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RYERSON UNIVERSITY RYERSON UNIVERSITY 1 2. BIOLOGICAL HAZARDS 2. BIOLOGICAL HAZARDS

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Page 1: RYERSON UNIVERSITY 1 2. BIOLOGICAL HAZARDS 2. BIOLOGICAL HAZARDS

RYERSON UNIVERSITYRYERSON UNIVERSITY 11

2. BIOLOGICAL HAZARDS2. BIOLOGICAL HAZARDS

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Biological Safety Training – Certificate Holder and User Training Biological Safety Training – Certificate Holder and User Training

2. BIOLOGICAL HAZARDS2. BIOLOGICAL HAZARDS

Topics Covered:Topics Covered:

What is a Biohazard?What is a Biohazard?

Risk GroupsRisk Groups

Containment LevelsContainment Levels

Risk AssessmentRisk Assessment

Lab Acquired InfectionsLab Acquired Infections

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Biological Safety Training – Certificate Holder and User Training Biological Safety Training – Certificate Holder and User Training

2. BIOLOGICAL HAZARDS2. BIOLOGICAL HAZARDSWhat is a Biohazard?What is a Biohazard?

A living biological organism material produced by such an A living biological organism material produced by such an organism than canorganism than can causecause diseasedisease in humans or animalsin humans or animals

ExamplesExamples::Microorganisms such as Microorganisms such as

bacteria, virus, fungusbacteria, virus, fungusTransformed cell lines Transformed cell lines Infected tissue cultures Infected tissue cultures Recombinant DNARecombinant DNA Human or animal blood or Human or animal blood or

body fluidsbody fluids

Bacteria which causes BotulismBacteria which causes Botulism

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Biological Safety Training – Certificate Holder and User Training Biological Safety Training – Certificate Holder and User Training

2. BIOLOGICAL HAZARDS2. BIOLOGICAL HAZARDSWhat is a Biohazard of Concern?What is a Biohazard of Concern?

Potential for acquiring a laboratory-associated infection Potential for acquiring a laboratory-associated infection (LAI)(LAI)

Contamination of the environmentContamination of the environment

Contamination of researchContamination of research

Public perceptionPublic perception

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Biological Safety Training – Certificate Holder and User Training Biological Safety Training – Certificate Holder and User Training

2. BIOLOGICAL HAZARDS2. BIOLOGICAL HAZARDSRisk GroupsRisk Groups

Classification of organisms according to Classification of organisms according to risk groups are the traditional way risk groups are the traditional way that infectious organisms categorizedthat infectious organisms categorized::

assumes growth in small volumes (< 10 litres) for assumes growth in small volumes (< 10 litres) for experimental, diagnostic or teaching purposesexperimental, diagnostic or teaching purposes

based on the relative hazards of the potential risk based on the relative hazards of the potential risk of causing disease in humans and in animalsof causing disease in humans and in animals

does not take into account the procedures that does not take into account the procedures that are to be employed during the manipulation of a are to be employed during the manipulation of a particular organismparticular organism

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Biological Safety Training – Certificate Holder and User Training Biological Safety Training – Certificate Holder and User Training

2. BIOLOGICAL HAZARDS2. BIOLOGICAL HAZARDSRisk GroupsRisk Groups

The Public Health Agency of Canada (PHAC) has defined 4 The Public Health Agency of Canada (PHAC) has defined 4 levels of risk in classification of organisms:levels of risk in classification of organisms:

RISK GROUP 1RISK GROUP 1 (low community and low individual risk of disease) (low community and low individual risk of disease)

Any biological agent that is unlikely to cause disease in Any biological agent that is unlikely to cause disease in health workers or animals. Agents that pose little or no risk health workers or animals. Agents that pose little or no risk are assigned to Risk Group 1. are assigned to Risk Group 1.

