diseases or parasites. ALWAYS wash your gloves or hands thoroughly with soap and warm water immediately after contact with any potentially infectious animal. Alternatively hand sanitizer (at least 60% alcohol) can be used, but soap and water is preferred. Gloves should be changed between animals. Hands should also be washed with soap and water after removing gloves and again before leaving the building. Hand washing is easy to do and it's one of the most effective ways to prevent the spread of disease. In addition, WRC suggests wearing dedicated footwear and clothing while at WRC and storing shoes/boots in a plastic bag in your car or at home. Clothing worn at WRC should be washed before being worn again. Source: Centers for Disease Control and Prevention: www.cdc.gov National Wildlife Health Center: http://www.nwhc.usgs.gov/ 30 WRC Safety Manual What is Baylisascaris Infection (often referred to at WRC as Baylis)? Baylisascaris procyonis is a parasitic disease caused by an intestinal roundworm found in raccoons that is transmitted to humans. The worms develop to maturity in the raccoon intestine, where they produce millions of eggs that are passed in the raccoon feces. Human infections are rare, but can be severe if the parasites invade the eye (ocular larva migrans), organs (visceral larva migrans) or the brain (neural larva migrans). How Does a Person Get Baylisascaris? People become infected by ingesting infectious roundworm eggs found in contaminated raccoon feces. When humans ingest these eggs, they hatch into larvae in the person's intestine and travel throughout the body. Baylisascaris is not spread from one person to another. Eggs that are excreted by raccoons are not immediately infectious. The eggs must develop in the environment for 2 to 4 weeks, after which the eggs can cause infection. The eggs are resistant to most environmental conditions and, with adequate moisture, can survive for years. Infection rarely causes symptoms in raccoons, so you cannot tell if a raccoon is infected by observing its behavior. Roundworm eggs passed in the feces of infected raccoons are not visible to the naked eye and the eggs can only be seen using a microscope. Which Animals can Spread Baylisascaris to People? Baylisascaris procyonis is found in raccoons and, while raccoons are the roundworm's primary host, other types of animals can become infected. Birds and small mammals, such as rodents and rabbits, are susceptible to the parasite. Unlike raccoons, these animals can show signs of infection, with neurological symptoms such as muscle spasms, tremors, ataxia (lack of coordination), visual disturbances, behavioral changes and weakness leading to death. How can Baylisacaris be Prevented? At WRC only experienced and specially-trained staff and volunteers are allowed to care for raccoons due to the strict procedures required to prevent the transmission of Baylisascaris eggs while removing raccoon feces. WRC strongly recommends wearing disposable gloves when cleaning, feeding or handling any of the wildlife, but particularly when working with species known to carry communicable diseases or parasites. In addition, we recommend washing your gloves or hands thoroughly with soap and warm water immediately after contact with any potentially infectious animal. Alternatively hand sanitizer (at least 60% alcohol) can be used, but soap and water is preferred. Disposable gloves should be changed between animals. Hands should also be washed with soap and water after removing gloves and again before leaving the building. Hand washing is easy to do and it's one of the most effective ways to prevent the spread of disease. In addition, WRC suggests wearing dedicated footwear and clothing while at WRC and storing shoes/boots in a plastic bag in your car or at home. Clothing worn at WRC should be washed before being worn again. Source: Centers for Disease Control and Prevention: www.cdc.gov 31 WRC Safety Manual What is Sarcoptic Mange? Sarcoptic mange is a contagious skin disease of mammals caused by an infestation of the skin by the mite Sarcoptes scabiei. There is a specific human-adapted variety of S. scabiei that causes scabies in people. Occasionally, humans can become infected with animal varieties of S. scabiei and may develop a short-lived (10-14 days), self-limiting infection. There are three major categories of mange that affect wild mammals and are caused by different species of mites. Sarcoptic mange is the most common and most studied in wildlife. The other types of mange, notoredric (squirrels), and demodectic (white-tailed deer and elk) are not contagious to humans, but can cause skin irritation and rash in sensitive individuals. How Does a Person Get Sarcoptic Mange (scabies)? Parasitic mites that cause mange in mammals burrow into the skin of the animal. The mite is then spread to humans by direct, prolonged contact with an animal having mange. Although human infestation from animal sources is usually self-limiting, skin irritation and itching might occur for multiple days and can be difficult to diagnose. Scabies infection is extremely contagious from person to person through direct contact and contact with contaminated materials (clothing, sheets, furniture, etc.). Which Animals can Spread