ing activities, as described in Chapters 7 and 8. Persons working with nonhuman primates or their tissues have the potential for exposure to infectious agents. Medical providers’ participation in infection control and biosafety review may be appropriate and help to ensure that occupational health providers are updated on these important risks of infectious disease.

Many facilities are using emergency departments in local hospitals and clinics for obtaining emergency medical care. The individual responsible for the occupational health program should develop a close working relationship with the local emergency department to ensure that (1) emergency medical staff are familiar with the specific hazards posed by nonhuman primates and (2) they can provide a timely evaluation and follow up when an employee arrives at the emergency department. This may involve periodic meetings of the occupational health program and emergency department staff, training of the emergency department staff, and developing a packet of information for the emergency-room physician. This packet should outline concerns and offer information for telephone consultation with a knowledgeable physician.

DEFINING EXPOSURE RISK

The risk of developing infection from an exposure to nonhuman primates depends on many factors, including the nature of the infectious agent, the mechanism and route of exposure, the physiologic status of the source animal and the employee, whether personal protective equipment was used, and whether appropriate postexposure first-aid procedures were followed. Data that could be used to define risk for most exposure scenarios are sparse. Therefore, assessing the risks posed by some agents is problematic, and best estimates must be based on knowledge of similar agents or exposure situations. Health-care providers will have to approach employees’ exposure concerns with a willingness to acknowledge unknowns while attempting to estimate risks and involve the employees in the clinical risk-assessment and decision tree process.

SCOPE OF POTENTIAL INFECTIOUS AGENTS IN NONHUMAN PRIMATES

The variety of potential infectious agents found in nonhuman primates is summarized in Chapter 3. Agents likely to be of concern in most facilities are reviewed here, but occupational health-care providers should become familiar with all exposures likely to be encountered in their facilities. For example, exposures to primates bred in captivity might pose different risks from exposures to wild-captured primates. Wild-captured



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