Assessing the Biological Safety Profession's Evaluation and Control of Risks... #FieldSampling

FRAGMENT: This study developed a web-based survey distributed to practicing biological safety professionals to determine the prevalence of and extent to which biological safety programs consider and evaluate field collection activities. In cases where such issues were considered, the data collected characterize the types of controls and methods of oversight at the institutional level that are employed. Sixty-one percent (61%) of the survey respondents indicated that research involving the field collection of biological specimens is conducted at their institutions. A majority (79%) of these field collection activities occur at academic institutions. Twenty-seven percent (27%) of respondents indicated that their safety committees do not consider issues related to biological specimens collected in the field, and only 25% with an oversight committee charged to review field collection protocols have generated a field research-specific risk assessment form to facilitate the assembly of pertinent information for a project risk assessment review. The results also indicated that most biosafety professionals (73% overall; 71% from institutions conducting field collection activities) have not been formally trained on the topic, but many (64% overall; 87% from institutions conducting field collection activities) indicated that training on field research safety issues would be helpful, and even more (71% overall; 93% from institutions conducting field collection activities) would consider participation in such a training course. Results obtained from this study can be used to develop a field research safety toolkit and associated training curricula specifically targeted to biological safety professionals.
REFERENCE:
Patlovich ST, et al. Assessing the Biological Safety Profession's Evaluation and Control of Risks Associated with the Field Collection of Potentially Infectious Specimens. Appl Biosaf. 2015 Mar; 20(1): 27–40. Author manuscript; available in PMC 2018 Jan 9.

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Safe-by-Design: from Safety to Responsibility

Safe-by-design (SbD) aims at addressing safety issues already during the R&D and design phases of new technologies. SbD has increasingly become popular in the last few years for addressing the risks of emerging technologies like nanotechnology and synthetic biology. We ask to what extent SbD approaches can deal with uncertainty, in particular with indeterminacy, i.e., the fact that the actual safety of a technology depends on the behavior of actors in the value chain like users and operators. We argue that while indeterminacy may be approached by designing out users as much as possible in attaining safety, this is often not a good strategy. It will not only make it more difficult to deal with unexpected risks; it also misses out on the resources that users (and others) can bring for achieving safety, and it is undemocratic. We argue that rather than directly designing for safety, it is better to design for the responsibility for safety, i.e., designers should think where the responsibility for safety is best situated and design technologies accordingly. We propose some heuristics that can be used in deciding how to share and distribute responsibility for safety through design.
REFERENCE:
Van de Poel, Ibo, and Zoë Robaey. “Safe-by-Design: From Safety to Responsibility.” Nanoethics 11.3 (2017): 297–306. PMC. Web. 8 Jan. 2018.

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National Framework for Personal Protective Equipment Conformity Assessment - Infrastructure

The goal of our efforts at the National Institute for Occupational Safety and Health (NIOSH) is to provide national and world leadership to prevent workplace illnesses and injuries. We accomplish this by conducting and supporting activities to protect workers from work-related exposures to hazards. One core objective of this approach involves the development and use of personal protective equipment (PPE). Workers are more likely to appropriately use PPE when they are confident that the equipment will provide the intended protections based on its conformance with appropriate standards. The National Academies of Sciences, Engineering, and Medicine (the Academies) indicates that “for the consumer or worker, conformity assessment provides confidence in the claims made about the product by the manufacturer and may assist the consumer with purchasing decisions in determining the fitness of a product for it its intended use.” [IOM, 2011, page 3] A comprehensive and tailor-made conformity assessment (CA) program is the most effective way to manage risks of a non-conforming PPE and instill this confidence in PPE users.
REFERENCE:
NIOSH [2017]. National framework for personal protective equipment conformity assessment – infrastructure. By D’Alessandro M. Pittsburgh, PA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, DHHS (NIOSH) Publication 2018–102.

