Cal. Code Regs. tit. 8 § 5199.1

Current through Register 2024 Notice Reg. No. 43, October 25, 2024

Section 5199.1 - Aerosol Transmissible Diseases - Zoonotic

(a) Scope, Application and Definitions.

(1) Scope.

(A) This section applies to work in the following facilities, service categories or operations:

1. Operations involving the management, capture, sampling, transportation or disposal of wild birds or other wildlife.

2. Farms producing animals or animal products, including the transport of animals and untreated animal products, byproducts, or wastes to or from farms.

3. Slaughterhouses and initial processing facilities for untreated animal products, byproducts, or wastes.

4. Veterinary, animal inspection, and other animal health operations.

5. Importers of live animals and untreated animal products.

6. Zoos, animal parks, pet stores and other operations in which animals are displayed, transported, or housed.

7. Laboratory operations involving samples, cultures, or other materials potentially containing zoonotic aerosol transmissible pathogens (zoonotic ATPs).

8. Zoonotic ATP incident response operations as defined below.

(B) This section does not apply to restaurants or facilities or portions of facilities in which the sole exposure to animal products, byproducts, or wastes comes from carcasses or portions thereof that have passed an inspection conducted in accordance with regulations of the USDA or CDFA and have been determined to be fit for human consumption.

(2) Application.

(A) Basic requirements applicable to all covered employers. Every employer with facilities, operations or services that are within the scope of this standard shall establish, implement, and maintain effective procedures for preventing employee exposure to zoonotic aerosol transmissible pathogens in accordance with Section 3203 of these orders. These procedures shall include sanitation, investigation of occupational injuries and illnesses, training, and where applicable, biosecurity and the use of personal protective equipment. Training shall cover all of the employer's exposure control procedures required by this subsection, and shall be appropriate in content and vocabulary for the educational level, literacy, and language of employees. An employer is not required to comply with any requirement of this standard beyond what is contained in this subsection if they do not have employees who participate in or are exposed to any of the work operations listed below in subsections (a)(2)(B) through (a)(2)(G). This subsection does not exclude the application of Section 3203 to zoonotic diseases that are not transmitted by infectious aerosols.

(B) In addition to complying with subsection (a)(2)(A), employers shall also comply with subsections (b) and (e) if they have work operations that involve:

1. capturing or sampling of wildlife for the purpose of determining whether they are infected with zoonotic ATPs, or

2. collecting and disposing of wildlife for which an alert regarding the potential of zoonotic ATP infection has been issued by the CDC, CDFA, CDFG, CDPH, USDA, or USDOI, and the alert is applicable to the employer's operations based on conditions specified in the alert, e.g., the geographic area and the species or type of animal.

(C) In addition to complying with subsection (a)(2)(A), employers shall also comply with subsections (c) and (e) if they have establishments or operations for which the USDA or CDFA have issued a quarantine order, movement restriction, or other infection control order due to an increased risk of zoonotic ATP infection.

(D) In addition to complying with subsection (a)(2)(A), employers shall also comply with subsections (d) and (e) if they have work operations that involve:

1. handling, culling, transporting, killing, eradicating, or disposing of animals infected with zoonotic ATPs as defined in subsection (a)(4), or

2. cleaning or disinfecting areas used, or previously used, to contain such animals or their wastes.

(E) Laboratory operations. Laboratory operations involving samples, cultures, or other materials potentially containing zoonotic ATPs shall comply with Section 5199(f) of these orders.

(F) Vertebrate animal research facilities shall comply with this standard by performing and documenting a risk assessment and adopting control measures consistent with Biosafety in Microbiological and Biomedical Laboratories. These facilities shall also comply with subsection (e) of this standard. Where the risk assessment determines that ABSL-3 or above practices are required the employer shall also comply with subsection (d).

(G) Hazardous Waste and Emergency Response Operations shall also comply with Section 5192 of these orders.

(3) The employer shall provide all safeguards required by this section, including provision of personal protective equipment, respirators, training, and medical services, at a reasonable time and place for the employee, at no cost to the employee, and during the employee's working hours.

