THOMAS JEFFERSON UNIVERSITY INCIDENT RESPONSE PLAN FOR BOTULINUM TOXIN

Transcription

1 THOMAS JEFFERSON UNIVERSITY INCIDENT RESPONSE PLAN FOR BOTULINUM TOXIN Botulinum Incidents Thomas Jefferson University s Internal Disaster Plan for Biological Incidents will be followed as outlined below. If there is such a threat during working hours, all toxin not involved in the incident will be secured in the storage freezer located in 315 Jefferson Alumni Hall (JAH). Purpose The purpose of this plan is to: 1. prevent or minimize biological spills or releases and reduce the effects of an incident, 2. prevent injury and/or exposure to employees, students, patients, and visitors, 3. provide assistance to affected persons, and 4. satisfy all applicable regulatory agencies. Mitigation A necessary component of this plan includes measures which will minimize or prevent any disaster caused by a biological incident. The following activities are required for successful prevention of a biological incident involving botulinum toxin. 1. An effective biological safety program which provides training on botulinum toxin, including its routes of entry, mechanism of action, and symptoms of exposure 2. Inventory control 3. Heat or chemical inactivation of botulinum toxin prior to disposal 4. Annual training for the Emergency Team 5. Periodic meetings of the University Safety Committee, its subcommittees and the Institutional Biosafety Committee to review activities concerning biosafety in the university Anyone who experiences or becomes aware of a biological spill should cordon off the area to prevent dispersion of the material and call Jefferson s internal emergency number ( 811 ) immediately. The Responsible Official (RO) and/or the Alternate Responsible Official (ARO) will serve as the primary responders and can assist in the cleanup. Other emergency response personnel may assist only in securing the area or in a support capacity through physical systems support (i.e. ventilation, electrical, etc ) Cleanup will proceed as outlined in Thomas Jefferson University s Chemical Hygiene Plan for Botulinum Toxin. Recovery 5/17/2010 1

2 Following any significant biological incident, all individuals involved in any aspect of the incident will identify: 1. why the incident occurred and take necessary measures for the prevention of similar future incidents 2. any facility or equipment malfunction, and 3. any segment of the plan or procedure that may require revision. Loss or Theft of Botulinum Toxin Thomas Jefferson University s Security Plan for Botulinum Toxin will be followed as outlined below. The person discovering the loss or theft of the toxin should immediately secure the remaining toxin in the storage freezer located in 315 JAH. If the storage freezer was damaged in the course of the theft, then the toxin should be secured in one of the other freezers located within the botulinum toxin facility. Purpose To establish guidelines for the loss or theft of botulinum toxin. Mitigation A major aspect of this plan is for the development of measures that will prevent the loss or theft of the toxin. Consequently, annual training on security measures presented in the Security Plan for Botulinum Toxin will occur. Any suspected loss or theft of botulinum toxin is reported to the RO (or ARO). Upon notification of a loss or theft, the RO (or ARO) will suspend all select agent activity, have the lock on the storage freezer immediately changed, disable all key card access (except their own), and notify the CDC and, as appropriate, local law enforcement and the FBI. Recovery 1. On determination that a theft or loss has occurred, the Report of Theft, Loss or Release of Select Biological Agents and Toxins APHIS/CDC Form 3 will be submitted to CDC within 7 (seven) calendar days. 2. Both this Incident Plan and the Security Plan will be reviewed by the RO and/or ARO with those involved in the discovery of the loss or theft. Revisions will be recommended and implemented as Inventory Discrepancies Thomas Jefferson University s Security Plan for Botulinum Toxin will be followed as outlined below. 5/17/2010 2

