Occupational health hazards in veterinary medicine: zoonoses and other biological hazards

This study describes biological hazards reported by veterinarians working in western Canada obtained through a self-administered mailed questionnaire. The potential occupational hazards included as biological hazards were zoonotic disease events, exposure to rabies, injuries due to bites and scratches, and allergies. Only 16.7% (136/812) of responding veterinarians reported the occurrence of a zoonosis or exposure to rabies in the past 5 years; the most commonly reported event was ringworm. Most bites and scratches (86%) described by 586 veterinarians involved encounters with cats; 81% of the resulting 163 infections were due to cat bites or scratches. Approximately 38% of participants reported developing an allergy during their career, with 41% of the affected individuals altering the way they practiced in response to their allergy.     

Disease and injury among veterinarians

OBJECTIVE: To identify occupational causes of disease and injury in veterinarians and their staff. DESIGN: A self-administered questionnaire was mailed to all of the 160 registered veterinary practices in Western Australia. RESULTS: Injuries accounted for most workers' compensation claims over a 12-month period with 31% of respondents losing a total of 360 work days with a mean of 13.3 days whereas non-occupational diseases such as influenza accounted for 408 work days lost. Over a 10-year period, 71% of respondents had been injured. The major physical injuries were dog and cat bites, cat scratches, scalpel blade cuts and back injuries from lifting heavy animals. Exposure to chemicals such as flea rinses, formalin, glutaraldehyde, x-ray developers and gaseous anaesthetics were reported to cause headache, nausea and allergies. Thirty percent of respondents did not have extractor fans for scavenging waste anaesthetic gases. The study showed high use of radiography (94%) for diagnostic purposes with 24% of respondents believing radiation exposure is a major occupational health and safety issue. Stress, drug abuse, suicide and burglary were also reported. Despite a high awareness of zoonotic diseases, there were very few reports of these. CONCLUSION: Injuries and other occupational hazards reported together with work days lost demonstrate a need for improving the working environment of veterinarians and their staff and the development of comprehensive health and safety programs.     

Physical, chemical and biological hazards in veterinary practice

OBJECTIVE: To identify major occupational hazards encountered by veterinarians and their staff in practice in Australia. PROCEDURE: A literature search of Medical (MEDLINE), Occupational Health and Safety (OSHRAM) and Nursing and Allied Health (CINAHL) electronic data bases plus continual monitoring utilising the Uncover alerting system using the key words, 'occupational injury', 'occupational disease' and 'safety' linked with use of the word 'veterinarians' has found relevant articles. Personal communication with people who have undertaken studies on occupational safety in veterinarians elicited further information. CONCLUSION AND RECOMMENDATIONS: Veterinarians often sustain animal-related injuries, the most common of which are dog and cat bites, cat scratches and being hit or crushed by large animals. The most costly to treat include strains and back injuries. Most veterinarians treat themselves. There is no single reporting system for injuries or disease in veterinarians and reported cases may greatly underestimate the total. There is a need to assess accurately the occupational hazards in veterinary practice, to determine the actual occurrence of injuries and to develop strategies to prevent them.     

Prevalence and patterns of self-reported animal-related injury among veterinarians in metropolitan Kampala

To establish the prevalence, patterns and risk factors of animal-related injuries among veterinarians, self-administered questionnaires were given to 60 veterinarians practicing in metropolitan Kampala. The prevalence of animal-related injuries in metropolitan Kampala was 72% (95%CI, 57~84). Some veterinarians (34%) suffered multiple injuries with a mean and median of 2.1 and 2.0 injuries per veterinarian, respectively. Of a total of 70 self-reported animal related injuries, cattle accounted for 72%, cats for 25%, dogs for 23%, self inoculation for 15% and birds for 13%. Injuries associated with poultry did not require hospital treatment. The upper limb was the most the frequently (68%) injured anatomical body part of veterinarians, and vaccination of animals (25%) was the major activity associated with injury. Animal-related injuries are common among practicing veterinarians in metropolitan Kampala; however, they did not differ significantly based on the veterinarian''s gender, experience or risk awareness.     

