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Biosafety in the laboratories

deals with biosafety in medical labs. universal safety precautions included. Includes updated 8 categories and colour coding for BMW management. Being a budding microbiologist, kept it focused on microbiology lab

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Biosafety in the laboratories

  1. 1. • Biosafety is the prevention of large-scale loss of biological integrity, focusing both on ecology and human health. • It is a system for the safe handling of toxic and dangerous biological and chemical substances • In Medicine- • It refers to the levels of lab containment protocols, measured as Bio Safety Level (BSL) 1, 2, 3, 4 in rising order of danger
  2. 2. • Safe handling, storage and disposal of -Specimens -Chemicals -Instruments -Radio active components • Fire safety • Electrical safety • Disaster management in areas risk prone for natural calamities like Earthquakes, Hurricanes or snowstorms
  3. 3. From- •Bacteria •Viruses •Fungi •Parasites •Prions •Recombinant DNA Source- •Various specimens •Human blood •Unfixed tissue •Human cell lines To- •Lab personnel •Community
  4. 4. Infections of special concern •Tuberculosis •Hepatitis B •HIV •Enteric infections Routes of infections •Inoculation •Ingestion •Inhalation
  5. 5. • Fundamental objective biosafety program- the containment of potentially harmful biological agents. • “Containment”- safe methods, facilities and equipment for managing infectious materials in the laboratory environment where they are being handled or maintained. • The purpose of containment- reduce or eliminate exposure of laboratory workers, other persons, and the outside environment to potentially hazardous agents. • The use of vaccines may provide an increased level of personal protection.
  6. 6. • Laboratories should recognize hazards of processing infectious agents • Guidelines should be developed to protect workers in microbiological and medical labs through engineering controls, management policies and standard work practices.
  7. 7. • It is issued under the Environmental (Protection) Act of 1986 • Rules for manufacture, use/import/export and storage of hazardous microorganisms/genetically engineered organisms or Cells, 1989, Dec 5 • There is a new law—the Biotechnology Authority of India (BRAI)—under consideration of the Central government.
  8. 8. 1. Consider all the specimens potentially infectious for HIV and other blood borne infections 2. All specimens should be placed in a leak-proof impervious container for transport 3. Use gloves while handling all samples, especially when there is contact with body fluids, non-intact skin or mucous membrane. 4. If there is likelihood of spattering, use face mask with glasses and gowns. Wrap around gowns should be preferred. These should not be used outside the lab. 5. Cover cuts or abrasions present over skin with waterproof bandage.
  9. 9. 6. Decontaminate the laboratory work surfaces immediately in case of spillage of blood or any other body fluids 7. Follow ‘no needle recapping’ strategy 8. All sharps should be collected and disposed away properly. 9. Never pipette by mouth. Use mechanical pipetting devices. 10. There should always be a system working efficiently for management of hospital generated waste. 11. It is advisable for the laboratory personnel to be vaccinated against Hepatitis-B 12. Facilities should be available easily for post exposure prophylaxis in case of exposure to HIV & HBV.
  10. 10. • NOT permitted in laboratories: Eating Drinking Storing food and drink Smoking Handling contact lenses Pipetting by mouth
  11. 11. Do’s •controlled access to the laboratory •Frequent hand wash •Mechanical pipetting •Appropriate waste management & Sterilization and disinfection measures •Training to the workers Don’ts •Eating, drinking, smoking, handling contact lenses, •storing food •Mouth pipetting
  12. 12. • - Primary barriers • - Secondary barriers • Primary barriers: Physical barriers or personal protective equipments for lab worker • Gloves, masks, Goggles, aprons, suits, special breathing apparatuses
  13. 13. • structural aspects of the laboratory that make working environment safer against infection • Sinks for hand washing • Special containment areas • Special air ventilation patterns • Sterilization equipments
  14. 14. • Tuberculosis • Rubella • Hepatitis B • Typhoid • Cholera • Anthrax • Rabies • Poliomyelitis • Diphtheria
  15. 15. • Precautions to be taken by people researching or trying to identify organisms • Labs must adhere to these specific safety regulations • A biosafety level is the level of the bio containment precautions, required to undertake while handling dangerous biological agents in an enclosed facility