3 Purpose To establish guidelines for reporting a discrepancy in the inventory of the botulinum toxin. Mitigation A major aspect of this plan is for the implementation of measures that will prevent the occurrence of an inventory discrepancy. Consequently, annual training on security measures presented in the Security Plan for Botulinum Toxin will occur. If, for any reason, there is suspicion that the inventory and use records of the botulinum toxin have been altered or compromised, it will be reported to the RO (or ARO). The RO (or ARO) will immediately initiate an investigation to further determine what has occurred. CDC will be notified immediately in situations where it has been determined that a theft or loss has occurred. When directed, local law enforcement and/or the FBI will be consulted. Recovery 1. Both this Incident Plan and the Security Plan will be reviewed by the RO and/or ARO with those involved in the discovery of the inventory discrepancy. Revisions will be recommended and implemented as 2. On determination that a theft or loss has occurred, the Report of Theft, Loss or Release of Select Biological Agents and Toxins APHIS/CDC Form 3 will be submitted to CDC within 7 (seven) calendar days. Security Breaches Loss of Keys: If either of the two keys to the select agent freezer is lost or stolen, the PI will immediately notify the RO (or ARO). The RO (or ARO) will authorize Security to remove the old lock, install a new one, and provide keys to the above authorized individuals. Computer Password Compromised: If the password protecting the inventory is lost, stolen, or forgotten, Jefferson s internal Information Technology Department will be contacted to gain access to the document. The inventory will be checked to verify that the document and the physical inventory are still in agreement. Assuming they are, the document will be password protected again. Loss or Theft of ID: Individuals who gain security clearance for access to the select agent lab also sign a document entitled, Access to Select Agent Laboratories at Thomas Jefferson University. (see attached) By signing this document, the individual acknowledges the responsibility 1) that comes with their access to the select agent lab, 2) of reading and following the SOP implemented for the select agent lab, 3) of not lending or sharing their ID with anyone for any reason and the repercussions if they do, and 4) to immediately notify the PI, the 5/17/2010 3

4 RO and the Security Department if their ID is lost or stolen. It will then be the responsibility of the RO (or ARO) to ensure that the lost or stolen ID is inactivated and that a new ID is issued. Suspicious Persons or Activities: All Thomas Jefferson Personnel are instructed to immediately report any suspicious persons or activities by calling 811. This will bring security personnel to the area immediately. Bomb Threats/ Suspicious Packages Thomas Jefferson University s Internal Disaster Plan for Bomb Threats will be followed as outlined below. If there is such a threat during working hours, all botulinum toxin will be secured in the storage freezer located in 315 JAH. Purpose To establish guidelines and emergency procedures in response to a potential bomb threat/suspicious package and make an assessment based on the degree of risk, to evacuate. If the situation is considered life threatening, coordinate and control an orderly evacuation of the premises. Mitigation Due to recent trends in this type of criminal activity, it is important to minimize the risk factor or degree of injury if an explosion occurs or eliminate the risk factor totally by recognizing and reacting to the danger. Therefore, reaction or countermeasures, regardless of the seriousness of the threat whether by phone or mail, will be conducted with extreme caution, concern, and sensitivity. All precautions will be incorporated by way of the procedures that are outlined below. 1. ALL CALLS indicating bomb threats must be treated as authentic. Panic must be prevented. The threat should not be discussed more than necessary and rumors should not be started or shared. 2. Bombs are principally homemade, come in many shapes and sizes and can be disguised as innocent objects. This makes them difficult to locate and increases their effectiveness. 3. A suspicious package is defined as a package that contains an address label with missing or incorrect information and/or no return address, is lopsided, has a strange odor, is stained on the exterior, or has wires protruding from it (indicating a possible explosive device). 4. ONLY QUALIFIED Bomb Disposal personnel (i.e. Philadelphia Police, FBI, etc.) shall deactivate, remove, and/or safely detonate found devices. 5. The Thomas Jefferson University Security Department Supervisor or designee on duty shall assume the responsibility as first responder to the scene as Scene Commander when an explosive device is found. The Security Supervisor can make immediate decisions without consulting the 5/17/2010 4

5 administrator on call or the Manager due to the nature of the emergency, but must ensure that these and other key personnel are made aware of the situation. 6. The Security Supervisor in cooperation with the Fire Marshal should follow the same evacuation procedures followed in fire situations (i.e. total evacuation). Fire towers should be used whenever or wherever possible. 7. Requests for services from external agencies must be approved by the Manager of Security or his/her designee. 8. Radio transmitters or any type of transmission devices shall not be used in the area in jeopardy. Recovery The Security Manager will submit a follow up Investigation Report and critique to the Emergency/Disaster Planning Subcommittee of the University Safety Committee. The report should include a brief description of the bomb threat incident (response, apprehensions, notifications, and need for evacuation if activated) and recommend revisions to this plan. Fire Thomas Jefferson University s Internal Disaster Plan for Fire will be followed as outlined below. If there is such a threat during working hours, all botulinum toxin will be secured in the storage freezer located in 315 JAH if it is safe to do so, depending on the emergency. (If the emergency occurs after working hours, the toxin will already have been secured.) Purpose The purposes of this plan are to: 1. prevent occurrence entirely or reduce the effects of the incident, 2. rescue entrapped persons, 3. prevent injury to visitors and employees, 4. prevent additional damage to property, and 5. satisfy all applicable regulatory agencies. Mitigation A major aspect of this plan is for the development of measures that will prevent a disaster caused by fire. The following activities are necessary requirements for successfully preventing the initiation of a fire and to alleviate the effects of its damage. 1. Annual fire safety training for ALL employees, with concentrated efforts in areas having high risks 2. New employee orientation covering fire safety procedures 3. Annual intensive training for employees who are assigned to the Emergency Team 4. Annual safety seminar for contractors 5. Annual familiarization tour of the facilities for local fire companies 5/17/2010 5