(4) Definitions.

Aerosol. A suspension of liquid or solid particles in the air, including droplets, droplet nuclei, fomites, and dusts.

Aerosol transmissible pathogen (ATP). A pathogen that is transmitted by liquid or solid particles in the air, including droplets, droplet nuclei, fomites and dusts.

Alert. A public announcement or notification by a local health officer, or California or federal agency, regarding a detected zoonotic ATP hazard. This notification may be issued for a species or type of animal and/or a geographic area.

Animal Biosafety Level 3 (ABSL-3). Compliance with the criteria for work practices, safety equipment, and facility design and construction recommended by the CDC in Biosafety in Microbiological and Biomedical Laboratories for work with laboratory animals infected with indigenous or exotic agents, agents that present a potential for aerosol transmission and agents causing serious or potentially lethal disease.

Animals infected with zoonotic ATPs. Animals that (1) have been diagnosed with a zoonotic ATP through recognized testing methods or (2) meet the clinical definition of a suspect case of infection with a zoonotic ATP or (3) have been identified by the CDFA, CDFG, USDA, or USDOI as requiring isolation, quarantine, or destruction due to suspected or confirmed infection.

Animal waste. Animal carcasses, excrement, contaminated litter, or debris from the bodies of animals, such as feathers or dander.

Biosafety in Microbiological and Biomedical Laboratories (BMBL). Biosafety in Microbiological and Biomedical Laboratories, Fifth Edition, CDC and National Institutes for Health, 2007, which is hereby incorporated by reference for the purpose of establishing requirements for risk assessments and control measures in vertebrate animal research facilities.

Biosecurity procedures. Control measures, such as traffic control, disinfection, and isolation, that are implemented to reduce the risk of transmission of infection into, from, or within an establishment. The purpose of biosecurity measures is to prevent direct or indirect animal-to-animal transmission of zoonotic ATPs, release of pathogens into the environment, and infection of people who may come into contact with animals or areas where animals are housed, or with debris from those areas. The specific biosecurity measures necessary depend on the type of operation conducted by the employer. Typically, no provision for biosecurity other than the use of common sanitation measures is required for incidental removal of animal carcasses or other wastes, unless the activity may result in the introduction of pathogens into areas where animals are kept or housed, or unless the animal is the subject of an applicable alert or disease control order.

CDFA. California Department of Food and Agriculture.

CDFG. California Department of Fish and Game.

CDC. United States Centers for Disease Control and Prevention.

CDPH. California Department of Public Health and its predecessor the California Department of Health Services.

Chief. The Chief of the Division of Occupational Safety and Health of the Department of Industrial Relations or his or her designated representative.

Decontamination. The removal of hazardous substances from employees and their equipment to the extent necessary to preclude the occurrence of foreseeable adverse health effects.

Immediately dangerous to life or health (IDLH). An atmosphere that poses an immediate threat to life, would cause irreversible adverse health effects, or would impair an individual's ability to escape.

Local health officer. The health officer for the local jurisdiction responsible for receiving and/or sending reports of communicable diseases, as defined in Title 17 of the California Code of Regulations.

NIOSH. The director of the National Institute for Occupational Safety and Health, CDC, or his or her designated representative.

Occupational exposure. Reasonably anticipated work exposure to a source of zoonotic ATPs under conditions that, without the use of protective measures, create a significant risk of contracting the disease caused by the pathogen. Examples of such conditions include: conducting diagnostic sampling of animals reasonably suspected of infection, performing animal husbandry activities with flocks quarantined due to an increased risk of infection with zoonotic ATPs, and disposing of infected animal carcasses or their wastes.

Oxygen deficient atmosphere. An atmosphere with an oxygen content below 19.5% by volume.

Physician or other licensed healthcare professional (PLHCP). An individual whose legally permitted scope of practice in California allows him or her to provide independently or be delegated the responsibility to provide some or all of the health care services required by this section.

