Working with Aerosol Transmissible Diseases (ATD)




Biosafety Manual 1sizedIndex

Working with Aerosol Transmissible Pathogens in the Laboratory

Each laboratory at UCSF that works with Aerosol Transmissible Pathogens-Laboratory (ATPs-L)  as specified in Appendix D of the California Occupational Safety and Health Standards board Title 8, section 5199 must submit a Biological Use Authorization (BUA) to the UCSF Institutional Biosafety Committee (IBC) that authorizes the possession, storage, transfer, and use of the biohazardous materials. The BUA must be reviewed and approved by the IBC before a laboratory is permitted to work with ATPs-L. The IBC will evaluate the engineering controls and PPE requirements during the BUA review process.

Approved BUA will provide a risk assessment in accordance with the methodology included in Section II of the BMBL for each agent and procedure involving the handling of ATPs-L. The BUA will contain sufficient information and detail to serve as a useful training document for laboratory employees and students.  The BUA will describe the procedures and measures to establish, implement and maintain an effective program to minimize research laboratory employee exposure to ATPs-L.  The BUA will include a Health Surveillance Program that ensures all vaccinations as recommended by applicable public health guidelines are available for specific laboratory operations, and methods for investigation and medical follow up for exposure incidents.

Additional requirements of CCR, Title 8, Sec. 5199 are outlined in the approved BUA.                                  Return to top of page


Aerosol Transmissible Disease Exposure Control Plan (ATD) in Dentistry

At the UCSF School of Dentistry, all patients are screened for ATDs and those with suspected or confirmed ATDs are referred to their medical provider if they show any signs or symptoms of ATD.  All staff members who observe patients with any signs or symptoms of ATDs are to give the patient a mask and alert the attending faculty and student dentist of the patient’s symptoms. The attending faculty member and student dentist will isolate the patient, if possible, into a private operatory. The attending faculty and student dentist shall wear all PPE, including mask, gown, gloves and eyewear. The attending faculty and student dentist shall refer the patient to their primary health care provider for a medical screening, and shall require a clearance from the medical provider prior to the patient being treated in the UCSF dental clinics.( More on ATD Standards in Dentistry)                                  


Policy on Zoonotic Aerosol Transmissible Diseases


Individuals involved in the care and use of animals may be at an increased risk of exposure to diseases that are transmitted from animals to humans by infectious aerosols. Although zoonotic diseases are uncommon in modern animal facilities, UCSF has established the following procedures to minimize the risk of transmission of aerosol transmissible diseases (ATD) to individuals involved in the care and use of research animals. These procedures are designed to comply with the California Occupational Safety and Health Administration (Cal-OSHA) Zoonotic ATD Standard Cal-OSHA CCR Title 8 Sec 5199.1.

Scope and Application

These procedures apply to all personnel working with, or exposed to, animals or their unfixed tissues including but not limited to veterinary staff, animal care technicians, research personnel, facilities personnel, Environmental Health and Safety Staff, IACUC staff and IACUC Committee members.

Control Methods

Several control measures are utilized in order to reduce the risk for introducing or transmitting zoonotic ATDs at UCSF laboratory animal facilities. These include quality veterinary care, adequate quarantine and animal acquisition procedures, sound work practices and personal protective equipment.

Veterinary Care

1) The Laboratory Animal Resource Center’s (LARC) central animal care program conducts full husbandry operations during weekends and holidays, under the coordination of the Animal Resources Managers.

2) All LARC-housed animals are observed at least daily and veterinary care is available at all times.

3) Research and LARC staffs are trained to contact the LARC on-call veterinarian if any unexpected clinical signs develop in a research animal.

  • An emergency on-call veterinarian is available for emergencies or off hours medical needs or consultation at all times.
  • The on call veterinarian number is posted in all appropriate animal activity areas on campus.

4) In the unlikely event a LARC veterinarian suspects or confirms a research animal of harboring a zoonotic ATD, the following procedures may be initiated;

  • The housing room may be placed under quarantine and access restricted to trained LARC and research personnel.
  • Samples for initial or confirmatory testing may be submitted to the appropriate diagnostic laboratories.
  • EH&S and/or the Biosafety Officer are notified of any suspected or confirmed zoonotic ATD.
  • The Biosafety Officer and/or EH&S will specify personal protective equipment, including respiratory protection, needed for entry into the housing room.
  1. LARC veterinarians, managers, and veterinary nurses are trained annually in the use of power air purifying respirators (PAPRs). 
  2. Only trained LARC and research staffs, with appropriate respiratory protection as prescribed by the Biosafety Officer, are permitted access to an animal that is suspected of harboring a zoonotic ATD.
  • Research labs housing animals in the positive room are immediately notified of the suspected or confirmed ATD case by the LARC veterinarian on the case. The Biosafety Officer shall confirm that notification occurred. 
  • A meeting with LARC veterinarian(s), Biosafety and Occupational Health staffs is scheduled to review the agent and the approaches available for managing the suspected/ confirmed case.
  • Personnel with possible exposure to an animal harboring a suspected zoonotic ATD will be trained in appropriate symptom monitoring and exposure follow up will be conducted through Occupational Health Services.