  16. 16. • These are the guidelines developed to protect workers in microbiological and medical labs through a combination of safeguards which include -engineering controls -management policies -standard work practices. • These BSL help you to understand why every lab cannot perform tests for every organism
  17. 17. • Labs are divided into 4 biosafety levels; in which protective practices increase with each level • Biosafety Level 1 labs - work with least dangerous agents, require fewest precautions • Biosafety Level 4 labs - have strictest methods because dealing with agents that are most dangerous to human health
  18. 18. BSL Laboratory type Laboratory practices Safety equipment 1 Basic teaching, research Good microbiological techniques None Open bench work 2 Primary health services; diagnostic services, research Good microbiological techniques, protective clothing, biohazard sign Open bench PLUS biological safety cabinet for potential aerosols 3 Special diagnostic services, research As BSL 2 PLUS special clothing, controlled access, directional airflow Biological safety cabinet and/or other primary devices for all activities 4 Dangerous pathogen units As BSL 3 PLUS airlock entry, shower exit, Class III biological safety cabinet, positive pressure suits,
  19. 19. BSL The Micro organisms Remarks 1 canine hepatitis virus, non-pathogenic Escherichia coli, other non-infectious bacteria, B.subtilis Minimal protection required 2 C. difficile, most Chlamydiae, hepatitis A, B, and C virus, HIV, orthomyxoviruses (other than smallpox), influenza A, Lyme disease, Salmonella, mumps, measles, scrapie, MRSA, and VRSA, B. anthracis Can cause only mild disease to humans, or are difficult to contract via aerosol in a lab setting 3 Yersinia pestis, Francisella tularensis, Leishmania donovani, Mycobacterium tuberculosis, Chlamydia psittaci, West Nile virus, Venezuelan equine encephalitis virus, Eastern equine encephalitis virus, SARS coronavirus, Coxiella burnetii, Rift Valley fever virus, Rickettsia rickettsii, several species of Brucella, rabies virus, and yellow fever virus Can cause serious or potentially lethal disease after inhalation in humans but for which treatments DOES exist 4 Bolivian and Argentine hemorrhagic fevers, Marburg virus, Ebola virus, Lassa virus, Crimean-Congo hemorrhagic fever, and various other hemorrhagic diseases Dangerous and exotic agents that pose a high individual risk of aerosol-transmitted laboratory infections, these cause severe to fatal disease in humans for which vaccines or other treatments are NOT available
  20. 20. • BSL1 - microorganisms that don’t consistently cause disease in healthy adults • E. coli , polyoma virus • Basic laboratory • Standard Microbiological Practices
  21. 21. • Standard practices required: • frequent hand washing • door that can be kept closed when working; • limits on access to the lab space when working; • no smoking, eating, drinking, storage of food in laboratory; • care to minimize splashes and actions that may create aerosols (tiny droplets); • decontamination of work surfaces after every use after any spills;
  22. 22. • Standard practices (continued): • decontamination of laboratory wastes; • use of mechanical pipettes only (no mouth pipetting); • "sharps" precautions, including special containers for disposing of needles and other sharp objects; • maintenance of insect/rodent control program; • use of personal protective equipment (lab coats, latex gloves, eye protection or face shields) • Open bench top sink for hand washing
  23. 23. • Agents associated with human disease •Generally required for any human-derived blood, bodily fluids, tissues in which infectious agent may be unknown •Agents include measles virus, Salmonella species, pathogenic Toxoplasma, Clostridium botulinum, hepatitis B virus
  24. 24. • Primary hazards: • accidental needle sticks • exposure to eyes and nose (mucous membranes) • ingestion of infectious materials • Agents do not cause lethal infections, are not transmissible via airborne route • (do not cause infection if tiny droplets become airborne and are inhaled, which might occur if the material were spattered) • Agents are pathogens for which immunization or antibiotic treatment is available • Extreme care should be taken with contaminated needles and sharp lab instruments
  25. 25. • Standard practices include BSL-1 plus: • policies to restrict access to lab; •biohazard warning signs posted outside lab; • surveillance of laboratory personnel with appropriate immunizations offered; • biosafety manual with definitions of needed waste decontamination or medical surveillance policies; • supervisory staff who have experience of working with infectious agents and specific training for laboratory personnel in handling these agents
  26. 26. • Primary barriers: biosafety cabinets or other approved containment devices • Personal protective equipment: lab coats, gloves, face protection as needed • Protective clothing removed when personnel leave laboratory area • Cabinets thoroughly decontaminated daily and monitored for radiation for personal protection • Secondary barriers: BSL-1 barriers plus autoclave for glassware