Untreated animal products, byproducts, or wastes. Materials derived from animals that have not been processed in a manner that will deactivate zoonotic ATPs the materials may contain. "Untreated animal products, byproducts, or wastes" do not include animal carcasses or portions thereof that have passed an inspection in accordance with the standards of the USDA or CDFA and have been determined to be fit for human consumption.

USDA. United States Department of Agriculture.

USDOI. United States Department of the Interior, or any of its agencies, including the United States Fish and Wildlife Service and the United States Geological Survey.

Wildlife. Wild birds and other animals that are not domesticated, including their remains and wastes.

Zoonotic aerosol transmissible pathogen (Zoonotic ATP). A disease agent that is transmissible from animals to humans by aerosol, and is capable of causing human disease. Zoonotic ATPs include pathogens that are classified as transmissible either by droplets or by an airborne route.

Zoonotic ATP incident response. Operations conducted to control an outbreak of an animal disease involving the destruction and/or disposal of animals infected with zoonotic ATPs and the clean up, decontamination and disinfection of areas and equipment associated with the infected animals or their remains.

(b) Exposure to potentially infectious wildlife.

(1) The employer shall establish, implement, and maintain effective written procedures for operations that involve capturing or sampling of wildlife to detect the presence of infection with zoonotic ATPs, or the collecting and disposing of wildlife for which an alert regarding the potential of zoonotic ATP infection has been issued by the CDC, CDFA, CDFG, CDPH, USDA or USDOI. These procedures shall be kept available at the site of all work operations covered by this subsection.

(2) These procedures shall include:

(A) work procedures that minimize the production of aerosols,

(B) use of personal protective equipment,

(C) cleaning and decontamination procedures,

(D) medical services as recommended by the CDC, CDPH or Local Health Officer, and

(E) training.

(3) These procedures shall include the use of a respirator at least as effective as an N95 filtering facepiece respirator, in accordance with Section 5144 of these orders, whenever:

(A) there is an increased potential of exposure to infectious aerosols, such as when handling animals in an enclosed or indoor area,

(B) responding to a mortality event involving a significant number of animals, or

(C) there are animal-related dusts in the environment that are reasonably likely to be an aerosol infection hazard to employees.

(c) When the USDA or the CDFA issues a quarantine order, movement restriction, or other infection control order applicable to an establishment due to an increased risk of zoonotic ATP infection, the employer shall establish, implement and maintain effective written zoonotic disease control procedures to protect employees from hazards related to undetected or early infection in animals. These procedures shall be available onsite at all times when employees are present, and shall include the following elements:

(1) The employer shall identify restricted areas in which occupational exposure to potentially infectious animals may occur and shall post signs at all entrances to those areas identifying them as restricted areas. These signs shall be in all languages necessary to ensure that they are understood by all employees who may be in the vicinity of an entrance to the restricted area.

(2) The employer shall ensure that all employees who enter into restricted areas are protected as follows:

(A) Those employees who enter into the restricted area shall be supervised by a person who is knowledgeable in the employer's zoonotic disease control procedures.

(B) The employer shall provide those employees with, and the employer shall ensure that the employees use, protective clothing and equipment, such as coveralls or similar whole-body clothing, head coverings, gloves, and foot coverings. The employer shall provide for the disposal or laundering of this clothing and equipment in a manner that will not further expose employees to potentially infectious materials. Laundry shall be handled in accordance with Section 5193(d)(3)(J) of these orders. Where the disease may be transmitted by contact with the eyes or mucous membranes, appropriate eye, mouth and nose protection shall be used. The use of personal protective equipment shall comply with Sections 3380 through 3387 of these orders.

(C) The employer shall provide, and ensure that the employees use approved respiratory protection when entering into enclosed areas in which aerosols from potentially infectious animals or animal wastes are present. Respirator use shall be in accordance with Section 5144 of these orders.

(D) The employer shall provide sanitary facilities, change rooms, shower rooms, and drinking water, and a method to access them. These facilities shall meet the requirements of Sections 3360 through 3368 of these orders.

