Webcast Script
Keeping the
Genome in the Bottle:
Reinforcing Biosafety Level 3 Procedures
Jovita
Moore:
Hello, Im Jovita Moore. Welcome to todays program, Keeping the Genome in
the Bottle: Reinforcing Biosafety Level 3 Procedures,
coming to you from the Centers for Disease Control and Prevention, in
The use and handling of biological materials in laboratory
settings always requires workers to consider the potential for exposure to
infectious agents and the precautions needed to reduce or eliminate the
possibility of exposure. Work with live pathogens requires even more care
and consideration of exposure hazards.
Recent laboratory-acquired infections with SARS-associated coronavirus, or SARS-CoV, remind
us of the need for strict adherence to and rigorous enforcement of biosafety precautions in laboratories working with
dangerous pathogens.
This webcast will provide a review
of important biosafety level 3 laboratory procedures for persons working with
live SARS coronavirus and other pathogens that require BSL-3 precautions.
The program is targeted to laboratory directors, biosafety officers, and
laboratory scientists and technicians in laboratories that have received live
SARS-CoV, are involved in propagating SARS-CoV, or are working with other
infectious agents under BSL-3 conditions.
The goals of the program are
to review guidelines for working with SARS-CoV, requirements for BSL-3
facilities, important BSL-3 practices, and key aspects of a medical surveillance
program.
This
webcast is directed specifically to personnel
involved in the propagation and manipulation of BSL-3 agents and therefore is
not directed to clinical laboratory
personnel in general. It is not intended
to replace any laboratory safety training activities. And it will not cover work with laboratory
animals. This is a special risk
category.
Todays panel of speakers includes leading
scientists from CDC who have had major roles in the groundbreaking research on
SARS-CoV and other emerging pathogens and who
continue to be at the forefront of infectious disease laboratory investigations
and activities.
Dr. Tom Ksiazek is Chief
of the Special Pathogens Branch in the Division of Viral and Rickettsial Diseases,
To begin our program, Dr. James Hughes, Director of CDCs
Video: Dr. Hughes Introduction
Dr. Hughes:
Thank you, Jovita. Hello.
I am going to present a brief overview of the events that provided an
impetus for this webcast.
Last years global SARS
epidemic is one of a number of recent examples of newly recognized diseases
that have been emerging worldwide at an unprecedented rate.
The emergence of SARS dramatically illustrated the
potential for a new disease to suddenly appear and spread, leading to
widespread health, social, and economic consequences.
Fortunately,
the world also witnessed the power of traditional public health measures
surveillance, infection control, isolation, and quarantine to contain an
international epidemic.
In July 2003, when the outbreak was officially
declared to be over, no one knew if SARS would reappear, but many believed that
a re-introduction was inevitable most likely from an animal reservoir.
Indeed,
SARS has reappeared. Sporadic cases have
been reported in
In less than a year, four
researchers have become infected with the SARS virus in three different
laboratories in
These cases of SARS linked to exposures in research laboratories remind
us of the risks associated with laboratory work with infectious agents and the
importance of following specific recommended biosafety
precautions in mitigating these risks.
A large number of
laboratories in the
CDC is presenting this webcast to remind laboratorians
of the importance of following established biosafety
procedures by all persons working in laboratories with live SARS virus and
other biosafety level 3 pathogens. Of equal importance is the need to monitor
the health of laboratory workers to enable prompt detection and appropriate
management of laboratory-acquired infections in order to prevent subsequent
transmission. We hope that this review
will prove useful in ensuring the health and safety of you and your colleagues.
Jovita Moore:
Thank you, Dr. Hughes. Your introduction sets the stage for our next
speaker, Dr. Tom Ksiazek, who will summarize the recent laboratory-acquired
cases of SARS. Welcome, Dr. Ksiazek.
Dr. Ksiazek:
Thank you, Jovita. I am going to review what we know about the
four recent cases of laboratory-acquired infection with SARS-CoV.
The first case occurred in
Epidemiologic and laboratory
investigations suggest that the patient acquired his infection on August
23. On that day, he was working with a
technician who was growing
The students SARS-CoV infection was documented by serologic, PCR, and virus
isolation studies. Tests of the frozen
materials that the patient worked with on August 23 were positive by RT-PCR for
SARS-CoV and
The infection was an isolated event that resulted in no secondary
transmission outside the lab.
