VETERINARY OCCUPATIONAL HEALTH & SAFETY

What is a field in public health with the aim of promoting the highest degree of physical, mental, and social well-being of workers?

Occupational health

What are the FIVE ways to achieve worker health and safety by?

• Basic principles & facility design

• Policies

• Personnel training

• Effective managerial & operational systems

• Positive work culture

WHY IS OCCUPATIONAL HEALTH

IMPORTANT IN VETERINARY MEDICINE?

• Reduced ___ and employee turnover

• Improved worker efficiency & _____

• (Increased/Decreased) worker errors

• More attentive/productive workers = better patient health outcomes

• Reduced ___ ___ to employee and employer

• Improved morale, job satisfaction, attitude, & work environment

• Improved interpersonal relationships

• Improved practice image within community

absenteeism, productivity, decreased, health costs

T/F Healthy workplaces are our responsibility to ourselves and our employees

True

What are the priorities in the day to day life?

patients and clients, not on our own or employees' health

WHO IS THE OCCUPATIONAL HEALTH

SPECIALIST IN YOUR PRACTICE?

YOU

T/F • All veterinary team members face similar occupational hazards but not all have the same ability to absorb the impact of injury or illness

True

What can put a greater financial strain if injured or sick?

lower income

Injury or illness can have disproportionate consequences for assistants

and technicians, what is the your role?

recognize this and support a culture of safety for the entire team

Of all industries, veterinary services ranks _#_ in incidence rates of nonfatal occupational injuries and illnesses

2 nd

What are the FIVE most common occupational injuries among veterinary personnel?

animal bites and scratches, kick and crush injuries, and needlesticks

There is a hierarchy of controls. What are the from most to least effective?

Elimination, Substitution, Engineering controls, Administrative controls, PPE

What is the regulatory agency that sets & enforces workplace safety & health standards?

OSHA (Occupational Safety & Health Administration)

What is the a research and educational institute that conducts research, makes

recommendations, and provides information to prevent work-related injuries and illnesses?

NIOSH (National Institute for Occupational Safety and Health)

T/F Zoonoses are more common than physical injuries in vet practice

False, less common

16.7% (136/812) of veterinarians reported zoonotic infections or exposure to rabies in the past 5 years, with most common zoonosis being ____

Ringworm

Most bites or scratches, and resulting infections, are from what animal?

cats

Wha are the FOUR most common zoonotic infections?

• Dermatophytosis

• Bite wound infections

• Salmonellosis

• Cryptosporidiosis

With regards to rabies, what are the THREE things that you need to train the workers?

• Bite prevention

• Bite reporting

• Bite wound care

What are some of the clinic policies that can be put into place that can help with rabies control?

• Rabies vaccine requirement for all pets

• Policy on intake of wildlife rabies vectors

T/F You should always keep rabies on the ddx list

True

_ ___ PrEP schedule has replaced 3-dose

schedule

2-dose

With the ACIP updated recommendations, risk categories have been redefined into __ ___

5 groups

ALWAYS wash bites/scratches immediately with

soap and water or povidone iodine solution for

minimum ___ _____

15 minutes

What are some vaccines that veterinary employees should have?

• Rabies*

• Tetanus*

• Influenza*

• COVID-19

What agent causes cat scratch fever?

Bartonella henselae

How do you control Cat Scratch Fever?

flea control

What is the causative agent of Dig bite septicemia and the reason why you need to wear eye protection?

Capnocytophaga canimorsus

What are some zoonotic bacteria that can cause disease?

• Salmonella enterica

• Cryptosporidium parvum

• Campylobacter

• Leptospira interrogans

• E. coli (STEC/EHEC)

• Listeria monocytogenes

T/F Standard precautions on all sick cases

a good idea because diagnosis is difficult

True

Why should you wear gloves in a derm case?

Microsporum canis and Trichophyton spp.

T/F Microsporum canis and Trichophyton spp are the most common zoonosis in veterinary practices.

True

What are THREE practices that you can do during derm cases to protect yourself?

• Wear gloves for any animal skin condition

• Wash hands with soap and water frequently

• Facility cleanliness and use of disinfectants

What is the zoonotic form of sarcoptes?

