1. Biopreparedness &
Incident Response
Miguel Mártin N. Moreno II, MD
SLMC-RBD, Research Scientist
PhBBA, Founding Secretary

2. Being Aware …… Being Prepared

3. Potential
Emergencies/Incidents
 External events
 Hurricanes, tornados, earthquakes
 Power outages
 Terrorism
 Internal events
 Medical (Bites, Scratches)
 Fires, explosions
 Spills, splashes
 Escapes
 Environmental releases

4. Guiding Principles
 Developing an Emergency Response Program is
essential to mitigating the effects of an incident
 Coordination with emergency responders is
essential
 Not all incidents are emergencies
 “Lessons learned” from past incidents and near
hits are crucial tools for avoiding future mistakes
 Planning is everything
 Training is everything else
 Attention to detail is the name of the game

5. What is an “emergency”?
Any unplanned event that could result in an
uncontrolled release of biohazardous materials
 Natural disasters
 Infrastructure disruptions
 Containment
compromise
 Security breach
 Spill outside the BSC
 Major injury

6. What is an “incident”?
Any unplanned event that disrupts normal
operations
 Brief power outage
 Small cut or minor injury
 Event in another part of the building
 Spill inside the BSC
 Impending weather

7. Types/Levels/Degrees
Minor incident
This type of incident is small and can be dealt
with locally in a small amount of time.
No major response is required and no one
needs to be alerted, however the BSO should
be informed and may require a written incident
report.
 e.g. minor spill inside the biosafety cabinet, a brief
power outage, a transient alarm on a biosafety
cabinet or centrifuge, etc.

8. Types/Levels/Degrees
Major incident
This type of incident is larger, but is still not an
emergency.
Personnel should stop work, secure their
cultures or animals, and await further
instruction.
Personnel may be required to exit the facility
via normal exit procedures in an orderly, but
rapid fashion.
 e.g. sustained power failure, minor fire that is quickly put out,
known impending weather problems, etc.

9. Types/Levels/Degrees
Minor emergency
This is an emergency that requires and
immediate response involving all personnel in
the laboratory or animal room.
Personnel should stop all work, secure their
cultures or animals, move to a safe location and
await further instructions.
Evacuation may be required and personnel
should be prepared to do so.
 e.g. major biological or chemical spills in the laboratory or
animal room, minor earthquake, fire that is being controlled,
etc.

10. Types/Levels/Degrees
Major emergency
This is a serious emergency that requires the
immediate evacuation of all personnel from the
laboratory or animal room.
This level of emergency abandons all biocontainment
and the focus is on preserving the life of the personnel.
Workers should immediately stop all work, alert others,
walk quickly to the nearest exit while removing PPE and
dropping it.
Personnel should immediately exit the facility and go to
the assembly point if safe to do so.
 e.g. major explosions in the facility, severe earthquakes, release of
toxic gas, or armed aggression, etc.

11. Risk Assessment
Probability X Magnitude = Risk
Probability (likelihood of occurrence)
1 = low or minimal
2 = medium or moderate
3 = high or substantial
Magnitude (potential harm to health or environment)
1 = minimal harm
2 = moderate harm
3 = substantial harm
How do you know?

12. Emergency Response Preparation Process
 Create an emergency response manual
 Identification of key personnel
 Internal Responders
 External Responders
 On-site preparation
 Spills, decontamination, first-aid supplies equipment
 Training and practice sessions
 Spill cleanup
 Alarm testing and evacuation drills
 Basic First Aid, CPCR
 Drills
 After action analysis

13. Emergency Response Manual
n Purpose
n Scope
n Emergency Organization
n Communication
n Call Procedures
n Responsibilities
n BSL3/ABSL3 Manager
n Biosafety Officer (BSO)
n Facilities/Engineering Department
n Security
n Authorized BSL3/ABSL3 Employees
n Training
n Recordkeeping
n Evacuation Procedure
n Fire Emergency Plan for Workers in the
BSL3/ABSL3 Facilities
n Existence of Fire Emergency
n Action or Emergency Procedures
■ Earthquake Response
■ Precautions Taken Before an Earthquake
■ Procedures for Employees to Follow During an
Earthquake
■ Procedures to Follow Immediately After the
Shaking Stops
■ Procedures to Follow After the Earthquake
■ Power Failure or Ventilation Failure
■ Injuries / Illnesses / Emergency Medical Event
■ Physical Injuries
■ Hazardous Materials Spills
■ Chemical Spill
■ Large Hazardous Materials Spills
■ Biological Spills
■ Personnel Contamination
■ Appendixes
■ Appendix 1 – Emergency Contacts and Phone Numbers
■ Appendix 2 – BSL3/ABSL3 Evacuation Route & Assembly
Point
 Purpose
 Scope
 Emergency Organization
 Communication
 Call Procedures
 Responsibilities
 BSL3/ABSL3 Manager
 Biosafety Officer (BSO)
 Facilities/Engineering Department
 Security
 Authorized BSL3/ABSL3 Employees
 Training
 Recordkeeping
 Evacuation Procedure
 Fire Emergency Plan for Workers in the
BSL3/ABSL3 Facilities
 Existence of Fire Emergency
 Action or Emergency Procedures

