Requirements for Contractor / Service Provider / Visitor Access to Animal Facilities at Yale University

Transcription

1 Requirements for Contractor / Service Provider / Visitor Access to Animal Facilities at Yale University Animal research facilities are highly controlled environments with significant security restrictions against non-authorized entry. This document provides the means by which contractors, consultants, and other Yale-authorized visitors may gain access to Yale Animal Resources Center (YARC) facilities to perform work, evaluate conditions, or prepare cost estimates for proposed work. Legitimate access to animal facilities will be granted providing the following criteria are met: 1. Authorized Yale contact identifies which facility access will be needed into, consults with the YARC facility supervisor, and assists contractor in completing the Contractor Access Application, attached. This document should then be faxed to Access will be granted unless medical requirements apply (see below); YARC will notify the Yale contact if the facility involves infectious agents. 2. Persons requiring entry into an animal facility involving low level hazard (BL1): Persons with a history of allergies to animals should consult with their personal physician before entering any animal facility at Yale University. At a minimum, it is required that personal protective equipment (gloves and mask) be worn when entering the facilities to limit the potential exposure to animal allergens, although some facilities have more stringent minimum entry requirements because of species or research being performed. In addition, anyone that is immunosuppressed, pregnant, or suffering from a chronic illness should consult their physician regarding contact with laboratory animals. Contractors, service providers or visitors are required to read this statement and sign it (page 2) confirming notification of risks. The authorized Yale contact will then forward to Regulatory & Safety Services, fax Persons requiring entry to an animal facility involving moderate (BL2) to high level hazard (BL2+, BL3) for infectious agents or facilities housing farm animals: Individuals must wear appropriate personal protective equipment and follow practices as required, which may include the use of a powered air purifying respirator. The Request for Medical Review for Entry to Animal Facilities by Contractor/Service Provider/Visitor Health History Questionnaire (pages 3-5) must be completed and returned it to the Employee Health Office for review and approval (fax ). If medical clearance is approved, the Employee Health Office will notify YARC and the authorized Yale contact, and access will be granted. 4. Persons requiring entry to non-human primate (NHP) facilities: Individuals must wear appropriate personal protective equipment (gown, mucous membrane protection, gloves, etc.). The Request for Medical Review for Entry to Animal Facilities by Contractor/Service Provider/Visitor Health History Questionnaire (pages 3-5) and complete or show proof of a negative skin test for tuberculosis within the past year and must have an up to date tetanus status. Contractors, service providers or visitors born after 1957 must also show proof of a measles vaccination performed since These vaccinations and tests are required to protect the non-human primates, who are extremely susceptible to infections from these agents upon contact with humans. The Request for Medical Review for Entry to Animal Facilities by Contractor/Service Provider/Visitor Health History Questionnaire (pages 3-5) must be completed and returned it to the Employee Health Office for review and approval (fax ), along with tuberculosis testing, tetanus and measles immunization documentation. Contractors should consult with their personal physicians in order to obtain records of testing or complete any necessary tests. The Yale University Employee Health physician (phone ) is also available to speak to any personal physician if there are questions about the testing or contact with animals. 5. Prior to initial entry into any YARC facility, the authorized Yale contact and the visitor(s) must review safe entry procedures and the use of personal protective equipment with the YARC facility supervisor. Please direct any questions or comments about this or related issues to either Regulatory & Safety Services at or the Employee Health Office at

2 Yale University Contractor/Service Provider/Visitor Security Access Application Animal Facilities Date Company Phone Fax Applicant Name If applicable, Yale Employee Net ID Signature (notification of risks) Name of Yale Contact Phone # CARD ACCESS SITES Please indicate required access sites(below). Access is granted after medical clearance is received from Employee Health, if applicable. Please fax this page (2) to for access. Amistad room # BCMM B DL room # GSF 2 room # GSF 8 room # LLCI Basement LEPH 9 Room LEPH 8 Room LSOG 5 LSOG Basement LSOG Sub-basement room # MEC 4 OML 5 Seamco SHM BG SHM IG SHM 4 TAC Room/Area YARF Bldg A C YPI WWW05 West Campus Building Room Yale Contact Authorization Dept Phone Duration of Access Date 2

3 DEPARTMENT OF EMPLOYEE HEALTH REQUEST FOR MEDICAL REVIEW FOR ENTRY TO ANIMAL FACILITY SERVICE PROVIDER/VISITOR HEALTH HISTORY QUESTIONNAIRE Name: Address: Date of Birth: Net ID: Job Title: Dept./Company Today's Date: Sex: M F Home Phone: Business Phone: Business Fax: Supervisor: MEDICAL HISTORY ALLERGIES To Medications: N Y If YES, please list: To the Environment: N Y If YES, please list: To Animals: N Y If YES, please list species: Are you under any medical treatment for your allergies at this time? N Y What symptoms do you experience as part of your allergy to animals? Do you have contact with pets in your home: N Y If YES, please list: Do you have contact with animals in your recreational activities? N Y If YES, please describe: PLEASE CHECK IF YOU HAVE OR HAD ANY OF THE FOLLOWING CONDITIONS: NO YES History of Asthma Family History of Asthma or Allergies History of Eczema Chronic Bronchitis Emphysema Tuberculosis High Blood Pressure Heart Disease Gastrointestinal Disease (Ulcers, Colitis, Gallbladder disease) DEPARTMENT OF EMPLOYEE HEALTH 3

4 REQUEST FOR MEDICAL REVIEW FOR ENTRY TO ANIMAL FACILITY SERVICE PROVIDER/VISITOR HEALTH HISTORY QUESTIONNAIRE PLEASE CHECK IF YOU HAVE OR HAD ANY OF THE FOLLOWING CONDITIONS: NO YES Parasites/Dysentery/Infectious Diarrhea Liver Disease/Jaundice Cancer or Malignancy Any Immunosuppressive Condition Anemia or Blood Disorder Diabetes Epilepsy or other Neurological Conditions Glaucoma, Cataracts or other Eye Disease Arthritis/Gout Kidney Disease Thyroid Disease List any other medical conditions for which you are under treatment: List any medications you take on a regular basis: Date of your last Tetanus vaccination (must be within the last 10 years): Have you ever been vaccinated against rabies? N Y If YES, please list dates: Have you ever tested positive or been treated for Tuberculosis exposure? N Y Please list date and result of last Tuberculosis test (PPD): If female, are you currently pregnant or contemplating pregnancy in the near future? N Y List dates of Measles vaccinations (at least one must be after 1980): 1, 1957) (only if your birth date is after January The above information is correct to the best of my knowledge. Signature: Date: 4

5 DEPARTMENT OF EMPLOYEE HEALTH REQUEST FOR MEDICAL REVIEW FOR ENTRY TO ANIMAL FACILITY SPECIES PREVENTATIVE HEALTH CHECKLIST This form must be completed by all individuals (potentially) exposed to or handling animals. The information provided will be used to determine the appropriate preventive health measures. Check all appropriate boxes below after discussing the (potential) exposures with the appropriate YARC supervisory personnel. The form should be signed by the individual and mailed or faxed with the Health History Questionnaire to: Employee Health, 55 Lock Street, P.O. Box , New Haven, CT , Fax : Date: Cat Dog Gerbil Hamster Non-human Primate Pig Rabbit Frog Chicken Ferret Guinea Pig Mouse Opossum Rat Sheep Wild or Feral Animals Animals Inoculated with Infectious agents Please specify agents: Other: Name: Date of birth: Department: Status: University Staff External Contractor / Visitor Title: Dept. / Company Name: 5