  27. 27. • Also called as biological safety cabinet or microbiological safety cabinet • It is an enclosed, ventilated laboratory workspace for safely working with materials contaminated with (or potentially contaminated with) pathogens requiring a defined biosafety level • BSCs first became commercially available in 1950
  28. 28. CATEGORYCATEGORY TYPE OF WASTETYPE OF WASTE TREATMENT &TREATMENT & DISPOSALDISPOSAL Category 1Category 1 Human anatomical wastesHuman anatomical wastes Incineration/ deep burialIncineration/ deep burial Category 2Category 2 Animal wastesAnimal wastes Incineration/ deep burialIncineration/ deep burial Category 3Category 3 Microbiology & biotechnologyMicrobiology & biotechnology waste,waste, Liquid wastes, wasteLiquid wastes, waste from Laboratory, bloodfrom Laboratory, blood banks, hospitals, house etc.banks, hospitals, house etc. Local autoclaving/Local autoclaving/ microwaving/microwaving/ incineration/incineration/ Disinfection byDisinfection by chemicalschemicals Category 4Category 4 Waste sharps like needles,Waste sharps like needles, syringes, scalpels, blades, glasssyringes, scalpels, blades, glass etcetc DisinfectionDisinfection (Chemical/autoclaving/(Chemical/autoclaving/ micro waving &micro waving & mutilation/shredding)mutilation/shredding) Category 5Category 5 Discarded Medicines & cytotoxicDiscarded Medicines & cytotoxic drugsdrugs Incineration/ destructionIncineration/ destruction & disposal in land fills& disposal in land fills
  29. 29. CATEGORYCATEGORY TYPE OF WASTETYPE OF WASTE TREATMENT &TREATMENT & DISPOSALDISPOSAL Category 6Category 6 Soiled wastesSoiled wastes Items contaminated withItems contaminated with blood, body fluids includingblood, body fluids including cotton, dressings etccotton, dressings etc Incineration,Incineration, autoclaving,autoclaving, microwavingmicrowaving Category 7Category 7 Solid wastes like catheters, IVSolid wastes like catheters, IV sets etc.sets etc. Disinfection byDisinfection by chemicalchemical treatment/autoclavingtreatment/autoclaving /micro waving and/micro waving and mutilation &mutilation & shreddingshredding Category 8Category 8 Chemical wastesChemical wastes Chemical treatment &Chemical treatment & discharge into drainsdischarge into drains for liquid and securedfor liquid and secured land fills for solids.land fills for solids.
  30. 30. • And these 8 categories are again sorted according to special colour coded receptacles for waste of those categories. • The waste is collected in these colour coded containers and processed further accordingly. • The following table depicts this categorization.
  31. 31. Colour CodingColour Coding Type of container Type of container  to be usedto be used Waste Category Waste Category  NumberNumber TreatmentTreatment YellowYellow Non Chlorinated Non Chlorinated  plastic bagsplastic bags Category 1,2,5,6Category 1,2,5,6 IncinerationIncineration RedRed Non Chlorinated Non Chlorinated  plastic plastic  bags/puncture proof bags/puncture proof  container for sharpscontainer for sharps Category 3,4,7Category 3,4,7 Disinfection, Disinfection,  autoclave, autoclave,  microwave, microwave,  mutilation & mutilation &  shredding, shredding,  landfillinglandfilling BlueBlue Non Chlorinated Non Chlorinated  plastic bags plastic bags  containercontainer Category 8Category 8 BlackBlack Non Chlorinated Non Chlorinated  plastic bagsplastic bags Municipal WasteMunicipal Waste
  32. 32. • BSL3 - microorganisms that cause serious disease, transmitted by inhalation • M. tuberculosis, yellow fever virus, hantavirus, Y. pestis (plague) • Containment lab: double door entry; directional airflow; all work in biosafety cabinet
  33. 33. • Care of patients with tuberculosis starts with a quality assured diagnosis, obtained by growing and identifying Myco bacte rium tube rculo sis from clinical specimens and conducting DST of the organism to confirm or exclude resistance. Uptake of TBdiagnostic technologies requires appropriate laboratory infrastructure and adequate policy reformat country level to enable theireffective use in TBscreening and diagnostic algorithms • Laboratory infrastructure, appropriate biosafety measures and maintenance Equipment validation and maintenance Specimen transport and referral mechanisms Management of laboratory commodities and supplies Laboratory information and data management systems Laboratory quality management system are a priority.
  34. 34. • With growing incidences of MDR-TB and XMDR- TB it is highly essential all Microbiology laboratories must install Grade 3 Biosafety cabinets to prevent exposure to Infection. If necessary precaution's are not taken a fraction of Medical and Technical personal will be infected with grave consequences.
