Care of Non-human 

Primates

Max Kiefer, MS, CIH

Doug Trout, MD, MHS

Health Hazard Evaluation Report

HETA 2001-0273; 2001-0274; 2001-0275;

2001-0407-3091

New Iberia, Louisiana; San Antonio, Texas; 

Davis, California; Covington, Louisiana

October 2009

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

Workplace

Safety and Health

 National Institute for Occupational 

Safety and Health

This Health Hazard Evaluation (HHE) report and any recommendations made herein are for the specific 

facility evaluated and may not be universally applicable. Any recommendations made are not to be 

considered as final statements of NIOSH policy or of any agency or individual involved. Additional HHE 

reports are available at http://www.cdc.gov/niosh/hhe/
The employer shall post a copy of this report 

for a period of 30 calendar days at or near 

the workplace(s) of affected employees. The 

employer shall take steps to insure that the 

posted determinations are not altered, defaced, 

or covered by other material during such 

period. [37 FR 23640, November 7, 1972, as 

amended at 45 FR 2653, January 14, 1980].
Health Hazard Evaluation Report 2001-0273; 2001-0274; 2001-0275; 2001-0407-3091 Page i

Appendix

Report Highlights of the NIOSH Health Hazard Evaluation.............i

Summary ............................................................................ iii

Introduction..........................................................................1

Background .........................................................................1

Methods...............................................................................2

Evaluation Criteria ...............................................................4

Results.................................................................................9

Discussion & Conclusion...................................................20

Recommendations.............................................................22

References ........................................................................23

Contents

Tables ................................................................................25

Acknowledgments Acknowledgments and Availability of Report.....................4
 Page ii Health Hazard Evaluation Report 2001-0273; 2001-0274; 2001-0275; 2001-0407-3091 

What NIOSH Did

● We surveyed employees who worked with or close to NHPs 

and/or their waste, body fluids, and tissues.

● We interviewed employees about work practices and 

procedures.

● We reviewed each facility’s policies, procedures, training 

requirements, and injury and illness logs.

● We interviewed employees responsible for occupational safety 

and health about policies and programs.

● We looked at animal handling and holding areas. 

What NIOSH Found

● Some work tasks were associated with exposure incidents.

● Despite knowing the potential health risks, employees often 

did not report exposure incidents. Many employees said they 

did not receive appropriate training on use of respirators. 

● Many employees said they did not receive appropriate 

training on use of bite and scratch kits before working with 

NHPs.

● Having more than 20 hours per week of contact with a NHP 

is linked with an increased risk of bites; scratches; needle 

sticks; and splashes in eyes, mouth, or nose with NHP 

secretions.

What NHP Managers Can Do

● Focus training on employees who have the most direct 

contact with NHPs.

● Revise training curriculum to include use of bite and scratch 

kits and respiratory protection.

● Create a procedure for employees to report exposure 

incidents.

● Continually review work practices to identify opportunities 

to prevent exposure incidents.

What NHP Employees Can Do

● Use bite and scratch kits as needed.

● Promptly report exposure incidents to management.

In December 2000, the 

National Institute for 

Occupational Safety and 

Health (NIOSH) received a 

grant to evaluate zoonotic 

disease risks among 

individuals working with 

non-human primates 

(NHPs). Four facilities 

were evaluated: California 

Regional Primate 

Research Center at the 

University of California 

(Davis, California), 

University of Louisiana 

at Lafayette (New Iberia, 

Louisiana), Southwest 

Foundation Regional 

Primate Research Center 

(San Antonio, Texas), 

and Tulane Regional 

Primate Research Center 

(Covington, Louisiana).

Highlights of 

NIOSH 

Hazard Eval
Health Hazard Evaluation Report 2001-0273; 2001-0274; 2001-0275; 2001-0407-3091 Page iii

On December 26, 2000, the Centers for Disease Control 

and Prevention’s (CDC) National Institute for Occupational 

Safety and Health (NIOSH) received a $25,000 grant from the 

Elizabeth R. Griffin Research Foundation to evaluate risks for 

acquiring zoonotic disease among those who work with nonhuman primates (NHPs) in research settings. NIOSH evaluated 

worker perceptions, attitudes, and general knowledge about safety 

and health policies and work practices. We made workplace 

observations and distributed questionnaires at the California 

Regional Primate Research Center at the University of California, 

in Davis, California, the University of Louisiana at Lafayette 

in New Iberia, Louisiana, the Southwest Foundation Regional 

Primate Research Center in San Antonio, Texas, and the Tulane 

Regional Primate Research Center in Covington, Louisiana. The 

voluntary, confidential questionnaire was offered to all primate 

center employees who worked with or near NHPs, and/or their 

waste, body fluids, and tissues. Among the four facilities, 476 

questionnaires were completed.

From the questionnaire, we determined that a number of work 

tasks (e.g., giving injections to NHPs) were associated with certain 

exposure incidents (being bitten, scratched, stuck with needles, 

etc.). We also found that although employees were aware that 

most of these incidents were a potential health risk and warranted 

reporting, actual reporting of the incident to a supervisor or health 

clinic did not occur. For example, being scratched or cut by dirty 

equipment or a NHP were among the most commonly occurring 

incidents, yet this was one of the incidents most commonly not 

reported to the supervisor. On a percentage basis, being splashed 

in the eyes, mouth, or nose with NHP secretions was the type of 

incident most commonly not reported to the supervisor (28 of 69 

incidents not reported, 41%). In terms of total numbers, being 

scratched by an NHP was the most common incident not reported 

(39 of 129 incidents not reported). The most common choice 

addressing why the incident was not reported was “did not think 

it serious enough to report,” chosen by 55 (73%). Though much 

less frequent, some employees reported they were afraid to report 

exposure incidents. 

Employees were asked to report whether or not they received 

training on eight specific topics prior to working with NHPs, 

including infectious disease risk, response and reporting, and 

safety procedures. While responses were positive to most types of 

appropriate training (typically greater than 90%), positive 

Reporting mechanisms 

need to be re-established 

and included in preassignment and refresher 

training because 

unreported exposure 

incidents occurred at all 

four facilities evaluated. A 

number of work practices 

were significantly 

associated with exposure 

incidents, and some 

groups of workers 

experienced significantly 

more incidents, which 

warrant focused, repeated 

training.

Summ
 Page iv Health Hazard Evaluation Report 2001-0273; 2001-0274; 2001-0275; 2001-0407-3091 

Summa   (continued) responses to training in the proper use of bite and scratch kits 

respirator training were much lower (e.g., 19% for bite and scratch 

kits and 37% for respirator training). Only 77 (66%) of employees 

at the Tulane facility reported receiving refresher training.

Most groups of employees reported experiencing exposure 

incidents; however, there was variability in reporting rates among 

workers in the various job groups. Although all employees should 

be included in appropriate training/education activities, more 

specific (and possibly more frequent) training/education activities 

should be focused on those employees with more direct contact 

with NHPs (such as caretakers). Recognition (by those responsible 

for health and safety at the NHP facility) that exposure incidents 

are occurring requires a reliable mechanism for systematic 

reporting. Recognition and rapid response to these events is 

important to ensure all necessary medical actions are taken 

promptly, and that appropriate measures are instituted to prevent 

future occurrences.

Keywords: NAICS 541712 (Research and Development in the 

Physical, Engineering, and Life Sciences), Non-human primate, 

macaque, biosafety, biomedical laboratory, bite, scratch, needle stick, 

B virus, zoonotic disease.
Health Hazard Evaluation Report 2001-0273; 2001-0274; 2001-0275; 2001-0407-3091 Page 1

Introduct

Following her death after being infected with Cercopithecine 

herpesvirus 1 (B virus) while working with non-human primates, 

Elizabeth Griffin’s family established The Elizabeth R. Griffin 

Research Foundation, Inc. to promote safe research practices 

and help fund further research in occupational safety and health, 

specifically zoonotic diseases, associated with animal work. The 

Foundation supports research regarding the health risks associated 

with zoonotic diseases, provides a prevention/treatment/

information network for research organizations, provides a support 

network for those who have contracted or are at risk of contracting 

zoonotic diseases, and promotes safe and responsible scientific 

research involving the use of animals. On December 26, 2000, the 

Centers for Disease Control and Prevention’s (CDC) National 

Institute for Occupational Safety and Health (NIOSH) received 

a $25,000 grant from the Foundation to conduct research on 

zoonotic disease among those who work with non-human primates 

(NHPs). This report provides the results of a survey of four 

National Institutes of Health-funded NHP facilities.

Hazards associated with NHPs and their tissues include exposure 

to naturally acquired zoonotic agents (e.g., B virus, tuberculosis, 

filoviruses) or agents used in biomedical research (e.g., simian 

immunovirus). Routes of exposure to NHP pathogens include 

inhalation, mucous membrane contact, bites, scratches, or 

accidental needle sticks and sharps injuries. Outcomes from 

exposure can be quite severe and even fatal (i.e., B virus from the 

macaque species). Injuries (e.g., bites, scratches, other trauma) can 

occur during work with NHPs. NHPs are considered essential for 

basic and clinical research and their use is expected to continue. 

The National Institutes of Health (NIH) currently funds research 

programs in a network of eight National Primate Research Centers 

(NPRCs) in the United States. Together the NPRCs have more 

than 26,000 animals representing more than 20 species of NHPs, 

mostly macaques. NPRC facilities and resources enable NPRC 

staff scientists and investigators from the host institution and 

others across the country, including investigators funded by other 

federal, state, and local agencies, as well as by research foundations 

and the private sector, to collaborate on research projects. One 

retrospective examination of two regional primate centers in the 

United States found an annual incidence for all injuries combined 

to range from 43.5 to 65.5 per 100,000 person workdays.1 The 

highest incidence observed was for animal-inflicted bites and 

Backgro
 Page 2 Health Hazard Evaluation Report 2001-0273; 2001-0274; 2001-0275; 2001-0407-3091 

Backgrou   (continued) scratches. Having more than 20 hours per week of contact w

an NHP was associated with a significantly increased risk of 

bites, scratches, needle sticks, and mucous membrane exposures. 

Professions potentially at risk for exposure include veterinarians, 

animal handlers, zookeepers, laboratorians, student researchers, 

academicians, government quarantine and import regulators, and 

Animal Welfare Act regulators. Because of the unique hazards 

associated with the NHP industry, specific criteria for safety and 

health and medical surveillance of workers are necessary. Although 

guidelines and recommendations have been developed, these are 

often focused on a particular agent (e.g., filovirus) or animal (e.g., 

macaques). Furthermore, a comprehensive assessment of safe 

work practices, management policies, and use of risk assessment 

techniques to evaluate activities involving NHPs in NHP-handling 

facilities has not been conducted.

To determine the most appropriate research path, we consulted 

NIOSH and other CDC (e.g., National Center for Infectious 

Disease Division of Quarantine) personnel familiar with NHP 

safety and health issues. Other organizations (Association of 

Primate Veterinarians, National Research Council Institute of 

Laboratory Animal Resources (ILAR)) that are involved in NHP 

worker safety and health or were recipients of Griffin Foundation 

funds were contacted to ensure that any efforts by NIOSH would 

be complementary. A general consensus from these discussions was 

that research to determine management policies, worker attitudes 

regarding these policies, and actual work practices as related to 

the care and use of NHPs would be beneficial to NHP-handling 

organizations. 