Occupational health risks in veterinary nursing: an exploratory study

OBJECTIVES: The aims of this exploratory study were to survey the prevalence of certain exposures and health problems among a group of veterinary nurses attending the International Veterinary Nurses' Conference in Brisbane, Australia, 2003 and to identify the main concerns among those veterinary nurses with regard to occupational health hazards they may face. METHODS AND MATERIALS: An anonymous self-administered questionnaire was distributed among all attendees of the International Veterinary Nurses' Conference 2003, Brisbane, Australia (N=147 respondents among 215 surveyed). RESULTS: The prevalence of exposure to X-radiation (97%), anaesthetics (96%), disinfectants (96%) and vaccines (85%) was high. More than 70% of the nurses were exposed to formaldehyde (76%) and pesticides/insecticides (71%). For all exposures except vaccines, about 50% of the nurses exposed were worried about negative health consequences. Acute injuries were common with 98% of the nurses experiencing dog/cat bites/scratches, 71% experiencing needle stick injuries and 43% experiencing lacerations. More than half of the nurses (52%) suffered from chronic back/neck pain and 39% reported having allergy or hay fever. Sixteen cases (11%) of Cat Scratch Fever were reported. Job related affective well-being was similar to a large sample of workers in comparable level jobs. CONCLUSION: Among attendees of a veterinary nurses conference, the proportion of this group of nurses exposed to hazards in their work environment was high and acute and chronic injuries were common. Considering that nurses account for more than 40% of total employment in the veterinary service industry, the results of this study show that the occupational health hazards of this professional group require further study.     

Accidental self-inoculation with Mycobacterium paratuberculosis bacterin (Johne's bacterin) by veterinarians in Wisconsin

We surveyed Wisconsin veterinarians to assess the frequency and severity of accidental self- and other human exposure to Mycobacterium paratuberculosis bacterin (Johne's bacterin). Of 199 veterinarians administering the bacterin to cattle, 22 reported one or more exposures, including 19 needle-stick exposures, 8 skin surface exposures, and 2 oral mucosa exposures. The mean incidence of needle sticks was 5.5/100 veterinarians/year of bacterin use or 1/1,000 doses administered. The mean total doses given in the needle-stick exposure group was 276 +/- 318 vs 80 +/- 268 in the group without needle-stick exposure, and the mean number of months administering the bacterin was 21.7 and 16.1, respectively; 63% of needle-stick exposures took place during the injection process. Five adverse reactions were reported, and each resulted from needle-stick exposure. The only systemic reaction followed an exposure to the original bacterin formulation of sonically ruptured M paratuberculosis in Freund incomplete adjuvant. The remaining reactions were to the current formulation of whole killed M paratuberculosis in mineral oil and ranged from a small nodule persisting for 4 to 6 months to painful inflammation of a finger persisting for 24 months. We anticipate an increase in incidence of these minimally debilitating injuries as the use and distribution of the bacterin expands. For hand wounds, we recommend conservative management. Surgical intervention should be considered if a granuloma persists and causes the patient functional difficulty.     

Occupational health hazards in veterinary medicine: physical, psychological, and chemical hazards

This paper reports physical, psychological, and chemical hazards relevant to western Canadian veterinarians as obtained by a self-administered mailed questionnaire. Nine-three percent (750/806) of veterinarians reported some form of injury during the previous 5 years; 17% of respondents (131/791) indicated injuries that resulted in 1 or more days off work. Median stress levels were similar across work environments; overall, 7% (57/813) indicated either no stress or severe stress, while 53% (428/813) indicated moderate stress. Twenty percent (3/15) of food animal practitioners and 37% (114/308) of companion animal practitioners who took X-rays reported accidental exposure. Accidental exposure to gas anesthetic was reported by 69% (394/570) of those in private practice. Exposure to chemicals occurred in all work environments. Veterinarians in western Canada are at risk of minor to severe injury due to both animal and non-animal related causes.     