This case illustrates three
important biosafety principles.
First is the need to
implement procedures that preclude the cross-contamination of laboratory
materials, such as that which occurred in this incident.
Second is the need to be
aware of all agents that are being worked with in the lab so that proper
precautions are taken. Workers should
also be vigilant for symptoms of the illnesses caused by agents in the lab,
even in the absence of known exposure to these agents.
The third lesson is the need
to use biosafety procedures that are appropriate for
the highest-level agent in the laboratory.
The second incident occurred
in
The researcher developed a
fever on December 10 and was diagnosed with pneumonia six days later. Infection with SARS-CoV
was subsequently confirmed by RT-PCR, serologic, and isolation studies.
Laboratory and epidemiologic
investigations implicated a laboratory incident on or about December 3, when
the scientist reportedly noted that some liquid waste had spilled into the
transport chamber. Unable to reach the
material through the attached gloves, he sprayed the area with alcohol, waited
10 minutes, opened the chamber door, and maneuvered his head and upper body
into the chamber to clean up the spill.
The incident was not reported.
RT-PCR confirmed that the
sequence of the virus obtained from the patient was the same as the laboratory
strain. Two of the 18 environmental
samples collected from the laboratory the handle of
the alcohol spray and the light switch in the glove box also tested positive
for SARS-CoV by RT-PCR.
As with the case in
However, the incident does
illustrate some additional biosafety principles.
Always use appropriate
decontamination procedures for clean-up of spills.
Use a disinfectant that is
appropriate for the agent you are handling.
And, finally, be sure to
report all spills and all other laboratory incidents.
The
two most recent laboratory-acquired infections occurred in
The
first student developed symptoms on March 25 at her home in
Her
mother became ill and subsequently died on April 19. A nurse who attended the student at the
hospital in
The 31-year-old male researcher who is
presumed to have acquired infection from the same laboratory source became ill
on April 17. He has not been linked to any other cases.
An investigation of the source of the
outbreak is focused on biosafety procedures at the
laboratory in
Jovita Moore:
Thank
you, Dr. Ksiazek, for giving us the details on the lab-acquired infections with
the SARS coronavirus.
What have we learned from these four cases?
Dr. Ksiazek:
The incidents in
One lesson is the need for complete and
comprehensive training of all laboratory personnel in the standard operating
procedures for BSL-3 laboratory practices.
Also, all persons working in a BSL-3
laboratory with live pathogens need to be aware of the presence of live
pathogens in the lab, need to know how to use appropriate disinfectants, and
must be familiar with the symptoms of infection with all pathogens that are
presentagent in the lab.
Laboratories working with several agents need
to use procedures that preclude cross-contamination of materials.
Importantly, every supervisor should foster a
work environment that encourages reporting of all incidents and any suggestive
symptoms of illness so that lab workers report spills, all other incidents, and
any symptoms immediately to the appropriate persons, without fear of punitive
action.
Finally, the lab should have an occupational
health program to ensure regular monitoring of workers health. Designated clinics should be available for
health consultations, and clinical consultants should be made aware of workers
potential occupational hazards.
Jovita Moore:
Thank
you, Dr. Ksiazek. Clearly, these
laboratory-related infections remind us of the need to handle SARS virus
according to appropriate biosafety practices.
Dr. Rob Weyant of CDCs
Office of Health and Safety will now remind us of the proper biosafety practices for work with SARS-CoV. Welcome, Dr. Weyant.
Dr. Weyant:
Thank you, Jovita. As you know,
standard biosafety systems, or levels, have been
established for work with all infectious agents. There are four biosafety
levels, each of which represents the appropriate combination of laboratory
practices and techniques, safety equipment, and laboratory facilities for work
with different types of infectious agents.
The
biosafety levels move from the least restrictive
conditions of BSL-1 to those of BSL-4, which are needed for work with dangerous
and exotic agents that pose a high risk of aerosol-transmitted lab infections
and life-threatening disease.