Although surveying a cross-section of NHP facilities was desirable, 

time and resource constraints required prioritizing the number and 

type of facilities that could be evaluated. Therefore, we limited our 

evaluation to primate facilities receiving funding from the NIH, 

because this type of research facility involves the largest group of 

animal handlers. Among these facilities, we selected those housing 

the largest number of NHPs at the time of our evaluation. These 

sites included the California Regional Primate Research Center 

at the University of California in Davis, California (UC Davis), 

the University of Louisiana at Lafayette in New Iberia, Louisiana 

(UL Iberia), the Southwest Foundation Regional Primate Research 

Center in San Antonio, Texas (SW Foundation), and the Tulane 

Metho
Health Hazard Evaluation Report 2001-0273; 2001-0274; 2001-0275; 2001-0407-3091 Page 3

Method  (continued) Regional Primate Research Center in Covington, Louisia

(Tulane). On-site surveys were conducted at these facilities to 

obtain information on facility policies, actual practices, tasks/

exposure events, post-exposure procedures, medical management, 

training, and safety program management. Data were gathered via 

interviews, work practice observations, facility inspections, and a 

review of safety procedures and injury and illness logs. A voluntary, 

confidential questionnaire was offered to all primate center 

employees who worked with or close to NHPs and/or their waste, 

body fluids, and tissues. The survey methods were consistent across 

all four facilities. Other systematic activities during the site visits 

included reviewing the facility’s standard operating procedures 

and training requirements, reviewing the selection and use of 

personal protective equipment and other controls, interviewing 

personnel who were responsible for occupational safety and health, 

reviewing medical surveillance activities and policies, inspecting 

animal handling and holding areas, reviewing infectious waste 

handling procedures, and reviewing injury and illness logs. Of all 

the data collected, the questionnaire results provided the most 

useful insight into areas where improvements were warranted, and 

are the focus of this report. Questionnaire respondents included 

supervisors, occupational health and safety staff, animal handling 

personnel, veterinarians, veterinarian technicians, students, 

laboratorians, maintenance personnel, and custodial staff. Among 

the four facilities, 469 questionnaires were completed. 

Questionnaire Methodology 

A self-administered questionnaire was handed out to all employees 

at each facility; NIOSH representatives were available to answer 

questions about the questionnaire. The questionnaire covered job 

title, job tasks, knowledge concerning safety and health related 

issues, and exposure incidents that occurred in the 5 years prior to 

the survey.

The goal of the questionnaire was to assess employees’ knowledge 

concerning health and safety issues related to handling NHPs and 

to assess exposure incidents that occurred in the 5 years prior to 

the survey. Analysis of the questionnaire data had two primary 

endpoints: (1) sufficient employee knowledge of pertinent health 

and safety factors and issues (assessed by whether employees 

considered a variety of scenarios such as secretions splashed onto 

skin, into a cut, etc. as infectious disease exposures or health risks), 
 Page 4 Health Hazard Evaluation Report 2001-0273; 2001-0274; 2001-0275; 2001-0407-3091 

Method  (continued) and (2) occurrence of exposure incidents (incidents including bit

or scratches by an NHP; needle sticks; scratches with equipment; 

and splash in the eyes, mouth, or nose with NHP secretions).

Some variables, specifically those concerning knowledge of safety 

and health issues, were considered in different instances as both 

independent (related to an exposure or risk factor) and dependent 

(outcome or endpoint) variables.

The magnitude of the relationships analyzed was assessed by the 

prevalence ratio (PR); a 95% Confidence Interval (95% CI) that 

excluded one or a significance level of p = 0.05, was considered 

to indicate a statistically significant finding. The PR represents 

the prevalence of an outcome (for example, the occurrence of a 

bite) in a group demonstrating a potential risk factor (for example, 

performing feeding tasks) relative to the prevalence in the group 

without that potential risk factor. A PR of 1 means there is no 

association between the outcome and risk factor. A PR of greater 

than 1 indicates evidence of an association. For example, a PR of 

2 would mean that a person in the group with the risk factor was 

2 times more likely to have reported the outcome than a person in 

the group without the risk factor.

As a guide to the evaluation of the hazards posed by workplace 

exposures, NIOSH field staff employ environmental evaluation 

criteria for the assessment of a number of chemical and physical 

agents. These criteria are intended to suggest levels of exposure 

to which most workers may be exposed up to 10 hours per day, 

40 hours per week for a working lifetime without experiencing 

adverse health effects. It is, however, important to note that not 

all workers will be protected from adverse health effects even 

though their exposures are maintained below these levels. A 

small percentage may experience adverse health effects because of 

individual susceptibility, a pre-existing medical condition, and/or 

a hypersensitivity (allergy). In addition, some hazardous substances 

may act in combination with other workplace exposures, the 

general environment, or with medications or personal habits of the 

worker to produce health effects even if the occupational exposures 

are controlled at the level set by the criterion. These combined 

effects are often not considered in the evaluation criteria. Also, 

some substances are absorbed by direct contact with the skin and 

mucous membranes, and thus potentially increases the overall 

Evaluation Cr
Health Hazard Evaluation Report 2001-0273; 2001-0274; 2001-0275; 2001-0407-3091 Page 5

Evaluation Cri      (continued) exposure. Finally, evaluation criteria may change over the ye

new information on the toxic effects of an agent become available.

The primary sources of environmental evaluation criteria for 

the workplace are: (1) NIOSH recommended exposure limits 

(RELs),2 (2) the American Conference of Governmental Industrial 

Hygienists’ (ACGIH®) threshold limit values (TLVs®),3 and (3) 

the U.S. Department of Labor, Occupational Safety and Health 

Administration (OSHA) permissible exposure limits (PELs) [29 

CFR* 1910].4 Employers are encouraged to follow the OSHA 

limits, the NIOSH RELs, the ACGIH TLVs, or whichever are the 

more protective criteria.

OSHA requires an employer to furnish employees a place of 

employment that is free from recognized hazards that are causing 

or are likely to cause death or serious physical harm [Occupational 

Safety and Health Act of 1970, Public Law 91–596, sec. 5(a)

(1)]. Thus, employers should understand that not all hazardous 

chemicals have specific OSHA exposure limits such as PELs and 

short-term exposure limits (STELs). An employer is still required 

by OSHA to protect their employees from hazards, even in the 

absence of a specific OSHA PEL.

A time-weighted average (TWA) exposure refers to the average 

airborne concentration of a substance during a normal 8- to 

10-hour workday. Some substances have recommended STEL or 

ceiling values which are intended to supplement the TWA where 

there are recognized toxic effects from higher exposures over the 

short-term.

Occupational Safety and Health at NonHuman Primate Institutions

When assessing workplace conditions where environmental 

evaluation criteria have not been developed or are not applicable, 

NIOSH field staff may use guidelines and recommendations 

developed by public health agencies or professional associations, 

accepted industry practice, or criteria for safe work practices 

published by standard-setting organizations. In some situations, 

workplace evaluations and recommendations may be based on state 

of the art industrial hygiene and occupational medicine concepts, 

principles, and practices, or by analogy to other industrial settings. 

* Code of Federal Regulations. See CFR in references.
 Page 6 Health Hazard Evaluation Report 2001-0273; 2001-0274; 2001-0275; 2001-0407-3091 

Evaluation Cri      (continued) Evaluation criteria may change over the years as new infor

on the toxic effects of an agent, efficacy of control systems, or safe 

work practices becomes available.

Although specific regulatory criteria have not been established, 

guidelines and recommendations for occupational safety and 

health programs associated with the care and use of research 

animals are available from a number of sources. The National 

Research Council (NRC) has published a report prepared by 

the Committee on Occupational Safety and Health in Research 

Animal Facilities, under the auspices of the ILAR.5 This report 

provides recommendations for implementing a safety and health 

program in animal research facilities, includes information about 

B virus and NHPs, and recommends that personnel working 

with NHPs wear face shields and other protective garments. 

The report also recommends identifying and eliminating sharp 

edges on cages and ancillary equipment. A more recent ILAR 

publication complements the previous publication and expands 

on topics particularly relevant to facilities where NHPs are 

housed or where NHP blood or tissues are used.6 The report 

describes the hazards associated with work involving NHPs and 

discusses the components of a successful occupational safety and 

health program, including hazard identification, risk assessment, 

applicable safety regulations, risk management, and personnel 

training. Topics include techniques for assessing the degree of 

risk of those hazards, options for managing those risks, including 

engineering controls, worker training, and personal protective 

equipment; institutional management of workers after suspected 

exposures; and examples of safety and health programs in both 

large and small NHP facilities. 

The ILAR book is a reference for vivarium managers, veterinarians, 

researchers, safety professionals, and any other persons involved 

in developing or implementing an occupational safety and health 

program in settings with NHPs. Combined with the prior NRC 

publication and other guidance,7 these reports provide the basis for 

industrywide standards for occupational health and safety in the 

NHP field.

Criteria for activities involving infectious disease work with 

experimental animals are described in a joint CDC-NIH 

publication, Biosafety in Microbiological and Biomedical Laboratories.

8

 

Recommendations in this guide include four combinations of 

work practices, safety equipment, and facilities that are based 
Health Hazard Evaluation Report 2001-0273; 2001-0274; 2001-0275; 2001-0407-3091 Page 7

Evaluation Cri      (continued) on the hazard presented by the infectious agent under 

The four animal biosafety levels described in this document 

provide for increasing protections, based on the level assigned. 

According to the this document, Biosafety Level 2 practices are 

recommended for tasks entailing the manipulation of tissues, 

body fluids, or primary tissue culture materials from macaques. 

More stringent Biosafety Level 3 practices are recommended when 

the use or manipulation of material known to contain B virus is 

conducted. Biosafety Level 4 criteria apply to the propagation and 

manipulation of production quantities of the virus.8

Most of the regulatory effort and recommendations regarding 

laboratory animal research address the care and well-being of the 

animals and research protocols. Regulatory or research funding 

agencies (e.g., U.S. Department of Agriculture, NIH), may not 

include detailed occupational safety and health criteria as part of 

their oversight activities.

Personal Protective Equipment 

Protective clothing and equipment are designed to shield or isolate 

individuals from the chemical, physical, or biological hazards they 

may encounter during their work.9 Personal protective equipment 

(PPE) is generally considered the last line of defense and is 

used after every effort to eliminate the hazard through feasible 

engineering or administrative controls has been implemented. 

PPE places the burden of protection on the employee, and 

if the equipment fails, exposure could occur. PPE can be an 

effective control technique for occupational hazards; however, 

PPE effectiveness depends on proper use by the wearer.10 PPE 

is also appropriate in some situations as a backup in the event 

of an engineering control failure or for jobs of short duration. 

Selection of PPE appropriate for a given task should be made from 

assessments of the worksite hazards, which includes an evaluation 

of each activity. Hazard assessments require a good understanding 

of the work tasks, knowledge of the potential routes of exposure, 

the opportunities for exposure in the task assessed (nature and 

extent of worker contact), and the potential for adverse health 

outcomes if exposure were to occur. Accident and incident reports 

should be reviewed to identify those injuries or exposure incidents 

(whether or not infection occurred) that could have been prevented 

by the proper use of PPE. Most approaches for selecting the 

appropriate PPE incorporate the following process:10
 Page 8 Health Hazard Evaluation Report 2001-0273; 2001-0274; 2001-0275; 2001-0407-3091 

Evaluation Cri      (continued) ● Determining the type of hazard most likely t

● Assessing the adverse effects of unprotected exposure

● Identifying other control options that can be used instead of 

protective clothing

● Determining the performance characteristics needed for 

protection

● Evaluating the need for decontamination

● Assessing constraints that may hinder the use of PPE 

(ergonomics, safety, vision, dexterity)

Once it is determined that PPE is required for a task, its use 

should be mandatory. PPE should be individually assigned 

whenever possible. Written procedures should be in place to 

ensure consistent selection and use of PPE. Affected users 

must be informed of the need for PPE; consequences of not 

wearing the appropriate PPE; and how to properly inspect, wear, 

maintain, and store the PPE. Users must also be informed of all 

limitations associated with the use of PPE and must be aware that 

the equipment does not eliminate the hazard. Finally, periodic 

inspections and evaluations of the PPE program should be 

conducted to ensure that procedures are consistently followed, 

to identify any process changes that may have occurred, and to 

confirm that the selected PPE is still appropriate for the given task.

Protective Eyewear

The types of protective eyewear vary widely, and appropriate 

selection should be based on a number of factors, the most 

important of which is the nature and extent of the hazard. For 

example, protection against eye impact hazards generated during 

chipping, grinding, or masonry work may dictate a specific type 

of protection. For splash hazards, goggles and face shields should 

be used. Face shields are considered a secondary protector and 

are only designed to provide limited protection to the face and 

front part of the neck.11 Face shields should always be used with 

suitable primary eye protection such as safety glasses or goggles. 