Prevalence of occupational exposures and protective practices in Australian female veterinarians

OBJECTIVE: To identify the prevalence of exposure to potentially harmful occupational hazards in Australian female veterinarians and to report factors associated with prevalence of occupational hazards in this profession. DESIGN: National cross-sectional survey of a cohort population. PROCEDURE: A self-administered questionnaire was mailed to 5748 veterinarians (males and females) graduating from Australian veterinary schools from 1960 to 2000. This paper reports the prevalence of occupational exposures in 1197 female veterinarians in their current job including radiation, anaesthetic gases, pesticides and long working hours. Comparisons were undertaken between respondents by practice type and decades of graduation. Multivariate logistic regression was undertaken to predict the risk for exposure to occupational hazards in female veterinarians by age, type of practice, graduation year and number of hours worked. RESULTS: The response rate for females was 59%. We found that age under 30 years, small and mixed animal practice, graduation year after 1990, and working more than 45 hours per week were all associated with greater exposure to putative risk factors. Mixed animal practitioners worked more than 45 hours per week (53%) and reported the highest exposure to anaesthetic gases (94%) and pesticides (54%). Twenty two percent of those who were exposed to anaesthetic gases did not have waste anaesthetic gas scavenging systems. Small animal practitioners reported they took more X-rays (90%). While taking X-rays, 56% of respondents reported physically restraining animals, and only one in five of respondents used film holders and lead screens. CONCLUSIONS: The high prevalence of potentially harmful exposures among female veterinarians and lack of use of protective equipment at work needs to be considered in developing and planning the safety of veterinary work.     

Investigation of Zoonotic Infections Among Auckland Zoo Staff: 1991–2010

Investigation was undertaken to assess the occurrence of zoonotic infection among staff at Auckland Zoological Park, New Zealand, in 1991, 2002 and 2010. Serial cross‐sectional health surveys in 1991, 2002 and 2010 comprising a health questionnaire, and serological, immunological and microbiological analysis for a range of potential zoonotic infections were performed. Laboratory results for zoo animals were also reviewed for 2004–2010 to assess the occurrence of potential zoonotic infections. Veterinary clinic, animal handler, grounds, maintenance and administrative staff participated in the surveys, with 49, 42 and 46 participants in the 1991, 2002 and 2010 surveys, respectively (29% of total zoo staff in 2010). A small number of staff reported work‐related infections, including erysipelas (1), giardiasis (1) and campylobacteriosis (1). The seroprevalence of antibodies to hepatitis A virus and Toxoplasma gondii closely reflected those in the Auckland community. No carriage of hepatitis B virus (HBV) was detected, and most of those with anti‐HBV antibodies had been vaccinated. Few staff had serological evidence of past leptospiral infection. Three veterinary clinic staff had raised Chlamydophila psittaci antibodies, all <1 : 160 indicating past exposure. Two staff (in 1991) had asymptomatic carriage of Giardia lamblia and one person (in 2010) had a dermatophyte infection. After 1991, positive tests indicating exposure to Mycobacterium tuberculosis were <10%, comparable to the general New Zealand population. Zoo animals had infections with potential zoonotic agents, including G. lamblia, Salmonella spp., Campylobacter spp. and T. gondii, although the occurrence was low. Zoonotic agents pose an occupational risk to zoo workers. While there was evidence of some zoonotic transmission at Auckland Zoo, this was uncommon and risks appear to be adequately managed under current policies and procedures. Nevertheless, ongoing assessment of risk factors is needed as environmental, human and animal disease and management factors change. Policies and procedures should be reviewed periodically in conjunction with disease monitoring results for both animals and staff to minimise zoonotic transmission.     

Survey of tuberculin testing in Swedish zoos.