EXCEPTION: Where change rooms and shower rooms are not feasible, the employer shall implement alternative measures for sanitation and changing clothes that protect employees from infectious materials that may be present on their clothing or their person.

(E) The employer shall provide all medical services, including surveillance, vaccinations, and prophylaxis recommended by the CDC, CDPH or local health officer for exposed employees.

(F) The employer shall provide training that is appropriate in content and vocabulary for the educational level, literacy, and language of employees. This training shall include the nature of the zoonotic disease hazard, the employer's control measures, the use of personal protective equipment and respiratory protective equipment, decontamination procedures, the employer's medical services program including recommended surveillance, evaluations, vaccinations and prophylaxis, and heat illness prevention.

(G) The employer shall establish procedures for recording the entry of persons into the restricted area. These records shall be maintained and made available in accordance with subsection (e).

(3) The additional protective measures required by subsection (c) are no longer required if testing acceptable to the agency placing the movement restriction, quarantine or other infection control order determines that the premises is free from infection, and is no longer at increased risk, although the movement restriction may remain in place.

(d) Every employer with work operations involving handling, culling, transporting, killing, eradicating, or disposing of animals infected with zoonotic ATPs, or the cleaning and disinfection of areas used, or previously used, to contain such animals or their wastes, shall establish, implement, and maintain written zoonotic disease control procedures to control the risk of transmission of disease from the animals to employees. These procedures shall be available onsite at all times when employees are present, and shall be maintained as an employee exposure record, in accordance with Section 3204 of these orders.

(1) The written procedures shall include all of the following as they apply to the employer's operation:

(A) A detailed work plan including an assessment of the risks to employees, including biological, chemical, physical, and safety hazards, and a description of site control measures including designating a restricted area consisting of contaminated zones and contaminant reduction zones. Support equipment and personnel shall be staged outside of the restricted area.

(B) A list of all jobs, tasks or procedures in which employees may have occupational exposure.

(C) The measures the employer will use to control employee exposure, including each of the following:

1. Engineering controls, work practice controls, and exposure monitoring.

2. Procedures for the safe handling of hazardous substances, including hazardous substances used for disinfection and decontamination.

3. Procedures for the application of toxic or asphyxiant gases, if such gases are to be used in the operation.

4. Respiratory protection.

5. Personal protective equipment and protective clothing.

6. Decontamination procedures.

7. Disposal of animal waste and contaminated personal protective equipment.

8. Medical services.

9. Training.

10. Recordkeeping.

(D) Procedures to provide employees ready or frequent access to drinking water and sanitation facilities, including appropriate decontamination methods for employees who need to access these facilities.

(E) Procedures to protect employees from the risk of heat illness.

(2) Operations in the restricted area shall be supervised at all times by a person knowledgeable about and authorized by the employer to enforce the employer's zoonotic disease control procedures. The supervisor shall ensure that all persons entering the restricted area have been trained in the control procedures applicable to the site or operation and are protected in accordance with this section. The supervisor shall record the identity and time of entry and exit for each person who enters and/or exits the restricted area. These records shall be maintained and made available in accordance with subsection (e).

(3) The employer shall provide and ensure that employees use personal protective equipment and clothing that meets the requirements of Sections 3380 through 3387 of these orders and is adequate to ensure that hazardous substances and contaminated fluids and aerosols do not penetrate to the employee's mucous membranes or skin. The equipment and clothing shall be reasonably comfortable and shall not unduly encumber the employee's movements necessary to perform the work. The equipment and clothing shall be compatible with decontamination and disposal methods available at the site.

(4) Respiratory Protection. The employer shall provide and ensure that employees use appropriate respiratory protection during operations in the restricted area in accordance with Section 5144 of these orders, unless the employer has demonstrated through objective evidence, that engineering and work practice controls have eliminated the risk of disease transmission to employees. Respirator selection shall be based on the infectious disease hazard and on any hazardous substances that may require respiratory protection. Respirators shall be used until work areas have been decontaminated. Employees who work in enclosed areas shall use, at a minimum, elastomeric facepiece respirators or powered air purifying respirators (PAPR) with appropriate cartridges, unless the employer has demonstrated through objective evidence, that such use is not necessary to protect employees. The employer shall provide and ensure that employees use appropriate eye protection, unless employees use full facepiece respirators or PAPRs that provide eye protection.