Most protective goggles and eyewear are available with an antifog lens option to prevent clouding in humid environments. 

Lens cleaning supplies and anti-fog materials should be available 

for employee use. Eye protection must be comfortable, allow for 

sufficient peripheral vision, and be adjustable to ensure a secure fit. 
Health Hazard Evaluation Report 2001-0273; 2001-0274; 2001-0275; 2001-0407-3091 Page 9

Evaluation Cri      (continued) Providing several different types, styles, and sizes may be nece

Protective eyewear should meet or exceed the criteria established by 

the American National Standard Institute (ANSI) Standard Practice 

for Occupational and Educational Eye and Face Protection (ANSI Z87.1-

1989).

11

The tables below summarize the results across all four facilities 

evaluated. All results for the individual facilities can be found in 

the Appendix).

Description of Respondents

Among the four facilities, 476 employees filled out the 

questionnaire; 469 employees reported contact with NHPs. This 

latter group of 469 questionnaires was used in the analysis. The 

number of employees by job category and by facility is presented in 

Table 1.

Results

Table 1. Questionnaire Results by Job Category and Facility

Job UC Davis UL New Iberia SW 

Foundation Tulane Overall

Caretaker 28 61 26 7 122 (26%)

Technician 8 12 18 26 64 (14%)

Supervisor 2 10 5 4 21 (5%)

Student 9 9 0 1 19 (4%)

Maintenance 5 20 11 19 55 (12%)

Veterinarian 7 3 3 7 20 (4%)

Guest Researcher 0 1 0 0 1 (0.2%)

Manager 3 1 0 2 6 (1%)

Laboratorian 34 0 4 29 67 (14%)

Visiting Scientist 1 0 0 2 3 (0.6%)

Other 40 21 11 19 91 (19%)

Total 137 138 78 116 469
 Page 10 Health Hazard Evaluation Report 2001-0273; 2001-0274; 2001-0275; 2001-0407-3091 

Results (continued) Employees were asked about their work experience, how long they

had been at the facility, whether they physically handled NHPs, 

and whether the animals were sedated or awake when handled. 

As shown in Table 2, the median time at their respective facilities 

was 5.4 years, with UL New Iberia employees reporting the least 

time (median 3.1 years) and Tulane employees reporting the most 

(median 9.7 years). Most employees (295, 63%) reported physically 

handling NHPs (as opposed to cleaning cages, etc.). Of these, 228 

(77%) reported handling NHPs while alone, and while the NHPs 

were awake/alert.

Table 2. Experience/Work Tasks

Facility Time at facility1 Handle NHPs2 Handle awake NHPs3

UC Davis 3.8 87 (64%) 80 (92%)

UL New Iberia 3.1 95 (69%) 64 (68%)

SW Foundation 5.0 55 (71%) 52 (95%)

Tulane 9.7 58 (50%) 32 (55%)

Overall 5.4 295 (63%) 228 (77%)

1 Median time (years) employed at the facility

2 Physically handle NHPs 3

 Of those who handle NHPs, reported physically handling awake/alert NHPs while alone

The most commonly reported tasks included handling tissues/

body fluids, handling/holding animals, feeding, giving injections/

drawing blood, cleaning cages, and behavior observations. The four 

most common tasks at each facility and the numbers of employees 

performing these tasks are shown by facility in Table 3.

Table 3. Four Most Commonly Reported Tasks at Each Facility

Task Facility

UC Davis UL New Iberia SW Foundation Tulane

Handling tissues/fluid 96 (70%) 68 (49%) — 77 (66%)

Handling/holding animals 60 (44%) 73 (53%) 50 (64%) 41 (35%)

Feeding 58 (42%) 76 (55%) 51 (65%) 36 (31%)

Giving injections/drawing blood 49 (36%) — — 42 (36%)

Cleaning cages — 69 (50%) 45 (58%) —

Behavior observation — — 41 (53%) —
Health Hazard Evaluation Report 2001-0273; 2001-0274; 2001-0275; 2001-0407-3091 Page 11

Results (continued) Employee Knowledge of Health and

Safety Risks

The questionnaire asked employees about six potential exposure 

incidents that can be considered as high risk for infectious disease 

exposure (NHP secretions on non-intact skin, puncture by a dirty 

needle, NHP bite breaking the skin, scratch with dirty equipment, 

NHP secretions in the mouth or nose, and NHP secretions in the 

eye). Also listed were four incidents (NHP secretions on the skin, 

puncture by a clean needle, NHP bite not breaking the skin, and 

scratch with clean equipment) that could represent a deficiency 

in the safety and health practice of the facility. Skin puncture 

with a clean needle, while not likely to represent an increased 

risk of infectious disease transmission, may be an indicator or a 

procedural problem because the incident may have easily have 

occurred with a dirty needle. From the list of ten incidents, 

employees were asked which they would consider an infectious 

disease exposure or health risk that would need to be reported. 

Nearly all employees at the UC Davis and UL New Iberia facilities 

recognized the six exposure incidents that can be considered as 

high risk for infectious disease. However, 6%–14% of employees 

at the Tulane and SW Foundation facilities did not identify these 

potential incidents as risks needing to be reported (Table 4).

Table 4. Knowledge of Potential Risk, by Type of Incident1

All Facilities

Incident

# (%) Reporting incident to be infectious disease risk that would need to be 

reported

UC Davis Tulane SW 

Foundation

UL New 

Iberia Overall

NHP secretions on wound 134 (98%) 108 (93%) 68 (86%) 135 (97%) 445 (95%)

NHP secretions in mouth 135 (99%) 105 (91%) 69 (87%) 132 (95%) 441 (94%)

NHP secretions in eye 133 (97%) 104 (90%) 70 (88%) 133 (96%) 440 (93%)

Puncture by dirty needle 134 (98%) 105 (91%) 68 (86%) 133 (96%) 440 (94%)

NHP bite breaking skin 135 (99%) 105 (91%) 72 (91%) 132 (95%) 444 (95%)

Scratch with dirty equipment 132 (96%) 109 (94%) 70 (89%) 132 (95%) 443 (95%)

NHP secretions on intact skin 59 (43%) 73 (63%) 38 (48%) 68 (49%) 238 (51%)

Puncture by clean needle 35 (26%) 32 (28%) 27 (34%) 76 (55%) 170 (36%)

NHP bite not breaking skin 82 (60%) 67 (58%) 40 (51%) 96 (69%) 285 (61%)

Scratch with clean equipment 63 (46%) 52 (45%) 41 (52%) 103 (74%) 259 (55%) 1 Responses to questions concerning whether participants would consider these types of incidents to be infectious disease 

exposures or health risks needing to be reported.
 Page 12 Health Hazard Evaluation Report 2001-0273; 2001-0274; 2001-0275; 2001-0407-3091 

Results (continued) Responses to the four incidents that could represent a deficiency

in the safety and health practices of the facility are presented in 

Table 5 by job title. By far, the least recognized hazard was being 

stuck with a clean needle (only 36% of employees recognized it as 

a potential hazard). Positive responses to the other three incidents 

(bite not breaking the skin, scratch with clean equipment, 

and secretions on intact skin) ranged between 50% and 60%. 

Veterinarians (39%) and technicians (38%) had the lowest overall 

positive response rate to the four incidents, while students and 

maintenance workers had the highest (65%). 

Table 5. Knowledge of Potential Risk by Job Title

All Facilities

 Job #

# (%) Reporting incident to be infectious disease risk that would need to be 

reported

Bite1 Needle 

stick2

Scratch with clean 

equipment3

Exposure to 

secretions4 Overall

Caretaker 122 69 (57%) 44 (36%) 75 (61%) 59 (48%) 51%

Technician 64 29 (45%) 18 (28%) 23 (36%) 28 (44%) 38%

Supervisor 21 11 (52%) 4 (19%) 12 (57%) 9 (43%) 43%

Student 19 13 (68%) 11 (58%) 14 (74%) 11 (58%) 65%

Maintenance 55 40 (73%) 31 (56%) 39 (71%) 39 (71%) 68%

Veterinarian 20 10 (50%) 7 (35%) 10 (50%) 4 (20%) 39%

Visiting Scientist 3 2 (66%) 1 (33%) 2 (66%) 1 (33%) 50%

Colony Manager 6 5 (83%) 5 (83%) 3 (50%) 1 (17%) 43%

Laboratorian 67 49 (73%) 23 (34%) 28 (42%) 40 (60%) 52%

Other 91 48 (53%) 24 (26%) 51 (56%) 47 (52%) 47%

Total 469 281 (60%) 169 (36%) 257 (55%) 240 (51%) 50%5

Positive responses for “Knowledge of potential risk” are indicated by the respondent (469 responding to the question) 

reporting affirmatively that: 

1

 NHP bites that do not break the skin are exposures/health risks that would need to be reported.

2

 Punctures with a clean needle are infectious disease exposures or health risks that would need to be reported.

3

 Scratches or cuts from clean animal equipment are an infectious disease exposure or health risk that would need to be 

reported.

4

 Exposures to NHP secretions (saliva, blood, urine, feces) splashed onto skin are infectious disease exposures or health 

risks that would need to be reported.

5

 Weighted average

The possible associations between characteristics of the participant 

(including frequency of work with NHP, being a supervisor, 

having received training prior to working with NHP, receiving 

refresher training) and knowledge about these four incidents as 

potential risks were assessed. UL New Iberia employees without 
Health Hazard Evaluation Report 2001-0273; 2001-0274; 2001-0275; 2001-0407-3091 Page 13

Results (continued

Employee Training

Employees were asked to report whether they received training on 

eight specific topics before they worked with NHPs. The topics 

and the number (%) reporting that they had received training are 

shown in Table 8.

training prior to working with NHPs were about twice as likely as 

those with training not to consider puncture with a clean needle 

and scratch with clean equipment as health risks that need to be 

reported (Table 6). Tulane employees without refresher training 

on infectious disease risks were about twice as likely as those with 

refresher training not to consider NHP secretions splashed onto 

skin as an infectious disease exposure or health risk (Table 7). No 

other associations between training and knowledge of potential 

risks were statistically significant 

Table 6. Relationship between Knowledge of Potential Risk of Puncture by a Clean Needle and Receipt 

of Refresher Safety and Health Training

University of Louisiana at Lafayette, New Iberia, Louisiana

 Training on NHP-related infectious 

disease risks prior to working with NHP

Puncture with clean needle as a health risk

Not considered as a risk Considered as a risk Total

Without training 6 3 9

With training 35 81 116

Total 41 84

Prevalence Ratio = 2.2; 95% Confidence Interval 1.3 – 3.8

Table 7. Relationship between Receipt of NHP-related Infectious Disease Training and Knowledge of 

Potential Risk of NHP Secretions Splashed onto Skin

Tulane Regional Primate Research Center, Covington, Louisiana

Training on infectious disease risks from 

 NHPs experimentally infected

NHP secretions splashed onto skin as an infectious disease 

exposure or health risk

Not considered as a risk Considered as a risk Total

Without training 18 9 27

With training 25 64 89

Total 43 73

Prevalence Ratio = 2.4; 95% Confidence Interval 1.5 – 3.6
 Page 14 Health Hazard Evaluation Report 2001-0273; 2001-0274; 2001-0275; 2001-0407-3091 

Results (continued

The UC Davis, SW Foundation, and Tulane facilities were 

essentially equal in the level of employee training prior to handling 

NHPs, with an overall training response of 77%–78%. New UL 

New Iberia facility employees reported the least training, with 

an overall response of 69%. By far, area with the lowest level 

of training was respiratory protection (only 37% of employees 

overall), followed by use of bite and scratch kits (51%). Positive 

responses to receiving training on the other six topics ranged from 

77% (procedures for seeking medical care) to 85% (task-specific 

precautions). All employees reported having refresher training at 

the UC Davis, UL New Iberia, and SW Foundation facilities; only 

77 (66%) of Tulane employees reported refresher training.

