I. Introduction
Those engaged in Research at Boston University (BU) and Boston Medical Center
(BMC) may be exposed to a variety of potentially hazardous materials (e.g. biological
agents, chemicals, radioactive materials) or other potential hazards (e.g. ionizing
radiations, lasers, noise) in the course of their work. The Office of Environmental Health
& Safety (OEHS) works with the academic community to reduce or eliminate the hazards
through use of appropriate personal protective equipment, engineering controls, safety
equipment, training and development of standard operating procedures. In addition, the
Research Occupational Health Program (ROHP) conducts medical surveillance as part of
the control, to monitor for personnel occupational exposure to these hazards.
Although most job classifications at BU and BMC do not require medical surveillance,
employees affected undergo the medical surveillance process. Medical surveillance is the
process of evaluating the health of employees to monitor and prevent occupational
injuries, illnesses and exposures to hazardous conditions. The employee undergoes
occupational and medical history, physical examination, testing and vaccination by a
licensed physician. These elements are used to establish a pre-employment baseline of
employee health condition and future monitoring of employee health. The medical
surveillance program meets regulatory standards and establishes minimum guidelines to
prevent, monitor and respond to occupational injuries and exposures.
The Institutional Oversight Committees which includes the Institutional Biosafety
Committee (IBC), Laboratory Safety Committees (LSC), Institutional Animal Care and
Use Committee (IACUC) have established criteria for employee participation in the
medical surveillance program. ROHP is an integral component of the BU and BMC and
occupational health and safety for research program.
The goal of the ROHP is:
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To develop and implement a comprehensive medical and occupational health
surveillance program for affected employees at BU and BMC.
Work with BU and BMC stake holders to develop and implement processes to
ensure that affected employees are reviewed and screened before they work with
hazardous materials or conduct procedures that will exposed them to potentially
hazardous processes.
Provide clinical assessment, prevention, and data management services that will
assist the research community with preventing exposure to infectious pathogens.
Provide written report or opinion on employee condition to conduct work to the
appropriate stake holder/s.
To provide or refer for the necessary services related to the prevention of
infectious diseases.
Develop and implement processes for health screening and monitoring of
employees that work in high containment biological laboratories (BSL3/BSL4)
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To assist in satisfying health screening and surveillance requirements for federal
agencies and accreditation bodies, such as the Association for Assessment and
Accreditation of Laboratory Animal Care international (AAALAC) and Boston
Public Health Commission (BPHC) Disease Surveillance and Reporting
Regulations.
To identify campus employees at risk for exposure to and transmission of
infectious pathogens,
To provide and coordinate, in the event of an exposure, single or multiple site
post-exposure follow-up and tracking for campus personnel,
To provide compliance reports on prevention and post-exposure measures, as
mandated by regulatory agencies and accreditation bodies, and
To develop a comprehensive system of databases that track campus employees
across multiple sites for compliance with mandated prevention measure
The medical surveillance program covers all individuals engaged in research at BU and
BMC who are considered “at risk population” as defined by the accrediting organization
or various BU and BMC oversight committees. They include research staff, students, and
personnel that provide support to the research community (i.e. facilities, health and
safety, etc.)
II. The Surveillance Program
The requirements of the Medical Surveillance Program are grouped into two basic
categories described below:
II.1.Preventive
A number of policies and procedures have been developed [link] to provide a
coherent preventive medical surveillance program for employees that are at risk. The
key components of the policies, requirements and the primary responsible offices are
summarized below:
a. Policies and provisions for identifying and evaluating individuals at risk.
The risk assessment is performed by the appropriate institutional
Oversight Committees, including the IBC, IACUC, LSC, and others
during the review of the proposed research projects.
b. Screening of newly hired individuals at risk for required baseline preplacement, occupational and medical history evaluations, vaccinations and
clinical testing (e.g. TB testing, serum banking, etc.) offered by the
ROHP.
c. Provide results and comprehensive summaries of findings, clearances and
recommendations to persons at risk, their employers and as necessary,
OEHS, by ROHP.
d. Training and consultation of individuals at risk, which is conducted by
oversight offices (e.g. Office of Environmental Health and Safety,
Laboratory Animal Science Center).
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e. Maintaining vigilance for the recognition of potential exposures and
identifying potentially exposed individuals which is done by the at risk
individuals.
II.2.Post-Exposure (presumptive or actual)
The post-exposure program is intended to rapidly provide the necessary care for any
potentially exposed (presumptive or actual) individuals.
Provide immediate and appropriate medical response to an accidental occupational
exposure or presumptive Laboratory-Acquired Infection (LAI) are important in
preventing the onset of disease and providing timely therapeutics if appropriate. In
addition it maintains compliance with the Boston Public Health Commission’s
(BPHC) Disease Surveillance and Reporting Regulation for potential infections of
interest. The BPHC compliance guidelines specify practices for ensuring that the
BPHC receives timely access to information regarding incidence of disease
syndromes, any outbreak or cluster of a disease, and potential exposures to reportable
diseases deemed harmful to the public health.
III. Services
The research community’s occupational health needs are similar to the standard services
that are required by most other health care worker groups. In general the needs are
grouped into two broad categories of:
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Routine Needs: this group describes the general requirements of most of the
individuals who work with biological agents or research animals. Items such as
drug testing, TB clearance, immunization requirements (i.e. Hep B vaccine for
Bloodborne pathogen clearance, etc.,) are identical to those provided for of any
healthcare worker
Specific Needs: describes the category of services that are unique to a subset of
the research community due to the potential exposure to certain pathogens or
research animals unique to their research
III.1.
Routine Needs
These are requirements that are most common for the majority of the research
community and may include:
a.
b.
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d.
e.
f.
g.
Medical questionnaire [we need the full title of the form and link]
Pre-employment medical clearance
Blood Borne Pathogen clearance
TB testing
Respirator use clearance
Tetanus vaccination
Drug testing
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h. Other vaccinations and immunizations
III.2.
(Special Needs
These are specific requirements dictated by the biological agents or animals that the
individual may be working with and may include:
i. Animal Exposure Surveillance Program (AESP)
i. Animal Exposure Surveillance Program Medical Evaluation Form
review and follow-up- initial and annual
ii. Rabies vaccination, if warranted
iii. Toxoplasmosis titer if the employee works with cats and is a
female
iv. Species specific zoonotic diseases
v. Vaccination or positive Rubella titer for those born before 1/1/57
vi. Medical susceptibility to Allergens
vii. Baseline and routine audiometric testing
j.
k.
l.
m.
n.
Herpes B virus (post exposure)
Francisella tularensis clearance
Vaccinia clearance
Periodic protocol specific issues (e.g. MTPT, cyanide, etc)
Other as indicated by the Risk Assessment conducted by the oversight
Committees (e.g. IBC, IACUC)
The major components of the Special Needs are related to a subset of researchers
working with animals whose AESP Medical Evaluation form indicates the need for
additional follow-ups. The existing AESP that has been approved by the oversight
committees may be found at the following URL:
This site includes the relevant forms and instructions.
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