(5) Additional procedures for the application of toxic or asphyxiant gases. Employers whose work operations include areas in which toxic or asphyxiant gases are applied shall develop and implement written procedures that ensure all of the following:

(A) Prior to the application of toxic or asphyxiant gases to occupiable areas, the employer shall take positive measures to ensure that no person is in areas to which gas is applied, unless that person is protected by all of the measures required in Section 5144(g) of these orders for atmospheres that are immediately dangerous to life or health (IDLH). The completion of the measures shall be documented in writing and the documentation shall be signed by the supervisor of the restricted area. These measures shall include, but not be limited to, each of the following:

1. A physical or visual search of the area.

2. An audible or visual warning that is distinctive and recognizable by all persons in the area.

3. An accounting for all personnel who are known to be in the restricted zone.

(B) Signs shall be posted at all possible entry points to the area prior to the application of gases. The signs shall be visible from a distance of 12 feet and clearly display the words "Danger -- Do Not Enter," the poison symbol shown in Appendix A, and the name of the gas being applied. The signs shall be in all languages necessary to be understood by employees. Employees shall be prohibited from entering the area once the signs have been posted unless the employees enter under procedures for IDLH atmospheres as required by Section 5144(g).

(C) The area shall be effectively ventilated prior to the re-entry of employees. Ventilation shall be accomplished in a manner that does not endanger employees working in other areas of the site.

(D) The signs required by subsection (d)(5)(B) shall not be removed until the employer has tested the atmosphere in the area and determined that it is not oxygen deficient, does not contain an atmosphere that is IDLH, and does not exceed the ceiling or short term exposure limits in Section 5155 of these orders for the applied gases. The employer shall ensure that the testing represents all potential exposures in the area. The results of this testing shall be recorded, including the specific area in which the measurements were taken, the date and time of the measurements, and the name and title of the person taking the measurements. This record shall be posted at the entrance to the area for the duration of the work operation, and then shall be retained in accordance with subsection (e).

(E) Continuous monitoring for oxygen deficiency and toxic gases shall be conducted in areas in which employees are working adjacent to the area of application and where a hazardous atmosphere may exist. Employees shall be directed to exit the area immediately if an oxygen deficient atmosphere is detected or if toxic substances are detected at levels which exceed the permissible exposure limits in Section 5155 of these orders, independent of the duration of exposure. The area shall be posted as described in subsection (d)(5)(B), and entry shall be prohibited except under IDLH procedures, until the employer has verified that the area is safe for re-entry in accordance with subsection (d)(5)(D).

(F) Where employees enter confined spaces, the employer shall comply with Section 5157 of these orders.

(G) Fumigation operations shall also comply with Sections 5221 through 5223 of these orders.

(6) Disposal. Procedures for treatment and disposal of animal waste and contaminated personal protective equipment and clothing shall minimize employee exposure to zoonotic disease hazards, and shall be in accordance with applicable standards of the California Environmental Protection Agency and the United States Environmental Protection Agency.

(7) Decontamination. The employer shall ensure that employees are properly decontaminated when leaving the restricted area and that contaminated clothing and equipment are appropriately decontaminated or disposed of. Decontamination facilities shall include change rooms and shower facilities that meet the requirements of Sections 3360 through 3368 of these orders.

EXCEPTION: Where change rooms and shower facilities are not feasible, the employer shall implement alternative effective measures for decontamination and changing clothes that protect employees from infectious materials and hazardous substances that may be present on their clothing or their person.