Reported Incidents in 5 Years Prior to the 

Survey

Employees were asked to report incidents that occurred in the 

5 years prior to the survey while working with NHPs. Incidents 

included being bitten by an NHP; scratched by an NHP; stuck 

by a non-sterile needle; scratched or cut by dirty equipment; or 

splashed in the eyes, mouth, or nose with NHP secretions (Table 

9). Being scratched or cut by dirty equipment and being scratched 

by an NHP were the two most commonly reported incidents. On 

a percentage basis, being splashed in the eyes, mouth, or nose 

with NHP secretions was the type of incident most commonly 

not reported to the supervisor (28 of 69 incidents not reported, 

Table 8. Employee Training Prior to Working with NHPs

Training Topic Facility

UC Davis UL New Iberia SW Foundation Tulane Overall

NHP disease risk 123 (90%) 116 (84%) 62 (80%) 88 (76%) 83%

Risk/experimentally infected 115 (84%) 108 (78%) 61 (78%) 89 (77%) 80%

Task-specific precautions 127 (93%) 113 (82%) 64 (82%) 93 (80%) 85%

Responding to an exposure 125 (91%) 116 (84%) 64 (82%) 83 (72%) 83%

Bite/scratch kit 66 (48%) 23 (17%) 64 (82%) 87 (75%) 51%

Seeking medical care 121 (88%) 103 (75%) 65 (83%) 74 (64%) 77%

Reporting 121 (88%) 114 (83%) 66 (85%) 82 (71%) 82%

Respirator use 48 (35%) 63 (46%) 33 (42%) 31 (27%) 37%

Total 77% 69% 77% 78%
Health Hazard Evaluation Report 2001-0273; 2001-0274; 2001-0275; 2001-0407-3091 Page 15

Results (continued

In a follow-up question, employees were asked to describe why 

incidents were not reported. Among the 75 persons stating that 

they had not reported at least one of these five types of incidents, 

the most common answer was “did not think it serious enough 

to report,” chosen by 55 (73%). Among all 469 respondents, 17 

(4%) reported that they were reluctant/afraid to report injuries or 

exposures to supervisors. When asked to whom would employees 

report exposures or other incidents, 375 (80%) said they would 

report first to a supervisor, 71 (15%) said they would report first 

to the occupational safety and health officer, and 32 (7%) said 

they would report to some other person (participants could choose 

more than one response).

Information concerning these five types of incidents is presented by 

job title in Table 10. Among the jobs with 10 or more employees, 

technicians experienced the most (percentage) incidents, followed 

closely by supervisors. The most common type of incident was 

being scratched or cut with dirty equipment, followed closely by 

being scratched by an NHP. 

41%); in terms of total numbers, being scratched by an NHP was 

the most common incident not reported (39 of 129 incidents not 

reported).

Table 9. Reported Incidents Occurring in the 5 Years Prior to the Survey

While Working with NHPs 

All Facilities

Incident

# (%) employees 

reporting incident 

occurring in the 

last 5 years

Among those reporting incident

Median (range) of 

# times incident 

occurred

Number (%)1 reporting 

that not all incidents 

reported to supervisor

Bitten by NHP 71 (15%) 1 (1–10) 6 (8%)

Scratched by NHP 129 (26%) 2.5 (1–30) 39 (30%)

Needle stick 73 (16%) 1.3 (1–9) 13 (18%)

Scratched/cut by dirty equipment 135 (29%) 1.75 (1–15) 32 (24%)

Splashed in eyes, mouth, or nose 

 with NHP secretions

69 (15%) 1.6 (1–10) 28 (41%)

1

 Percentage among those experiencing an incident who stated that they had not reported at least one of these incidents 

to a supervisor.
 Page 16 Health Hazard Evaluation Report 2001-0273; 2001-0274; 2001-0275; 2001-0407-3091 

Results (continued

Further evaluation of work tasks versus the occurrence of incidents 

at each facility reveals that at the UC Davis facility:

● Employees reporting daily work with NHPs had a higher 

prevalence of all five incidents compared to those working 

with NHPs weekly or less, although the differences were not 

statistically significant.

● Persons reporting bites in the 5 years prior to the survey had 

spent more time working with NHPs (median 7.2 years) than 

those not reporting bites (median 3.3 years; p= 0.048).

Specific work tasks were evaluated as potential exposures or risk 

factors for these five types of incidents at the UC Davis facility; 

these analyses are presented in Table 11. All work tasks except 

handling tissues or fluids were associated with an increased 

prevalence of at least one of the five incidents. Giving injections 

was the one work task associated with an increased prevalence of 

all five incidents. Working with awake/alert NHPs (versus sedated/

anesthetized NHPs) by itself was not associated with an increased 

prevalence of any of the five incidents.

Table 10. Occurrence of Incidents by Job Title

All Facilities

Job #

Incident # (%) employees reporting incident occurring in the last 5 years

Bitten, 

resulting in 

broken skin

Needle 

stick

Scratched 

by NHP

Scratched/

cut by 

dirty 

equipment

Splashed in 

eyes, nose, 

or mouth 

with NHP 

secretions

Overall

Caretaker 122 34 (28%) 13 (11%) 43 (35%) 53 (43%) 21 (17%) 27%

Technician 64 13 (20%) 25 (39%) 34 (53%) 23 (36%) 16 (25%) 35%

Supervisor 21 8 (38%) 6 (29%) 10 (48%) 5 (24%) 5 (24%) 33%

Student 19 0 (0%) 1 (5%) 2 (11%) 0 (0%) 0 (0%) 3%

Maintenance 55 0 (0%) 2 (4%) 2 (4%) 19 (35%) 9 (16%) 9%

Veterinarian 20 3 (15%) 9 (45%) 5 (25%) 5 (25%) 3 (15%) 25%

Researcher 1 0 (0%) 0 (0%) 0 (0%) 0 (0%) 0 (0%) 0%

Visiting Scientist 3 0 (0%) 1 (33%) 0 (0%) 0 (0%) 0 (0%) 0%

Colony Manager 6 0 (0%) 0 (0%) 2 (33%) 1 (17%) 0 (0%) 0%

Laboratorian 67 1 (2%) 4 (6%) 4 (6%) 9 (13%) 3 (5%) 6%

Other 91 4 (4%) 11 (12%) 26 (29%) 20 (22%) 12 (13%) 16%

Total 469 63 (13%) 72 (15%) 128 (27%) 135 (29%) 69 (15%) 20%
Health Hazard Evaluation Report 2001-0273; 2001-0274; 2001-0275; 2001-0407-3091 Page 17

Results (continued

At the UL New Iberia facility:

● Employees reporting daily work with NHPs had a higher 

prevalence of all five incidents compared to those working 

with NHPs weekly or less, although the differences were not 

statistically significant. 

● Persons reporting all incidents (except being scratched/

cut by dirty NHP equipment) in the 5 years prior to the 

survey had spent more time working with NHPs than those 

not reporting bites. For example, those reporting bites had 

worked at the facility a median of 6 years compared to those 

not reporting bites who had worked a median of 3 years 

(p = 0.005).

Specific work tasks were evaluated at this facility as potential 

exposures or risk factors for these five types of incidents; these 

analyses are presented in Table 12. All work tasks were associated 

with an increased prevalence of at least one of the five incidents. 

Working with awake/alert NHPs (versus sedated/anesthetized 

NHPs) by itself was not associated with an increased prevalence of 

any of the five incidents.

Table 11. Prevalence Ratios and 95% Confidence Intervals for Associations 

Between Work Tasks and Incidents

California Regional Primate Research Center at the University of California, Davis, California

Task

Incident

Bitten by NHP Scratched by 

NHP Stuck by needle

Scratched/

cut by dirty 

equipment

Splashed in eyes, 

mouth, nose with 

secretions

PR1 95% CI2 PR 95% CI PR 95% CI PR 95% CI PR 95% CI

Feeding 6.8 2.1–22.4 3.7 1.9–7.0 1.0 0.4–2.4 1.4 0.8–2.4 1.9 0.6–5.7

Drawing blood 4.8 2.0–11.3 3.6 2.1–6.0 4.3 1.8–10.5 1.7 1.0–3.0 4.2 1.4–12.5

Handling NHP 6.4 1.9–21.2 3.0 1.6–5.6 3.1 1.1–8.3 1.1 0.7–2.0 3.9 1.1–13.6

Handling tissues 

 or fluids

1.5 0.5–4.3 2.2 1.0–4.9 6.8 0.9–49.3 0.8 0.4–1.3 0.9 0.3–2.7

Making behavior 

 observations

1.3 0.5–3.1 2.7 1.6–4.6 0.9 0.3–2.3 2.0 1.2–3.5 2.0 0.7–6.0

Cleaning cages 2.5 1.1–6.0 1.7 1.0–3.0 0.1 0.02–0.9 2.3 1.3–4.0 1.0 0.3–3.2

Giving injections 6.3 2.2–18.0 2.6 1.5–4.6 3.3 1.3–8.4 2.2 1.3–3.9 3.6 1.1–11.3

Bold text represents statistically significant findings

1

 PR = prevalence ratio

2

 CI = 95% Confidence Interval
 Page 18 Health Hazard Evaluation Report 2001-0273; 2001-0274; 2001-0275; 2001-0407-3091 

Results (continued

At the SW Foundation facility:

● Employees reporting daily work with NHPs had a statistically 

significantly higher prevalence of being scratched by an NHP 

compared to those working with NHPs weekly or less. 

● No statistically significant relationships were found between 

the length of time working with NHPs and the number of 

incidents reported.

Specific work tasks were evaluated at the SW Foundation facility 

as potential exposures or risk factors for the five types of incidents 

on which information was gathered in the questionnaire; these 

analyses are presented in Table 13. All tasks except handling tissues 

or fluids were associated with an increased prevalence of at least 

one of the five incidents. Working with awake/alert NHPs (versus 

sedated/anesthetized NHPs) by itself was not associated with a 

statistically significantly increased prevalence of any of the five 

incidents.

Table 12. Prevalence Ratios and 95% Confidence Intervals for Associations 

Between Work Tasks and Incidents

University of Louisiana at Lafayette, New Iberia, Louisiana

Task

Incident

Bitten by NHP Scratched by 

NHP

Stuck by 

needle

Scratched/cut by 

dirty equipment

Splashed in eyes, 

mouth, nose with 

secretions

PR1 95% CI2 PR 95% CI PR 95% CI PR 95% CI PR 95% CI

Feeding 2.6 1.0–6.7 1.8 1.0–3.0 0.8 0.4–1.8 1.9 1.2–3.1 0.9 0.4–2.2

Drawing blood 0.7 0.3–1.8 1.5 0.9–2.4 3.3 1.5–7.2 0.9 0.5–1.5 2.6 1.1–6.2

Handling NHP 5.3 1.6–17.3 3.7 1.8–7.4 2.4 1.0–6.0 2.1 1.3–3.4 1.6 0.6–4.2

Handling tissues 

 or fluids 1.4 0.6–3.0 1.3 0.8–2.2 2.8 1.2–6.7 1.0 0.6–1.5 1.9 0.7–4.8

Making behavior

 observations 0.9 0.4–2.1 1.7 1.0–2.8 1.8 0.8–3.8 1.8 1.2–2.8 1.2 0.5–2.9

Cleaning cages 2.5 1.0–6.1 1.7 1.0–3.0 0.7 0.3–1.5 1.9 1.2–3.1 0.9 0.4–2.2

Giving injections 1.0 0.4–2.4 1.6 1.0–2.8 3.0 1.4–6.5 0.9 0.5–1.4 3.0 1.2–7.2

Bold text represents statistically significant findings

1

 PR = prevalence ratio

 2 CI = 95% Confidence Interval
Health Hazard Evaluation Report 2001-0273; 2001-0274; 2001-0275; 2001-0407-3091 Page 19

Results (continued

At the Tulane facility:

● Employees reporting daily work with NHPs had a statistically 

significantly higher prevalence of three of the five incidents 

(NHP bite, NHP scratch, and scratched/cut by dirty NHP 

equipment) compared to those working with NHPs weekly or 

less. 

● Persons reporting bites in the 5 years prior to the survey had 

spent more time working with NHPs (median: 15 years) than 

those not reporting bites (median 7 years; p< 0.01).