Tuberculin test results from 214 animals in three Swedish zoos, tested between the years 1993 and 2000, were compiled from a questionnaire sent out to zoo veterinarians. Comparative testing with bovine and avian tuberculin was used on various sites of injection. A total of five skin test reactors were found: three cotton-top tamarins (Saguinus oedipus) in one zoo and two tapirs (Tapirus terrestris) in another zoo. Postmortem culture from one of the tapirs revealed growth of Mycobacterium tuberculosis, and a stamping out policy was adopted in the herd. Tuberculosis in the primates was ruled out by further investigations. Zoo veterinarians should try to adopt a common scheme for the regular testing of zoo animals to improve the diagnostic ability and comparison of results between institutions.     

Veterinarian injuries associated with bovine TB testing livestock in Michigan, 2001

Testing all the cattle in an entire state with a uniform procedure for each animal affords an opportunity to relate human injury data to a known number of animals handled while carrying out a standardized procedure. Our objective was to describe the type and incidence density of injuries associated with TB-testing a large number of cattle herds, and to delineate the various factors associated with the risk of injury. A survey was mailed to all veterinarians (N = 259) who had completed at least five official bovine TB (bTB) herd tests in Michigan in 2001. We collected data regarding basic demographics and health status, work experience, veterinary specialty, and practice information. Each veterinarian was also requested to complete a separate injury questionnaire for each injury received while TB testing livestock in 2001. Accurate addresses were found for 247 eligible veterinarians, 175 (71%) of whom returned the survey. Thirty-six veterinarians reported a total of 53 injuries (10 major, 12 minor and 31 self-treated). Hands (29%) and legs (21%) were the anatomic locations most frequently injured, with sprains/strains (30%) and abrasion/contusion (30%) the most common types of injuries sustained. The overall incidence density of injuries was 1.9 per 10,000 animals tested. Female gender (RR = 3.3), being employed by the government (RR = 4.5), and smoking (RR = 6.0) were significantly associated with a higher rate of injury. Significant colliniearities were found between some risk factors associated with an increased rate of injury and participants thought 81% of their injuries could have been prevented. These results are explained by the administrative structure of the bTB testing program in Michigan, and the changing demographics of the veterinary workforce.     

Exposure to rabies - an occupational hazard for veterinarians

Interviews to solicit information about animal bites and rabies vaccinations were completed on 1165 of 1175 non-military veterinarians in Illinois in 1968. Two hundred and sixty-one veterinarians reported 380 exposure incidents that precipitated the administration of rabies vaccine; 72 veterinarians had received two or more series of vaccine. Vaccine was administered after exposure from: examination of a patient (n = 230), bite (n = 79), necropsy (n = 17), other causes (n = 13) and unstated (n = 41). Eighty-six percent of the exposures were to dogs or cattle. In 231 veterinarians receiving postexposure vaccinations, where year of first vaccination and year of graduation from veterinary school were known, 97 (42%) were exposed in the six years spanning one year before graduation and four years after graduation. There were 296 veterinarians, including 12 receiving postexposure vaccination, who had received their first series of vaccine as preexposure prophylaxis. Twenty-one percent of all vaccinees (pre- and postexposure) reported reactions to the rabies vaccine. Seventy-two veterinarians reported they had been treated for an animal bite in the previous year.     

Zoonotic disease concerns in animal-assisted therapy and animal visitation programs

A survey was done of 150 systematically selected United States animal care agencies and 74 Canadian humane societies to determine the prevalence of animal assisted therapy (AAT) programs; concerns about, and experience with, zoonotic diseases; and precautions taken to prevent zoonotic disease transmission. Of the 69 US agencies and 49 Canadian societies that reported having AAT programs, 94% used dogs and/or cats in their programs, 28% used rabbits, 15% used “pocket pets” (hamsters, gerbils, mice, guinea pigs), and 10% used birds (excluding poultry). About two-thirds of the programs were involved with the elderly in nursing homes, about a quarter of them worked with schools, and a quarter worked with hospitals. Half of the respondents had concerns about zoonotic disease control. Rabies, ringworm, and external parasitism were the most commonly cited zoonotic diseases of concern. Few concerns were based on actual experience. Fewer than half of the programs consulted a health professional about prevention of zoonotic diseases. Only 10% of the respondents reported having printed guidelines about the prevention of zoonotic disease transmission. Practising veterinarians are encouraged to make their expertise available to local AAT programs.     