Sarcoptes scabiei var. canis,

What is the non zoonotic form is sarcoptes?

sarcoptes scabiei var. hominis

What causative agent can causes nonpainful pustules on arms/hands?

Dermatophilus congolensis

What fungus causes cutaneous nodules or

pustules?

Sporothrix schenckii

What are THREE bacterias that are classified as aerosolized pathogens?

Chlamydophila spp.

Coxiella burnetii

Yersinia pestis

What is the is the single most important

measure veterinary personnel can take to reduce the risk of disease transmission?

hand hygiene

Respiratory or contact dermatitis are allergies associated to what things?

dander/hair, body fluids, animal feed dust, hay

How can you prevent mosquito borne infections?

• Repellents: DEET, picardin, IR3535, oil of lemon eucalyptus, oil of citronella

• Wear light, long-sleeved clothing

• Limit time outdoors at dawn/dusk

How do you prevent tick borne infections?

• Check for ticks

• Shower after being outdoors

• Dry clothing in hot dryer

What is a way hazard control by elimination is done in practice?

curbside service

What is an introduction of outdoor air, indoor air movement and dilution of germs through mechanical or natural means

ventilation

What are some ways that you can ventilate your clinic? (5)

• Open windows/doors and air dampers

• Use fans near open windows

• Set thermostat to "on" instead of "auto"

• HVAC inspection and proper filters

• In room air cleaners: HEPA filters in higher-risk areas

What is the proper lifting technique?

Lift with your legs, not with your back

What is the proper technique for Palpation?

shoulder aligned with cow's rectum, use stool to stand on if needed, maintain neutral spine

to avoid excessive twisting

What % of veterinarians and their staff had been injured by a needle or other sharps?

77%

What was the most common cause of that people get hurt with sharps?

Recapping of needles

What are some hazards that can come from sharps and needles?

• Infection from contaminated needle

• Inflammation from product (adjuvants)

• Allergic reaction to organic matter or drug/vaccine

Response to drug

There were 12 deaths reported from tilmicosin (Micotil) due to what?

cardiotoxicity

What drugs can cause miscarriage if you get stuck with a needle?

prostaglandins

With sharps and needle sticks, you should point needle __- from self and others

away

T/F Do not recap needles unless hinged cap or one-handed scoop

True

You should dispose of needle and sharps immediately where?

in hard-sided sharps container

Rapid fire time:

• Keep needles ___ until ready for use

• Never carry syringe in pocket or carry around uncapped

• Proper animal ____

• Caution with finger placement with skin tenting technique

• Don't ___

• Schedule regular trainings on safe practices

capped, restraint, RUSH

What are SIX ways to prevent injuries from bites and scratches?

• Personnel training

• Appropriate restraint and safety equipment

• No owner restraint of pets

• Sedation of aggressive animals

• Communicate

about aggression

• Bite prevention education for clients

In equine medicine, one injury per practitioner every ~___ years

3.6

What is the main way that horses injure people?

kick with hind limb

T/F 50% of equine injuries result in hospital injuries

False 33%

What are some ways that you can prevent injury in large animals?

• Well-trained staff

• Proper restraint

• Appropriate equipment

• Sedation for procedures

• Analgesia

• Escape route planned

• Clear communication

with staff & client

• Client education

• Right to refuse service if

unsafe facility

How do you prevent heat stress?

• Loose-fitting, lightweight clothing

• Protect against sunburn

• Drink plenty of water

• Never leave person/animal in parked vehicle

• Avoid hottest part of day

• Use caution if on heat-interacting medication (anticholinergics, etc.)*

• Work in groups and educate team members

How do you prevent IONIZING RADIATION?

• Wear appropriate shielding

• Collimate beam to reduce scatter

• Increase distance from beam

• Consider sedation

• Use correct technique even if digital radiographs (kVp & mAs)

• Use positioning devices instead of hands

T/F 69% reported accidental exposure to waste

anesthetic gases in practice

True

How do you prevent chemical exposure?

adequate scavenging of gases + adequate ventilation (OSHA)

What is illegal distribution or abuse of

prescription drugs for purposes not intended by the prescriber?

Drug diversion

What are FIVE signs of substance misuse?