6 6. Semi annual safety audits to be conducted in all buildings 7. Frequent testing of all fire alarm systems with immediate correction procedures for deficiencies 8. Semi annual monthly fire drills in all buildings covering all shifts 9. Annual review of fire safety procedures 10.Scheduled preventative maintenance for all essential equipment 11.Quarterly meetings of the Safety Committee and monthly meetings of its subcommittees to fire incidents will be handled by the Philadelphia Fire Department and the Emergency Team. Security: Security will call the Philadelphia Fire Department giving the street address, floor number, and indicating this is the select agent facility where the incident is occurring. They will also notify the Emergency Team and Facilities to assure that everyone is aware of the alarm. Security will meet and direct the Philadelphia Fire Department to the fire location. They will also maintain communications at the fire and direct those not involved in the emergency to evacuate the area. They are authorized to stop others from entering the building in jeopardy. Gas Leaks/Explosions A similar plan to Thomas Jefferson University s Internal Disaster Plan for Fire will be followed as outlined below. If there is such a threat during working hours, all botulinum toxin will be secured in the storage freezer located in 315 JAH if it is safe to do so, depending on the emergency. (If the emergency occurs after working hours, the toxin will already have been secured.) Purpose The purposes of this plan are to: 1. prevent occurrence entirely or reduce the effects of the incident, 2. rescue entrapped persons, 3. prevent injury to visitors and employees, 4. prevent additional damage to property, and 5. satisfy all applicable regulatory agencies. Mitigation A major aspect of this plan is for the development of measures that will prevent a disaster caused by a gas leak/explosion. The following activities are necessary requirements for successfully preventing the initiation of a gas leak/explosion and to alleviate the effects of its damage. 1. Annual intensive training for employees who are assigned to the Emergency Team 2. Annual safety seminar for contractors 3. Annual familiarization tour of the facilities for local fire companies 5/17/2010 6

7 4. Semi annual safety audits to be conducted in all buildings 5. Scheduled preventative maintenance for all essential equipment 6. Quarterly meetings of the Safety Committee and monthly meetings of its subcommittees to gas leaks/explosion incidents will be handled by the Philadelphia Fire Department and the Emergency Team. Security: Security will call the Philadelphia Fire Department giving the street address, floor number, and indicating this is the select agent facility where the incident is occurring. They will also notify the Emergency Team and Facilities to assure that everyone is aware of the alarm. Security will meet and direct the Philadelphia Fire Department to the gas leak/explosion location. They will also maintain communications at the location and direct those not involved in the emergency to evacuate the area. They are authorized to stop others from entering the building in jeopardy. Severe Weather or Other Natural Disaster Thomas Jefferson University is not likely to experience a natural disaster such as an earthquake. However, we might be subject to severe weather. In the case of severe weather or natural disasters, there is adequate time for Thomas Jefferson University to determine if they will open for business or if they need to close the institution. That determination is made by the institutional authorities per Thomas Jefferson University s Weather Emergency Policy. Even if the weather becomes severe during normal working hours, there is time for select agent personnel to secure the toxin they are working with before leaving for the day. (If the emergency occurs before or after working hours, the toxin will already have been secured.) Workplace Violence Workplace violence will be handled as outlined in Thomas Jefferson University s various policies covering these events. In the event that select agent personnel are targeted for violence because of the nature of their work, or for any other reason, they should immediately call Thomas Jefferson s internal emergency response number 811. According to our policies, a Security Shift Supervisor or Special Investigator will respond. Upon gathering the information, the supervisor or investigator will notify the appropriate campus personnel, which will include the RO or ARO, as well as the Philadelphia Police Department. It will be the RO or ARO s responsibility to notify the CDC if it is determined that the violence occurred as a result of the individual s work with botulinum toxin OR if there is any indication that the security of the toxin is threatened or compromised. 5/17/2010 7