Specific work tasks were evaluated at the Tulane facility as potential 

exposures or risk factors for the five types of incidents on which 

information was gathered in the questionnaire; these analyses are 

presented in Table 14. All tasks except handling tissues or fluids 

were associated with an increased prevalence of at least one of the 

five incidents. Working with awake/alert NHPs (versus sedated/

anesthetized NHPs) by itself was associated with an increased 

prevalence of being scratched by an NHP (PR 13.8; 95% CI 2.0-97).

Table 13. Prevalence Ratios and 95% Confidence Intervals for Associations 

Between Work Tasks and Incidents

SW Foundation Regional Primate Research Center in San Antonio, Texas

Task

Incident

Bitten by NHP Scratched by 

NHP Stuck by needle

Scratched/

cut by dirty 

equipment

Splashed in eyes, 

mouth, nose with 

secretions

PR1 95% CI2 PR 95% CI PR 95% CI PR 95% CI PR 95% CI

Feeding 6.0 1.5–23.8 2.4 1.1–5.1 1.4 0.6–3.6 2.5 0.9–6.6 0.8 0.5–1.4

Drawing blood 1.4 0.7–2.7 2.1 1.2–3.6 5.7 2.1–15.8 1.4 0.7–2.8 0.9 0.5–1.5

Handling NHP 1.4 0.7–3.0 2.1 1.0–4.2 4.6 1.1–18.8 1.5 0.7–3.5 1.0 0.6–1.7

Handling tissues 

m or fluids

1.0 0.5–2.0 1.7 1.0–3.0 2.7 1.0–6.8 1.0 0.5–2.1 0.7 0.4–1.2

Making behavior 

m observations

1.5 0.8–3.1 1.2 0.7–2.0 0.9 0.4–2.1 0.9 0.5–1.9 1.1 0.6–1.8

Cleaning cages 2.3 1.0–5.1 1.7 0.9–3.0 1.5 0.6–3.6 2.6 1.1–6.3 0.9 0.5–1.5

Giving injections 1.3 0.6–2.4 2.1 1.2–3.7 6.3 2.0–20.0 1.5 0.7–3.1 0.9 0.5–1.5

Bold text represents statistically significant findings

1

 PR = prevalence ratio 

2

 CI = 95% Confidence Interval 
 Page 20 Health Hazard Evaluation Report 2001-0273; 2001-0274; 2001-0275; 2001-0407-3091 

Discussion & Conclus

(continued

We assessed the extent to which workers were educated concerning 

possible occupational health risks related to various types of 

exposures, which we termed “knowledge of infectious disease 

exposure or health risks.” In this assessment, we found that in 

situations that clearly represented potential infectious disease risks 

(such as NHP bites that break the skin), there was near 100% 

recognition of the potential for infectious disease exposure at the 

California Regional Primate Research Center, and the University 

of Louisiana. SW Foundation Regional Primate Research Center 

and Tulane Regional Primate Research Center employees reported 

a lesser degree of recognition of these clear health risks, indicating 

a need for additional training. Other types of incidents (NHP bites 

that do not break the skin, needle puncture with a clean needle, 

scratch from clean equipment, or NHP secretions splashed onto 

Discussion & Conclus

Table 14. Prevalence Ratios and 95% Confidence Intervals for Associations 

Between Work Tasks and Incidents

Tulane Regional Primate Research Center, Covington, Louisiana

Task

Incident

Bitten by NHP Scratched by 

NHP Stuck by needle

Scratched/

cut by dirty 

equipment

Splashed in 

eyes, mouth, 

nose with 

secretions

PR1 95% CI2 PR 95% CI PR 95% CI PR 95% CI PR 95% CI

Feeding Undefined p<0.001 4.8 2.0–1.5 2.2 0.9–5.3 1.9 1.0–3.6 0.7 0.2–3.4

Drawing blood 12.2 1.5–95.5 3.8 1.5–9.2 7.4 2.2–24.6 2.0 1.0–4.0 1.0 0.3–4.1

Handling NHP 3.0 0.8–12.0 3.9 1.6–9.5 4.0 1.5–10.9 2.1 1.1–4.1 1.8 0.5–6.8

Handling tissues

 or fluids

0.5 0.1–1.9 1.9 0.6–5.2 3.5 0.8–14.6 2.1 0.8–5.1 1.5 0.3–7.0

Making behavior 

 observations

3.0 0.8–11.1 4.1 1.8–9.1 2.3 0.9–5.6 2.2 1.1–4.2 1.0 0.2–4.6

Cleaning cages 8.9 1.9–41.7 2.7 1.2–5.9 1.3 0.5–3.5 1.6 0.8–3.1 0.4 0.1–3.3

Giving injections 15.4 2.0–120.3 3.0 1.3–6.9 2.8 1.1–6.9 1.9 1.0–3.6 0.7 0.2–3.4

Bold text represents statistically significant findings

1

 PR = prevalence ratio. In cases where the PR is undefined (0 cell), Fisher’s exact test was used to determine the p value.

2

CI = 95% Confidence Interval. In cases where the PR is undefined (0 cell), Fisher’s exact test was used to determine the p 

value.
Health Hazard Evaluation Report 2001-0273; 2001-0274; 2001-0275; 2001-0407-3091 Page 21

Discussion & Conclus

(continued

skin) showed a much lower degree of recognition. Being stuck 

with a clean needle was the least recognized by veterinarians (39%) 

and technicians (38%). When these incidents were analyzed as 

dependent variables to determine if they were associated with other 

characteristics of the participant or the participants’ work/training 

history, significant associations were found between two outcomes 

and a lack of training. Although these four types of incidents may 

not, by themselves, represent an infectious disease risk they could 

represent a deficiency in the safety and health practice of the 

facility that might in other circumstances lead to increased risk of 

infectious disease exposure. For example, a needle puncture with a 

sterile needle (not likely to represent an increased risk of infectious 

disease transmission from the needle) might also easily have been 

a puncture with a dirty needle. This type of event may represent 

a deficiency in work practices, education, or some other factor(s); 

the same principle may hold for the other three events noted above 

(bites not breaking skin, NHP secretions splashed onto intact 

skin, and scratch from clean equipment). Recognition (by those 

responsible for health and safety at the NHP facility) that these 

events are occurring depends on some mechanism for reporting 

these events. Recognition of these events is important so that 

measures can be instituted to minimize their occurrence.

In our questionnaire we asked participants to report work tasks 

that they perform at least once per week. Our univariate (single 

variable) analyses show that many of the work tasks are identified 

with increased prevalence of incidents such as being bitten by an 

NHP. These findings make sense, and call for continued review of 

work practices to minimize incidents that may be associated with 

infectious disease transmission.

Our analysis of the occurrence of potential exposure incidents 

by job title shows that most groups of employees have reported 

exposure incidents, but that there is some variability across job 

groups. Therefore, although all employees should be included in 

appropriate training/education activities, more specific training/

education activities (and perhaps training/education at increased 

frequency) might be focused on those employees with more direct 

contact with NHPs (such as caretakers). On a percentage basis, 

being splashed in the eyes, mouth, or nose with NHP secretions 

was the type of incident most commonly not reported to the 

supervisor (28 of 69 incidents not reported, 41%—the type of 
 Page 22 Health Hazard Evaluation Report 2001-0273; 2001-0274; 2001-0275; 2001-0407-3091 

Discussion & Conclus

(continued) exposure that resulted in the death of Ms. Griffin). In terms of

total numbers, being scratched by an NHP was the most common 

incident not reported (39 of 129 incidents not reported). The most 

common choice addressing why the incident was not reported was 

“did not think it serious enough to report,” chosen by 55 (73%). 

Among all 469 respondents, 17 (4%) reported that they were 

reluctant/afraid to report injuries or exposures to supervisors. 

Although a small percentage, this is an important deficiency to 

correct.

Our analyses are subject to at least three limitations. First, no 

determination of which of the work tasks might be the most 

important (relative to the others) in terms of infectious disease 

risk was performed in the evaluation. Additionally, persons who 

perform one work task (such as drawing blood) may also routinely 

perform a second work task (such as giving injections). Our 

analyses did not take these interrelationships into account. Lastly, 

we do not know the extent to which the participants in our surveys 

were representative of all employees at each facility.

The following recommendations are provided to reduce infectious 

disease risks among employees working with NHPs. These 

recommendations were based on conditions at the facilities at the 

time of our evaluations in 2001.

1. Determine which employees, or employee groups, have 

the most direct contact with NHPs, and focus training/

education activities on these groups.

2. Revise the training curriculum to include use of bite and 

scratch kits and respiratory protection.

3. Emphasize recognition of infectious disease potential during 

training.

4. Establish a mechanism for continued review of work 

practices to identify those that lead to potential exposure 

incidents.

5. Establish and actively maintain a mechanism for reporting 

exposure incidents. 

6. Ensure that all managers are aware of the reporting 

mechanism and that they encourage its use among their 

employees.

Recommendatio
Health Hazard Evaluation Report 2001-0273; 2001-0274; 2001-0275; 2001-0407-3091 Page 23

Recommendatio

(continued) 7. Reassure employees that there will be no penalty for

reporting incidents.

8. Make bite and scratch kits readily available to employees.

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Academy Press.

6. NRC [2003]. Occupational health and safety in the care and 

use of non-human primates. Washington, D.C.: National 

Research Council, National Academy of Sciences, National 

Academy Press.

7. Cohen JI, Davenport DS, Stewart JA, Deitchman S, Hilliard 

JK, Chapman LE, and the B Virus Working Group [2002]. 

Recommendations for prevention of and therapy for 

exposure to B virus (Cercopithecine Herpesvirus 1). Clin 

Infect Dis 35:1191–1203.

Referenc
 Page 24 Health Hazard Evaluation Report 2001-0273; 2001-0274; 2001-0275; 2001-0407-3091 

Reference  (continued) 8. DHHS [1993]. Biosafety in microbiological and biomedic

laboratories. 3rd. Ed. Washington, D.C.: U.S. Department 

of Health and Human Services, DHHS Publication No. 

(CDC) 93-8395. 

9. OSHA [1995]. OSHA Industrial Hygiene Technical Manual. 

Section VII Chapter 1 - Chemical Protective Clothing. 

OSHA Instruction TED 1.15.

10. Mansdorf SZ, Henry NW [1997]. Personal protective 

clothing. In: DiNardi SR, ed. The occupational 

environment: its evaluation, control, and management. 

Second edition. Fairfax, VA: AIHA Press.

11. ANSI [1989]. Practice for occupational and educational eye 

and face protection, Z87-1.1989. Des Plaines, IL: American 

Society of Safety Engineers.
Health Hazard Evaluation Report 2001-0273; 2001-0274; 2001-0275; 2001-0407-3091 Page 25

Table A1. Knowledge of Potential Risk, by Type of Incident

California Regional Primate Research Center at the University of California, Davis, California

Incident # (%) Reporting incident to be infectious disease

risk that would need to be reported

NHP secretions on skin 59 (43%)

NHP secretions on cut, abrasion, or other wound 134 (98%)

NHP secretions in mouth or nose 135 (99%)

NHP secretions in eye 133 (97%)

Puncture by dirty needle 134 (98%)

Puncture by clean needle 35 (26%)

NHP bite breaking skin 135 (99%)

NHP bite not breaking skin 82 (60%)

Scratch with dirty equipment 132 (96%)

Scratch with clean equipment 63 (46%)

Table A2. Relationship Between Knowledge of Potential Risk of Puncture by a Clean Needle and Receipt 

of Refresher Safety and Health Training

California Regional Primate Research Center at the University of California, Davis, California

Refresher Training

Puncture with clean needle as a health risk

Not considered as a risk Considered as a risk Total

Without training 34 14 48

With training 68 21 89

Total 102 35

Prevalence Ratio = 0.9; 95% Confidence Interval 0.7 – 1.1

Appendix: Tab
 Page 26 Health Hazard Evaluation Report 2001-0273; 2001-0274; 2001-0275; 2001-0407-3091 

Appendix: Tabl   (contin

Table A3. Knowledge of Potential Risk by Job Title

California Regional Primate Research Center at the University of California, Davis, California

Job #

# (%) Reporting incident to be infectious disease risk that would need to be reported

Bite1 Needle Stick2 Scratch with clean 

equipment3 Exposure to secretions4

Caretaker 28 15 (54%) 8 (29%) 14 (50%) 14 (50%)

Technician 8 2 (25%) 0 (0%) 0 (0%) 2 (25%)

Supervisor 2 2 (100%) 0 (0%) 1 (50%) 0 (0%)

Student 9 6 (67%) 2 (22%) 5 (56%) 6 (67%)

Maintenance 5 2 (40%) 2 (40%) 2 (40%) 1 (20%)

Veterinarian 7 3 (43%) 0 (0%) 1 (14%) 0 (0%)

Visiting Scientist 1 0 (0%) 0 (0%) 1 (100%) 0 (0%)

Colony Manager 3 2 (67%) 2 (67%) 2 (67%) 0 (0%)

Laboratorian 34 29 (85%) 13 (38%) 16 (47%) 21 (62%)

Other 40 21 (53%) 7 (18%) 21 (53%) 15 (38%)

Positive responses for “Knowledge of potential risk” are indicated by the respondent reporting affirmatively that: 

1

 NHP bites that do not break the skin are exposures/health risks that would need to be reported.