Marine Mammal Zoonoses: A Review of Disease Manifestations

Marine mammals evoke strong public affection as well as considerable scientific interest. However, the resultant close contact with marine wildlife poses human health risks, including traumatic injury and zoonotic disease transmission. The majority of zoonotic marine mammal diseases result in localized skin infections in man that resolve spontaneously or with appropriate medical therapy. However, other marine mammal zoonoses, if left untreated, induce life‐threatening systemic diseases that could pose public health risks. As the number of zoonotic diseases rises, the diagnosis of and treatment for these emerging pathogens pose special challenges requiring the expertise of physicians, veterinarians and wildlife biologists. Here, we provide a comprehensive review of the bacterial, viral and fungal marine mammal zoonotic diseases that we hope will be utilized by public health professionals, physicians, veterinarians and wildlife biologists to better understand, diagnose and prevent marine mammal zoonotic diseases.     

A survey of zoonotic diseases contracted by South African veterinarians

A survey of 88 veterinarians employed at the Faculty of Veterinary Science, University of Pretoria, South Africa, was carried out to investigate the occurrence of zoonotic diseases among South African veterinarians. The survey found that 63.6% of veterinarians interviewed had suffered from a zoonotic disease. Veterinarians predominantly involved in farm animal practice were 3 times more likely to have contracted a zoonotic disease than those working in other veterinary fields. Fifty-six percent of disease incidents were initially diagnosed by the veterinarians themselves. Fifty-three percent of incidents required treatment by a medical practitioner, but the majority (61%) of incidents did not require absence from work. The incidence density rate for contracting a zoonotic disease was 0.06 per person year of exposure. Kaplan-Meier survival analysis estimated that the probability of having contracted a zoonotic disease was 50% after 11 years in practice. The risk of contracting a zoonotic disease appeared to be higher early in practice. The most common mode of transmission was by direct contact. Approximately 46% of South Africans still live in rural areas and regularly come into close contact with farm animals. The implications of this in the light of this survey's results are discussed.     

Characterizing the Role of Animal Exposures in Cryptosporidiosis and Shiga Toxin‐producing Escherichia coli Infections: South Dakota, 2012

Cryptosporidium spp. and Shiga toxin‐producing Escherichia coli strains (STEC) are important causes of human illness. Incidence rates of these illnesses are high in South Dakota compared to the USA as a whole. Direct animal contact has been identified as a possible route of exposure for these illnesses. Ruminant animals may carry STEC subclinically, while young ruminants are common sources of zoonotic strains of Cryptosporidium. South Dakota patients with either STEC or cryptosporidiosis during 2012 were interviewed regarding seven categories of animal exposure: (i) petting zoo/fair attendance, (ii) animal event/rodeo attendance, (iii) feed/pet store visits, (iv) farm visits, (v) employment or residence at a farm, (vi) residence with pets and (vii) visiting other households with pets. Of the 50 STEC cases, 78.0% reported animal exposure prior to illness onset, with 23.3% having lived or worked on a farm. Farm visitors in particular had high degrees of animal contact and infrequently practiced personal protective measures. Of the 115 cryptosporidiosis cases, 87.8% reported animal exposures, with 45.6% having lived or worked on a farm and 29.0% having visited a farm prior to illness. Cases with farm exposures reported a high degree of direct animal contact and inconsistent use of personal protective measures. Cryptosporidiosis patients were significantly more likely than STEC patients to have lived or worked on a farm prior to their illness and were older on average. Patients with these illnesses had high rates of animal contact prior to illness. Animal contact on farms emerged as an important exposure route. Educational messages about personal protective measures should be directed at these individuals.     