Sarcoptic Mange to People? Sarcoptic mange, the only type that can be passed to humans, has been reported in over 100 species of wild and domestic mammals. In North America, sarcoptic mange is most often reported in red fox, coyotes, and gray and red wolves, but has also been reported in black bears, porcupines, rabbits, squirrels and raccoons. How can Sarcoptic Mange be Prevented? WRC strongly recommends wearing disposable gloves when cleaning, feeding or handling any of the wildlife, but particularly when working with species that are known to carry communicable zoonotic diseases or parasites. ALWAYS wash your gloves or hands thoroughly with soap and warm water immediately after contact with any potentially infectious animal. Alternatively hand sanitizer (at least 60% alcohol) can be used, but soap and water is preferred. Gloves should be changed between animals with known disease. Hands should also be washed with soap and water after removing gloves and again before leaving the building. In addition, WRC suggests wearing dedicated footwear and clothing while at WRC and storing shoes/boots in a plastic bag in your car or at home. Clothing worn at WRC should be washed before being worn again. Sources: Wildlife OnLine: http://www.wildlifeonline.me.uk/mange.html Centers for Disease Control and Prevention: www.cdc.gov Pennsylvania Game Commission Wildlife Disease Reference Library 32 WRC Safety Manual F. HANDWASHING: CLEAN HANDS SAVE LIVES Hand washing is easy to do and it's one of the most effective ways to prevent the spread of many types of disease. When should you wash your hands? •Before, during and after preparing food •Before eating food •Before and after treating a cut or wound •After using the restroom •After blowing your nose, coughing or sneezing •After touching an animal, animal feed, or animal waste •After touching garbage What is the right way to wash your hands? •Wet your hands with clean running water (warm or cold) and apply soap. •Rub your hands together to make a lather and scrub them well; be sure to scrub the backs of your hands, between your fingers, and under your nails. •Continue rubbing your hands for at least 20 seconds. Need a timer? Hum the "Happy Birthday" song from beginning to end twice. •Rinse your hands well under running water. •Dry your hands using a clean towel. Washing hands with soap and water is the best way to reduce germs. Alternatively hand sanitizers (at least 60% alcohol) can quickly reduce the number of germs on hands in some situations, but sanitizers do not eliminate all types of germs. Hand sanitizers may not be as effective when hands are visibly dirty. How should you use hand sanitizer? •Apply the product to the palm of one hand (read the label to learn the correct amount). •Rub your hands together •Rub the product over all surfaces of your hands and fingers until your hands are dry. Source: Centers for Disease Control and Prevention: http://www.cdc.gov/handwashing/ What’s the difference between cleaners, sanitizers, and disinfectants? Cleaners or detergents are products that are used to remove soil, dirt, dust, organic matter, and germs (like bacteria, viruses, and fungi). Cleaners or detergents work by lifting dirt and germs off surfaces so they can be rinsed away with water. Rinsing is an important part of the cleaning process. Use these products for routine cleaning of surfaces. ‘Jungle Jake’®is a cleaner. Sanitizers are used to reduce germs from surfaces but not totally remove them. Sanitizers reduce the germs from surfaces to levels considered safe. Purell® is a sanitizer. Disinfectants are chemical products that destroy or inactivate germs and prevent them from growing. Disinfectants have no effect on dirt, soil, or dust. Disinfectants are regulated by the 33 WRC Safety Manual U.S. Environmental Protection Agency (EPA). Use a disinfectant after cleaning surfaces that have visible blood or drainage from infected skin. EnviroCare® and Accel® are disinfectants. There are PPEs (personal protective equipment) stations throughout the first floor of the building. These are marked on the map earlier in this manual and you will be shown where they are during your orientation and training. These stations contain goggles, gloves, hand sanitizer and masks. Use these items to protect your health. G. ANIMAL HANDLING As a volunteer at the WRC we want you to know that the safety of the people (staff, volunteers, visitors, guests) in our building is our foremost priority. The work we do is unusual and poses a unique challenge to protecting everyone who is in the building. It is not possible for any manual to be written in such a way as to anticipate ALL of the risks. Instead, the information you are given is intended to set forth general guidelines to minimize and reduce risks when handling wild animals. Each individual must assess the circumstances and risks as they handle the wild animals. Therefore, YOU are the key to a safe and successful experience at WRC. Compliance with these guidelines is critical to the safety of all who are here. All new volunteers must work with our trainer or their crew leader to learn safety techniques. New Animal Care Crew (ACC) volunteers will initially only work with birds and waterfowl. Only when the trainer and the