A BSL-3 laboratory is designed to contain
agents that may cause serious or lethal disease as a result of inhalation. Examples of the microorganisms assigned to
this level are Mycobacterium tuberculosis,
St. Louis encephalitis virus, and Coxiella burnetii, the agent that causes Q fever.
Because of the risk of airborne transmission
of BSL-3 agents, emphasis at this level is placed on barriers to protect
workers and the environment from exposure to potentially infectious aerosols.
BSL-3
is the appropriate containment level for work with live SARS coronavirus cultures.
Routine
diagnostic testing on inactivated specimens may be performed in BSL-2
facilities using standard BSL-2 work practices.
Diagnostic testing of non-inactivated patient specimens may be done in
BSL-2 facilities but with more stringent BSL-3 work practices, including the
use of a biological safety cabinet. SARS-CoV
propagation in cell culture must, however, be performed in a BSL-3 facility
using BSL-3 work practices. BSL-3
procedures are also required for manipulation of replicating infectious clones.
Jovita Moore:
Thank
you, Dr. Weyant. This brings us to the
main purpose of the presentation, which is to review BSL-3 laboratory
requirements. But, first, would you
remind the audience of the standard requirements for all laboratories?
Dr. Weyant:
Yes, Jovita. An effective laboratory safety program
requires a commitment from all levels:
the institutional leadership, the supervisory staff, and the laboratory
personnel.
The role of the
institutional leadership is to support the safety program, provide adequate
resources, and provide a safe work environment.
The laboratory supervisor
should be a skilled scientist who is experienced in working with the agent of
interest. The supervisor is responsible
for establishing criteria for entry into the laboratory. Examples of entry criteria are immunization
requirements for work with yellow fever or annual skin testing for work with
TB.
The supervisor also develops
site-specific laboratory policies and procedures, trains laboratory personnel
in scientific and safety techniques, takes hands-on responsibility for the safe
operation of the lab, and encourages compliance with the medical surveillance
program.
Laboratory personnel have their own responsibilities. They need to be aware of the potential
hazards involved in their work and proficient in laboratory practices and
techniques. Workers are responsible for
receiving appropriate scientific and safety training, strictly following
guidelines, demonstrating proficiency in all relevant procedures, reporting
incidents, and participating in medical surveillance as required.
To ensure safe practices, every laboratory needs to have a training program. Key components of laboratory training are
formal training in general concepts of biosafety and
training in specific BSL-3 safety requirements, emergency response, and
accident reporting. In addition, there
should be a period of direct, on-the-job training and observation during which the new worker
must demonstrate competence.
Every lab also needs a site-specific laboratory biosafety manual
that specifies the practices and procedures that need to be followed to keep
workers safe.
Jovita Moore:
Thank you for that review of standard laboratory
requirements. Next, Dr. Weyant will
remind us of the components of laboratory biosafety.
Dr. Weyant:
As with any safety program,
laboratory biosafety has several components that must work in concert to ensure
a safe workplace.
Three of these components
facility design, safety equipment, and laboratory practices are aimed at the
physical containment of hazardous research materials to reduce the potential
for infection of the laboratory worker and persons outside the laboratory.
The fourth component,
medical surveillance, comes into play whenever a lab worker either has a
potential exposure to a pathogen or develops an illness that might be caused by
an agent being handled in the laboratory, even without a known exposure.
So, lets review each of
these components for a BSL-3 lab.
First is the facility design.
The design of a facility is
important in providing a barrier to protect those working inside and outside
the laboratory. BSL-3 facilities are
usually separated from the general traffic flow by controlled access corridors
and double doors.
Because a BSL-3 lab is
designed for work with microorganisms that pose a risk of aerosol transmission,
particular attention is given to air movement.
The ventilation system is designed to ensure inward directional airflow. The air is discharged to the outdoors and not
recirculated to other parts of the building. The air may be passed through HEPA filters to
remove any infectious particles.
The surfaces of all walls,
ceilings, and floors in a BSL-3 laboratory are sealed to prevent seepage of
spilled liquids and to facilitate decontamination. Each laboratory room should contain a sink
for handwashing.
The sink should be hands-free, or automatically operated, and located
near the exit door. Chairs used for work
in BSL-3 labs should be adjustable, comfortable, stable, and covered with a
non-fabric material that can be easily decontaminated.