2

 Punctures with a clean needle are infectious disease exposures or health risks that would need to be reported.

3

 The scratch or cut from clean animal equipment is an infectious disease exposures or health risks that would need to be 

reported.

4

 Exposures to NHP secretions (saliva, blood, urine, feces) splashed onto skin are infectious disease exposures or health 

risks that would need to be reported.

Table A4. Reported Incidents Occurring in the 5 Years Prior to the Survey 

While Working with NHPs

California Regional Primate Research Center at the University of California, Davis, California

Incident

# (%) employees 

reporting incident 

occurring in the 

last 5 years

Among those reporting incident

Median (range) of 

# times incident 

occurred

Number (%)1 reporting 

that not all incidents 

reported to supervisor

Bitten by NHP 18 (13%) 1 (1–3) 0 (0%)

Scratched by NHP 37 (27%) 2 (1–10) 18 (49%)

Needle stick 17 (12%) 1 (0–6) 4 (21%)

Scratched/cut by dirty equipment 36 (26%) 2 (1–6) 12 (33%)

Splashed in eyes, mouth, or nose

 with NHP secretions

12 (9%) 1 (1) 1 (8%)

1

 Among those experiencing an incident, percentage who stated that they had not reported at least one of these incidents 

to a supervisor.
Health Hazard Evaluation Report 2001-0273; 2001-0274; 2001-0275; 2001-0407-3091 Page 27

Appendix: Tabl   (contin

Table A5. Occurrence of Incidents by Job Title

California Regional Primate Research Center at the University of California, Davis, California

Job #

# (%) employees reporting incident occurring in the last 5 years

Bitten, 

resulting in 

broken skin

Needle 

stick

Scratched 

by NHP

Scratched/

cut by dirty 

equipment

Splashed in eyes, 

nose, or mouth with 

NHP secretions

Caretaker 28 8 (29%) 1 (4%) 10 (36%) 14 (50%) 5 (18%)

Technician 8 2 (25%) 4 (50%) 5 (63%) 2 (25%) 3 (38%)

Supervisor 2 1 (50%) 0 (0%) 1 (50%) 0 (0%) 0 (0%)

Student 9 0 (0%) 1 (11%) 1 (11%) 0 (0%) 0 (0%)

Maintenance 5 0 (0%) 0 (0%) 1 (20%) 5 (100%) 1 (20%)

Veterinarian 7 2 (29%) 3 (43%) 2 (29%) 2 (29%) 2 (29%)

Visiting Scientist 1 0 (0%) 1 (100%) 0 (0%) 0 (0%) 0 (0%)

Colony Manager 3 0 (0%) 0 (0%) 0 (0%) 0 (0%) 0 (0%)

Laboratorian 34 1 (3%) 2 (6%) 3 (9%) 6 (18%) 1 (3%)

Other 40 4 (10%) 5 (13%) 14 (35%) 7 (18%) 0 (0%)

Table A6. Prevalence Ratios and 95% Confidence Intervals for Associations 

Between Work Tasks and Incidents

California Regional Primate Research Center at the University of California, Davis, California

Task

Incident

Bitten by NHP Scratched by 

NHP Stuck by needle

Scratched/

cut by dirty 

equipment

Splashed in eyes, 

nose or mouth 

with secretions

PR1 95% CI2 PR 95% CI PR 95% CI PR 95% CI PR 95% CI

Feeding 6.8 2.1–22.4 3.7 1.9–7.0 1.0 0.4–2.4 1.4 0.8–2.4 1.9 0.6–5.7

Drawing blood 4.8 2.0–11.3 3.6 2.1–6.0 4.3 1.8–10.5 1.7 1.0–3.0 4.2 1.4–12.5

Handling NHP 6.4 1.9–21.2 3.0 1.6–5.6 3.1 1.1–8.3 1.1 0.7–2.0 3.9 1.1–13.6

Handling tissues

 or fluids

1.5 0.5–4.3 2.2 1.0–4.9 6.8 0.9–49.3 0.8 0.4–1.3 0.9 0.3–2.7

Making behavior 

 observations

1.3 0.5–3.1 2.7 1.6–4.6 0.9 0.3–2.3 2.0 1.2–3.5 2.0 0.7–6.0

Cleaning cages 2.5 1.1–6.0 1.7 1.0–3.0 0.1 0.02–0.9 2.3 1.3–4.0 1.0 0.3–3.2

Giving injections 6.3 2.2–18.0 2.6 1.5–4.6 3.3 1.3–8.4 2.2 1.3–3.9 3.6 1.1–11.3

Bold text represents statistically significant findings

1

 PR = prevalence ratio

2

 CI = 95% Confidence Interval
 Page 28 Health Hazard Evaluation Report 2001-0273; 2001-0274; 2001-0275; 2001-0407-3091 

Appendix: Tabl   (contin

Table A7. Knowledge of Potential Risk by Type of Incident

University of Louisiana at Lafayette, New Iberia, Louisiana

Incident # (%) Reporting incident to be infectious disease 

risk which would need to be reported

NHP secretions splashed on skin 68 (49%)

NHP secretions splashed on cut, abrasion, or other wound 135 (97%)

NHP secretions splashed in mouth or nose 132 (95%)

NHP secretions splashed in eye 133 (96%)

Puncture by dirty needle 133 (96%)

Puncture by clean needle 76 (55%)

NHP bite breaking skin 132 (95%)

NHP bite not breaking skin 96 (69%)

Scratch with dirty equipment 132 (95%)

Scratch with clean equipment 103 (74%)

Table A8. Relationship between Knowledge of Potential Risk of Puncture by a Clean Needle and Receipt 

of Refresher Safety and Health Training

University of Louisiana at Lafayette, New Iberia, Louisiana

Training on NHP-related infectious disease 

risks prior to working with NHP

Puncture with clean needle as a health risk

Not considered as a risk Considered as a risk Total

Without training 6 3 9

With training 35 81 116

Total 41 84

Prevalence Ratio = 2.2; 95% Confidence Interval 1.3 – 3.8
Health Hazard Evaluation Report 2001-0273; 2001-0274; 2001-0275; 2001-0407-3091 Page 29

Appendix: Tabl   (contin

Table A9. Knowledge of Potential Risk by Job Title

University of Louisiana at Lafayette, New Iberia, Louisiana

Job #

# (%) Reporting incident to be infectious disease risk that would need to be reported

Bite1 Needle 

stick2

Scratch with clean 

equipment3 Exposure to secretions4

Caretaker 61 35 (57%) 26 (43%) 43 (70%) 26 (42%)

Technician 12 9 (75%) 7 (58%) 8 (67%) 3 (25%)

Supervisor 10 6 (60%) 3 (30%) 5 (50%) 5 (50%)

Student 9 6 (67%) 9 (100%) 9 (100%) 4 (44%)

Maintenance 20 19 (95%) 18 (90%) 19 (95%) 17 (85%)

Veterinarian 3 2 (67%) 2 (67%) 3 (100%) 0 (0%)

Researcher 1 0 (0%) 1 (100%) 0 (0%) 1 (100%)

Colony Manager 1 (100%) 1 (100%) 0 (0%) 0 (0%)

Other 21 17 (81%) 9 (43%) 15 (71%) 11 (52%)

Positive responses for “Knowledge of potential risk” are indicated by the respondent reporting affirmatively that: 

1

 NHP bites that do not break the skin are exposures/health risks that would need to be reported.

2

 Punctures with a clean needle are infectious disease exposures or health risks that would need to be reported.

3

 The scratch or cut from clean animal equipment is an infectious disease exposures or health risks that would need to be 

reported.

4

 Exposures to NHP secretions (saliva, blood, urine, feces) splashed onto skin are infectious disease exposures or health 

risks that would need to be reported.

Table A10. Reported Incidents Occurring in the 5 Years Prior to the Survey 

While Working with NHPs

University of Louisiana at Lafayette, New Iberia, Louisiana

Incident

# (%) employees 

reporting incident 

occurring in the 

last 5 years

Among those reporting incident

Median (range) of 

# times incident 

occurred

Number (%)1 reporting 

that not all incidents 

reported to supervisor

Bitten by NHP 21 (15%) 1 (1–10) 2 (10%)

Scratched by NHP 41 (30%) 2 (1–15) 7 (18%)

Needle stick 22 (16%) 1 (1–9) 2 (9%)

Scratched/cut by dirty equipment 50 (36%) 1 (1–10) 9 (20%)

Splashed in eyes, mouth, or nose 

 with NHP secretions

17 (12%) 2 (1–5) 7 (37%)

1

 Percentage among those experiencing an incident who stated that they had not reported at least one of these incidents to a 

supervisor.
 Page 30 Health Hazard Evaluation Report 2001-0273; 2001-0274; 2001-0275; 2001-0407-3091 

Appendix: Tabl   (contin

Table A11. Occurrence of Incidents by Job Title

University of Louisiana at Lafayette, New Iberia, Louisiana

Job #

# (%) employees reporting incident occurring in the last 5 years

Bitten, 

resulting in 

broken skin

Needle 

stick

Scratched 

by NHP

Scratched/

cut by dirty 

equipment

Splashed in eyes, 

nose, or mouth with 

NHP secretions

Caretaker 61 14 (23%) 7 (11%) 21 (34%) 30 (49%) 7 (11%)

Technician 12 1 (8%) 5 (42%) 6 (50%) 4 (33%) 3 (25%)

Supervisor 10 3 (30%) 3 (30%) 6 (60%) 3 (30%) 4 (40%)

Student 9 0 (0%) 0 (0%) 1 (11%) 0 (0%) 0 (0%)

Maintenance 20 0 (0%) 1 (5%) 1 (5%) 5 (26%) 1 (5%)

Veterinarian 3 1 (33%) 3 (100%) 2 (67%) 2 (67%) 0 (0%)

Researcher 1 0 (0%) 0 (0%) 0 (0%) 0 (0%) 0 (0%)

Colony Manager 1 0 (0%) 0 (0%) 0 (0%) 0 (0%) 0 (0%)

Other 21 2 (10%) 2 (10%) 4 (19%) 6 (29%) 2 (10%)