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CDC Safety Training Course for Ebola Virus Disease Healthcare Workers

Response to sudden epidemic infectious disease emergencies can demand intensive and specialized training, as demonstrated in 2014 when Ebola virus disease (EVD) rapidly spread throughout West Africa. The medical community quickly became overwhelmed because of limited staff, supplies, and Ebola treatment units (ETUs). Because a mechanism to rapidly increase trained healthcare workers was needed, the US Centers for Disease Control and Prevention developed and implemented an introductory EVD safety training course to prepare US healthcare workers to work in West Africa ETUs. The goal was to teach principles and practices of safely providing patient care and was delivered through lectures, small-group breakout sessions, and practical exercises. During September 2014–March 2015, a total of 570 participants were trained during 16 course sessions. This course quickly increased the number of clinicians who could provide care in West Africa ETUs, showing the feasibility of rapidly developing and implementing training in response to a public health emergency.
REFERENCE:
Narra, Rupa et al. “CDC Safety Training Course for Ebola Virus Disease Healthcare Workers.” Emerging Infectious Diseases 23.Suppl 1 (2017): S217–S224.

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Network Experiences from a Cross-Sector Biosafety Level-3 Laboratory Collaboration

The Swedish Forum for Biopreparedness Diagnostics (FBD) is a network that fosters collaboration among the 4 agencies with responsibility for the laboratory diagnostics of high-consequence pathogens, covering animal health and feed safety, food safety, public health and biodefense, and security. The aim of the network is to strengthen capabilities and capacities for diagnostics at the national biosafety level-3 (BSL-3) laboratories to improve Sweden's biopreparedness, in line with recommendations from the EU and WHO. Since forming in 2007, the FBD network has contributed to the harmonization of diagnostic methods, equipment, quality assurance protocols, and biosafety practices among the national BSL-3 laboratories. Lessons learned from the network include: (1) conducting joint projects with activities such as method development and validation, ring trials, exercises, and audits has helped to build trust and improve communication among participating agencies; (2) rotating the presidency of the network steering committee has fostered trust and commitment from all agencies involved; and (3) planning for the implementation of project outcomes is important to maintain gained competencies in the agencies over time. Contacts have now been established with national agencies of the other Nordic countries, with an aim to expanding the collaboration, broadening the network, finding synergies in new areas, strengthening the ability to share resources, and consolidating long-term financing in the context of harmonized European biopreparedness.

REFERENCE:
Thelaus, Johanna et al. “Network Experiences from a Cross-Sector Biosafety Level-3 Laboratory Collaboration: A Swedish Forum for Biopreparedness Diagnostics.” Health Security 15.4 (2017): 384–391.

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A biosafety level 2 virology lab for biotechnology undergraduates

Medical, industrial, and basic research relies heavily on the use of viruses and vectors. Therefore, it is important that bioscience undergraduates learn the practicalities of handling viruses. Teaching practical virology in a student laboratory setup presents safety challenges, however. The aim of this article is to describe the design and implementation of a virology laboratory, with emphasis on student safety, for biotechnology undergraduates. Cell culture techniques, animal virus infection, quantification, and identification are taught at a biosafety level 2 for a diverse group of undergraduates ranging from 20 to 50 students per group.

REFERENCES:
Matza‐Porges, Sigal, and Dafna Nathan. “A Biosafety Level 2 Virology Lab for Biotechnology Undergraduates.” Biochemistry and Molecular Biology Education 45.6 (2017): 537–543. PMC.

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Feliz 2018

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NOM-005-SCT/2008, Información de emergencia para el transporte de substancias, materiales y residuos peligrosos

La presente Norma Oficial Mexicana establece en forma uniforme para su aplicación en los diversos modos de transporte, los datos y especificaciones que debe contener la Información de Emergencia para el Transporte de Substancias, Materiales y Residuos Peligrosos, que indique las acciones a seguir para casos de incidentes o accidentes (fugas, derrames, explosiones, incendios, exposiciones, etc.), que debe llevar toda unidad durante el transporte de substancias, materiales y residuos peligrosos, en un lugar accesible de la unidad y retirada de la carga.