The second component of
laboratory safety is the safety equipment, or primary barriers.
Safety equipment includes
biological safety cabinets, enclosed containers, and other engineering controls
designed to remove or minimize exposure to hazardous biological materials. Together with good practices and techniques,
the use of safety equipment helps to reduce risks when dealing with hazardous
biological materials.
The biological safety
cabinet, or BSC, is the principal device used to contain infectious splashes or
aerosols generated by manipulations of infectious microorganisms. When used with good microbiological
technique, BSCs offer protection to laboratory personnel, the material being
handled, and the environment.
All work that may create
aerosols or splatter is done inside a biological safety cabinet. Safety cabinets must be certified on a
regular basis and regularly maintained, situated away from airflow ducts, and
located away from laboratory entry doors or other high-traffic areas that
generate air turbulence and may therefore compromise containment.
Other types of safety equipment such as centrifuge cups and other
enclosed containers also help to contain research materials and prevent their
escape via aerosols into the laboratory or outside environment.
Safety equipment also includes the personal protective
clothing; gloves; and face shields, safety glasses, or goggles that form the
primary barrier between the worker and the infectious material. When indicated by a risk assessment,
respiratory protection should also be
used.
Gloves must be worn when handling any infectious materials
or contaminated equipment. Frequent
changing of gloves, accompanied by hand washing, is recommended. Disposable gloves should not be reused.
The third and most important
element of containment is strict adherence to safe laboratory practices and techniques. Persons working with infectious agents must
be aware of potential hazards and must be trained and proficient in the
practices and techniques required for handling such materials safely.
Because of the special risks
in a BSL-3 lab, every worker needs to be meticulous in performing every
task. You should never assume that you
are performing all procedures safely and correctly just because you have never
had an accident.
For every procedure
performed in the BSL-3 lab those done only occasionally and those done every
day you need a standard operating procedure that emphasizes safety. Laboratory workers must always remember to
respect the agent they are handling and to perform every procedure with the
same high level of expertise, concentration, and caution.
Standard laboratory
practices that reduce the potential for infection include washing hands after
handling infectious materials, after removing gloves, and before leaving the
laboratory; handling sharps safely; performing all procedures carefully to
minimize splashes and the creation of aerosols; and decontaminating work surfaces
at least once a day and after any spill of viable material.
In addition to these
standard practices for all types of
laboratories, BSL-3 facilities have
several other requirements to ensure the containment of infectious materials.
Laboratories working with
BSL-3 agents should have a hazard warning sign posted on all access doors. The sign should identify the containment
level and any special requirements for entry into the lab. Emergency contact information should also be
provided.
All personnel must comply
with laboratory access restrictions.
Next is personal protective
equipment. A BSL-3 laboratory is a
hazardous place to work. Nearly every
laboratory technique, practice, or procedure carries some risk of
exposure or injury.
Used correctly and consistently,
personal protective equipment PPE provides an essential barrier between you
and hazardous biological materials.
Jovita Moore:
Lets stop here for a moment
and have a quick review of the proper way to put on and remove PPE to avoid contaminating
yourself or the laboratory environment.
Lets take a look.
Narrator:
Before entering a BSL-3
laboratory, you must put on a solid-front or wrap-around gown, scrub suit, or
coveralls.
Next, disposable foot covers
must be used because they can prevent contamination of your feet or shoes.
Remember, if you have long
hair, tie your hair back or wear a head cover.
Safety glasses
should always be worn when working in the laboratory.
If your work requires any aerosol-generating
procedures that cannot be done inside a biological safety cabinet, you will
need respiratory protection. You must
wear a respirator for any aerosol-generating procedures that cannot be done
inside a biological safety cabinet.
Decisions about whether or
not to use a respiratory protection should be determined by a risk
assessment. All workers who use
respirators should first be enrolled in a respiratory protection program.
Gloves must be worn for all
procedures involving infectious agents.
Remember, gloves must overlap the sleeve of the gown. In some cases, double gloving may be
appropriate.
Of course,
laboratory doors should remain closed at all times.
When leaving the BSL-3
laboratory, take special care in removing and disposing of personal protective
equipment to prevent exposing yourself and contaminating the environment.
