NIOSHTIC-2 Publications Search

Health hazard evaluation report: evaluation of potential employee exposures to Mycobacterium tuberculosis at an elephant refuge.

Niemeier RT; Mead K; de Perio MA; Martin SB Jr.; Burr GA

Cincinnati, OH: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, HHE 2010-0080-3235, 2015 Apr; :1-27

https://www.cdc.gov/niosh/hhe/reports/pdfs/2010-0080-3235.pdf

20046174

The Health Hazard Evaluation Program received a technical assistance request from officials at a state health department. They asked us to evaluate the ventilation systems, work practices, and personal protective equipment used by employees at an elephant refuge. A state investigation found evidence of elephant to employee transmission of Mycobacterium tuberculosis in nine employees from 2006-2009. The refuge occupied about 2,700 acres and had four barns housing elephants. Most of the roughly 30 employees worked on the refuge grounds around elephants, but some administrative employees worked in a building that was outside the refuge. Several employees lived on the refuge grounds. We made four site visits from 2010 to 2012. During these visits, we met with refuge managers and employees; reviewed employee health records; observed workplace conditions, work processes and practices; and evaluated ventilation systems in barns by measuring pressure differences and by using smoke and tracer gas. On the basis of our findings and recommendations, refuge managers improved the employee screening program for tuberculosis (TB) disease and the respiratory protection program, installed new ventilation systems, and sealed wall openings in the quarantine barn, among other changes. We found that these changes better controlled potential employee exposures to Mycobacterium tuberculosis. Additional recommendations we made in this report include: (1) treating all elephants with active TB disease, (2) turning on the barns' exhaust fans 15 minutes before employees enter, and (3) checking air pressure indicators when elephants with known or suspected TB disease are present. We recommended employees (1) get a tuberculin skin test at least every year if their last skin test was negative or they had not been tested, (2) get a medical evaluation for TB disease every year if they had a positive tuberculin skin test in the past, (3) report ventilation system problems to their supervisor, and (4) wear a respirator when working within 25 feet of an elephant with confirmed or suspected TB disease and when entering the isolation or quarantine barn elephant stall areas, even if elephants are not present.

Region-4; Health-hazards; Employee-exposure; Ventilation-systems; Work-practices; Personal-protective-equipment; Animals; Humans; Disease-transmission; Infectious-diseases; Bacterial-disease; Bacterial-infections; Respiratory-protection; Medical-screening; Pathogens; Lung-disorders; Pulmonary-system-disorders; Respirators; Skin-tests; Air-pressure; Employee-exposure; Work-environment; Environmental-control; Zoonoses; Author Keywords: Activities for Animal Production; Tennessee; TB; tuberculosis; Mycobacterium tuberculosis; ventilation; tracer gas; elephant; refuge; PPE; zoonosis

20150401

Field Studies; Health Hazard Evaluation

2015

PB2015-104157

A04

HHE-2010-0080-3235

EID; DSHEFS

NAICS-115210

National Institute for Occupational Safety and Health

TN; OH