ExamplesExamples: : LactobacillusLactobacillus spp., spp., Bacillus subtilisBacillus subtilis, , Naegleria gruberiNaegleria gruberi, , MicrococcusMicrococcus spp., spp., E. coliE. coli K12 K12

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Biological Safety Training – Certificate Holder and User Training Biological Safety Training – Certificate Holder and User Training

2. BIOLOGICAL HAZARDS2. BIOLOGICAL HAZARDSRisk GroupsRisk Groups

RISK GROUP 2RISK GROUP 2 (low community risk and moderate individual risk to disease) (low community risk and moderate individual risk to disease)

can cause human disease, but under normal circumstances can cause human disease, but under normal circumstances is unlikely to be a serious hazard to laboratory workers, the is unlikely to be a serious hazard to laboratory workers, the community, livestock or the environment community, livestock or the environment lab exposures rarely cause infection leading to serious lab exposures rarely cause infection leading to serious disease, effective treatment and preventive measures are disease, effective treatment and preventive measures are available and the risk of spread is limited.available and the risk of spread is limited.

ExamplesExamples: : Escherichia coliEscherichia coli 0157:H7, 0157:H7, Hepatitis B virus, Hepatitis B virus, ToxoplasmaToxoplasma spp, spp,

HIV (non-cultured), HIV (non-cultured), Salmonella typhimuriumSalmonella typhimurium, Measles, Mumps, Adnoviruses, , Measles, Mumps, Adnoviruses, Influenza virusesInfluenza viruses

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Biological Safety Training –Certificate Holder and User Training Biological Safety Training –Certificate Holder and User Training

2. BIOLOGICAL HAZARDS2. BIOLOGICAL HAZARDSRisk GroupsRisk Groups

RISK GROUP 3RISK GROUP 3 (low community risk and high individual risk to (low community risk and high individual risk to

disease)disease)

causes serious human disease or can result in serious causes serious human disease or can result in serious economic consequences but does not ordinarily spread economic consequences but does not ordinarily spread by casual contact from one individual to another, or that by casual contact from one individual to another, or that causes diseases treatable by antimicrobial or causes diseases treatable by antimicrobial or antiparasitic agents.antiparasitic agents.

ExamplesExamples: : Hantavirus,Hantavirus, Yersinia pestis, Bacillus anthracis, Yersinia pestis, Bacillus anthracis, HIV (cultured HIV (cultured

isolates) isolates) Bacillus anthracis, Mycobacterium tuberculosis, Bacillus anthracis, Mycobacterium tuberculosis, Creutzfeldt-Jakob Creutzfeldt-Jakob

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Biological Safety Training – Certificate Holder and User Training Biological Safety Training – Certificate Holder and User Training

2. BIOLOGICAL HAZARDS2. BIOLOGICAL HAZARDSRisk GroupsRisk Groups

Risk Group 4Risk Group 4 (agents with extremely high community and individual (agents with extremely high community and individual

riskrisk pose the greatest risk are assigned to Risk Group 4. pose the greatest risk are assigned to Risk Group 4. usually produces very serious human disease, often usually produces very serious human disease, often untreatable and may be readily transmitted from one untreatable and may be readily transmitted from one individual to another or from animal to human or vice-versa individual to another or from animal to human or vice-versa directly or indirectly or by casual contact. directly or indirectly or by casual contact.

ExamplesExamples: : Marburg virus, Ebola virus, Crimean-Congo hemorrhagic Marburg virus, Ebola virus, Crimean-Congo hemorrhagic

fever virusfever virus

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BSL 4

BSL 3

BSL 2

BSL 1

_

_

As the level so does ;

• the risk of the organism to humans, animals, plants and/or the environment

•the procedural and facility requirements

• the level of containment required

• the degree of protection for personnel, the environment and the community.