To lessen the chances of
spreading the contamination, the laboratory should always be equipped with a
hands-free sink.
Also, protective
clothing should not be worn outside the laboratory.
First, carefully remove your
protective clothing to minimize the creation of infectious aerosols and
remember to remove and discard your gloves as the last step.
As always, proper hand
washing is one of the most effective ways to prevent transmission of infectious
agents while a hands-free sink prevents the contamination of faucets.
To ensure the removal of
potential contaminants, always wash your hands vigorously and for at least 30
seconds.
These simple procedures
should become second nature because protecting yourself and
others should become your first priority.
Jovita Moore:
So far, weve covered two of
the important BSL-3 laboratory practices:
access control and personal protective equipment. Dr. Ksiazek will now tell us about another biosafety precaution for BSL-3 labs.
Dr. Ksiazek:
Thank you, Jovita. Next we will
talk about the primary containment device in BSL-3 laboratories the
biological safety cabinet, or BSC.
Any laboratory procedure that may generate aerosols or droplets should
be performed in a biological safety cabinet.
Opening of centrifuge buckets should also be done in the biological
safety cabinet. Infectious materials
should never be manipulated on an open bench.
Strict adherence to
recommended practices for the use of BSCs and their
proper placement in the laboratory are as important in attaining the maximum
containment capability of the equipment as is the mechanical performance of the
equipment itself. In the next brief
video, we will review the appropriate way to set up a BSC and how to maintain
safety and effectiveness through the use of proper procedures.
Narrator:
You must wear personal
protective equipment when working in the laboratory.
When you enter the
laboratory, make sure the door is closed securely, and always confirm the
correct airflow into the lab.
Check the airflow by
examining the digital magnahelic monitor.
If a monitor is not present,
simply use a paper telltale to observe the flow of air.
The biological safety
cabinet is one of the most important safety devices in a BSL-3 laboratory.
All manipulations of
infectious BSL-3 agents should be done in a biological safety cabinet.
Before starting work, make
sure the cabinet is working properly . . . drawing air from the laboratory,
purifying it through a HEPA filter, delivering it to the work surface, and then
venting to the outside.
Since BSCs
should be certified every year by a certification specialist, check to make
sure that the certification of the BSC is current.
Next, confirm the proper
airflow by examining the magnehelic gauge.
BSCs are certified to function at a specified sash
height. Before working in the BSC,
adjust the sash to the correct height as specified by the manufacturer.
On many models, an alarm
will sound if the sash is adjusted incorrectly.
Before you begin work you
should first disinfect the work surface.
This is especially important in laboratories with shared BSCs.
An absorbent pad soaked with
disinfectant provides an additional layer of protection against spills or
splashes inside the cabinet.
Next, put a waste pan inside
the cabinet across the back. Do not
place the pan so that it extends toward the front of the cabinet because this
may direct air out of the front opening.
An appropriate disinfectant
should be placed in the pan to receive potentially contaminated materials. Sharps should be placed into a separate
sharps container.
An effective disinfectant
should always be available in the BSC and whenever possible, use disposable
laboratory equipment.
Remember to always use a pipetting device, which can either be manual or automated.
Always put sterile or clean
reagents into the cabinet before introducing any infectious materials.
And once all work materials
have been placed into the BSC, let it run for three to five
minutes to purge the cabinet of any contaminants that might have been
introduced. On initial start-up, a
longer purge time, for example 15 minutes, may be required for aseptic work.
Dr. Ksiazek:
As with any other piece of laboratory equipment, personnel must be
trained in the proper use of biological safety cabinets. Of particular note are activities that may
disrupt the inward directional airflow.
Among the activities that have been shown to cause the escape of
aerosolized particles from biosafety the cabinets
are: opening and closing the doors to the laboratory, briskly walking past the
cabinet, and repeatedly inserting and withdrawing your arms into and out of the
cabinet. Laboratory personnel also need
to be aware that the airflow can be disturbed by placing materials improperly
inside the cabinet, operating equipment incorrectly inside the cabinet, or
covering the grill work with paper or equipment.
When a procedure cannot be conducted in a biological safety cabinet,
then appropriate combinations of personal protective equipment, repiratory protection, and physical containment devices
should be used.