  35. 35. • Pathogenic agents are grouped in Risk group 3 which can cause serious diseases • Effective treatment and preventive measures are usually available • Little person-to-person spread
  36. 36. • Standard practices include BSL-2 plus: • strictly controlled access to the lab; • specific training for lab personnel in handling potentially lethal agents; • decontaminating all waste; • changing contaminated protective lab clothing, decontaminating lab clothing before laundering; • institutional policies regarding specimen collection and storage from workers to prevent exposure
  37. 37. • Primary barriers: • Similar to BSL-2 personal protective equipment • Respiratory equipment Secondary barriers: • All BSL-2 barriers • Corridors separated from direct access to lab • Access through self-closing double doors • Air handling systems to ensure negative air flow (air flows into the lab) • Air pumped into lab not re-circulated in building
  38. 38. • BSL4 - microorganisms that cause lethal disease, with no known treatment or vaccine Ebola virus, Marburg virus Maximum containment lab; positive pressure ventilated suits (moon suits)
  39. 39. • Pathogenic agents are grouped in Risk group 4 which is lethal • Readily transmittable- direct or indirect • Effective treatment and preventive measures are not usually available
  40. 40. • Dangerous and exotic agents with high risk of life-threatening disease and are aerosol- transmittion • Related agents with unknown risk of transmission • Agents (all viruses) include Marburg virus, Ebola virus, viruses that cause Congo- Crimean hemorrhagic fever, Lassa fever
  41. 41. • Primary hazards: • respiratory exposure to infectious aerosols • mucous membrane exposure to infectious droplets • accidental sticks with needles or other sharp objects contaminated with infectious material • For example • In late 1960s, 25 laboratory-acquired Marburg infections, including 5 deaths • Affected workers studying infected monkeys from Uganda
  42. 42. • Personnel must receive specialized training in handling extremely dangerous infectious agents, containment equipment and functions • Access to lab is restricted: immunocompromised persons are never allowed to enter the lab •  Standard practices include BSL-3 plus: • More strictly controlled access to the laboratory; • Changing clothing before entering and exiting lab (showering upon exiting recommended); • Decontaminating all material exiting facility
  43. 43. • Primary barriers: • Biosafety cabinets used at other biosafety levels • Full-body, air-supplied, positive pressure personnel suit • Secondary barriers: • All physical barriers at BSL-3 • isolated zone or a separate building; • dedicated supply and exhaust, vacuum, decontamination systems; • a recommended absence of windows (or sealed and resistant to breakage)
  44. 44. • BSL-1: high schools, community colleges, municipal drinking water treatment facilities • BSL-2: local health departments, universities, state laboratories, private laboratories (hospitals, health care systems), industrial laboratories (clinical diagnostic companies) • BSL-3: state health departments, universities, private companies, industry, federal government (NIH, CDC) • BSL-4: only 15 facilities in the US • 9 federal (CDC, NIH), 4 university (Georgia State University, University of Texas Medical Branch), 1 state, 1 private • Renovations underway at several labs, new facilities proposed at additional sites
  45. 45. • All India Institute of Medical Sciences, New Delhi • Microbial Containment Complex, Pune • Centre for Cellular and Molecular Biology, Hyderabad • High Security Animal Disease Laboratory (HSADL), Bhopal
  46. 46. • Four standard biosafety levels are also described for activities involving infectious disease work with commonly used experimental animals.
  47. 47. • Acharya, D.B. and Singh, Thebook of hospital wastemanagement 2000 • World Health Organization. Laboratory biosafety manual. 3rd ed. Geneva; 2004 • http://www.who.int/injection_safety/toolbox/docs/AM_HCW_Safety. pdf • WHO guidelineson laboratory training for Field Epidemiologists • "Biohazard Symbol History".theoriginal on July 16, 2011. • Biosafety in Microbiological and Biomedical Laboratories, 5th Edition, U.S. Department of Health and Human Services, Public Health ServiceCentersfor DiseaseControl and Prevention National Institutesof Health, HHSPublication No. (CDC) 21-1112Revised December 2009 • UNC School of Public Health Laboratory Safety Levels • U.S. Centers for Disease Control and Prevention; U.S. National Institutes of Health (2000). Prim ary Co ntainm e nt fo r Bio haz ards: Se le ctio n, Installatio n and Use o f Bio lo g icalSafe ty Cabine ts . U.S. Centers for Disease Control and Prevention.

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