• Irregularities in drug ordering, logging, inventory

• Decreased effectiveness of injectable controlled drugs

(dilution or substitution)

• Extreme mood swings or irritability

• Erratic behavior, change in disposition

• Spending unnecessary time near controlled drugs

What are some of the recommendations on how to prevent substance misuse? (9)

• Take regular inventory of drugs

• Assign drug ordering and inventory tasks to different employees

• Maintain accurate records

• Follow all DEA rules, including rules for disposal (two witnesses,

document on DEA forms)

• Keep controlled drugs locked in safe and keep keys/codes secure

• Require two employees to fill controlled substance prescriptions

• Use security cameras

• Treat gabapentin as controlled substance (if not considered so by your state)

• Keep your prescription pads and DEA number secure

A vet shopper is someone who using their pets drugs for their own use. What are some common behaviors of vet shoppers

• Patient presented with injuries when history doesn't

make sense

• Unwilling to provide previous medical records

• Reporting clinical signs that do not match physical

exam findings

• Claiming medications were lost, stolen, or left

behind during travel

• Specifically requesting controlled drugs by name

• Requesting early refills, frequent refills, and refusing

to return for recheck appointments

• Becoming hostile when controlled drugs are refused

What is the SIX ways that you can controll drug stewardships?

• Dispense small quantities for limited duration

• Follow DEA regulations for refills based on schedule of

controlled substance you are prescribing

• Photo ID required for dispensing and keep a copy

• Train staff to flag record and notify management when vet

shopping is suspected

• Prescriptions for oral controlled substances may be sent to human

pharmacy to ensure clients information entered into National

PMP (Prescription Monitoring Program)

• Educate clients about keeping drugs secure at home

• Direct clients to drop boxes at pharmacies or police stations for

disposal

What is a syndrome resulting from chronic

workplace stress that has not been successfully managed?

workplace burnout

What are low energy levels, disengagement, exhaustion, cynicism toward the job (depersonalization), low sense of personal efficacy?

Symptoms

What is a poor performance, increased medical errors, reduced working hours, absenteeism, job turnover, early retirement?

Results

Burnout costs the vet industry between $1-2 (million/ billion) a year in lost revenue from turnover and reduced working hours (range depends on whether vet techs included

billion

What are vets with more experience, practice owners, higher annual income, professional identification, feeling of meaningful work?

Protective factors

What are some risk factors that contribute to emotional and stress burnout?

Excessive workload & long hours

• Frequent on-call duties

• Decreased control over the work environment

• Workplace conflicts

• Client complaints

• Negative patient outcomes/deaths

• Recent veterinary grads

• High educational debt

• Female sex

• Associates (compared with practice owners)

• Spending >75% of time with dogs/cats

• Empathy for animals

What can you do to limit burnout?

• Promote worker diversity, inclusion, & accessibility

• Evaluate workload, work hours, & on-call duty

• Rest breaks and flexibility in scheduling

• Engage/empower employees

• Recognize employee skills & permit autonomy

• Foster open communication

• Give and receive regular feedback to show employees are valued

• Recognize social connection and community as a core value

What are some of the benefits you can offer to limit burnout?

competitive wages, paid sick/family leave, educational

debt support

T/F You should fire abusive clients

true (like helloooo)

What are the FIVE essentials for workplace mental health?

-protection from harm, connection and community, work life harmony, mattering at work, opportunity for growth

What is a CRUCIAL COMPONENT of occupational health and safety?

having a disaster plan

The majority of the veterinary population is female. What are some of the hazards that pregnant women face?

• Anesthetic gases

• Radiation

• Drugs: antineoplastic drugs, chloramphenicol, bone cement (MMA),

reproductive hormones

• Physical hazards

• Zoonoses: Toxoplasma, Chlamydophila, Listeria, Leptospira, Coxiella, Brucella,

Campylobacter, Lymphocytic choriomeningitis

• Miscarriage, premature birth, stillbirth, fetal congenital

abnormalities

• Immunosuppression

IF you are the employer, what are you responsibilities to ensure occupational health and safety?

• Written safety and health program— practice-specific, including disaster plan

• Keep written records of staff training, immunizations, work-related health conditions

• Comply with federal and state occupational hazard laws

• Train all workers about workplace hazards

• Promote safe work habits

• Ensure equipment is maintained and operated safely

• Safety in design of practices to "design out" hazards

• Prioritize employee mental, emotional, and social health