Medical Surveillance for BSL-3 & BSL2+ Labs

The Medical Surveillance Program assesses the exposure risk and health status of BSL-3 and 2+ personnel to prevent occupational injury or illness.

It may include:

• Medical assessment of each participant’s ability to safely work in the BSL-3 or 2+ facility
• Medical recommendations for appropriate medical screening, immunizations, and protective measures
• Periodic medical assessment and monitoring to confirm safety practices are effectively preventing occupational injury or illness

BSL-3 risks

Personnel working in BSL-3 facilities face occupational health risk due to work with agents that:

• Have a known potential for aerosol transmission
• May cause serious or potentially lethal infections
• Are indigenous or exotic in origin

Primary hazards to personnel working with BSL-3 agents relate to:

• Autoinoculation (intact/broken skin or mucous membranes)
• Ingestion
• Exposure to infectious aerosols

BSL-2+ risks

Personnel working in BSL-2+ facilities face occupational risk due to work with moderate-risk agents that may cause human disease of varying severity by ingestion or through percutaneous or mucous membrane exposure.

Medical surveillance service providers

EH&S Occupational Health and UC San Diego Center for Occupational & Environmental Medicine (COEM) are the only acceptable providers of medical surveillance services.

• Obtain an Authorization Form and/or the EH&S
• recharge account code from the EH&S Occupational Health Nurse prior to making a COEM appointment.

Screening, exams, testing, and consultations are specific to the agents each person contacts. An annual schedule applies for most people participating in the basic Medical Surveillance Program. In selected high-risk cases, more frequent screening may be required.

All medical records associated with medical surveillance are maintained in a confidential medical record.

Costs

• Initial Occupational Health and Safety Program (OHSP) enrollment is provided at no cost by the EH&S Occupational Health Nurse.
• For UC San Diego paid individuals and registered volunteers, costs for additional medical evaluation, testing, vaccinations, or other medical services received at COEM are paid for through UCOP Risk Management funding, if recommended and approved by the EH&S Occupational Health Nurse.
• For individuals not paid by UC San Diego and unregistered volunteers, the PI is responsible for the cost of additional medical evaluation or services (except vaccinations or TB testing) received at COEM when required to complete OHSP enrollments.
• For individuals not paid by UC San Diego and unregistered volunteers, campus EH&S funding currently covers the cost of vaccinations and TB testing at COEM, if recommended and approved by the EH&S Occupational Health Nurse.

Department account code

Employees must provide a department account code when receiving services, generally used only for tracking purposes. However, if the services are not authorized by the EH&S Occupational Health Nurse, or if the individual is found to not be a paid employee or registered volunteer, the recharge may be made back to the department account code.

A/BSL-3 work

Important: For A/BSL-3 work, enroll in the program before commencing work in the A/BSL-3 facility.

• Have your PI/Lab manager complete the form below:
  • Part 1 - Risk Assessment
  • If you are working in the ABSL-3 with animals, please also have your PI also submit an A Form.
• COEM will reach out to schedule your initial in-clinic medical assessment
  • You must have your “risk assessment” completed and signed by your PI prior to your in-clinic visit. If not completed or signed, you may be turned away.
• Direct questions to EH&S Occupational Health, Mail Code 0090, or COEM-campus@health.ucsd.edu. 

Additional requirements may include the following:

• Tuberculosis (TB) screening (if entering a facility where TB work is conducted)
• Respirator Medical Questionnaire (if respirator use is required)
• Latex Allergy Questionnaire (if history of latex allergy)
• Immunizations (based upon specific agents in use – See Vaccination for Researchers and Research Support Staff)
• Serum Storage (if indicated for specific agents)
• Medical referral (if indicated based upon initial surveillance review)

BSL-2+ work

For BSL-2+ work, contact COEM, to obtain instructions on required or recommended medical screening, testing, and/or vaccinations.

PI responsibility

Principal investigators must ensure faculty, staff, and students working in BSL-3 and 2+ research facilities under their control participate in appropriate medical surveillance as required by the Exposure Control Plan (ECP) for the biologic agents being used.

The UC San Diego Institutional Biosafety Committee (IBC) has approved specific Exposure Control Plans (ECP) that require the use of additional practices and safety equipment for certain agents and high-risk blood, body fluids, and tissue.

Exposure Control Plans are available on the My Research Safety Web portal in your lab's Biosafety Use Authorization (BUA). Ask your PI or lab contact for assistance.

Examples of Exposure Control Plans with specific medical surveillance requirements are:

• Cynomologous macaque
• Hepatitis B
• Herpes B virus
• Handling Old World monkeys or their blood, tissue, or body fluids requires using the Herpes B virus ECP
• Listeria
• LCMV (lymphocytic choriomeningitis virus)
• Rabies viral vector
• Vaccinia virus
• Zika virus 

• Information for Immune Compromised Researchers
• Non-Human Primate tissues / body fluids / cells (B Virus risk) (PDF)