volunteer are both comfortable will the new volunteer be allowed to work alone. We strongly encourage you to seek help and/or advice if you are unsure of how to handle an animal or if you are handling a species for the first time. Some animals are best handled by two people and volunteers should not hesitate to ask for assistance. As Animal Care Crew volunteers become more experienced they will be given individual training on the care of mammals. Under no circumstances should an ACC volunteer work with mammals before having specific training on the care of various mammal species and a current rabies titer on file. 34 WRC Safety Manual H. SAFE HANDLING/STORAGE OF MEDICATIONS/MEDICAL EQUIPMENT The Wildlife Rehabilitation Center is a wildlife hospital and as such has veterinary medications and medical instruments for use in treating the animals. The veterinary medications and equipment are for use exclusively on the animals and are to be used only by trained, qualified staff members. All medications are to be kept under a staff member’s physical control at all times or are to be locked in the designated cabinets. AT NO TIME SHOULD ANY ANIMAL CARE MEDICATIONS, MEDICAL INSTRUMENTS, OR MEDICAL PRODUCTS BE USED FOR HUMANS. For Poison Emergencies or Questions – CALL 1-800-222-1222 (Minnesota Poison Control System) I. SAFE HANDLING OF CHEMICALS Material Safety Data Sheets (MSDS) are the resource for information about chemical safety. Chemical manufacturers are required to make available an MSDS for each hazardous chemical they manufacture or import. The MSDS provides more detailed information regarding special conditions for safe handling and properties of the chemical than the label attached to the container. It also contains emergency and first aid information as well as safe handling, spill or leak cleanup, storage and disposal information. Only two potentially hazardous chemicals are used in the building; ENVIROCARE® Neutral Disinfectant (used as a general disinfectant in animal wards) and ACCEL® Disinfectant Cleaner (used in the treatment room, Raccoon Nursery, and occasionally for adult raccoons suspected of having Parvo virus). According to the Material Safety Data Sheets (MSDS – attached behind this section), the hazard level for these products is slight. They are not considered a fire hazard. Skin contact may cause irritation. They may be harmful if swallowed. Eye contact will cause irritation. First Aid: •For eye contact, flush with normal saline or clear water, removed contact lenses and continue flushing for 15 minutes. •For skin contact, flush with cool water. Wash with soap and water. •If ingested, or if any irritation persists, consult a physician. Do NOT induce vomiting. Rubber, vinyl, or latex gloves should be used to minimize skin contact and splash-proof chemical safety goggles should be used to eliminate the possibility of eye contact. 35 WRC Safety Manual Information about other potentially hazardous chemicals is contained in the Material Safety Data Sheet (MSDS) Reference Binder located in the cupboard above the staff computer in the treatment room. 36 WRC Safety Manual J. CHEMICAL SPILLS Accidents happen and it is important for all staff and volunteers to be familiar with the proper course of action to follow. • Warn anyone in the vicinity of the spill and evacuate if necessary. • Refer to the appropriate MSDS sheet for detailed instructions on cleanup and disposal. The MSDS manual is in the cupboard above the staff computer in the treatment room. • Carefully remove any broken glass using tongs or a scoop such as a dustpan or stiff piece of cardboard. Do not use your hands (even if gloved). Place broken glass in the puncture-proof Sharps® receptacle. • Absorb the liquid with disposable towels and wrap in double plastic bags to contain the chemical. Mark clearly for final disposition. Clean the area with soap and water. RADIOLOGY The radiology room is adjacent to the treatment room. The door into radiology is clearly marked with a sign that states, “Caution – Radiation Area, Authorized Personnel Only.” Only staff members and students enrolled in a Certified Veterinary Technician program are permitted to operate radiology equipment. Dosimeter badges for monitoring radiation exposure need to be worn by anyone taking x-rays. No other individuals are permitted in the radiology room. Women who are pregnant are not permitted in the radiology room while it is in use. MEDICAL GASES The building has a separate room for storage of medical gases. The door to this room must be kept locked at all times. Only authorized personnel, trained in the equipment operation, will be allowed access to this room. The treatment room at WRC has a waste gas scavenger system installed to pick up and dispose of any excess anesthetic gases that may be present in the room. This system is limited to the treatment room and does not extend to the wards or hallways. 