Table A12. Prevalence Ratios and 95% Confidence Intervals for Associations 

Between Work Tasks and Incidents

University of Louisiana at Lafayette, New Iberia, Louisiana

Task

Incident

Bitten by NHP Scratched by 

NHP

Stuck by 

needle

Scratched/cut by 

dirty equipment

Splashed in eyes, 

mouth, nose with 

secretions

PR1 95% CI2 PR 95% CI PR 95% CI PR 95% CI PR 95% CI

Feeding 2.6 1.0–6.7 1.8 1.0–3.0 0.8 0.4–1.8 1.9 1.2–3.1 0.9 0.4–2.2

Drawing blood 0.7 0.3–1.8 1.5 0.9–2.4 3.3 1.5–7.2 0.9 0.5–1.5 2.6 1.1–6.2

Handling NHP 5.3 1.6–17.3 3.7 1.8–7.4 2.4 1.0–6.0 2.1 1.3–3.4 1.6 0.6–4.2

Handling tissues

 or fluids

1.4 0.6–3.0 1.3 0.8–2.2 2.8 1.2–6.7 1.0 0.6–1.5 1.9 0.7–4.8

Making behavior 

 observations

0.9 0.4–2.1 1.7 1.0–2.8 1.8 0.8–3.8 1.8 1.2–2.8 1.2 0.5–2.9

Cleaning cages 2.5 1.0–6.1 1.7 1.0–3.0 0.7 0.3–1.5 1.9 1.2–3.1 0.9 0.4–2.2

Giving injections 1.0 0.4–2.4 1.6 1.0–2.8 3.0 1.4–6.5 0.9 0.5–1.4 3.0 1.2–7.2

Bold text represents statistically significant findings

1

 PR = prevalence ratio

2

 CI = 95% Confidence Interval
Health Hazard Evaluation Report 2001-0273; 2001-0274; 2001-0275; 2001-0407-3091 Page 31

Appendix: Tabl   (contin

Table A13. Knowledge of Potential Risk by Type of Incident

SW Foundation Regional Primate Research Center in San Antonio, Texas

Incident # (%) Reporting incident to be infectious disease 

risk which would need to be reported

NHP secretions on skin 38 (48%)

NHP secretions on cut, abrasion, or other wound 68 (86%)

NHP secretions in mouth or nose 69 (87%)

NHP secretions in eye 70 (89%)

Puncture by dirty needle 68 (86%)

Puncture by clean needle 27 (34%)

NHP bite breaking skin 72 (91%)

NHP bite not breaking skin 40 (51%)

Scratch with dirty equipment 70 (89%)

Scratch with clean equipment 41 (52%)

Table A14. Relationship between Receipt of NHP-related Infectious Disease Training and Knowledge of 

Potential Risk of NHP Secretions Splashed Onto Skin

SW Foundation Regional Primate Research Center in San Antonio, Texas

Training on infectious disease risks 

from NHPs experimentally infected

NHP secretions splashed onto skin as an infectious disease 

exposure or health risk

Not considered as a risk Considered as a risk Total

Without training 8 9 17

With training 33 29 62

Total 41 38

Prevalence Ratio = 0.9; 95% Confidence Interval 0.5 – 1.5
 Page 32 Health Hazard Evaluation Report 2001-0273; 2001-0274; 2001-0275; 2001-0407-3091 

Appendix: Tabl   (contin

Table A15. Knowledge of Potential Risk by Job Title

SW Foundation Regional Primate Research Center in San Antonio, Texas

Job #

# (%) Reporting incident to be infectious disease risk that would need to be reported

Bite1 Needle stick2 Scratch with clean 

equipment3 Exposure to secretions4

Caretaker 26 15 (58%) 9 (35%) 15(58%) 14 (54%)

Technician 18 6 (33%) 6 (33%) 8 (44%) 9 (50%)

Supervisor 5 0 (0%) 0 (0%) 3 (60%) 1 (20%)

Maintenance 11 8 (73%) 5 (45%) 6 (55%) 6 (55%)

Veterinarian 3 0 (0%) 2 (67%) 2 (67%) 1 (33%)

Laboratorian 4 3 (75%) 2 (50%) 2 (50%) 2 (50%)

Other 11 5 (45%) 3 (27%) 4 (36%) 8 (73%)

Positive responses for “Knowledge of potential risk” are indicated by the respondent reporting affirmatively that: 

1

 NHP bites that do not break the skin are exposures/health risks that would need to be reported.

2

 Punctures with a clean needle are infectious disease exposures or health risks that would need to be reported.

3

 The scratch or cut from clean animal equipment is an infectious disease exposures or health risks that would need to be 

reported.

4

 Exposures to NHP secretions (saliva, blood, urine, feces) splashed onto skin are infectious disease exposures or health 

risks that would need to be reported.

Table A16. Reported Incidents Occurring in the 5 Years Prior to the Survey 

While Working with NHPs

SW Foundation Regional Primate Research Center in San Antonio, Texas

Incident

# (%) employees 

reporting incident 

occurring in the 

last 5 years

Among those reporting incident

Median (range) of 

# times incident 

occurred

Number (%)1 reporting

that not all incidents 

reported to supervisor

Bitten by NHP 24 (30%) 1 (1–6) 4 (17%)

Scratched by NHP 32 (41%) 4 (1–30) 13 (41%)

Needle stick 18 (23%) 1.5 (1–5) 5 (28%)

Scratched/cut by dirty equipment 22 (28%) 2 (1–10) 9 (41%)

Splashed in eyes, mouth, or nose 

 with NHP secretions

32 (41%) 2.5 (1–9) 18 (56%)

1 Percentage among those experiencing an incident who stated that they had not reported at least one of these incidents to a 

supervisor.
Health Hazard Evaluation Report 2001-0273; 2001-0274; 2001-0275; 2001-0407-3091 Page 33

Appendix: Tabl   (contin

Table A17. Occurrence of Incidents by Job Title

SW Foundation Regional Primate Research Center in San Antonio, Texas

Job #

# (%) employees reporting incident occurring in the last 5 years

Bitten, 

resulting in 

broken skin

Needle 

stick

Scratched 

by NHP

Scratched/

cut by dirty 

equipment

Splashed in eyes, 

nose, or mouth with 

NHP secretions

Caretaker 26 12(46%) 4 (15%) 10 (38%) 8 (31%) 9 (35%)

Technician 18 5 (28%) 10 (56%) 12 (67%) 6 (33%) 8 (44%)

Supervisor 5 2 (40%) 2 (40%) 2 (40%) 1 (20%) 1 (20%)

Maintenance 11 0 (0%) 0 (0%) 0 (0%) 4 (36%) 5 (45%)

Veterinarian 3 0 (0%) 0 (0%) 1 (33%) 0 (0%) 1 (33%)

Laboratorian 4 0 (0%) 0 (0%) 0 (0%) 0 (0%) 0 (0%)

Other 11 4 (36%) 2 (18%) 6 (55%) 3 (27%) 8 (73%)

Table A18. Prevalence Ratios and 95% Confidence Intervals for Associations 

Between Work Tasks and Incidents

SW Foundation Regional Primate Research Center in San Antonio, Texas

Task

Incident

Bitten by NHP Scratched by 

NHP Stuck by needle

Scratched/

cut by dirty 

equipment

Splashed in eyes, 

mouth, nose with 

secretions

PR1 95% CI2 PR 95% CI PR 95% CI PR 95% CI PR 95% CI

Feeding 6.0 1.5–23.8 2.4 1.1–5.1 1.4 0.6–3.6 2.5 0.9–6.6 0.8 0.5–1.4

Drawing blood 1.4 0.7–2.7 2.1 1.2–3.6 5.7 2.1–15.8 1.4 0.7–2.8 0.9 0.5–1.5

Handling NHP 1.4 0.7–3.0 2.1 1.0–4.2 4.6 1.1–18.8 1.5 0.7–3.5 1.0 0.6–1.7

Handling tissues 

 or fluids

1.0 0.5–2.0 1.7 1.0–3.0 2.7 1.0–6.8 1.0 0.5–2.1 0.7 0.4–1.2

Making behavior

 observations

1.5 0.8–3.1 1.2 0.7–2.0 0.9 0.4–2.1 0.9 0.5–1.9 1.1 0.6–1.8

Cleaning cages 2.3 1.0–5.1 1.7 0.9–3.0 1.5 0.6–3.6 2.6 1.1–6.3 0.9 0.5–1.5

Giving injections 1.3 0.6–2.4 2.1 1.2–3.7 6.3 2.0–20.0 1.5 0.7–3.1 0.9 0.5–1.5

Bold text represents statistically significant findings

1

 PR = prevalence ratio 

2

 CI = 95% Confidence Interval 
 Page 34 Health Hazard Evaluation Report 2001-0273; 2001-0274; 2001-0275; 2001-0407-3091 

Appendix: Tabl   (contin

Table A19. Knowledge of Potential Risk by Type of Incident

Tulane Regional Primate Research Center, Covington, Louisiana

Incident # (%) Reporting incident to be infectious disease 

risk which would need to be reported

NHP secretions on skin 73 (63%)

NHP secretions on cut, abrasion, or other wound 108 (93%)

NHP secretions in mouth or nose 105 (91%)

NHP secretions in eye 104 (90%)

Puncture by dirty needle 105 (91%)

Puncture by clean needle 32 (28%)

NHP bite breaking skin 105 (91%)

NHP bite not breaking skin 67 (58%)

Scratch with dirty equipment 109 (94%)

Scratch with clean equipment 52 (45%)

Table A20. Relationship between Receipt of NHP-related Infectious Disease Training and Knowledge of 

Potential Risk of NHP Secretions Splashed onto Skin

Tulane Regional Primate Research Center, Covington, Louisiana

Training on infectious disease risks from 

NHPs experimentally infected

NHP secretions splashed onto skin as an infectious disease 

exposure or health risk

Not conisdered as a risk Considered as a risk Total

Without Training 18 9 27

With Training 25 64 89

Total 43 73

Prevalence Ratio = 2.4; 95% Confidence Interval 1.5 – 3.6
Health Hazard Evaluation Report 2001-0273; 2001-0274; 2001-0275; 2001-0407-3091 Page 35

Appendix: Tabl   (contin

Table A21. Knowledge of Potential Risk by Job Title

Tulane Regional Primate Research Center, Covington, Louisiana

Job #

# (%) Reporting incident to be infectious disease risk which would need to be reported

Bite1 Needle stick2 Scratch with clean 

equipment3 Exposure to secretions4

Caretaker 7 4 (57%) 1 (14%) 3(43%) 5 (71%)

Technician 26 12 (46%) 5 (19%) 7 (27%) 14 (54%)

Supervisor 4 3 (75%) 1 (25%) 3 (75%) 3 (75%)

Student 1 1 (100%) 0 (0%) 0 (0%) 1 (100%)

Maintenance 19 11 (58%) 6 (32%) 12 (63%) 15 (79%)

Veterinarian 7 5 (71%) 3 (43%) 4 (57%) 3 (43%)

Visiting Scientist 2 2 (100%) 1 (50%) 1 (50%) 1 (50%)

Colony Manager 2 2 (100%) 2 (100%) 1 (50%) 1 (50%)

Laboratorian 29 17 (59%) 8 (28%) 10 (34%) 17 (59%)

Other 19 10 (53%) 5 (26%) 11 (58%) 13 (68%)

Positive responses for “Knowledge of potential risk” are indicated by the respondent reporting affirmatively that: 

1

 NHP bites that do not break the skin are exposures/health risks that would need to be reported.

2

 Punctures with a clean needle are infectious disease exposures or health risks that would need to be reported.

3

 The scratch or cut from clean animal equipment is an infectious disease exposures or health risks that would need to be 

reported.

4

 Exposures to NHP secretions (saliva, blood, urine, feces) splashed onto skin are infectious disease exposures or health 

risks that would need to be reported.