Biological Safety Training – Certificate Holder and User Training Biological Safety Training – Certificate Holder and User Training

2. BIOLOGICAL HAZARDS2. BIOLOGICAL HAZARDSRisk GroupsRisk Groups

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Biological Safety Training – Certificate Holder and User Training Biological Safety Training – Certificate Holder and User Training

2. BIOLOGICAL HAZARDS2. BIOLOGICAL HAZARDSContainment LevelsContainment Levels

Containment levelsContainment levels are selected to provide the are selected to provide the user with a description of the user with a description of the minimumminimum containment containment required for handling the organism safely in the required for handling the organism safely in the laboratory. laboratory.

PHAC outlines four containment levels:PHAC outlines four containment levels:

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Biological Safety Training – Certificate Holder and User Training Biological Safety Training – Certificate Holder and User Training

2. BIOLOGICAL HAZARDS2. BIOLOGICAL HAZARDSContainment LevelsContainment Levels

Containment Level 1 (CL1)Containment Level 1 (CL1)

Organisms requiring Containment Level 1 Organisms requiring Containment Level 1 requires no special design features beyond a requires no special design features beyond a basic level, well-designed functional basic level, well-designed functional laboratory. laboratory.

Work may be done on an open bench top and Work may be done on an open bench top and containment is usually achieved through the containment is usually achieved through the use of good work practices in a basic use of good work practices in a basic microbiology laboratory. microbiology laboratory.

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Biological Safety Training – Certificate Holder and User Training Biological Safety Training – Certificate Holder and User Training

2. BIOLOGICAL HAZARDS2. BIOLOGICAL HAZARDSContainment LevelsContainment Levels

Containment Level 2 (CL2Containment Level 2 (CL2))

The primary exposure hazards associated with The primary exposure hazards associated with organisms required CL2 are through the ingestion, organisms required CL2 are through the ingestion, inoculation and mucous membrane route. Agents inoculation and mucous membrane route. Agents requiring CL2 facilities are not generally transmitted requiring CL2 facilities are not generally transmitted by airborne routes but care must be taken to avoid by airborne routes but care must be taken to avoid the generation of aerosols. Primary containment the generation of aerosols. Primary containment devices used in these types of laboratories includes devices used in these types of laboratories includes such as biological safety cabinets or centrifuges in such as biological safety cabinets or centrifuges in addition to proper personal protective equipment addition to proper personal protective equipment such as laboratory coats, gloves, eye protection are such as laboratory coats, gloves, eye protection are require. Minimization of contamination includes require. Minimization of contamination includes proper hand washing facilities and decontamination proper hand washing facilities and decontamination facilities such as autoclaves. facilities such as autoclaves.

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Biological Safety Training – Certificate Holder and User Training Biological Safety Training – Certificate Holder and User Training

2. BIOLOGICAL HAZARDS2. BIOLOGICAL HAZARDSContainment LevelsContainment Levels

Containment Level 3 (CL3)Containment Level 3 (CL3)

Organisms requiring CL3 labs can cause serious or life-Organisms requiring CL3 labs can cause serious or life-threatening disease and often have a low infectious dose.threatening disease and often have a low infectious dose.

primary and secondary barriers are required to minimize primary and secondary barriers are required to minimize the release of infectious organism into the immediate the release of infectious organism into the immediate laboratory area and the environment. laboratory area and the environment.

depending on the organism being used, both Public depending on the organism being used, both Public Health Agency of Canada and the Canadian Food Health Agency of Canada and the Canadian Food Inspection Agency are required to certify the laboratory Inspection Agency are required to certify the laboratory prior to start of work.prior to start of work.

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Biological Safety Training – Certificate Holder and User Training Biological Safety Training – Certificate Holder and User Training

2. BIOLOGICAL HAZARDS2. BIOLOGICAL HAZARDSContainment LevelsContainment Levels

Containment Level 4 (CL4)Containment Level 4 (CL4)

Organisms are highly pathogenic, low infectious Organisms are highly pathogenic, low infectious dose and have the potential for aerosol transmission dose and have the potential for aerosol transmission and produce very serious and often fatal disease. and produce very serious and often fatal disease.

offers maximum containment and a complete offers maximum containment and a complete sealing of the perimeter of the laboratory facility. sealing of the perimeter of the laboratory facility.