8 Select agent personnel will report any violent threats received either at home or at work to their local authorities, Thomas Jefferson s Security Department, and the RO or ARO. Any demonstrations will be handled in accordance with Thomas Jefferson s policy. Upon notification that a demonstration is being formed, Thomas Jefferson s Security Force will be dispatched. Often, the presence of the uniformed security forces is enough to keep demonstrations peaceful. It will be Security s responsibility to request assistance from the Philadelphia Police Department. Loss of Air Conditioning Thomas Jefferson University s Internal Disaster Plan for Loss of Air Conditioning will be followed as outlined below. If the area affected involves the Select Agent Labs, all botulinum toxin will be secured in the storage freezer located in 315 JAH prior to maintenance personnel being granted admittance to the area. Purpose To establish a procedure to be used in the event of an air conditioning failure that affects a large area of a building or the entire building. Mitigation All components of each air conditioning system are on a preventive maintenance program designed to ensure that all equipment included in the preventive maintenance schedule is maintained for safe and reliable operation and that periodic inspections are performed. The preventive maintenance time intervals for inspections are established through either manufacturer's specifications, past historical reference or regulatory agency requirements. Training of personnel responsible to inspect, test and maintain utility systems is reviewed annually and provided as required. RESPONSE When a service call is received for an area that is too hot, a mechanic will be dispatched to evaluate and correct the problem. If the mechanic determines that this is a major problem, he/she will notify the immediate supervisor. The problem should be identified as an individual air conditioner problem, an individual air handler problem or a chiller plant problem. In most buildings, the chiller plant produces chilled water for the entire building. There is usually more than one chiller in a building and air handlers use this chilled water to provide cooling. 5/17/2010 8

9 The Facilities ' Director responsible for JAH will contact the Associate Vice President for Facilities Management and the administrative personnel for the department(s) affected. The following information should be provided: 1. nature of problem 2. estimated down time and repair time 3. temporary measures to be taken (if any) Air conditioning and air handler problems usually affect specific areas. Failures requiring replacements of large equipment may be a major problem requiring down time to replace. Replacement parts and repairs of this nature are expedited. Complete chiller plant failures are very rare and usually require a heating, ventilation and air conditioning (HVAC) contractor. Emergency 24 hour service will be provided by Herman Goldner at All pertinent information relating to the problem will be documented in the Facilities ' supervisor's daily report. RECOVERY An evaluation team consisting of the Facilities Director responsible for the equipment and three supervisors will be assigned to determine the cause of the failure. The same team will determine what should be reviewed and altered, if The frequency of the inspections should be reviewed and altered, if The training requirements of personnel should be reviewed and altered, if A review of the response procedure should be reviewed and altered, if Loss of Electrical Service Thomas Jefferson University s Internal Disaster Plan for Loss of Electrical Service will be followed as outlined below. If the area affected involves the Select Agent Labs, all toxin will be secured in the storage freezer located in 315 JAH prior to maintenance personnel being granted admittance to the area. PURPOSE To establish a procedure to be used in the event of a partial or complete electrical failure that affects a large or critical area of a building. MITIGATION 5/17/2010 9

10 All components of the Electrical Distribution System are on a preventive maintenance program. Our program is designed to ensure that all equipment included in the preventive maintenance schedule is maintained for safe and reliable operation and that periodic inspections are performed. The Preventive Maintenance time intervals for inspections are established through either manufacturer's specifications, past historical reference or regulatory agency requirements. Training of personnel responsible to inspect, test and maintain utility systems is reviewed annually and provided as required. RESPONSE When a service call is received for a power outage, a mechanic will be dispatched to evaluate and correct the problem. If the mechanic determines that this is a major problem he/she will notify their immediate supervisor. The Facilities Director responsible for the building affected will contact the Associate Vice President for Facilities Management and the administrative personnel for the department(s) affected. The following information should be provided. 1. nature of the problem; 2. estimated down time and repair time; and 3. temporary measures to be taken (if any). The Department of Facilities will make repairs when possible; extension cords and temporary lighting may be provided. If the electrical failure affects the electronic security swipe card entry systems, emergency service will be provided by Siemens, Inc If the assistance of a contractor is required, emergency service will be provided by Shaffer Electric at their 24 hour service number Emergency generator service will be provided by Ransome Engines at their 24 hour service number In the event that the loss of electrical service affects the key card access system to the select agent area, then Siemens will also be notified at Temporary power can be supplied to most areas by placing a generator on the street with cables running to the location of the power distribution equipment. All pertinent information relating to the problem will be documented in the supervisors daily report. 5/17/

