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Biosafety Containment: Aerosol Transmissible Diseases

See requirements for research with listed aerosol transmissible pathogens at UC San Diego.

Purpose

The Aerosol Transmissible Disease (ATD) program protects employees who can reasonably anticipate being exposed to aerosol-transmissible pathogens while performing their job duties. Aerosol-transmissible pathogens are spread by infectious particles or droplets through inhalation or direct contact with mucous membranes in the respiratory tract or eyes. There are common laboratory procedures that may generate aerosols or droplets. The ATD program outlines safe research practices in compliance with the ATD Standard.

The Aerosol Transmissible Diseases Standard, CCR Title 8, Section 5199, issued by California Occupational Safety and Health Administration (Cal/OSHA) requires employers to implement an effective program to minimize exposure of employees to pathogens transmitted via aerosols and droplets.

Requirements for principal investigators

Principal investigators with research involving any agent listed in Appendix D: Aerosol Transmissible Pathogens – Laboratory, or required by the Institutional Biosafety Committee (IBC), must meet the requirements below:

  • Work with ATDs requires submission of a Biohazardous Use Authorization (BUA) application and approval by the IBC prior to start of work.
  • Implement a written ATD Biosafety Plan. The ATD Biosafety Plan is available in the Hazard Control Plan (HCP) application under My Research Safety. 
  • Have personnel complete the annual Aerosol Transmissible Disease Pathogens Training available through UC Learning Center. 
  • Assure personnel complete required medical surveillance. Vaccines for aerosol-transmissible pathogens are offered to all employees working with these materials. For a list of available vaccines, visit Vaccination for Researchers and Research Support Staff. Some pathogens require medical consult prior to start of work.
  • Eliminate "clean areas" from bays where aerosol-transmissible pathogens are handled.

Requirements for the laboratory personnel

  • Listed on a Principal Investigator’s approved BUA and ATD Hazard Control Plan.
  • Complete all required training and/or medical consults for work with the specific agents.
  • Read and sign the Hazard Control Plans associated with the specific agents.
  • Implement all aerosol mitigation measures as outlined in the ATD Hazard Control Plan

See specific implementation procedures for UC San Diego researchers:

ATD Biosafety Plan

  1. Complete the UCSD Aerosol Transmissible Disease Biosafety Plan identifying agents, personnel, operations, and safety practices.
    Aerosol Transmissible Disease Biosafety Plan 
    • For guidance on completing the HCP, see Hazard Control Plan.
    • Identify which personnel are working with specific agents.
  2. In some cases, the lab should use an agent-specific HCP in lieu of the ATD HCP. In these cases, only the agent-specific HCP must be completed. Here is the list of agent-specific HCPs:
  • COCCIDIOIDES SPP
  • COXIELLA BURNETII
  • ESCHERICHIA COLI (SHIGA TOXIN (VEROCYTOTOXIN) PRODUCING STRAINS)
  • HAEMOPHILUS INFLUENZAE TYPE B
  • HEPATITIS B VIRUS
  • HEPATITIS C VIRUS
  • HUMAN IMMUNODEFICIENCY VIRUS BSL 2+
  • HUMAN IMMUNODEFICIENCY VIRUS BSL 3
  • INFECTIOUS PRIONS
  • INFLUENZA VIRUS
  • LYMPHOCYTIC CHORIOMENINGITIS VIRUS
  • MACAQUE TISSUE
  • MEASLES, MUMPS, AND RUBELLA VIRUS
  • MPOX BSL 3
  • MPOX BSL2+
  • MYCOBACTERIUM TUBERCULOSIS BSL-3
  • RABIES VIRUS OR RABIES VIRAL VECTOR
  • RISK GROUP 3 FLAVIVIRUSES
  • SALMONELLA TYPHI
  • SARS-COV-2 BSL-2+
  • SARS-COV-2 BSL3
  • SHIGELLA DYSENTERIAE
  • SIMIAN IMMUNODEFICIENCY VIRUS (SIV)
  • STREPTOCOCCUS PNEUMONIAE
  • VACCINIA VIRUS OR VECTOR
  • YELLOW FEVER VIRUS, VACCINE STRAIN
  • ZIKA VIRUS

This exposure control plan must have documented review at least annually by the PI and by employees.