14.  Define personnel roles
& responsibilities for
each type of (potential)
incident
 Responsibilities in spill
response are different
than in security breaches
 Keep names and
contact information
updated!!
Responsibility Contact Info
Spill
Coordinator Extension Pager Home PH
Spill Team Lead
Spill Primary
Responder
Spill Secondary
Responder
Safety
Responder
Planning: Internal

15.  Lab staff
 Departmental contacts
 Internal security
 Emergency management office
 EH&S
 Facilities operations, maintenance, plant
services
 Occupational Health Services
 Public information/media services office
Identify Internal Responders

16.  Dispatch
 Fire
 Police
 Hazardous Materials Team
 Bomb Squad
 Local Terrorism Response Coordinators
 Emergency Medical Services
 Hospitals/Emergency Rooms
 Infectious Disease Physicians
Identify External Responders and
Develop Cooperative Relationships

17. Biologics - Use absorbents with disinfectants
Solvents - Use solvent absorbents
Acids - Use acid neutralizers
Caustics - Use caustic neutralizers
Mercury - Use Hg Absorb® sponges &
powder
Strong Oxidizers - Use inert absorbents
Spills
Environmental Exposure

18.  Commercial kits
available
 “DIY” – do it yourself
 Small disposable broom
with dustpan, tongs or
forceps
 Biohazard waste bags
 Concentrated disinfectant
agent suitable for the
agents in the lab
 Container for diluting and
holding disinfectant
 Paper towels or other
absorbent material
 Long metal forceps
 Dike material or spill
pillows for large spills
 Spill control and clean-up
procedures
 Sharps container
 Warning signs
 Storage container
…and PPE
Biological Spill Kit

19.  Gloves - nitrile (double?) or rubber utility
 Face/eye protection
 Shoe covers
 Protective clothing - Tyvek® gowns
 Respirator (depends on risk assessment—user
must be medically cleared and fit-tested)
Personal Protective Equipment

20.  Develop an appropriate kit with Employee
Health physician advice
 Bandages, tape
 Disinfectant
 Scissors
 Sling
 Gloves, goggles
First Aid Kit Contents

21.  Written emergency procedures provided to labs
 During an incident, follow the directions of the
Incident Commander
 Response and follow-up procedures included in
training
 Internal, non-lab responders fully trained on
expected roles/responsibilities and response
procedures
 Participate in external responder training,
especially outreach
Training: Internal Responders

22.  Location specific plans
 Escape paths
 Alarm systems
 Safety equipment & use
 Handicap assistance
 Assembly areas
 Accountability
Training for evacuations

23. Training for Medical Emergencies
 Check the scene and victim:
Is the scene safe, what happened, how many victims, is
their any help?
 Call for medical help if victim is:
Unconscious, has trouble breathing, has chest pain/pressure,
bleeding severely, has possible broken bones, has persistent
pressure/pain in abdomen, is vomiting/passing blood, has
seizures, headache or slurred speech
 Care for victim:
Only if you are trained, do not move
unless you have training, provide CPCR
and first aid if trained, comfort victim
until help arrives

24.  Building Maps & Access
 Fire Alarm/Monitoring Systems
 Hazardous Materials Awareness Outreach
 Chemical
 Radiological
 Biological
 Emergency Procedures
 Tour
Training: External Responders

25.  Intended to test the validity and effectiveness of
the emergency plan
 Two types of drills
 Tabletop
 On-the-ground exercise
 Both are useful and important
 Both result in credible upgrades to the emergency
plan
Drills

26.  The final element of the emergency plan
 Important because hindsight is 100% accurate
 Reveals the consequences of mistakes, missing safety
equipment, inadequate SOP’s, poor lab design
 Most of all, reveals the consequences of inadequate
training/preparedness
 Conduct first review very soon after the incident
 Reveals immediate necessary emergency plan revisions
 Second review some time later to add further
incident data, evaluate progress in corrective
actions, and revise policy if necessary
Post-incident review

27. Planning for the Aftermath
● Notifications
● Contact with agencies
● Laboratory decontamination
 Have contracts in place, vendor on call
● Repairs
● Media contacts

28. Keys to Emergency Response
 Emergency plan
 Risk Assessment
 Risk mitigation
 Plan: personnel, procedures, follow-up
 Integrate with facility emergency plans
 Training & drills
 Post-emergency
 Analyze, report, review
 Modify the emergency plan as necessary
 Retrain, restructure drills

29. Acknowledgements
Robert Heckert, DVM, CBP
David Bressler, CBP
PhBBA National Chapter
SLMC-QC-RBD

30. Be Aware ……
Be Prepared!
Thank you for your attention