Transcript BIOLOGICAL HAZARDS IN LAB & NSI

EOH 3202
BIOLOGICAL HAZARD
&
BIOSAFETY LEVEL
ANITA BINTI ABD. RAHMAN
M.D. ; M.Comm. H [OH]; AOEMM
DEPARTMENT of COMMUNITY HEALTH
7th November 2012
CONTENT
► BIOLOGICAL
HAZARD
 Definition
 Types & Exposure
 Example - epidemiology
 Prevention & Control
►BIOSAFETY LEVEL
OCCUPATIONAL
HAZARDS
PSYCHOLOGICAL
Stress, boredom
PHYSICAL AGENTS
noise, vibration, radiation,
defective illumination,
temperature extremes
BIOLOGICAL AGENTS
viruses, bacteria, fungi,
parasites, insects, etc.
CHEMICAL AGENTS
dusts, gases, vapors,
fumes, mists, etc.
LACK OF ERGONOMIC PRINCIPLES
exhaustive physical exertions,
excessive
standing, improper motions, lifting
heavy load, job monotony, etc.
DEFINITION
► BIOLOGICAL
HAZARD @ BIOHAZARDS
 A substance derived from an organism, that poses a
threat to (primarily) human health.
►A
naturally occurring substance.
 Example:
► medical waste, samples of
a microorganism, virus or toxin
(from a biological source)
► substances harmful to animals- zoonotic diseases
CONCERN?
Potential for acquiring a laboratory-acquired
infections (LAIs)
Contamination of the environment
Contamination of research
TYPES
► Divided into:
►Body fluids pathogen
Protozoa, Parasites
►Animal –
– Bacteria, Viruses, Fungi,
insects, birds
►Recombinant DNA
►Nano-technology
– genetic engineering, cloning
EXPOSURE
EXPOSURE
► Direct contact
 Broken skin – NSI
 Allergy/Irritant
► Inhalation
► Ingestion
EXPOSURE
Routes of Transmission
Infection Source
•Specimens
•Culture & stocks
•Research animals
•Item contaminated with above
Susceptible Host
• Age
• Immune system
• Vaccination status
• pre-morbid condition:
• DM
WHO IS AT RISK?
► Laboratory staff
► Health Care Workers
 Doctor, Nurses, Medical Assistant
► Agricultural workers
► Armed Forces
EXAMPLE
► Occupational Exposure to blood borne pathogen
 2 million exposure per year
 Among HCW:
►40% of Hepatitis B
►40% of Hepatitis C
►4% of HIV
 Needle Stick Injury
WHO Environmental Burden of Disease No .3
PREVALENCE
Source : OHU, MOH
Bilangan dan kadar kecederaan di kalangan anggota KKM
1998-2005
Bilangan
kecederaan
1000
75
56
800
37
80
67
64
972
70
53
830
799
600
842
726
571
400
200
90
85
13
60
50
40
30
377
20
10
125
0
0
1998
1999
2000
2001
2002
2003
2004
2005
Tahun
Number of Injuries
Injury Rate Per 10,000 Worker
Kadar Kecederaan
setiap 10,000
Pekerja
1200
PREVALENCE
Source : OHU, MOH
EXAMPLE
► MALAYSIA
 HEPATITIS B
1999 - 5295 cases reported & 9% were carriers
 TB
2005 – 11 notification of HCW with MTB
LAB-ACQUIRED INFECTIONS (LAI’s)
WHO
WHAT
WHERE
WHEN
HOW
Doctor, Nurse
Researcher
SARS
Singapore
Taiwan
December
2003
Contact
Microbiologist
West Nile Virus
US
August 2002
Laceration
Laboratory
Worker
Meningococcal
Disease
US
2000
Aerosol?
Laboratory
worker
Vaccinia virus
Europe
2002
Contact
OH- HIERARCHY OF CONTROL
► Elimination/Substitution
► Engineering control
 Biosafety Cabinet (BSL)
► Administrative control
 Work Practice - SOP
 Standard Precaution
► PPE
 Gloves, mask, gown
PREVENTION & CONTROL
► WHO
has long recognized that safety and in particular,
biological safety are important international issues.
► In 1983 - 1st edition of its Laboratory Biosafety Manual
which encourages countries to prepare :
 Specific Codes of Practice for the safe handling of
pathogenic microorganisms in laboratories within their
geographical borders & provide expert guidance for
developing such codes of practice.
CONVENTION ON
BIOLOGICAL DIVERSITY
►
At the 1992 Earth Summit in Rio de Janeiro, world leaders agreed on
a comprehensive strategy for : "sustainable development“-
►
One of the key agreements adopted at Rio was the Convention on
Biological Diversity.
►
The Convention establishes three main goals:
1. the conservation of biological diversity
2. the sustainable use of its components, and
3. the fair and equitable sharing of the benefits from the
use of genetic resources.
CONVENTION ON
BIOLOGICAL DIVERSITY
► Revision : In accordance with the precautionary approach contained in
Principle 15 of the Rio Declaration on Environment and Development
 Ensuring an adequate level of protection in the field of the
safe transfer, handling and use of living modified
organisms resulting from modern biotechnology that may
have adverse effects on the conservation and sustainable
use of biological diversity, taking also into account risks to
human health, and specifically focusing on transboundary
movements.
CARTAGENA PROTOCOL
ON BIOSAFETY
►
The Conference of the Parties to the Convention on
Biological Diversity adopted a supplementary agreement to
the Convention known as the Cartagena Protocol on
Biosafety on 29 January 2000.
►
The Protocol seeks to protect biological diversity from the
potential risks posed by living modified organisms (LMO)
resulting from modern biotechnology.
PRINCIPLE OF BIOSAFETY
► Containment
 Safe management of infectious agent in a laboratory
► Purpose
 Reduce/eliminate exposure to workers, persons &
environment
PRINCIPLE OF BIOSAFETY
► PRIMARY CONTAINMENT
 Protection of workers & environment from
exposure to hazard
► Good microbiological technique
► Appropriate safety equipment
► Vaccination
► SECONDARY CONTAINMENT
 Combination of facility design & operational
practices; 3 elements:
► Lab practices &
technique
► Safety equipment
► Facility design
BIOSAFETY LEVEL (BSL)

