[MCOH-EH] [EXTERNAL] Re: serum sample save

[Swift, Melanie D., M.D.]

This is a huge bugaboo in occupational health programs in research settings. It was certainly the historical practice to obtain and store frozen serum samples for people working with animals who might be later exposed to zoonotic or research agents.

However a few things have likely contributed to this falling out of favor. The first is that we have much better diagnostics now, and when an exposure event occurs, we have the opportunity to collect and test baseline and follow-up samples related to that exposure.  The second issue is that if you have ever run a program like this, you know how difficult it is to ensure the integrity of serum storage over decades, and then accurately and reliably retrieve those samples later. Nowadays we would just grab a baseline sample at the time of the exposure, and depending on the specifics of the test we might run it immediately (e.g. herpes B exposures) or save it to be run alongside a follow-up test a few weeks or months later. It is much easier for clinical labs to keep up with these baseline samples for that timeframe than for them to retrieve a frozen serum sample from 20 years ago.

The BMBL used to have more strongly worded language recommending this practice. Now it has softened to a general recommendation that institutions consider the need for it, and the only agents they specifically recommend for baseline serum storage are SARS and highly pathogenic avian influenza. (and oddly enough they recommend “baseline serum” for anyone working with human blood/body fluids, but I think they are referring to testing at baseline for hep b surface Ab, though they are really vague. Anyway OSHA has clear guidance for blood/OPIM and we don’t need the BMBL to guide us on that!)

At one point I was involved with a SARS research protocol that did require baseline serum storage, and over time the multi-site protocol did get modified to stop doing that, when diagnostics for SARS got more reliable.

If you have a program, as it sounds like you have for years, then you have the opportunity to use your own data to assess the value of it. Have you needed to retrieve samples and were they available and intact and valid for testing? And did that guide the clinical care of the employee? If so then you have justification for it. But if you’ve been routinely storing samples that you have never needed, or could not access when you did need them, it’s probably not worth doing.

Just my personal opinion. Hope it helps,

Melanie

Melanie Swift, MD
Senior Associate Consultant
Division of Preventive, Occupational, and Aerospace Medicine
Phone 507.284.2560
_______________________________
Mayo Clinic
200 First Street SW
Rochester, MN 55905
www.mayoclinic.org<http://www.mayoclinic.org/>

From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of arlen rollins
Sent: Tuesday, March 06, 2018 3:46 PM
To: MCOH/EH
Subject: [EXTERNAL] Re: [MCOH-EH] serum sample save

I wonder how you might be able to detect an adverse effect from exposure to the animals and agents administered without biologic testing


Arlen Rollins, D.O., M.Sc, FACPM

On Tue, Mar 6, 2018 at 9:44 AM, Reneau, Jennifer <jenniferreneau at wustl.edu<mailto:jenniferreneau at wustl.edu>> wrote:
Hello everyone,

Our office has  collected serum samples  from employees in animal husbandry  and those working with select agents for years.  We have had a recent change in veterinary leadership who is opposed to this, stating that this increases the university’s liability and the practice is outdated.  I am wondering if you could share your policy/experience with me? Thank you for your time.- Jennifer




Jennifer Reneau RN BSN
Manager, Washington University School of Medicine  Occupational Health Services
(314) 362-3528<tel:(314)%20362-3528> phone
(314) 362-0058<tel:(314)%20362-0058> fax

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Dr. Arlen J. Rollins
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