An established medical surveillance program has different components. The first thing we must know is that, before a position is posted for hire, the human resources department, safety department, and veterinarian should develop a description that identifies all the job requirements. Those hiring conditions would require prospective candidates to successfully complete a post-offer, pre-employment physical. The physical and medical requirements must be clearly written out in a document read by all candidates applying for a position. For example, a position may require an employee to be able to lift a specified amount of weight (animal feed bags can weigh as much as 50 lbs). It may also require serum banking, TB skin tests, or vaccinations. If these requirements are clearly stated for all candidates, one cannot be accused of discrimination or have to deal with the possibility of hiring employees who refuse to take vaccines (the idea is to protect the workers and/or the animals).
Another thing is that, the safety department, in consultation with the veterinarian and supervisor, should come up with a medical questionnaire. It should identify the risks associated with the animal work, including any required pre-employment vaccinations or physical screenings. It is important that this document cover all prior medical history, especially any existing allergies and the extent of those symptoms. If the employee has pre-existing allergies, it is far more likely that a LAA could develop sometime in the future.
If the potential employee has allergies, a discussion should be initiated with human resources, the supervisor, and the employee. The conversation should explain that potentially, they may have to find alternative positions or other employment, should occupational exposures to animals become a problem.
At Southern Research, it is required of employees to wear PPE that includes outer garments, gloves, and N-95 respirators in animal rooms. We do this to prevent the development of LAAs. Nonetheless, when they have developed, we try to work with the employee by either placing them in additional PPE, such as powered air purifying respirators, or find them positions outside the animal labs, if available.
Lastly, the organization should note the frequency of employee medical evaluations.