REFERENCIA:
NOM-005-SCT/2008, Información de emergencia para el transporte de substancias, materiales y residuos peligrosos.

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NOM-003-SEGOB-2011, Señales y avisos para protección civil.- Colores, formas y símbolos a utilizar.

La experiencia indica que la correcta aplicación de esta Norma Oficial Mexicana, contribuye a mejorar las condiciones de seguridad en instalaciones y sitios en los que, conforme a leyes, reglamentos y normatividad aplicable en materia de prevención de riesgos, debe implementarse un sistema de señalización sobre protección civil, en beneficio de la población que concurre o labora en ellos.

REFERENCIA:
NORMA Oficial Mexicana NOM-003-SEGOB-2011, Señales y avisos para protección civil.- Colores, formas y símbolos a utilizar.

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Lessons to be Learned from #Biosafety Incidents in the USA

During recent months, the Centers for Disease Control and Prevention (CDC) announced the occurrence of three major biosafety incidents, raising serious concern about biosafety and biosecurity guideline implementation in the most prestigious agencies in the United States: the CDC, the National Institutes of Health (NIH) and the Federal Drug Administration (FDA). These lapses included: a) the mishandling of Bacillus anthracis spores potentially exposing dozens of employees to anthrax; b) the shipment of low pathogenic influenza virus unknowingly cross-contaminated with a highly pathogenic strain; and c) an inventory lapse of hundreds of samples of biological agents, including six vials of variola virus kept in a cold storage room for decades, unnoticed. In this review we present the published data on these events, report the CDC inquiry's main findings, and discuss the key lessons to be learnt to ensure safer scientific practice in biomedical and microbiological service and research laboratories.

REFERENCE:
Weiss S, Yitzhaki S, Shapira SC. Lessons to be Learned from Recent Biosafety Incidents in the United States. Isr Med Assoc J. 2015 May;17(5):269-73. Review. PubMed PMID: 26137650.

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Enhancing Surveillance and Diagnostics in Anthrax-Endemic Countries

Naturally occurring anthrax disproportionately affects the health and economic welfare of poor, rural communities in anthrax-endemic countries. However, many of these countries have limited anthrax prevention and control programs. Effective prevention of anthrax outbreaks among humans is accomplished through routine livestock vaccination programs and prompt response to animal outbreaks. The Centers for Disease Control and Prevention uses a 2-phase framework when providing technical assistance to partners in anthrax-endemic countries. The first phase assesses and identifies areas for improvement in existing human and animal surveillance, laboratory diagnostics, and outbreak response. The second phase provides steps to implement improvements to these areas. We describe examples of implementing this framework in anthrax-endemic countries. These activities are at varying stages of completion; however, the public health impact of these initiatives has been encouraging. The anthrax framework can be extended to other zoonotic diseases to build on these efforts, improve human and animal health, and enhance global health security.

REFERENCE:

Vieira, Antonio R. et al. “Enhancing Surveillance and Diagnostics in Anthrax-Endemic Countries.” Emerging Infectious Diseases 23.Suppl 1 (2017): S147–S153. PMC. Web. 9 Dec. 2017.

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Shelf-Life of Chlorine Solutions Recommended in Ebola Virus Disease Response