A serological survey of Toxoplasma gondii infection in zoo animals and other animals

A survey for Toxoplasma gondii (Tp) infection in the animals bred or caught in and around Kobe Municipal Oji Zoo was conducted by the Latex Agglutination (LA) test using plasma samples collected for the years from 1980 to 1988. Plasma antibody to Tp (greater than or equal to 1:64) was found in 5.0% (0 of 181) mammals belonging to 28 families of 10 orders and 6.7% (12 of 179) aves belonging to 22 families of 15 orders, respectively. Cats, rats and pigeons caught in and around the zoo lower positive rates than those reported in previous studies: 9.3% (4 of 43), 0% (0 of 55) and 4.9% (4 of 82), respectively. High antibody titers were obtained from a Caribbean flamingo, a chimpanzee and 7 other animals born in the zoo. These results suggest presence of some primary Tp infection in the animals bred in the zoo.     

Survey of veterinarians' recommendations for treatment and control of intestinal parasites in dogs: public health implications

A systematic, random sample of 450 small and mixed-animal practitioners was selected from the client list of a prominent veterinary pharmaceutical and animal health company. A telephone survey was conducted, using a standard questionnaire, to assess whether current veterinary practices concerning prophylaxis and treatment of canine roundworm (Toxocara canis) and hookworm (Ancylostoma spp) infections are adequate to prevent transmission to human beings. Analysis of results focused on 3 questions related to prevention: practitioner's frequency of client education regarding zoonotic potential of roundworms and hookworms, pup age at which veterinarian recommends first anthelmintic treatments, and proportion of veterinarians recommending prophylactic drug administration for pups and nursing bitches. Despite the proven association of household pet dogs and human toxocariasis, only a third (148/450) of veterinarian respondents routinely discussed the potential zoonotic hazards of canine roundworms with their clients. A total of 29% (130/450) of veterinarians surveyed either never discussed these potential hazards or discussed them only when asked by their clients. With regard to anthelmintic treatment practices, 31% (140/450) of veterinarians surveyed recommended that pups first be examined and treated for intestinal parasites within 4 weeks of age. Thirty-three percent (163/450) recommended first examination and deworming at 5 to 6 weeks of age, and 36% (163/450) suggested that it be done at or after 7 weeks of age. Less than half (208/450) of veterinarians administered anthelmintics prophylactically to at least some pups and dogs. Sixty-four percent (287/450) of respondents recommended routine testing and treatment of nursing bitches.(ABSTRACT TRUNCATED AT 250 WORDS)     

2007 North American zoo and aquarium veterinary employment survey

A web-based survey was presented to 158 Association of Zoos and Aquariums (AZA)-accredited zoos and 31 AZA-accredited aquariums or marine-life parks in the United States and Canada via e-mail. The survey included questions about veterinary employment and salaries. Representatives from 124 zoos and 15 aquariums responded. Zoos and aquariums with higher operating budgets were more likely to employ full-time veterinarians. The number and percentage of zoos employing full-time zoo veterinarians have increased since the previous job survey that took place in 1988, with 59.6% of all responding zoos employing at least one full-time veterinarian. During the same time span, the proportion of male to female zoo veterinarians has shifted from a predominantly male group to an almost equal ratio. Salaries for full-time zoo and aquarium veterinarians ranged from $20,800 to $150,000.     

Field Techniques in Zoo and Wildlife Conservation Work

Wildlife conservation fieldwork and field-like situations in zoo settings can be challenging to veterinarians and include restraining, sedating/anesthetizing, examining, and sampling wild animals. The lack of amenities and utilities such as running water or electricity, climatic conditions, biting insects, and even the general public can all be a hindrance when working with animals in this environment. Zoonotic diseases and local conflicts, as well as the work itself, can all be hazards. On the basis of our combined experience, with field examples set in Scotland, working practices and suggestions for fieldwork equipment and the processing of samples are outlined. Equipment, references for obtaining additional information, and considerations for capture and anesthesia in the field are also covered. The importance of good communications, within the animal care team, with stakeholders, and with the general public, is emphasized. Potential health and environmental hazards are discussed, with recommendations on protective clothing and resources to identify these hazards.