11 RECOVERY An evaluation team consisting of the Facilities Director responsible for the equipment and three supervisors will be assigned to determine the cause of the failure. The same team will determine what should be reviewed and altered, if The frequency of the inspections should be reviewed and altered, if The training requirements of personnel should be reviewed and altered, if A review of the response procedure should be reviewed and altered, if Loss of Heat Thomas Jefferson University s Internal Disaster Plan for Loss of Heat will be followed as outlined below. If the area affected involves the Select Agent Labs, all botulinum toxin will be secured in the storage freezer located in 315 JAH prior to maintenance personnel being granted admittance to the area. PURPOSE Purchased steam is used to provide heat to all University buildings. It is the responsibility of the Department of Facilities to ensure that these facilities have an adequate steam supply. This procedure is to be used in the event of an equipment failure or loss of purchased steam to JAH which would result in the loss of heat. MITIGATION All components of a building's heating system are on a preventive maintenance program. Our program is designed to ensure that all equipment included in the preventive maintenance schedule is maintained for safe and reliable operation and that periodic inspections are performed. The Preventive Maintenance time intervals for inspections are established through either manufacturer's specifications, past historical reference or regulatory agency requirements. Training of personnel responsible to inspect, test and maintain utility systems is reviewed annually and provided as required. RESPONSE When a major problem occurs which is the result of an equipment failure, replacement parts will be identified and secured in order to expedite the repairs. If assistance is required to secure the parts or make the repairs, emergency 24 5/17/

12 hour service will be provided by the Herman Goldner Co. and can be reached at When a major problem occurs that is the result of a loss of purchased steam, Trigen Philadelphia Energy Corporation is the purchased steam supplier and can be contacted at their 24 hour service number The Facilities ' Director responsible for JAH will contact the Associate Vice President for Facilities Management and the administrative personnel for the department(s) affected. The following information should be provided: 1. nature of the problem; 2. estimated down time and repair time; and 3. temporary measures to be taken (if any). Loss of purchased steam to a building can only be supplemented by a contractor with a portable steam generator on a tractor. With a limited amount of steam supplied by a portable generator service, selective usage may be required and prioritization would be the responsibility of Facilities. All pertinent information relating to the problem will be documented in the Facilities ' supervisor s daily report. RECOVERY An evaluation team consisting of the Regional Manager responsible for the equipment and three supervisors will be assigned to determine the cause of the failure. The same team will determine what should be reviewed and altered, if The frequency of the inspections should be reviewed and altered, if The training requirements of personnel should be reviewed and altered, if A review of the response procedure should be reviewed and altered, if Loss of Steam Thomas Jefferson University s Internal Disaster Plan for Loss of Steam will be followed as outlined below. If the area affected involves the Select Agent Labs, all botulinum toxin will be secured in the storage freezer located in 315 JAH prior to maintenance personnel being granted admittance to the area. 5/17/

13 PURPOSE To establish a procedure to be used in the event of a steam failure to JAH that would affect equipment using steam. Purchased steam is used to provide heat to all University buildings. The Department of Facilities is responsible to ensure that the University has an adequate steam supply. This procedure is to be used in the event of an equipment failure or loss of purchased steam to a building which would result in the loss of heat. MITIGATION All components of a building's steam distribution system are on a preventive maintenance program. Our program is designed to ensure that all equipment included in the preventive maintenance schedule is maintained for safe and reliable operation and that periodic inspections are performed. The preventive maintenance time intervals for inspections are established through either manufacturer's specifications, past historical reference or regulatory agency requirements. Training of personnel responsible to inspect, test and maintain utility systems is reviewed annually and provided as required. RESPONSE When a major problem occurs that is the result of an equipment failure, replacement parts will be identified and secured in order for repairs to be expedited. If assistance is required to secure parts or make the repairs, emergency 24 hour service will be provided by the Elliott Lewis Corporation at When a major problem occurs that is the result of a loss of purchased steam, Trigen Philadelphia Energy Corporation is the supplier and can be contacted at their 24 hour service number The Facilities ' Director responsible for JAH will contact the Associate Vice President for Facilities Management and the administrative personnel for the department(s) affected. The following information should be provided: 1. nature of the problem; 2. estimated down time and repair time; and 3. temporary measures to be taken (if any) Loss of purchased steam to a building can only be supplemented by a contractor with a portable steam generator on a tractor. 5/17/