In Ebola Virus Disease (EVD) outbreaks, it is widely recommended to wash living things (handwashing) with 0.05% (500 mg/L) chlorine solution and non-living things (surfaces, personal protective equipment, dead bodies) with 0.5% (5,000 mg/L) chlorine solution. Chlorine solutions used in EVD response are primarily made from powdered calcium hypochlorite (HTH), granular sodium dichloroisocyanurate (NaDCC), and liquid sodium hypochlorite (NaOCl), and have a pH range of 5–11. Chlorine solutions degrade following a reaction highly dependent on, and unusually sensitive to, pH, temperature, and concentration. We determined the shelf-life of 0.05% and 0.5% chlorine solutions used in EVD response, including HTH, NaDCC, stabilized NaOCl, generated NaOCl, and neutralized NaOCl solutions. Solutions were stored for 30 days at 25, 30, and 35°C, and tested daily for chlorine concentration and pH. Maximum shelf-life was defined as days until initial concentration fell to <90% of initial concentration in ideal laboratory conditions. At 25–35°C, neutralized-NaOCl solutions (pH = 7) had a maximum shelf-life of a few hours, NaDCC solutions (pH = 6) 2 days, generated NaOCl solutions (pH = 9) 6 days, and HTH and stabilized NaOCl solutions (pH 9–11) >30 days. Models were developed for solutions with maximum shelf-lives between 1–30 days. Extrapolating to 40°C, the maximum predicted shelf-life for 0.05% and 0.5% NaDCC solutions were 0.38 and 0.82 hours, respectively; predicted shelf-life for 0.05% and 0.5% generated NaOCl solutions were >30 and 5.4 days, respectively. Each chlorine solution type offers advantages and disadvantages to responders, as: NaDCC is an easy-to-import high-concentration effervescent powder; HTH is similar, but forms a precipitate that may clog pipes; and, NaOCl solutions can be made locally, but are difficult to transport. We recommend responders chose the most appropriate source chlorine compound for their use, and ensure solutions are stored at appropriate temperatures and used or replaced before expiring.
REFERENCIA:
Iqbal, Qais et al. “Shelf-Life of Chlorine Solutions Recommended in Ebola Virus Disease Response.” Ed. Vincent Jacobus Munster. PLoS ONE 11.5 (2016): e0156136.


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Enterococcus hirae biofilm formation on hospital material surfaces and effect of new biocides

BACKGROUND: Nowadays, the bacterial contamination in the hospital environment is of particular concern because the hospital-acquired infections (HAIs), also known as nosocomial infections, are responsible for significant morbidity and mortality. This work evaluated the capability of Enterococcus hirae to form biofilm on different surfaces and the action of two biocides on the produced biofilms.
METHODS: The biofilm formation of E. hirae ATCC 10541 was studied on polystyrene and stainless steel surfaces through the biomass quantification and the cell viability at 20 and 37 °C. The effect of LHIDROXI FAST and LH ENZYCLEAN SPRAY biocides on biomasses was expressed as percentage of biofilm reduction. E. hirae at 20 and 37 °C produced more biofilm on the stainless steel in respect to the polystyrene surface. The amount of viable cells was greater at 20 °C than with 37 °C on the two analyzed surfaces. Biocides revealed a good anti-biofilm activity with the most effect for LH ENZYCLEAN SPRAY on polystyrene and stainless steel at 37 °C with a maximum biofilm reduction of 85.72 and 86.37%, respectively.
RESULTS: E. hirae is a moderate biofilm producer depending on surface material and temperature, and the analyzed biocides express a remarkable antibiofilm action.
CONCLUSION: The capability of E. hirae to form biofilm can be associated with its increasing incidence in hospital-acquired infections, and the adoption of suitable disinfectants is strongly recommended.
REFERENCIA:
Di Lodovico S, et al. Enterococcus hirae biofilm formation on hospital material surfaces and effect of new biocides. Environ Health Prev Med. 2017 Aug 2;22(1):63. doi: 10.1186/s12199-017-0670-3. PubMed PMID: 29165147; PubMed Central PMCID: PMC5664585.

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Guidance on regulations for the transport of infectious substances 2017–2018

This publication provides information for identifying, classifying, marking, labelling, packaging, documenting and refrigerating infectious substances for transportation and ensuring their safe delivery.

The document provides practical guidance to facilitate compliance with applicable international regulations for the transport of infectious substances by all modes of transport, both nationally and internationally, and include the changes that apply from 1 January 2017. The current revision replaces the document issued by the World Health Organization (WHO) in 2015 (document WHO/HSE/GCR/2015.2). This publication, however, does not replace national and international transport regulations.