CL4 laboratories are very rare in Canada.CL4 laboratories are very rare in Canada.

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Biological Safety Training – Certificate Holder and User Training Biological Safety Training – Certificate Holder and User Training

2. BIOLOGICAL HAZARDS2. BIOLOGICAL HAZARDSRisk AssessmentRisk Assessment

Hazard classifications of biological agents reflect the Hazard classifications of biological agents reflect the judgements made on their inherent risks based on:judgements made on their inherent risks based on:

infectious dose infectious dose route of infection route of infection pathogenicity & virulencepathogenicity & virulencehost range, host range, vectors vectors disease incidence and severitydisease incidence and severityprevention & treatmentprevention & treatmentWhether the pathogen is indigenous to CanadaWhether the pathogen is indigenous to CanadaEffect on animals, plants, fishEffect on animals, plants, fish

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A risk assessment A risk assessment should take into accountshould take into account::

the the components of the work to be done in order to determine what components of the work to be done in order to determine what procedures and activities put employees at greatest risk of having an procedures and activities put employees at greatest risk of having an exposure exposure alternate processes considered to eliminate the risk of exposure. alternate processes considered to eliminate the risk of exposure. llarge volumes (>10 litres) and high concentrations of an organism in arge volumes (>10 litres) and high concentrations of an organism in growth media may pose greater risk than smears of the same agent growth media may pose greater risk than smears of the same agent on a microscope slide. on a microscope slide. if infectious droplets and aerosols may be produced, containment if infectious droplets and aerosols may be produced, containment should be elevated to the next level should be elevated to the next level

Material safety data sheetsMaterial safety data sheets are available for many organisms are available for many organisms from PHAC’s website:from PHAC’s website:

www.phac-aspc.gc.ca/msds-ftss/index.htmlwww.phac-aspc.gc.ca/msds-ftss/index.html

Biological Safety Training – Certificate Holder and User Training Biological Safety Training – Certificate Holder and User Training

2. BIOLOGICAL HAZARDS2. BIOLOGICAL HAZARDSRisk AssessmentRisk Assessment

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Biological Safety Training – Certificate Holder and User Training Biological Safety Training – Certificate Holder and User Training

RISK ASSESSMENTRISK ASSESSMENTCell Lines and Tissue CulturesCell Lines and Tissue Cultures

Cell cultures derived from humans or animals suspected or Cell cultures derived from humans or animals suspected or known to be infected with a pathogen should be assigned to known to be infected with a pathogen should be assigned to the risk group appropriate for the suspected or known the risk group appropriate for the suspected or known pathogen and handled using the relevant containment level pathogen and handled using the relevant containment level and work practices. and work practices.

cell cultures may carry oncogenic or infectious particles; cell cultures may carry oncogenic or infectious particles; even well characterized lines with a history of safe use can even well characterized lines with a history of safe use can become contaminated with infectious microorganisms become contaminated with infectious microorganisms

prudent to treat all eukaryotic cultures as moderate risk prudent to treat all eukaryotic cultures as moderate risk agents (Risk Group 2) and to use Containment Level 2 agents (Risk Group 2) and to use Containment Level 2 facilities and work practicesfacilities and work practices

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Tissue CultureTissue CultureHave the potential to contain pathogenic organismsHave the potential to contain pathogenic organisms

In general;In general;

Level 2Mammalian primate, and mycoplasma-containing cell lines

A detailed risk assessment should be undertaken when using a new cell line.http://www.phac-aspc.gc.ca/publicat/lbg-ldmbl-04/ch2-eng.php#jmp-lan23

Others Level 1

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Biological Safety Training – Certificate Holder and User Training Biological Safety Training – Certificate Holder and User Training