BUA - Risk Assessment

Use and storage of ATDs requires submission of a Biohazardous Use Authorization (BUA) application and approval by the IBC prior to start of work. The BUA application can be found on My Research Safety.

  • Identify and describe any attenuated strains of aerosol transmissible pathogens. In some cases, attenuation will exempt the pathogen from the ATD program.
Related links:

Training requirement

Provide initial Aerosol Transmissible Disease Pathogens Training to employees at the time of assignment to tasks where occupational exposure may take place and at least annually thereafter.

Provide additional training after incidents and when changes in the workplace or procedures could affect worker exposure to aerosol-transmissible disease pathogens. Training must be documented and dated.

How to meet the training requirement:

Annual Aerosol Transmissible Disease Pathogens Refresher Training is required within 1 year of initial training, and annually thereafter.

Related links:

Medical services

Ensure employees working with agents listed below are provided with corresponding medical services from Center for Occupational and Environmental Medicine (COEM):

Chart of medical services needed by employees working with the following agents.
Agent Medical service
Bordetella pertussis Vaccination offered
Corynebacterium diphtheria Vaccination offered
Haemophilus influenzae, type b Vaccination offered
Hepatitis B Virus Vaccination offered
Herpesvirus simiae (B-virus) and any material suspected to contain the virus

Medical consult required

Influenza Virus Seasonal vaccination offered

Japanese Encephalitis Virus

Vaccination offered
Measles Virus Vaccination offered
Mumps Virus Vaccination offered
Mycobacterium tuberculosis (TB) Requires annual TB medical surveillance  and Biosafety Level 3: Practices, Equipment, and Facilities training
Mycobacterium tuberculosis complex other than Mycobacterium tuberculosis Requires annual TB medical surveillance
Neisseria meningitidis Vaccination offered
Rabies Virus Vaccination offered, medical consult  required
Rubella Virus Vaccination offered

Salmonella typhi

Vaccination offered

Streptococcus pneumoniae

Vaccination offered
Vaccinia Virus Vaccination offered, medical consult required
Varicella-Zoster Virus Vaccination offered

Yellow Fever Virus

Vaccination offered

Immunizations

Job-related recommended immunizations are voluntary. After completing training and reviewing the Vaccine Information Statement, the employee must sign a vaccine Accept/Decline Form to document their intention to either accept or decline the vaccination.

Contact EHS Biosafety for more information.

If the vaccination is requested, an Authorization/Registration Form with instructions for scheduling a COEM appointment will be sent to you.

Costs

Vaccinations, TB screening, and medical consult costs are covered by the University if related to job task as described under the ATD program or required by the IBC.

How to obtain medical services

  1. Contact COEM.

Emergency procedures

Emergency Guide 2011

UCSD Emergency Guide

All workers should review the UCSD Emergency Guide (see image at right). The Emergency Guide contains emergency phone numbers and procedures for UCSD personnel, is widely distributed in laboratories, and is available online.

Spills or uncontrolled release

If a spill is too large or dangerous for lab staff to safely clean up, call UCSD Police at (858) 534-4357 or 9-1-1.

Agent-specific details can be found in the Hazard Control Plan.

Respiratory protection may be needed to clean up a spill or uncontrolled release of aerosol-transmissible disease pathogens. UCSD Police will activate the EH&S HazMat team. HazMat team members are medically cleared, trained, and fit-tested to wear self-contained breathing apparatus.

Spills or uncontrolled releases outside of biosafety cabinets must be reported to EHS Biosafety.

Report exposure incidents

An exposure incident is a significant exposure to an aerosol containing an aerosol transmissible disease pathogen without the benefit of applicable exposure control measures required by the agent-specific ATD Biosafety Plan.

If an exposure occurs, seek medical help and report the incident.

Prompt medical attention may reduce the risk of serious health consequences after an exposure incident.

Definitions

Per Cal/OSHA Aerosol Transmissible Diseases Standard, Title 8, Section 5199:

Aerosol transmissible pathogen - laboratory (ATP-L)
"A pathogen that meets one of the following criteria: (1) the pathogen appears on the list in Appendix D, (2) the Biosafety in Microbiological and Biomedical Laboratories (BMBL) recommends biosafety level 3 or above for the pathogen, (3) the biological safety officer recommends biosafety level 3 or above for the pathogen, or (4) the pathogen is a novel or unknown pathogen."

Regulations and policies

Contact EH&S Biosafety.