Animal Quarantine and Acquisition                                                                                       Return to top of page

1) Dogs, Cats, Pigs and Rabbits

  • Random source animals are not accepted by UCSF. Only purpose bred animals of known health status from class A dealers or AAALAC accredited facilities are accepted.
  • Animals are evaluated for good health upon arrival at the facility. Any animal not appearing healthy will be examined by a veterinarian.
  • Sick animals may be isolated from healthy animals, as prescribed by a LARC veterinarian.

2) Non-Human Primates

  • Non-human primate medical records are reviewed and approved by a LARC veterinarian and appropriate diagnostics and treatments are instituted before importation.
  • California source primates are transferred directly from the shipping crates into the animal room. Animals are visually examined for good health upon arrival. Any animal appearing unhealthy would be further examined by a veterinarian.
  • Quarantine of non-California source monkeys is in compliance with state laws
  • which mandate animals be isolated to pre-approved rooms for a minimum of 30 days. As required by the California Department of Public Health (CDPH), quarantined animals receive a tuberculin skin test and veterinary examination upon entry which are repeated again 30 days later.
  • Sick primates are isolated at the cage level within the animal quarters and receive a prompt cage evaluation by the LARC veterinarian to determine appropriate actions.

3) Sheep

  • UCSF has an extensive Q fever exclusion program.
  • UCSF purchases sheep only from approved vendors based on LARC review of their preventative health programs and the Q-fever serology screening of the incoming sheep.
  • All adult sheep are tested twice by ELISA serology and confirmed to be seronegative prior to transport to UCSF facilities. A PCR on the buffy coat is performed on all incoming lambs. Additionally, a PCR is performed on the amniotic fluid of any pregnant ewe prior to transport to UCSF when possible as part of the research protocol. Only PCR negative and seronegative postpartum ewes are allowed entrance into UCSF facilities. Male sheep require only 2 serologically negative tests.

Work Practices

1) Procedures that may result in the aerosolization of pathogens include, but are not limited to, necropsy, dentistry, and certain clinical, surgical and laboratory procedures.

  • Appropriate PPE and respirator protection must be used when performing such a procedure on an animal suspected or confirmed of harboring a zoonotic ATD.
  • Persons NOT involved in these procedures shall be excluded from the area, unless they use the respiratory protection and PPE required for employees performing these procedures.

2) Staff members should perform all manipulations of potentially infectious materials so as to minimize aerosol production.

3) Hand hygiene is an important means for preventing laboratory acquired infections. Workers should wash their hands after removing gloves and before leaving the laboratory, procedure room, or animal room.

4) Eating, drinking, and smoking are prohibited in all animal housing and procedural spaces.

5) All reusable equipment and procedural spaces must be appropriately decontaminated after use.

6) Contaminated waste materials must be disposed of and packaged in accordance with the UCSF Medical Waste Policy.

Personal Protective Equipment

1) Personal protective equipment requirements for individuals with exposure to elevated risk animals and/or their unfixed tissues is determined by the Institutional Biosafety Committee in accordance with recommendations outlined in the Biosafety in Microbiological and Biomedical Laboratories (5th edition).

2) Careful work practices and rigorous use of personal protective equipment is recommended to reduce the risk of exposure to zoonotic pathogens.

3) Biological safety cabinets should be used when manipulating infectious materials. Workers may also rely on personal protective devices, such as respirators, to minimize exposure to infectious aerosols.

Training                                                                                                                                    Return to top of page

1) Occupational health and safety information for staff with animal exposure is available in pamphlets and online under “Working Safely with Animals”.

2) The UCSF Medical Health Screening questionnaire must be completed annually by all individuals with exposure to animals or their tissues.

  • This questionnaire provides an individualized risk assessment for all animal users and categorizes each individual’s risk level based on the species worked with.
  • Information on zoonoses is provided to the animal user as part of this risk assessment.