RISK ASSESSMENTRISK ASSESSMENTRecombinant DNARecombinant DNA

In vitro incorporation of segments of genetic In vitro incorporation of segments of genetic material from one cell into another is termed material from one cell into another is termed “recombinant DNA”“recombinant DNA” has resulted in altered organisms that can has resulted in altered organisms that can manufacture products such as vaccines, enzymes, manufacture products such as vaccines, enzymes, etc. etc. Genetically engineered organisms are used for Genetically engineered organisms are used for treatment of waste and spills and plants can be treatment of waste and spills and plants can be made resistant to disease or adverse weather made resistant to disease or adverse weather conditions. A genetically altered organism may be conditions. A genetically altered organism may be directly pathogenic or toxic and if released into the directly pathogenic or toxic and if released into the environment transfer undesirable genetic traits to environment transfer undesirable genetic traits to wild species or mutate to pathogenic form.wild species or mutate to pathogenic form.

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Biological Safety Training – Certificate Holder and User Training Biological Safety Training – Certificate Holder and User Training

RISK ASSESSMENTRISK ASSESSMENTRecombinant DNARecombinant DNA

The risk assessment for recombinant DNA should The risk assessment for recombinant DNA should include:include:

source of the DNA to be transferredsource of the DNA to be transferred

ability of vector to survive outside the laboratoryability of vector to survive outside the laboratory

interaction between transferred gene and hostinteraction between transferred gene and host

When assessing the risk group and containment When assessing the risk group and containment level for a genetic engineered protocol, if one of level for a genetic engineered protocol, if one of the components is potentially hazardous, a risk the components is potentially hazardous, a risk level appropriate to the known hazard is assigned. level appropriate to the known hazard is assigned.

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Recombinant DNARecombinant DNA

Canada: Level of risk Canada: Level of risk depends on source of depends on source of DNA, vector and host. DNA, vector and host.

The Biosafety Committee The Biosafety Committee will assist the investigator will assist the investigator in this determination.in this determination.

Genetic Engineering = in vitro incorporation of genetic material from one cell into another

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Biological Safety Training – Certificate Holder and User Training Biological Safety Training – Certificate Holder and User Training

RISK ASSESSMENTRISK ASSESSMENTBlood and Body FluidsBlood and Body Fluids

risk associated with blood and bodily fluids is the potential risk associated with blood and bodily fluids is the potential exposure to bloodborne pathogens which may be present in exposure to bloodborne pathogens which may be present in contaminated blood and bodily fluids and are capable of causing contaminated blood and bodily fluids and are capable of causing disease in exposed individuals. The pathogens of greatest disease in exposed individuals. The pathogens of greatest concern are the hepatitis B virus (HBV), the hepatitis C virus concern are the hepatitis B virus (HBV), the hepatitis C virus (HCV) and the Human Immunodefiency Virus (HIV). (HCV) and the Human Immunodefiency Virus (HIV). Human Immunodefiency VirusHuman Immunodefiency Virus is a retrovirus that causes is a retrovirus that causes Acquired Immunodeficiency Syndrome (AIDS ). The mean Acquired Immunodeficiency Syndrome (AIDS ). The mean incubation period is 10 years. It is difficult to become infected with incubation period is 10 years. It is difficult to become infected with HIV through a needle stick injury or other exposure to blood or HIV through a needle stick injury or other exposure to blood or other body fluids. The risk depends on the amount of virus to other body fluids. The risk depends on the amount of virus to which one is exposed and the titre of HIV viral RNA.. There is no which one is exposed and the titre of HIV viral RNA.. There is no vaccine for HIV, but drugs are available which reduce the risk of vaccine for HIV, but drugs are available which reduce the risk of becoming infected with the virus. To be effective, the drugs must becoming infected with the virus. To be effective, the drugs must be started within 1 to 2 hours after the exposure. be started within 1 to 2 hours after the exposure.