Combination of agent involved, lab practices &
techniques, safety equipment & facilities.

Microorganisms are categorized in risk groups
(relative risk) based on the following factors:





Pathogenicity of the organism
Mode of transmission and host range
Availability of effective preventive measures (e.g. vaccines)
Availability of effective treatment (e.g. antibiotics)
Other factors
BIOSAFETY LEVEL (BSL)
►
LABORATORY BIOSAFETY MANUAL 2ND EDITION
(REVISED) WHO, Geneva 2003
 References are made to the relative hazards of infective
microorganisms by WHO Risk Groups 1, 2, 3 & 4.
 This risk group classification is to be used for laboratory
work only.
 The risk assessment of the work to be done with a specific
agent will determine the appropriate combination of these
elements.
CLASSIFICATION OF INFECTIVE
MICROORGANISMS BY RISK GROUP
►
RISK GROUP 1 (low individual and community risk)
This group includes those microorganisms which are unlikely to
cause disease in healthy workers or animals (pose little or no risk) –
Lactobacillus sp, Bacillus subtilis
►
RISK GROUP 2 (moderate individual risk, low community risk)
Can cause human disease, but under normal circumstances is
unlikely to be a serious hazard to laboratory workers, the
community, livestock or the environment . Effective treatment and
preventive measures are available and the risk of spread is limited.
E. Coli 0157, Measles, Mumps, Hepatitis B, HIV
CLASSIFICATION OF INFECTIVE
MICROORGANISMS BY RISK GROUP
►
RISK GROUP 3 (high individual risk, low community risk)
A pathogen that usually causes serious human or animal disease, or
which can result in serious economic consequences but does not
ordinarily spread by casual contact from one individual to another, or
that can be treated by antimicrobial or antiparasitic agents.
Mycobaterium TB, Anthrax, Small Pox,
►
RISK GROUP 4 (high individual risk, high community risk)
A pathogen that usually produces very serious human animal
disease, often untreatable, and may be readily transmitted from one
individual to another, or from animal to human or vice-versa directly
or indirectly, or casual contact – H5N1, Ebola virus
BIOSAFETY LEVEL (BSL)

Laboratories are designated according to their design features,
construction and containment facilities as :
Basic
 Basic
 Containment
 Maximum containment

►
- Biosafety Level 1
- Biosafety Level 2
- Biosafety Level 3
- Biosafety Level 4.
NIH & CDC : 4 biosafety levels (BSLs) are described which
comprise all of the elements of containment. Each combination is
specifically appropriate for :
 the operations performed
 the documented or suspected routes of transmission of the infectious
agents
 for the laboratory function or activity.
BIOSAFETY LEVEL (BSL)
_
As the level  so does ;
BSL 4
 the risk of the organism to humans, animals, plants
and/or the environment
BSL 3
the procedural and facility requirements
BSL 2
BSL 1
_
 the level of containment required
 the degree of protection for personnel, the
environment and the community.
Summary of Recommended Biosafety Level for
Infectious Agent
C.
Recommended Guidelines
REMEMBER…
► Every
incident (no matter how small)
must be investigated to determine if
the risk of exposure exists, and what
could be done to prevent the possibility
of reoccurrence.
THANK YOU