(8) Medical Services. The employer shall provide a medical services program to all employees who enter the restricted area. The employer shall consult a PLHCP knowledgeable about chemical and zoonotic disease hazards in developing the program. The program shall maintain medical confidentiality in accordance with Section 3204 of these orders. The employer shall provide all vaccinations, prophlyaxis, and medical surveillance recommended by the PLHCP, the CDC, the CDPH or the local health officer for employees involved in these operations. The medical services program shall include, at a minimum:

(A) Initial medical evaluation to be provided prior to first entrance into a restricted area. This shall include a respirator medical evaluation, in accordance with Section 5144(e) of these orders.

(B) Surveillance for signs and symptoms of zoonotic disease. Employees exhibiting signs or symptoms of zoonotic disease and employees requesting referral shall be referred immediately to the PLHCP for follow-up evaluation.

(C) Surveillance for signs and symptoms of over-exposures to hazardous substances as appropriate for substances present in the work operation. Employees exhibiting these signs or symptoms shall be referred immediately to the PLHCP for follow-up evaluation, and the employer shall further investigate the source of the potential over-exposure and take corrective measures, as needed.

(D) Provision of vaccinations or prophylaxis as recommended by the CDC, the CDPH, the local health officer, or the PLHCP.

(E) Follow-up medical evaluations as recommended by the CDC, the CDPH, the local health officer or the PLHCP.

(F) The PLHCP shall provide the employer with a written report that shall contain only the following information:

1. For respirator medical evaluations, information shall be limited to the information required in Section 5144(e)(6)(A) of these orders.

2. For provision of vaccination or prophylaxis, the PLHCP shall inform the employer as to whether the employee has been provided with vaccine and/or prophylaxis, and whether the employee is authorized to enter the restricted area.

3. For referrals and follow-up medical evaluations, the PLHCP shall inform the employer that the employee has received the evaluation, whether additional evaluation is required, and whether the employee is authorized to work in the restricted area.

(9) Training. Employees shall receive training upon initial assignment, when site conditions are substantially changed, and when hazards are newly introduced or newly recognized. Training shall be appropriate in content and vocabulary for the educational level, literacy, and language of employees. The training shall include each of the following as they apply to the work operation:

(A) The identification and description of the zoonotic diseases that may be present in the work operation, and their signs and symptoms.

(B) The processes and procedures employees will use in restricted areas or when dealing with infected animals or their waste.

(C) The employer's safety program, including engineering and administrative controls, exposure monitoring and the results of exposure monitoring, the use of personal and respiratory protection equipment, cleaning and decontamination procedures, access to sanitation facilities and drinking water, and methods to control the risk of heat illness.

(D) The meaning of signs that will be used onsite.

(E) Hazard communications training in accordance with Section 5194 of these orders.

(F) The employer's medical services program.

(e) Recordkeeping. The employer shall establish and maintain records of implementation of the employer's zoonotic disease control procedures as follows:

(1) Records of implementation of hazard identification, evaluation and control, and employee training required by this section shall be created and maintained in accordance with Section 3203 of these orders.

(2) Employee exposure records, including the employer's zoonotic disease control procedures as required by subsections (b), (c), and (d), records of entry into restricted areas, records of atmospheric testing, and records of exposures to hazardous substances shall be maintained in accordance with Section 3204 of these orders.

(3) Employee medical records shall be maintained in a confidential manner in accordance with Section 3204 of these orders.

(4) Records of the respiratory protection program shall be established, maintained, and made available in accordance with Sections 5144 and 3204 of these orders.

(5) Availability.

(A) Employee medical records required by this section shall be provided upon request for examination and/or copying, in accordance with Section 3204 of these orders, to the subject employee, to anyone having the subject employee's written consent, and to the Chief, NIOSH, and the local health officer.

(B) All other records shall be made available upon request for examination and/or copying to employees, employee representatives, the Chief, NIOSH, and the local health officer.

Cal. Code Regs. Tit. 8, § 5199.1

1. New section and Appendix A filed 7-6-2009; operative 8-5-2009 (Register 2009, No. 28).

Note: Authority cited: Section 142.3, Labor Code. Reference: Section 142.3, Labor Code.