14 RECOVERY An evaluation team consisting of the Facilities Director responsible for the equipment and three supervisors will be assigned to determine the cause of the failure The same team will determine what should be reviewed and altered, if The frequency of the inspections should be reviewed and altered, if The training requirements of personnel should be reviewed and altered, if A review of the response procedure should be reviewed and altered, if Loss of Water Thomas Jefferson University s Internal Disaster Plan for Loss of Water will be followed as outlined below. If the area affected involves the Select Agent Labs, all botulinum toxin will be secured in the storage freezer located in 315 JAH prior to maintenance personnel being granted admittance to the area. PURPOSE In the event of the loss or contamination of the water supply, the Department of Facilities will make contact with a contracted outside water company for delivery of up to 20,000 gallons of potable water per day for the duration of the emergency. MITIGATION All components of the domestic water system are on a preventive maintenance program. Our program is designed to ensure that all equipment included in the preventive maintenance schedule is maintained for safe and reliable operation and that periodic inspections are performed. The preventive maintenance time intervals for inspections are established through either manufacturer's specifications, past historical reference or regulatory agency requirements. Training of personnel responsible to inspect, test and maintain utility systems is reviewed annually and provided as required. RESPONSE When it has been determined that the city water supply has been lost to JAH, the Facilities ' Director responsible for the building will contact the Associate Vice President for Facilities Management and the administrative personnel for the department and building affected. 5/17/

15 The following information should be provided: 1. nature of the problem; 2. estimated down time and repair time; and 3. temporary measures to be taken (if any). The Department of Facilities will contact Great Bear Springs Company at (24 hour service) or , for delivery of up to 20,000 gallons of potable water per day for the duration of the emergency. The water will be delivered to an area that is best suited to serve the select agent laboratory. Upon delivery of the water supply, the administrative personnel responsible for the building affected will be notified for implementation of emergency water distribution. All pertinent information relating to the problem will be documented in the Facilities ' supervisor's daily report. RECOVERY An evaluation team consisting of the Facilities Director responsible for the equipment and three supervisors will be assigned to determine the cause of the failure. The same team will determine what should be reviewed and altered, if The frequency of the inspections should be reviewed and altered, if The training requirements of personnel should be reviewed and altered, if A review of the response procedure should be reviewed and altered, if 5/17/

16 THOMAS JEFFERSON UNIVERSITY INTERNAL DISASTER SCENARIOS UTILITIES Disaster Event Loss of Water Loss of Electric Criteria Action Jefferson Responders Reduced flow or no water Flood Reduced or damaged power lines Call Facilities Call Facilities Loss of Steam No steam Call Facilities Loss of Phones Loss of Computers Loss of Medical Gas Loss of Oxygen/ Compression Lines Loss of Air Conditioning Loss of Heat Absent dial tone, reduced phone service No mainframe access No wall gases No oxygen suction Warm work spaces, loss of chillers Cold work spaces Call or contact Security Call DIS DIS Security Call Facilities Call Facilities Environmental Health & Safety Respiratory Care Call Facilities Call Facilities Outside Responders As Needed Philadelphia Water Dept. Great Bear Water Company PECO Shaffer Electric (610) Siemens (215) Trigen Philadelphia Energy Corporation Bell Telephone Philadelphia Police Dept. (911) Herman Goldner (800) Trigen Philadelphia Energy Corporation 5/17/

17 FACILITIES Disaster Event Criteria Action Jefferson Responders Structure/Building Damage Street Closure Loss of Elevator Leaks, floods, exterior/ interior building damage Access to building limited Elevators not functioning Call Call 811 Call Facilities Facilities Design & Construction Custodial Security Facilities ENVIRONMENT Disaster Event Criteria Action Jefferson Responders Bomb Threat Fire/Smoke Call/communication that bomb has been planted Smoke, flames visualized Call 811 Call 811 Emergency Team Emergency Team Chemical Incidents Odd smells, fumes Call 811 Emergency Team Environmental Health & Safety Biological Incidents Biohazard leak Loss of select agent material Call 811 Emergency Team Environmental Outside Responders As Needed Outside Contractors Otis Elevator (800) Outside Responders As Needed Philadelphia Police Dept. (911) Philadelphia Fire Dept. (911) FBI Philadelphia Fire Dept. (911) Philadelphia Fire Dept. Hazardous Materials Unit (911) Onyx Environmental Philadelphia Police Dept. (911) FBI 5/17/