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RISK ASSESSMENTRISK ASSESSMENTBlood and Body FluidsBlood and Body Fluids

Hepatitis BHepatitis B is caused by a potentially fatal virus that destroys liver is caused by a potentially fatal virus that destroys liver cells and may permanently damage the liver. It can be transmitted cells and may permanently damage the liver. It can be transmitted not only by percutaneous exposures, but also via mucous not only by percutaneous exposures, but also via mucous membranes. The incubation period for hepatitis B is 45 to 160 membranes. The incubation period for hepatitis B is 45 to 160 days. Of the people infected with hepatitis B, 10% become chronic days. Of the people infected with hepatitis B, 10% become chronic carriers and may develop cirrhosis and an increased susceptibility carriers and may develop cirrhosis and an increased susceptibility to liver cancer. Immunization is a very effective method of to liver cancer. Immunization is a very effective method of preventing hepatitis B. Personnel in high risk groups, must show preventing hepatitis B. Personnel in high risk groups, must show confirmation of vaccination against hepatitis B.confirmation of vaccination against hepatitis B.

Hepatitis CHepatitis C is caused by a virus and the interval between is caused by a virus and the interval between exposure and seroconversion is approximately 8 to 10 weeks. At exposure and seroconversion is approximately 8 to 10 weeks. At least 85% of people infected with the virus will become chronically least 85% of people infected with the virus will become chronically infected. An increased risk of liver cancer does exist, especially in infected. An increased risk of liver cancer does exist, especially in individuals who develop cirrhosis. individuals who develop cirrhosis.

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RISK ASSESSMENTRISK ASSESSMENTBlood and Body FluidsBlood and Body Fluids

The types of body fluids capable of transmitting HIV, The types of body fluids capable of transmitting HIV, HBV, and HCV from an infected samples include: HBV, and HCV from an infected samples include: – blood, serum, plasma and all biologic fluids visibly blood, serum, plasma and all biologic fluids visibly

contaminated with bloodcontaminated with blood– laboratory specimens, samples or cultures that contain laboratory specimens, samples or cultures that contain

concentrated HIV, HBV, HCVconcentrated HIV, HBV, HCV– organ and tissue transplantsorgan and tissue transplants– pleural, amniotic, pericardial, peritoneal, synovial and pleural, amniotic, pericardial, peritoneal, synovial and

cerebrospinal fluidscerebrospinal fluids– uterine/vaginal secretions or semen (unlikely able to transmit uterine/vaginal secretions or semen (unlikely able to transmit

HCV)HCV)– saliva ( for HCV, HBV, and HIV if a bite is contaminated with saliva ( for HCV, HBV, and HIV if a bite is contaminated with

blood and for HBV if a bite is not contaminated with blood). blood and for HBV if a bite is not contaminated with blood).

Feces, nasal secretions, sputum, tears and urine are Feces, nasal secretions, sputum, tears and urine are not indicated in the transmission of HIV, HBV or HCV not indicated in the transmission of HIV, HBV or HCV unless visibly contaminated with blood.unless visibly contaminated with blood.

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RISK ASSESSMENTRISK ASSESSMENTAnimal PathogensAnimal Pathogens

The Canadian Food Inspection Agency (CFIA) The Canadian Food Inspection Agency (CFIA) establishes conditions under which work with establishes conditions under which work with animal pathogens may be carried out. animal pathogens may be carried out.

The level of containment will be dependent on not The level of containment will be dependent on not only the risk to human health, but also the only the risk to human health, but also the requirements to prevent to escape of an animal requirements to prevent to escape of an animal pathogen into the outside environment. pathogen into the outside environment.

CFIA publishes the CFIA publishes the Containment Standards for Containment Standards for Veterinary FacilitiesVeterinary Facilities, outline the requirements for , outline the requirements for work with animal or zoonotic (i.e., both an animal work with animal or zoonotic (i.e., both an animal and human) pathogens.and human) pathogens.