37 WRC Safety Manual K. ENVIROCARE® MSDS 38 WRC Safety Manual 39 WRC Safety Manual L. ACCEL® MSDS 40 WRC Safety Manual 41 WRC Safety Manual IV. PERSONAL SAFETY A. HYGIENE Handling wild animals can increase the opportunity for exposure to many diseases. Below are listed general precautions that should be taken while handling all wildlife, especially those that appear sick. Depending on the circumstances, some or all of the personal protective measures listed should be used. Personal protective measures include washing of hands, using disposable gloves, wearing facemasks, wearing long pants and boots or closed-toe shoes, and wearing eye protection. Jewelry, perfume/cologne and scented personal care products should not be used at WRC. Disposable gloves: WRC strongly recommends wearing disposable gloves when cleaning, feeding and handling wildlife for protection from the diseases that can be carried by animal fluids and wastes. Open cuts should be bandaged and bandages should be replaced when wet. Gloves should be worn over bandages and changed if torn. Disposable gloves are available in multiple locations throughout the WRC and it is recommended that they be worn at all times when working with animals, doing laundry or washing cages. Facemasks: WRC strongly recommends wearing disposable facemasks when loading laundry into the washing machines to avoid inhalation of airborne infectious material from the soiled linens. Facemasks are also strongly recommended when cleaning cages in the cage wash area to prevent inhalation of aerosolized animal fluids and wastes. Facemasks are available in the laundry room and outside the cage wash area. Protective eyewear (goggles or safety glasses): WRC strongly recommends wearing protective eyewear in the cage wash area to prevent splashing of infectious material into the eyes during cage cleaning. There are PPEs (personal protective equipment) stations throughout the first floor of the building. These are marked on the map earlier in this manual and you will be shown where they are during your orientation and training. These stations contain goggles, gloves, hand sanitizer and masks. Use these items to protect your health. Clothing and footwear: WRC suggests wearing dedicated footwear and clothing while working at WRC. Comfortable, old clothes are suggested as clothing may become soiled or stained. We ask you to wear long pants (jeans, khakis, scrubs, etc.) and closed-toe/non-slip shoes. Tennis shoes are not recommended as they can get wet, resulting in cold, wet feet). “Duck boots” and “wellies” work well, but any old closedtoe, non-slip shoes will be fine. Shoes/boots can be stored in a plastic bag in your car or at home. Clothing worn at WRC should be washed before being worn again. 42 WRC Safety Manual Prevention of disease includes avoiding contact with an animal’s body fluids or other infectious material through skin, especially if the skin is broken from a cut or scratch, or mucous membranes (eyes, nose or mouth). Use common sense and good judgment if you should come in contact with animal fluids and wastes. This would, at a minimum, include hand washing and removing soiled gloves and garments. B. EYE PROTECTION It is important to protect your eyes in an appropriate manner when in close proximity to any animals with beaks or claws. Large shorebirds and water birds have sharp, strong beaks and use their beaks as weapons. Clear, protective eye goggles are available for your use when working near or with such birds. Safety glasses or goggles should also be worn when there is a possibility of splashing contaminated water or body fluids into the eyes (example: when washing/spraying cages in the cage wash area). Regular eyeglasses are not an adequate substitution for protective eye equipment. C. PHYSICAL LIMITATIONS Activities or tasks at WRC should be undertaken only in accordance with each person’s physical abilities. Since duties involve interacting with wild animals, healthy and sick, big and small, and usually include some lifting, carrying, moving or otherwise engaging in physical labor, it is important for you to proceed within your own capabilities. While you are encouraged to discuss any physical restrictions or limitations with your crew leader or a staff member, you should not proceed with activities that you believe may exceed your capabilities. Each person must be “self-monitoring” in this matter. D. EATING/DRINKING Food or drink for human consumption is only allowed in the lounge area on the lower level and should always be stored in the lounge refrigerator. Animal food is kept in the kitchen on the main floor and in refrigerator/freezers located throughout WRC. At no time should human food or beverages be stored or consumed in animal areas. 43 WRC Safety Manual E. CONTROL OF PERSONAL BELONGINGS TO CONTROL THEFT WRC cannot be responsible for personal articles you may bring into the building. While lockers are available near the lounge, they are offered as a convenience only. You should not leave any valuables unattended. It is recommended that only essential personal belongings be brought into the WRC with you while you are working or volunteering here. F. PARKING and PERSONAL SAFETY Parking is available in a public lot on the west side of Dale Street. WRC is not responsible for any losses or damages caused to your vehicle or its contents while parked there. MP3 players, GPS devices, radar detectors, laptop computers, and cell phones are all popular items for would-be thieves. Vehicles with a visible power cord or mount, briefcase, purse, gym bag, backpack or book bag are more likely to