Lab Acquired Animal Allergies Prevention and Protection, Educational Information Debra Murphy, Director Research Integrity and Assurance July 29, 2014 (revised February 17, 2015) First let’s define allergy, and allergen. An allergy is a damaging immune response by the body to a substance, especially pollen, fur, a particular food, or dust, to which it has become hypersensitive (Google Web). An allergen is any substance that triggers the allergic response and you can be exposed to an allergen by inhalation, direct skin contact, ingestion or injection. The goal of this presentation is to make you aware of the allergens, how to protect yourself and others from exposure, and most importantly to prevent the development of asthma, a chronic lung disease.

Objectives Be able to: Identify allergens Advancing Research, Entrepreneurship and Economic Development Objectives Be able to: Identify allergens Identify ways to reduce exposure Identify and use appropriate personal protective equipment Identify symptoms of developing allergies After you complete this instruction, you should know what animals and parts of animals, like urine and dander, are most allergenic. You will learn how to reduce exposure to yourself and others. You will know what is the appropriate PPE to use and also to be able to identify developing allergies.

What Are Animal Allergens Advancing Research, Entrepreneurship and Economic Development What Are Animal Allergens Mice - Urine is most allergenic protein, dander (dead skin cells), and saliva Rats - dander, saliva, and urine Guinea pigs - urine, saliva, fur Rabbits - fur, urine Birds - feathers, leads to hypersensitivity pneumonitis Cats - saliva, dander Dogs - dander, saliva Reptiles – much less likely, but reports of allergies to scales, blood, and saliva Rat and mouse urine proteins are some of the most allergenic of all allergens and is in the bedding, so protection with cage or bedding changes is very important.

Advancing Research, Entrepreneurship and Economic Development Animal Allergens Workers with no history of any allergy have a 10% chance of developing allergies to animals Workers with a history of an allergic reaction to anything have a 30% chance of developing allergies to animals Workers with allergies to lab animals have a 10% chance of developing asthma If you have never responded to anything, you are lucky and have only a 10% chance of developing allergies to animals. The American Academy of Allergy, Asthma and Immunology states that 40% of the world’s population have IgE (allergic antibodies) to foreign proteins and in children that is approaching 50%.

Allergy Symptoms Most common: Also: Itchy eyes Runny nose Sneezing Advancing Research, Entrepreneurship and Economic Development Allergy Symptoms Most common: Itchy eyes Runny nose Also: Sneezing Coughing Wheezing Shortness of breath Rashes Hives Hay fever is a very common allergenic response to pollens. The runny nose, itchy eyes of advertisements for Zyrtec or Claritin are on TV and are listing symptoms of allergies

Allergies - Consequences Contact urticaria – red, itchy skin; welts, hives Conjunctivitis – red, itchy eyes Rhinitis – sneezing, nasal itching/congestion, clear discharge Asthma – cough, wheezing, shortness of breath, chest tightness Anaphylaxis – most severe; itching, hives, throat tightness, eye or lip swelling, shortness of breath leading to respiratory failure and shock with up to 2% dying from the reaction The symptoms of allergies are varied and I have listed the most common, but sometimes even severe fatigue is a sign of allergic response as the body is mounting a reaction to the allergen. GI symptoms such as cramps, nausea, vomiting and diarrhea occur also, though usually with food allergies/ingestion of allergen.

Laboratory Environment Advancing Research, Entrepreneurship and Economic Development Laboratory Environment Signage - there should be signage alerting others that animals are present Use of Primary Barrier Equipment e.g., safety cabinets, caging, local exhaust systems Respirators Mandatory use of N95 respirators requires medical clearance, respirator training, and fit testing DACT and Tier 1 workers contact ASU Health Services for their fit tests All other employees contact EHS for their fit tests This review of the environment alerts all laboratory personnel of potential hazards and ways to mitigate exposure risk.

This is a face mask or surgical mask, not a respirator. Respirators This is a face mask or surgical mask, not a respirator.