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RISK ASSESSMENTRISK ASSESSMENTPlant PathogensPlant Pathogens

The Canadian Food Inspection Agency is The Canadian Food Inspection Agency is proposing a draft for containment standards for proposing a draft for containment standards for facilities housing plant pests. facilities housing plant pests. The risk to laboratory personnel from plant pests is The risk to laboratory personnel from plant pests is relatively low risks, since plant pests rarely infect relatively low risks, since plant pests rarely infect healthy people. healthy people. some plant pests, pose a significant threat to some plant pests, pose a significant threat to agricultural production, and natural environments.agricultural production, and natural environments.important that personnel working with plant pests important that personnel working with plant pests take steps to prevent the accidental escape of take steps to prevent the accidental escape of potentially damaging pests into the environmentpotentially damaging pests into the environmentThe level of containment required to prevent The level of containment required to prevent escapes will depend on specific pest biology and escapes will depend on specific pest biology and the impact that an escape might have on the the impact that an escape might have on the Canadian environment.Canadian environment.

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Unconventional PathogensUnconventional PathogensTSE prion diseases; lethal transmissible TSE prion diseases; lethal transmissible neurodegenerative conditionsneurodegenerative conditions• Creutzfeld-Jakob disease, Variant C-J Disease, Creutzfeld-Jakob disease, Variant C-J Disease,

Mad Cow Disease, Scrapie, Chronic Wasting Mad Cow Disease, Scrapie, Chronic Wasting Disease.Disease.

Resistant to destruction by procedures that Resistant to destruction by procedures that normally inactivate viruses.normally inactivate viruses.

Contact CEHSM to assess requirements with Contact CEHSM to assess requirements with PHAC and CFIA (containment, procedures, PHAC and CFIA (containment, procedures, waste disposal, etc.)waste disposal, etc.)

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RISK ASSESSMENTRISK ASSESSMENTUnconventional PathogensUnconventional Pathogens

unconventional or slow viruses, e.g. prions unconventional or slow viruses, e.g. prions (proteinaceous infectious particles) have been (proteinaceous infectious particles) have been associates with transmissible degenerative disease of associates with transmissible degenerative disease of the central nervous system in humans (e.g., Creutzfeldt-the central nervous system in humans (e.g., Creutzfeldt-Jacob) and in animals such as encephalopathy). Jacob) and in animals such as encephalopathy). resistant to destruction by chemical or physical resistant to destruction by chemical or physical disinfection. disinfection. precautions should be observed when handling precautions should be observed when handling neurological material from suspected infected humans or neurological material from suspected infected humans or animals:animals:– handle as a minimum of Risk Group 2 or higher, depending on handle as a minimum of Risk Group 2 or higher, depending on

nature of the work and amount of agent being manipulated;nature of the work and amount of agent being manipulated;– handle tissue as if still infectious even if tissue is fixed with handle tissue as if still infectious even if tissue is fixed with

formalin or embedded in wax;formalin or embedded in wax;

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RISK ASSESSMENTRISK ASSESSMENTLab Acquired InfectionsLab Acquired Infections

Health Canada reports that there have been over Health Canada reports that there have been over 5,000 reported cases of lab-acquired infections and 5,000 reported cases of lab-acquired infections and 190 deaths up to 1999 worldwide. 190 deaths up to 1999 worldwide.

It is also estimated that only 20% of infections can be It is also estimated that only 20% of infections can be attributed to any known, single exposure event. attributed to any known, single exposure event.

80% of laboratory acquired infections (LAI's) go 80% of laboratory acquired infections (LAI's) go undetected due to long incubation periods, mild undetected due to long incubation periods, mild symptoms, or symptoms common to every day symptoms, or symptoms common to every day illnesses (i.e. flu-like symptoms). illnesses (i.e. flu-like symptoms).

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Biological Safety Training – Certificate Holder and User Training Biological Safety Training – Certificate Holder and User Training

RISK ASSESSMENTRISK ASSESSMENTLab Acquired InfectionsLab Acquired Infections

Several ways in which infectious substances Several ways in which infectious substances can enter the body and cause infection:can enter the body and cause infection: ingestioningestion inhalationinhalationcontact with mucous membranes, including contact with mucous membranes, including

transfer of microorgansims to the eyes by transfer of microorgansims to the eyes by contaminated hands or with non intact skin. contaminated hands or with non intact skin.