Sharp items such as needles, syringes, and slides can present an
additional hazard when working with infectious agents.
Lab workers should use sharp
instruments only when there is no alternative. Substitute plasticware
for glass whenever possible. When
handling any contaminated sharp item, use extreme caution. Place items into a sharps container when work
is completed.
An essential part of BSL-3 laboratory biosafety
is proper decontamination of
surfaces and instruments. The specific
requirements for decontamination will depend on the type of experimental work
and the nature of the infectious agent being manipulated.
BSL-3 laboratory procedures call for decontamination of equipment and
work surfaces at least once a day, after completion of any work with infectious
materials, and especially after any spills, splashes, or other contamination
with infectious materials. All
potentially contaminated waste materials should be decontaminated before
disposal.
BSL-3 lab guidelines also specify procedures for storage of infectious materials.
All infectious materials should be stored in clearly labeled storage
containers. Freezers should be marked
with biohazard warning labels and emergency contact information. Storage containers should be decontaminated
before removal from either a biological safety cabinet or the lab.
Jovita Moore:
Thank you, Dr. Ksiazek. Lets
stop here for a moment and review how to prepare materials for transfer outside
of the BSL-3 laboratory.
Narrator:
Safe and correct preparation
of materials for transfer out of the laboratory is essential to prevent
exposures of workers and contamination of the laboratory.
In BSL-3
laboratories, it is advisable to use a sealed transport container to protect
against accidents occurring outside of a BSC.
Remember to always treat
everything that comes out of a BSC with an appropriate disinfectant plus, its
especially important to disinfect the outside of primary containers to avoid
accidental exposures while handling these items outside of the BSC.
In the event of an accident
in the laboratory, the transport container provides a secondary containment
barrier that will prevent release of the infectious agent.
But if you are transferring
individual samples within the laboratory, you may simply use plastic Ziploc
bags.
Then, after appropriate
surface decontamination, the samples can be safely removed from the BSC.
Jovita Moore:
The next topic Incident Response is highly relevant to the SARS
laboratory exposures we heard about earlier.
Accidents will happen . . .
even in the BSL-3 lab. BSL-3 laboratory
personnel are required to report all incidents and to participate in medical
surveillance programs.
Knowing how to properly clean up a spill is another important safety
factor. Lets review how to clean up a
spill in a biological safety cabinet.
Narrator:
In the event of a spill
inside a biological safety cabinet, do not panic.
Leave the biosafety cabinet turned on, and begin cleaning up the
spill.
Do not place your head
inside the cabinet to clean the spill, and keep your face behind the front view
screen.
If the spill is large, cover
it with absorbent towels and apply disinfectant.
And if glass is involved in
the spill, use appropriate sharps precautions.
Next, re-cover the spill
area with absorbent towels, and soak the toweling with disinfectant.
Decontaminate your second
layer of gloves before removal and place the gloves in the waste pan.
Wait 20 minutes for the
spill area to be completely disinfected.
Notify your supervisor about
the spill while you wait for the disinfectant to take effect.
After a full 20 minutes,
wipe
up the disinfectant and spill, and discard the absorbent materials into
the waste container.
Finally, clean the cabinet
surfaces with disinfectant.
Jovita Moore:
Our final topic is medical
surveillance, the fourth component of laboratory biosafety. To talk about this subject is Dr. Mehran
Massoudi from CDCs SARS Task Force.
Welcome, Dr. Massoudi.
Dr. Massoudi:
Thank you, Jovita. Medical
surveillance of laboratory personnel can help ensure that workers who are at
risk of occupational exposure to infectious agents and who develop symptoms of
illness receive timely and appropriate medical evaluation and treatment.
This obviously benefits the
laboratory worker but also helps to prevent further transmission, alerts
medical personnel to the potential risks, and ensures prompt attention to the
infection.
The importance of medical
surveillance was vividly illustrated in the recent case of lab-acquired SARS
infection in
Significantly, medical surveillance
was absent or inadequate for this case and for all of the other recent SARS
incidents originating in laboratories.
Medical surveillance has
several components.
