This is a copy of Guidance Note EH23 from the (UK) Health and Safety Executive
Environmental Hygiene 23 (August 1979)
Introduction
Synonyms
1: Malignant pustule (skin), Woolsorters' disease (lungs)
Description
2: Anthrax is an infection caused by Bacillus anthracis which principally affects grass eating animals which become infected by grazing on infected pastureland or by eating infected food stuffs. Some infections are known to have occurred as a result of animals with minor wounds on their feet
walking on soft ground which was infected. Whilst cases of
anthrax among farm animals in this country are uncommon, there has been an increase in the number of confirmed cases in recent years.
3: In man, the most common form (malignant pustule) occurs externally on an exposed area of skin which has come into contact with infected animal material. The risk is greater where the skin has been irritated by friction or been subject to injury (ie., cuts etc). Case to case infection has also
been recorded.
4: Rarer forms include pulmonary anthrax, caused by the inhalation of infected dust which affects the lungs (known as woolsorters' disease) and intestinal anthrax which is caused by the consumption of infected food.
5: The bacilli which causes the infection produce spores which can live for many years.
Symptoms
Malignant pustule
6: Usually after an incubation period of two to seven days, a small itchy pimple forms at the site of infection. This soon develops into a blister which becomes surrounded by a red swollen area. The centre area later becomes black when it is surrounded by a ring of blisters. At this stage swelling may be quite marked and extensive. The person infected will usually by this time be very ill and in the absence of treatment may die
from blood poisoning.
7: Diagnosis of anthrax is not easy in its earlier stages of malignant pustule which may closely resemble a pimple or boil. Treatment should be sought with all speed and the medical practitioner should be informed that an anthrax infection is a possibility.
8: The symptoms of pulmonary anthrax are similar to those of influenza. The symptoms of intestinal anthrax are severe stomach pain accompanied by vomiting and diarrhoea. In both cases it is important that the person affected seeks urgent medical advice and informs the medical practitioner of the nature of his work.
Sources
9: Materials which have been identified as having a
potential anthrax risk include the following:
a. goat hair, including mohair and cashmere (unless previously disinfected)
b. wool and other animal hair from the Indian subcontinent,
ie., material exported from India, Pakistan etc.
c. wool and other animal hair exported from Persian (Arabian) Gulf Ports, including wool from Iran, Iraq, Saudi Arabia, Kuwait etc.
d. wool and other animal hair from the Arab Republic of Egypt and Sudan.
e. alpaca
f. camel hair
g. wool and other animal hair exported from the Peoples
Republic of China and the Mongolian Peoples Republic.
h. tail or main horsehair (raw or dressed) exported from the Peoples Republic of China, Taiwan, the Mongolian Peoples Republic or the USSR.
i. dry and dry-salted raw hides and skins exported from Africa, Asia, Central and Southern America.
j. trimmings from dry and dry-salted raw hides and skins
exported from Africa, Asia, Central and Southern America.
k. bones and bone meal, hoof and horn meal exported from the Indian subcontinent.
l. packaging such as hessian sacks that have contained anthrax risk material of the types referred to above.
Occupations and processes where found:
10 Occupations where there is a risk of coming into contact
with anthrax spores in infected materials include the following:
a. manufacture of glue and gelatine (contact with imported bone and sinews)
b. manufacture of bone charcoal (contact with imported bones)
c. manufacture and sale of fertiliser (contact with imported bones, hooves, horns, dried blood, bone and horn meal, hide cuttings and skin waste, shoddy and wool waste).
d. tanning ( contact with imported dry and dry-salted hides and skins).
e. brush manufacture (contact with imported bristle and hair).
f. manufacture of hair cloth and the production of stuffing for mattresses and upholstery (contact with imported horsehair, hog and cow hair).
g. wool, worsted and felt industries (contact with imported
wool and hair).
h. demolition of old buildings in which imported cow hair may have been used as a binder in plastering).
i. the distribution industry (eg., dock, warehouse and
transport services where there is contact with imported animal products).
j. fur skin dressing (contact with imported furs).
k. agricultural work (contact with infected animals,
pastureland and foodstuff).
l. slaughterhouse work (contact with infected animals).
m. manufacture and sale of animal foodstuffs (contact with
imported meat).
n. handling and repair of packaging such as hessian sacks that have contained anthrax risk material.
Preventative measures
General
11 These include:
a. Active immunisation, which is administered in the form of injections is available under the National Health Service for any worker who is exposed to a substantial risk of contracting anthrax. The recommended dosage of anthrax vaccine is 0.5ml given intramuscularly on four separate occasions, with an interval of three weeks between the first and second and
third doses and an interval of six months between the third and
fourth doses. Reinforcing doses of 0.5ml are advised at yearly
intervals. Immunisation need not be pressed for others at slight or occasional risk eg., dockers and agricultural workers, but should be made available to persons of those categories wishing it. The injections may be given by:
i. the worker's general practitioner
ii the factory works doctor (where one exists); or
iii by arrangement with the local Medical Officer for
Environmental Health in England and Wales and with the Chief Administrative Officer of the Area Health Board in Scotland.
Immunisation should be considered as an addition to and not a
substitute for other precautions.
b Control over certain imported animal products coming from areas where animal infection is common and control poor, is exercised by means of compulsory disinfection (see para 15).
Specific
12 The following are also necessary:
a. A high standard of cleanliness should be maintained in
premises where material potentially infected with anthrax are handled.
b. Washing facilities of a high standard should be
provided.
c. Separate cloakroom accommodation, each with drying
facilities, should be provided for protective clothing and clothing taken off during working hours.
d. Messroom facilities should be provided so that no meals are taken in rooms where potentially infected materials are handled or stored.
e. First aid equipment of a high standard with a suitably
briefed first aider should be available, so that all cuts and abrasions can be treated without delay.
f. Suitable protective clothing and equipment should be
provided for the handling of materials, for the cleaning of machinery and premises and in other instances where contact with materials having an anthrax risk is unavoidable. This clothing and equipment should be disinfected after use.
g. Mechanical handling techniques should be introduced wherever possible to keep to a minimum physical contact with unprocessed material.
h. Exhaust ventilation to a high standard should be provided for dusty processes (eg., wool or animal hair sorting) and dust collected in extraction plants should be burned.
i. Persons exposed to the known risk should be advised of the importance of early recognition and prompt treatment by means of the exhibition of the Anthrax Cautionary notice (F410) and the distribution of the Anthrax Card MS(B)3. Every effort should be made to ensure that these persons have read these publications and understand them. Before the introduction of
antibiotics the disease was often fatal, but as a result of modern treatment complete recovery can now be expected in nearly all cases of external anthrax provided the diagnosis is prompt and treatment adequate.
j. In all premises where material with an anthrax risk is
handled, there should be recognised procedures for referring all cases of suspected anthrax for immediate medical advice.
Note: Page 3 of this leaflet describes the Legal Requirements for industry, I have not included them here as they are not relevant.
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