Table A22. Reported Incidents Occurring in the 5 Years Prior to the Survey 

While Working with NHPs

Tulane Regional Primate Research Center, Covington, Louisiana

Incident

# (%) employees 

reporting incident

occurring in 

the last 5 years

Among those reporting incident

Median (range) of 

# times incident 

occurred

Number (%)1 reporting 

that not all incidents 

reported to supervisor

Bitten by NHP 8 (7%) 1.5 (1–10) 0 (0%)

Scratched by NHP 19 (16%) 2 (1–10) 1 (5%)

Needle stick 16 (14%) 1 (1–2) 2 (13%)

Scratched/cut by dirty equipment 27 (23%) 2 (1–15) 2 (7%)

Splashed in eyes, mouth, or nose 

 with NHP secretions

8 (7%) 1 (1–10) 2 (25%)

1

 Percentage among those experiencing an incident who stated that they had not reported at least one of these incidents to a 

supervisor.
 Page 36 Health Hazard Evaluation Report 2001-0273; 2001-0274; 2001-0275; 2001-0407-3091 

Appendix: Tabl   (contin

Table A23. Occurrence of Incidents by Job Title

Tulane Regional Primate Research Center, Covington, Louisiana

Job #

# (%) employees reporting incident occurring in the last 5 years

Bitten, 

resulting in 

broken skin

Needle 

stick

Scratched 

by NHP

Scratched/

cut by dirty 

equipment

Splashed in eyes, 

nose, or mouth with 

NHP secretions

Caretaker 7 0 (0%) 1 (14%) 2 (29%) 1 (14%) 0 (0%)

Technician 26 5 (19%) 6 (23%) 11 (42%) 11 (42%) 2 (8%)

Supervisor 4 2 (50%) 1 (25%) 1 (25%) 1 (25%) 0 (0%)

Student 1 0 (0%) 0 (0%) 0 (0%) 0 (0%) 0 (0%)

Maintenance 19 0 (0%) 1 (5%) 0 (0%) 5 (26%) 2 (11%)

Veterinarian 7 0 (0%) 3 (43%) 0 (0%) 1 (14%) 0 (0%)

Visiting Scientist 2 0 (0%) 0 (0%) 0 (0%) 0 (0%) 0 (0%)

Colony Manager 2 0 (0%) 0 (0%) 2 (100%) 1 (50%) 0 (0%)

Laboratorian 29 0 (0%) 2 (7%) 1 (3%) 3 (10%) 2 (7%)

Other 19 1 (5%) 2 (11%) 2 (11%) 4 (21%) 2 (11%)

Table A24. Prevalence Ratios and 95% Confidence Intervals for Associations

Between Work Tasks and Incidents

Tulane Regional Primate Research Center, Covington, Louisiana

Task

Incident

Bitten by NHP Scratched by 

NHP Stuck by needle

Scratched/

cut by dirty 

equipment

Splashed in 

eyes, mouth, 

nose with 

secretions

PR1 95% CI2 PR 95% CI PR 95% CI PR 95% CI PR 95% CI

Feeding Undefined p<0.001 4.8 2.0–11.5 2.2 0.9–5.3 1.9 1.0–3.6 0.7 0.2–3.4

Drawing blood 12.2 1.5–95.5 3.8 1.5–9.2 7.4 2.2–24.6 2.0 1.0–4.0 1.0 0.3–4.1

Handling NHP 3.0 0.8–12.0 3.9 1.6–9.5 4.0 1.5–10.9 2.1 1.1–4.1 1.8 0.5–6.8

Handling tissues 

 or fluids

0.5 0.1–1.9 1.9 0.6–5.2 3.5 0.8–14.6 2.1 0.8–5.1 1.5 0.3–7.0

Making behavior 

 observations

3.0 0.8–11.1 4.1 1.8–9.1 2.3 0.9–5.6 2.2 1.1–4.2 1.0 0.2–4.6

Cleaning cages 8.9 1.9–41.7 2.7 1.2–5.9 1.3 0.5–3.5 1.6 0.8–3.1 0.4 0.1–3.3

Giving injections 15.4 2.0–120.3 3.0 1.3–6.9 2.8 1.1–6.9 1.9 1.0–3.6 0.7 0.2–3.4

Bold text represents statistically significant findings

1

 PR = prevalence ratio. In cases where the PR is undefined (0 cell), Fisher’s exact test was used to determine the p value. 2

 CI = 95% Confidence Interval. In cases where the PR is undefined (0 cell), Fisher’s exact test was used to determine the p 

value.
Health Hazard Evaluation Report 2001-0273; 2001-0274; 2001-0275; 2001-0407-3091 Page 37

Appendix: Tabl   (contin

Table A25. Knowledge of Potential Risk, by Type of Incident1

All Facilities

Incident

# (%) Reporting incident to be infectious disease 

risk which would need to be reported

UC Davis Tulane SW 

Foundation

UL New 

Iberia Overall

NHP secretions on skin 59 (43%) 73 (63%) 38 (48%) 68 (49%) 238 (51%)

NHP secretions on wound 134 (98%) 108 (93%) 68 (86%) 135 (97%) 445 (95%)

NHP secretions in mouth 135 (99%) 105 (91%) 69 (87%) 132 (95%) 441 (94%)

NHP secretions in eye 133 (97%) 104 (90%) 70 (88%) 133 (96%) 440 (93%)

Puncture by dirty needle 134 (98%) 105 (91%) 68 (86%) 133 (96%) 440 (94%)

Puncture by clean needle 35 (26%) 32 (28%) 27 (34%) 76 (55%) 170 (36%)

NHP bite breaking skin 135 (99%) 105 (91%) 72 (91%) 132 (95%) 444 (95%)

NHP bite not breaking skin 82 (60%) 67 (58%) 40 (51%) 96 (69%) 285 (61%)

Scratch with dirty equipment 132 (96%) 109 (94%) 70 (89%) 132 (95%) 443 (95%)

Scratch with clean equipment 63 (46%) 52 (45%) 41 (52%) 103 (74%) 259 (55%)

1 Responses to questions concerning whether participants would consider these types of incidents to be infectious disease 

exposures or health risks needing to be reported.
 Page 38 Health Hazard Evaluation Report 2001-0273; 2001-0274; 2001-0275; 2001-0407-3091 

Appendix: Tabl   (contin

Table A26. Knowledge of Potential Risk by Job Title

All Facilities

Job #

# (%) Reporting incident to be infectious disease risk which would need to be reported

Bite1 Needle stick2 Scratch with clean 

equipment3

Exposure to 

secretions4

Caretaker 122 69 (57%) 44 (36%) 75 (61%) 59 (48%)

Technician 64 29 (45%) 18 (28%) 23 (36%) 28 (44%)

Supervisor 21 11 (52%) 4 (19%) 12 (57%) 9 (43%)

Student 19 13 (68%) 11 (58%) 14 (74%) 11 (58%)

Maintenance 55 40 (73%) 31 (56%) 39 (72%) 39 (72%)

Veterinarian 20 10 (50%) 7 (35%) 10 (50%) 4 (20%)

Visiting Scientist 3 2 (66%) 1 (33%) 2 (66%) 1 (33%)

Colony Manager 6 5 (83%) 5 (83%) 3 (50%) 1 (17%)

Laboratorian 67 49 (73%) 23 (34%) 28 (42%) 40 (60%)

Other 91 48 (53%) 24 (26%) 51 (56%) 47 (52%)

Positive responses for “Knowledge of potential risk” are indicated by the respondent (469 responding to the question) 

reporting affirmatively that: 

1

 NHP bites that do not break the skin are exposures/health risks that would need to be reported.

2

 Punctures with a clean needle are infectious disease exposures or health risks that would need to be reported.

3

 The scratch or cut from clean animal equipment is an infectious disease exposures or health risks that would need to be 

reported.

4

 Exposures to NHP secretions (saliva, blood, urine, feces) splashed onto skin are infectious disease exposures or health risks 

that would need to be reported.

Table A27. Reported Incidents Occurring in the 5 Years Prior to the Survey 

While Working with NHPs

All Facilities

Incident

# (%) employees 

reporting incident 

occurring in the 

last 5 years

Among those reporting incident

Median (range) of 

# times incident 

occurred

Number (%)1 reporting 

that not all incidents 

reported to supervisor

Bitten by NHP 71 (15%) 1 (1–10) 6 (8%)

Scratched by NHP 129 (26%) 2.5 (1–30) 39 (30%)

Needle stick 73 (16%) 1.3 (1–9) 13 (18%)

Scratched/cut by dirty equipment 135 (29%) 1.75 (1–15) 32 (24%)

Splashed in eyes, mouth, or nose 

 with NHP secretions

69 (15%) 1.6 (1–10) 28 (41%)

1

 Percentage among those experiencing an incident who stated that they had not reported at least one of these incidents to a 

supervisor.
Health Hazard Evaluation Report 2001-0273; 2001-0274; 2001-0275; 2001-0407-3091 Page 39

Appendix: Tabl   (contin

Table A28. Occurrence of Incidents by Job Title

All Facilities

Job #

# (%) employees reporting incident occurring in the last 5 years

Bitten, 

resulting in 

broken skin

Needle 

stick

Scratched 

by NHP

Scratched/

cut by dirty 

equipment

Splashed in eyes, 

nose, or mouth with 

NHP secretions

Caretaker 122 34 (28%) 13 (11%) 43 (35%) 53 (43%) 21 (17%)

Technician 64 13 (20%) 25 (39%) 34 (53%) 23 (36%) 16 (25%)

Supervisor 21 8 (38%) 6 (29%) 10 (48%) 5 (245%) 5 (24%)

Student 19 0 (0%) 1 (5%) 2 (11%) 0 (0%) 0 (0%)

Maintenance 55 0 (0%) 2 (4%) 2 (4%) 19 (35%) 9 (16%)

Veterinarian 20 3 (15%) 9 (45%) 5 (25%) 5 (25%) 3 (15%)

Researcher 1 0 (0%) 0 (0%) 0 (0%) 0 (0%) 0 (0%)

Visiting Scientist 3 0 (0%) 1 (33%) 0 (0%) 0 (0%) 0 (0%)

Colony Manager 6 0 (0%) 0 (0%) 2 (33%) 1 (17%) 0 (0%)

Laboratorian 67 1 (2%) 4 (6%) 4 (6%) 9 (13%) 3 (5%)

Other 91 4 (4%) 11 (12%) 26 (29%) 20 (22%) 12 (13%)
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Health Hazard Evaluation Report 2001-0273; 2001-0274; 2001-0275; 2001-0407-3091 Page 41

Acknowledgments a

Availability of Re

The Hazard Evaluation and Technical Assistance Branch (HETAB) 

of the National Institute for Occupational Safety and Health 

(NIOSH) conducts field investigations of possible health hazards 

in the workplace. These investigations are conducted under the 

authority of Section 20(a)(6) of the Occupational Safety and 

Health (OSHA) Act of 1970, 29 U.S.C. 669(a)(6) which authorizes 

the Secretary of Health and Human Services, following a written 

request from any employer or authorized representative of 

employees, to determine whether any substance normally found 

in the place of employment has potentially toxic effects in such 

concentrations as used or found. HETAB also provides, upon 

request, technical and consultative assistance to federal, state, and 

local agencies; labor; industry; and other groups or individuals to 

control occupational health hazards and to prevent related trauma 

and disease.

The findings and conclusions in this report are those of the 

authors and do not necessarily represent the views of NIOSH. 

Mention of any company or product does not constitute 

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Furthermore, NIOSH is not responsible for the content of these 

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This report was prepared by Max Kiefer and Doug Trout, HETAB, 

Division of Surveillance, Hazard Evaluations and Field Studies 

(DSHEFS). Field assistance was provided by Angela Weber. 

Health communication assistance was provided by Stefanie Evans. 

Editorial assistance was provided by Ellen Galloway. Desktop 

publishing was performed by Robin Smith. Funding for the 

evaluation was provided by the Elizabeth R. Griffin Research 

Foundation. 

Copies of this report have been sent to employee and management 

representatives at the California Regional Primate Research 

Center at the University of California, in Davis, California, the 

University of Louisiana at Lafayette in New Iberia, Louisiana, the 

Southwest Foundation Regional Primate Research Center in San 

Antonio, Texas, the Tulane Regional Primate Research Center in 

Covington, Louisiana, and the OSHA Regional Office. This report 

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purchased from the National Technical Information Service (NTIS) 

at 5825 Port Royal Road, Springfield, Virginia 22161.
Below is a recommended citation for this report:

NIOSH [2009]. Health hazard evaluation report: care of non-human primates, New 

Iberia, Louisiana; San Antonio, Texas; Davis California; Covington, Louisiana. By 

Kiefer M, Trout D. Cincinnati, OH: U.S. Department of Health and Human Services, 

Centers for Disease Control and Prevention, National Institute for Occupational 

Safety and Health, NIOSH HETA No. 2001-0273; 2001-0274; 2001-0275; 2001-

0407-3091.

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