Infections are caused from exposure to Infections are caused from exposure to infectious aerosols, spills, splashes, needle infectious aerosols, spills, splashes, needle stick injuries, cuts, centrifuge accidents.stick injuries, cuts, centrifuge accidents.

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Biological Safety Training – Certificate Holder and User Training Biological Safety Training – Certificate Holder and User Training

RISK ASSESSMENTRISK ASSESSMENTLab Acquired InfectionsLab Acquired Infections

Exposure to aerosols is estimated to be the Exposure to aerosols is estimated to be the single largest cause of laboratory single largest cause of laboratory infections. Operational practices and infections. Operational practices and techniques must be used to minimize the techniques must be used to minimize the creation of aerosols associated with creation of aerosols associated with common laboratory procedures. common laboratory procedures. Where chemical disinfection procedures are Where chemical disinfection procedures are employed, effective concentrations and employed, effective concentrations and contact times must be used. Chemical contact times must be used. Chemical disinfectants used to decontaminate disinfectants used to decontaminate materials to be removed from the laboratory materials to be removed from the laboratory must be replaced regularly.must be replaced regularly.

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ALWAYS WASH HANDSWASH HANDS

BEFORE EATINGBEFORE EATING

BEFORE GOING HOMEBEFORE GOING HOME

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Biological Safety Training – Certificate Holder and User Training Biological Safety Training – Certificate Holder and User Training

RISK ASSESSMENTRISK ASSESSMENTLab Acquired InfectionsLab Acquired Infections

Every incident (no matter how small) must be Every incident (no matter how small) must be investigated to determine if the risk of investigated to determine if the risk of exposure exists, and what could be done to exposure exists, and what could be done to prevent the possibility of reoccurrence. prevent the possibility of reoccurrence.

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Laboratory Associated InfectionsLaboratory Associated Infections

Routes of Transmission

Susceptible HostInfection Source

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Laboratory Associated InfectionsLaboratory Associated Infections

Routes of exposureRoutes of exposure

• Percutaneous inoculationPercutaneous inoculation• Inhalation of aerosolsInhalation of aerosols• Contact of mucous membranes Contact of mucous membranes • IngestionIngestion

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Laboratory Associated InfectionsLaboratory Associated Infections

Sources of InfectionSources of Infection

Cultures and stocksCultures and stocksResearch animalsResearch animalsSpecimensSpecimensItems contaminated with aboveItems contaminated with above

Susceptible HostSusceptible Host

Immune systemImmune systemVaccination statusVaccination statusAgeAge

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Laboratory Associated InfectionsLaboratory Associated Infections

80% unknown or unrecognized causes80% unknown or unrecognized causes

20% causative or defined event20% causative or defined event• 80% of which are caused by human error80% of which are caused by human error• 20% are caused by equipment failure20% are caused by equipment failure

Top 4 accidents resulting in infectionTop 4 accidents resulting in infection1.1. Spillages & splashesSpillages & splashes

2.2. Needle and syringeNeedle and syringe

3.3. Sharp object, broken glassSharp object, broken glass

4.4. Bite or scratch from animals or ectoparasitesBite or scratch from animals or ectoparasites

http://www.weizmann.ac.il/safety/bio2.html

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Laboratory Associated Laboratory Associated InfectionsInfections

WHOWHO WHATWHAT WHEREWHERE WHENWHEN HOWHOW

ResearcherResearcher SARSSARS TaiwanTaiwan December 2003December 2003

MicrobiologistMicrobiologist West Nile VirusWest Nile Virus United StatesUnited States August 2002August 2002 LacerationLaceration

Laboratory Laboratory WorkerWorker

Meningococcal Meningococcal DiseaseDisease

United StatesUnited States 20002000 Aerosol?Aerosol?

Laboratory Laboratory workerworker

Vaccinia virusVaccinia virus EuropeEurope 20022002 ContactContact