N95 Surgical Respirators Most N95 respirators are manufactured for use in construction and other industrial type jobs that expose workers to dust and small particles. These respirators are evaluated for effectiveness by the National Institute for Occupational Safety and Health (NIOSH), which is part of the Centers for Disease Control (CDC). These are labeled "For occupational use.” N95 respirators cleared by FDA for use in the healthcare setting are called “surgical N95 respirators”. These devices meet some of the same performance standards as surgical face masks and are also NIOSH-certified to meet the N95 respirator performance requirements.

N95 Surgical Respirators A surgical N95 respirator is a respiratory protective device designed to achieve a very close facial fit and very efficient filtration of airborne particles. In addition to blocking splashes, sprays, and large droplets, the respirator is also designed to prevent the wearer from breathing in very small particles that may be in the air. ALL FDA-cleared surgical N95 respirators are labeled as "single use", disposable devices. If your respirator is damaged or soiled, or if breathing becomes difficult, you should remove the respirator, discard it properly, and replace it with a new one. To safely discard your N95 respirator, place it directly in the trash. Wash your hands after handling the used respirator. N95 respirators are not designed for children or people with facial hair. Because a proper fit cannot be achieved on children and people with facial hair, the N95 respirator may not provide full protection.

Facemasks A facemask is a loose-fitting, disposable device that creates a physical barrier between the mouth and nose of the wearer and potential contaminants in the immediate environment. Facemasks are also called surgical or mist masks. If worn properly, a facemask is meant to help block large-particles and droplets, splashes, sprays, or splatter that may contain germs (viruses and bacteria) from reaching your mouth and nose. Facemasks may also help reduce exposure of your saliva and respiratory secretions to others. Facemasks are not intended to be used more than once. If your mask is damaged or soiled, or if breathing through the mask becomes difficult, you should remove the facemask, discard it safely, and replace it with a new one. To safely discard your mask, place it directly into the trash. Wash your hands after handling the used mask. While a facemask may be effective in blocking splashes and large-particle droplets, a facemask, by design, does not filter or block very small particles in the air that may be transmitted by coughs, sneezes or certain medical procedures. Facemasks also do not provide complete protection from germs and other contaminants because of the loose fit between the surface of the facemask and your face.

Laboratory Environment Advancing Research, Entrepreneurship and Economic Development Laboratory Environment Laboratory Clothing Disposable laboratory coats/coverings are ideal; when removed, turned it inside out and disposed of appropriately Non-disposable coverings must be laundered frequently and never at home Gloves Decontamination of Work Areas Mechanically remove allergens from surface, wash hands, etc. This review of the environment alerts all laboratory personnel of potential hazards and ways to mitigate exposure risk.

Primary Prevention Goal: to reduce or eliminate exposure Advancing Research, Entrepreneurship and Economic Development Primary Prevention Goal: to reduce or eliminate exposure Primary Barrier Equipment: Biological safety cabinet Exhaust systems: fume hoods, downdraft table or sink Microisolator cage Individual ventilated cages Ventilated cage change station Mist masks Respirators If you are not exposed to an allergen, you cannot develop an allergic response. Prevention is the best way to not develop allergies to lab animals. Everyone working in the lab is part of the prevention team, in addition to the barriers provided such as the safety cabinets, cages and PPE. When you are working with animals and take them out of their “barrier” then it is your responsibility to use the PPE provided, wash down surfaces to prevent exposures to others. It is important to be aware of potential surfaces that may have become contaminated, like your hands and arms, and wash with soap and water to remove any allergens on the skin.

Advancing Research, Entrepreneurship and Economic Development Health Questionnaire Every year, you complete a health questionnaire that specifically asks about allergy symptoms. If at ANY TIME between questionnaires you begin to experience allergy symptoms, contact ASU Health Services/Occupational Health

Advancing Research, Entrepreneurship and Economic Development Acknowledgments Completion of the annual Health Surveillance Questionnaire and review of accompanying training materials is your acknowledgment that that you have been provided with the information you need to make decisions about PPE usage that can prevent lab-acquired animal allergies.

Resources and References Occupational Health Surveillance Program http://www.asu.edu/ehs/documents/asu-animal-allergies.pdf http://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/G eneralHospitalDevicesandSupplies/PersonalProtectiveEquipment/ucm05 5977.htm http://www.cdc.gov/niosh/npptl/topics/respirators/disp_part/RespSour ce3healthcare.html#e