Before working with a BSL-3
agent, laboratory personnel should have a baseline serum sample obtained and
stored for future reference. Personnel
should also receive any appropriate immunizations.
Every person who works in a
BSL-3 laboratory with an infectious disease agent should be familiar with the
signs and symptoms of infection with all agents that are being handled in the
lab and should monitor themselves for these symptoms. Persons working with
SARS-CoV should be especially alert for the
development of fever or lower respiratory symptoms.
All BSL-3 lab workers should
be provided with contact information for reporting of incidents or symptoms, 7
days a week, 24 hours per day. Likewise,
the officials to whom they report should have 24-7 access to clinical
consultation and advice. If secondary
transmission is a concern as it is for SARS the clinical contact also needs
to know who should be alerted at the state and local health departments.
Any breach
in laboratory procedure needs to be reported and evaluated right away.
In the event of a breach in procedure, the laboratory worker should
immediately implement the applicable laboratory procedures for emergency
management and notify the supervisor.
The supervisor and other appropriate personnel will evaluate the breach in procedure to determine if an exposure
has occurred and to plan appropriate follow-up, including any further
diagnostic evaluation such as collection of an acute-phase serum sample.
If it is determined that an exposure has occurred, the laboratory worker
should be instructed to be vigilant for the development of relevant
symptoms. The worker should immediately
notify the supervisor if symptoms develop.
Workers with an exposure and
no symptoms of illness should discuss the need for activity restrictions with
the appropriate contact person. In the
case of an exposure to SARS-CoV, the occupational health clinic and the local
health department should be notified.
Any exposed laboratory
worker who develops symptoms should immediately inform the appropriate contact
person and report to the designated location for clinical evaluation.
Likewise, laboratory workers who develop symptoms and who have
no recognized exposure should immediately contact the supervisor. The supervisor will notify the appropriate
occupational health personnel, who will review the workers illness and work
practices to determine if any precautions or additional consultations are
indicated.
The institutional leadership
should also notify the local or state health department when appropriate.
Jovita Moore:
Thank you to all of our
speakers for this informative and educational program. The message is clear: laboratory accidents and exposures always
present a risk to workers in the lab and sometimes also pose a risk to the
community.
The safe handling of
infectious pathogens requires the right laboratory design, proper personal
protective equipment, adequate training, correct technique, and comprehensive
medical surveillance. Personnel in BSL-3
laboratories must never forget the dangers inherent in their work and must pay
the strictest attention possible to the safe work practices that they have been
taught. As we have seen, breaks in basic
laboratory procedures can lead to laboratory-acquired infections with serious
consequences.
If you have questions about
the topics discussed during this program, you may e-mail them to: bsl3webcast@cdc.gov.
Additional information on laboratory biosafety is available from CDCs
Office of Health and Safety at this website: www.cdc.gov/od/ohs/biosfty/biosfty.htm.
Specific recommendations for
BSL-3 and other labs are provided in the BMBL, which is the federal guidebook
on Biosafety in Microbiological and Biomedical Laboratories. The BMBL is available on the CDC website at
this address: www.cdc.gov/od/ohs/biosfty/bmbl4/bmbl4toc.htm.
Laboratory guidance related to SARS can be found on
CDCs SARS website at this address: www.cdc.gov/ncidod/sars/lab.htm
.
This program will remain
available as an archived webcast on CDCs Public
Health Training Network website at www.phppo.cdc.gov/phtn/webcast/bsl3.
Copies of the program on
videotape and CD-ROM will be available shortly from the Public Health
Foundation for $22 per copy. Order
online at bookstore.phf.org or call
877-252-1200.
Participants are encouraged but not required
to register and evaluate the program on the CDCs Training and Continuing
Education Online System. That address is
www.phppo.cdc.gov/phtnonline.
Questions about registration should be
directed to 800-41-TRAIN or 404-639-1292.
You may also email questions to ce@cdc.gov. When emailing a request, please indicate BSL-3
webcast in the subject line.
It has been my pleasure
being your moderator for this webcast.
Thank you again to all of the speakers for sharing their expertise on
this important topic.
And thank you for participating in this
program. On behalf of everyone at CDC
and the Public Health Training Network, Im Jovita
Moore wishing you a good day from Atlanta.
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