3) All new and current UCSF employees/research personnel who work with animals at UCSF are required to complete Animal Biosafety Level Training. This training provides information on the following:

  • Animal Biosafety Levels
  • Appropriate personal hygiene practices
  • Safe work practices
  • Personal protective equipment
  • Decontamination
  • Waste disposal

4) All individuals with exposure to old world non-human primates must complete an in person herpes b training prior to beginning work as well as an online herpes B training annually.

5) All individuals with exposure to sheep or their unfixed tissues must complete an online Q fever training once every three years.


1) A Biological Use Authorization application (BUA) to work with animals involving infectious or transmissible agents must be submitted as an online BUA application to the IBC for review and approval.

2) Animal biosafety levels are assigned by the IBC for each BUA involving animal use.

3) Once approved, LARC must be contacted prior to initiation of the research to ensure that safe operating procedures will be established.  

4) Higher-risk, complicated, or unusual animal projects are assigned a Biosafety Considerations Meeting by the IBC.

  • The meeting includes project-related scientists, animal facility staff, a biosafety officer (BSO), and occupational health professionals.
  •  The BSO and all in attendance discuss the details of the project and conduct a risk assessment (including discussion of the possible routes of exposure of biohazardous materials and zoonotic agents to staff).
  •  Any special conditions designated by the IBC, applicable occupational health concerns, and medical surveillance are discussed. 
  •  The meeting continues until consensus is reached regarding research-related procedures, required equipment, PPE, waste disposal, animal care and use issues, and emergency response procedures.

5) Biohazardous animal carcasses and body parts must be disposed of through a contract vendor approved to haul infectious waste.  Biohazardous animal carcasses must be double bagged in red biohazard bags, transported in leak-proof containers and taken to freezers located in LARC for storage until vendor pick-up.

Medical Surveillance

1) All individuals with exposure to sheep are screened annually for Q fever in accordance with the UCSF Sheep Worker Policy on Surveillance and Training.

2) Individuals with exposure to old world non human primates must provide one time proof of measles immunity prior to beginning work and participate in annual tuberculosis screening.

3) Medical surveillance services are provided by UCSF Occupational Health Services.

Investigation of Occupational Injuries or Illnesses

1) The UCSF Occupational Health and Safety Exposure Hotline operates 24 hours daily for the provision of emergency care of acute biologic exposures. The Exposure Hotline Pager (415-353-7842) is answered by a live operator who connects the affected employee with an Exposure Hotline clinician.

2) All research related exposures including potential zoonotic ATD exposures are reported to the Biosafety Officer 415/476-2097 and Public Health Officer 415/514-3531 and an exposure investigation is conducted.

3) In the event of an exposure to a communicable disease, the campus exposure plan is followed.

  • This plan assigns actions and responsibilities for confirming a campus exposure, identifies those people likely exposed to a communicable disease and determines the risk of transmission and the appropriate follow-up activities.


UC Santa Barbara Office of Research. [Internet]. 2011. Zoonotic Diseases. [Cited 3 January 2011]. Available at:

NRC (National Research Council). Guide for the Care and Use of Laboratory Animals. Washington, DC: National Academy Press; 1996.

NRC (National Research Council). Occupational Health and Safety in the Care and Use of Research Animals. Washington, DC: National Academy Press; 1997.

Public Health Service. Biosafety in Microbiological and Biomedical Laboratories, 5th ed. Washington, DC: US Government Printing Office; 2009.

Title 8, California Code of Regulations 5199.1, Aerosol Transmissible Disease Standard – Zoonotic

If You have any questions, contact OEH&S Biosafety Officer at 514-2824.                                 Return to top of page


Biosafety Manual 2sizedIndex


Appendix 1: Aerosol Transmissible Zoonotic Pathogens and Current Status at UCSF LARC Facilities



Host / Reservoir


Monitoring and Risk Reduction Activities

Documented @ UCSF; and presumed to be still present

No Active Monitoring / Current positives not known

Actively monitored and currently not at UCSF


(Mycobacterium tuberculosis or bovis)

Non-Human Primates



Non-human primates are screened semi-annually. Employees with primate exposure are screened annually.

Q Fever

(Coxiella burnetii )




Extensive Q fever exclusion program in place for all imported animals. Employees with sheep exposure have titers checked annually.

Herpes B

Old World Primates



Education and training. PAPRs used during dental procedures.

Measles (Rubeola)

Non-Human Primates



All employees must show proof of measles immunity prior to working with non-human primates.


Wild Rodents




Used under ABSL2 conditions. Bioconsiderations meeting required for wild rodent users.


(Chlamydia psittaci)

Finches, Sheep




Employee education and training.