18 Health & Safety Mercury Spills Call 811 Emergency Team Facilities Radiation/Nuclear Medicine Incidents Exposure to Infectious Diseases Weather Emergencies Loss, misuses of radiation substances Student/staff exposure to communicable disease Extreme of ice, snow, rain, etc. Riot/Demonstration Large number of people gathering for specific purpose External Work Stoppage Mass Transportation Interruption Disruptive Person Delivery of goods/services interrupted Roads, bridges, public transportation lines closed Loud, abusive behavior Call 811 Call 811 Call Emergency Team Radiation Safety Emergency Team Infection Control Environmental Health & Safety Human Resources Security, Facilities Onyx Environmental NRC Philadelphia Dept. of Health Philadelphia City/State Depts. Call 811 Security Philadelphia Police Dept. (911) Call 811 Contact your Supervisor Security Materiel Management Commuter Office State, City Depts., PATCO Public Works, SEPTA Call 811 Security Philadelphia Police Dept. (911) 5/17/

19 Contact Information for the RO and ARO Both the Responsible Official and the Alternate Responsible Official s (ARO=Biosafety Officer) contact information is maintained on file at the Security Command Center. The personnel that man this center 24/7 are trained to contact either of these individuals in the case of an incident affecting the botulinum toxin facilities. Name and Contact Information for the Building Owner Not applicable Name and Contact Information for the Tenant Office Not applicable Name and Contact Information for Security All personnel at Thomas Jefferson are trained to dial 811 in an internal emergency or threatening situation. 811 is Thomas Jefferson University s Security Command Center which is manned 24/7 by trained personnel. Personnel Roles and Lines of Authority and Communication These have been detailed in each of the incidents above as they vary by incident. Planning and Coordination with Local Emergency Responders The local fire and police departments have been invited to tour the facilities. In addition, Thomas Jefferson University maintains chemical inventories for each laboratory on their internal intranet site. This is so Security personnel can access them in the event of a fire and, thus, inform the Philadelphia Fire Department what chemical hazards they might need to deal with. The chemical inventory for the select agent area includes the botulinum toxin listed at the top of the inventory. Procedures to be Followed by Employees Performing Rescue or Medical Duties As a security precaution, any employee performing rescue or medical duties who have not received HHS approval will be escorted into the botulinum toxin area. These individuals will need to put on a lab coat and gloves at a minimum. Further PPE will depend on the nature of the incident leading up to their being there, i.e. shoe covers if there has been a spill outside the biosafety cabinet that has not been cleaned. Due to the low quantity and concentration of the botulinum toxin in use, there is no need for respiratory protection. Emergency Medical Treatment and First Aid There are no prophylactic measures available. All personnel who work within the botulinum toxin laboratories are required to take the pentavalent toxoid vaccination available through the CDC. Any responder to an incident within the 5/17/

20 botulinum toxin facilities should immediately enter into a medical surveillance program as outlined below. Employees must be given the opportunity to receive medical attention whenever 1) they exhibit signs or symptoms related to botulinum toxin exposure, 2) monitoring reveals that action levels are routinely exceeded, or 3) an incident or spill results in the likelihood of an exposure to the employee. Medical evaluations shall be under the direct supervision of a licensed physician and must be provided by Thomas Jefferson University at no cost to the employee, without loss of pay and at a reasonable time and place. Employees would report to Jefferson s University Health during business hours and Jefferson s Emergency Department after hours. Should a medical consultation/examination become necessary, Thomas Jefferson University will provide the following information to the physician: 1. the identity of the toxin to which the employee has been exposed 2. a description of the conditions under which the exposure occurred including any quantitative exposure data, if available, and 3. a description of the signs and symptoms of botulinum toxin exposure the employee is experiencing, if any The physician, after the consultation/examination, will provide to Thomas Jefferson University a written opinion which shall include the following information. 1. any recommendation for future medical follow up 2. the results of the medical examination and any associated tests 3. any medical condition which may be revealed at the time of examination which may place the employee at increased risk as a result of exposure to botulinum toxin 4. a statement that the employee has been informed by the physician of the results of the consultation/examination and any medical condition that may warrant further treatment The written opinion shall NOT reveal specific findings of a diagnosis unrelated to the occupational exposure. Personal Protective and Emergency Equipment Boxes of gloves (one each of small, medium, and large) and shoe coverings will be kept on top of the coat rack adjacent to the select agent lab. Two or three lab coats will also be kept there for emergency use. These supplies can be accessed by emergency responders prior to entering into the select agent facilities. A portable defibrillator is maintained at the Security desk on the ground floor. Security personnel are trained in the use of this device. 5/17/