become targets. Sunglasses, wallets, credit cards, house keys and loose change are also common targets. We urge you to leave your valuables at home or place them in your trunk before reaching WRC. Always remove all valuables and lock your car. Please use caution at all times when crossing Dale Street coming to and from the parking lots. Exercise the same care and caution as you would in any public parking lot. G. HARASSMENT/MISCONDUCT It is the policy of WRC that all staff and volunteers will be treated with respect and courtesy. Moreover, all staff and volunteers are expected to behave in a courteous and professional manner at all times As part of this policy, WRC firmly prohibits harassment of any employee or volunteer by any other employee or volunteer. The purpose of this policy is not to regulate any individual’s personal morality. It is to ensure that, while at WRC, no person here harasses or is harassed by another person. While it is not easy to define precisely what harassment is, it includes, but is not limited to, unwelcome sexual advances and other verbal or physical conduct of a sexual nature such as uninvited touching, or sexuallyrelated comments. It also includes any verbal or physical harassment, whether or not it is sexual in nature. Any infraction of this policy should be reported immediately to the Executive Director or the Director of Volunteer Services. As an alternative, any staff or volunteer may also report any infractions to the Chair or Vice Chair of the Board of Directors. Violations of this policy will not be permitted, and may result in immediate termination or other disciplinary actions for staff and immediate termination of volunteer duties by a volunteer. 44 WRC Safety Manual It is also important to remember that staff and volunteers are expected to perform all duties in a satisfactory and professional manner. Management of WRC is legally required to determine what constitutes satisfactory performance of duties in the best interests of the organization. Volunteers can, and may be, requested by a staff member to leave the premises and or to terminate their role as a volunteer at any time for any reason. Also, while WRC depends heavily on a large corps of active volunteers to perform essential daily functions involving care of animals and administrative duties, WRC reserves the right at all times to terminate volunteer privileges and duties. While we expect such terminations to occur rarely, we do acknowledge that all volunteer duties may not be suitable for certain individuals and it is the sole responsibility of WRC’s staff and management to evaluate volunteers’ performance. H. PREGNANCY Women who are pregnant, or who might be pregnant, should be aware of the possible risks to them at WRC and, after consultation with their physician, determine if it is appropriate for them to work with wild animals while pregnant. PERSONAL PROTECTION: Prevention of disease includes avoiding contact with animal body fluids or other infectious material through mucous membranes (eyes, nose, or mouth) or skin, especially if the skin is broken. WRC strongly recommends wearing disposable gloves when cleaning, feeding or handling the wildlife. Open cuts should be bandaged and bandages should be replaced when wet. Gloves should be worn over bandages and changed if torn. In addition, WRC suggests wearing dedicated footwear and clothing while at WRC and storing shoes/boots in a plastic bag in your car or at home. Clothing worn at WRC should be washed before being worn again. Use common sense and good judgment when coming in contact with animal fluids and wastes. This would, at a minimum, include hand washing and removing soiled gloves and garments. RABIES VACCINE: Women should not receive rabies immunizations unless they are certain they are not pregnant. While rabies immunizations can be given in an emergency situation, preexposure prophylaxis does not fall into that category and immunizations should be deferred. 45 WRC Safety Manual TETANUS VACCINE: Pregnant women can receive primary vaccinations or a booster at any time during their pregnancy after consultation with their care provider. EXPOSURE TO DISEASES AND PARASITES WITH WILD ANIMALS: Women who are pregnant, or who might be pregnant, should refer to the “Exposure to Diseases and Parasites in Wild Animals” section of this manual. They should discuss with their doctor the risks associated with working with wild animals. ANESTHETIC GAS: Very few chemicals are used at the WRC so the risk of exposure is low. However, any woman who is, or may be, pregnant should not administer anesthetic gas or hold an animal receiving the anesthesia without proper ventilation. Pregnant women can be in the room when anesthesia is used, but should not be close enough to smell the fumes. FLEA SPRAY/CHEMICALS: Flea spray/powder can also present a risk and should not be used by pregnant women. Pregnant women should use caution around all chemicals. RADIOLOGY: Women who are pregnant are not permitted in the radiology room while it is in use. The above discussion is not all-inclusive, but is only intended to point out that women who are pregnant should carefully monitor their activities at WRC so as not to be exposed to undue risk. 46 WRC Safety Manual