21 Site Security and Control Please refer to the various incident scenarios above. Thomas Jefferson s internal Security force will be the first on the scene. It is their responsibility to secure the area and gain control of the situation. The Scene Commander (as outlined in the scenario) will be responsible for notifying the Philadelphia Fire and/or Police Department. Procedures for Emergency Evacuation The Scene Commander will determine if evacuation from either the select agent facility or the entire building is If evacuation is deemed necessary, then individuals will exit into the nearest fire stairwell and leave the building entirely. The nearest fire stairwell is either within the select agent facility or just outside the main door into the facility. The select agent personnel will congregate across Locust Street in Lubert Plaza to await further instructions from Emergency Personnel. While the fire tower stairs in JAH allow for a place of refuge, Thomas Jefferson University does not recommend using them as such as this impedes the fire fighters in their efforts to combat the fire. Consequently, personnel are instructed to leave the building. Decontamination Procedures For a spill occurring within a biological safety cabinet, the blower is to remain on. Remove contaminated clothing (gloves, lab coat) and dispose of them in the biohazard trash. Warn others of the spill and isolate the area. Wash all exposed skin surfaces with soap and water. Notify the PI and RO (and/or ARO). Put on a clean lab coat, double gloves, and eye protection. Pour concentrated bleach on paper towels and lay them on top of the spill. Place a plastic backed diaper on top of the towels, plastic side towards you. Allow to sit for 30 minutes. Clean up the materials and dispose of in biohazardous trash. Change the outer pair of gloves. Clean the area with 10% bleach followed by 70% EtOH. Repeat. For a spill occurring outside the biosafety cabinet, the following steps will be taken. The initial steps are the responsibility of the person(s) whose actions led to the spill. Warn others of the spill and isolate the area. Remove contaminated protective clothing (including shoes) immediately at the door before leaving the contaminated area Wash all exposed skin surfaces with soap and water. If shower facilities are available, then shower using a germicidal soap. Dial 811 from a Jefferson phone Emergency responders may assist only in securing the area. The RO and/or the ARO are authorized personnel who may assist in the clean up. After the above immediate steps have been taken, the PI and/or an authorized person in the laboratory knowledgeable about the toxin and biohazard decontamination will direct the decontamination and clean up. The following elements will be included in this phase. 5/17/

22 The contaminated area should not be re entered for a minimum of 30 minutes if there is a danger of airborne particles Personnel responsible for the clean up will wear protective shoe coverings, a tyvek suit, double gloves, eye protection, and head covering. Pour concentrated bleach on paper towels and lay them on top of the spill. Place a plastic backed diaper on top of the towels, plastic side towards you. Allow to sit for 30 minutes. Clean up the materials and dispose of in biohazardous trash. Change gloves. At a minimum, remove the outer pair of gloves and dispose of them in the biohazard trash. Put on a clean pair of gloves. Clean the area with 10% bleach followed by 70% EtOH. Repeat. For any equipment that needs to be decontaminated but cannot be subjected to liquid disinfectants, gas sterilization will be used. Before leaving the immediate area, the decontamination team will remove their personnel protective equipment by removing the outer pair of gloves, then all other clothing beginning from the head down. When the shoe coverings are removed, the individuals will step on a pad soaked with a disinfectant solution. All protective clothing will be disposed of as biohazardous trash. Review of Incident Plan This Incident plan will be reviewed on a yearly basis, and drills or exercises conducted to test and evaluate its effectiveness. The plan will be reviewed and revised as necessary based on the outcomes of any drills, exercises, or incidents. 5/17/

23 APPENDIX Bomb Threats 04 Botulinum Incidents 01 Contact Information for the RO and ARO 19 Decontamination Procedures 21 Emergency Equipment 20 Emergency Medical Treatment 19 Explosions 06 Fire 05 First Aid 19 Gas Leaks 06 Internal Disaster Scenarios Chart Environment 17 Internal Disaster Scenarios Chart Facilities 17 Internal Disaster Scenarios Chart Utilities 16 Inventory Discrepancies 02 Lines of Authority and Communication 19 Loss of Air Conditioning 08 Loss of Botulinum Toxin 02 Loss of Electrical Service 09 Loss of Heat 11 Loss of Steam 12 Loss of Water 14 Name and Contact Information for the Building Owner 19 Name and Contact Information for Security 19 Name and Contact Information for the Tenant Office 19 Natural Disasters 14 Personal Protective Equipment (PPE) 20 Personnel Roles 19 Planning and Coordination with Local Emergency Responders 19 Procedures for Emergency Evacuation 21 Procedures to be Followed by Employees Performing Rescue or Medical Duties 19 Review of Incident Plan 22 Security Breaches 03 Severe Weather 07 Site Security and Control 21 Suspicious Packages 04 Theft of Botulinum Toxin 02 Workplace Violence 07 5/17/