Applicable as from 1 January 2017

Authors:
World Health Organization

Publication details

Number of pages: 40
Publication date: 2017
Languages: English
WHO reference number: WHO/WHE/CPI/2017.8

Downloads

• ==> English pdf 1.63 MB <== 

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Biological samples transportation by drones: ready for prime time?

FRAGMENT:
According to the concept originally introduced by George D. Lundberg in the 1980s, the total testing process entails three essential and sequential parts, that are the preanalytical phase, the analytical phase and the postanalytical phase (1). Briefly, the preanalytical phase encompasses all those (prevalently) manually-intensive activities designed for obtaining, handling, transporting, preparing and storing biological samples before testing (2). Reliable evidence, accumulated after decades of research aimed to improve the total quality of the testing process, underpins the notion that the vast majority of problems in laboratory diagnostics are attributable to incorrect or inappropriate preanalytical activities (3).
REFERENCE:
Lippi, Giuseppe, and Camilla Mattiuzzi. “Biological Samples Transportation by Drones: Ready for Prime Time?” Annals of Translational Medicine 4.5 (2016): 92. PMC. Web. 6 Nov. 2017.

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Molecular Viability Testing of UV-Inactivated Bacteria

The polymerase chain reaction (PCR) is effective at detecting bacterial DNA in samples, but it is unable to differentiate viable bacteria from inactivated cells or free DNA fragments. New PCR-based analytical strategies have been developed to address this limitation. Molecular viability testing (MVT) correlates bacterial viability with the ability to rapidly synthesize species-specific ribosomal RNA precursor (pre-rRNA) in response to brief nutritional stimulation. Previous studies demonstrated that MVT can assess bacterial inactivation by chlorine, serum, and low-temperature pasteurization. Here, we demonstrate that MVT can detect inactivation of Escherichia coli, Aeromonas hydrophila, and Enterococcus faecalis cells by ultraviolet (UV) irradiation. Some UV-inactivated E. coli cells transiently retained the ability to synthesize pre-rRNA post-irradiation (generating false-positive MVT results), but this activity ceased within one hour following UV exposure. Viable but transiently undetectable (by culture) E. coli cells were consistently detected by MVT. An alternative viability testing method, viability PCR (vPCR), correlates viability with cell envelope integrity. This method did not distinguish viable from UV-inactivated bacteria under some conditions, indicating that the inactivated cells retained intact cell envelopes. MVT holds promise as a means to rapidly assess microbial inactivation by UV treatment.
IMPORTANCE Ultraviolet (UV) irradiation is increasingly used to disinfect water, food, and other materials for human use. Confirming the effectiveness of UV disinfection remains a challenging task. In particular, microbiological methods that rely on rapid detection of microbial DNA can yield misleading results. This is due to the detection of “remnant” DNA associated with dead microbial cells. This report describes a novel method that rapidly distinguishes living from dead microbial cells after UV disinfection.
REFERENCE:
Kris M. Weigel, et al. Molecular Viability Testing of UV-Inactivated Bacteria. Appl Environ Microbiol. 2017 May 15; 83(10): e00331-17. Prepublished online 2017 Mar 10. Published online 2017 May 1. doi: 10.1128/AEM.00331-17. PMCID: PMC5411506

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#History 1990: Model for inactivation and disposal of infectious HIV and radioactive waste in a BL3 facility

A method is described for autoclaving low levels of solid infectious, radioactive waste. The method permits steam penetration to inactivate biologic waste, while any volatile radioactive compounds generated during the autoclave process are absorbed. Inactivation of radiolabeled infectious waste has been problematic because the usual sterilization techniques result in unacceptable radiation handling practices. If autoclaved under the usual conditions, there exists a high probability of volatilization or release of radioisotopes from the waste. This results in the radioactive contamination of the autoclave and the laboratory area where steam is released from the autoclave. Our results provide a practical method to inactivate and dispose of infectious radioactive waste. For our research, Bacillus pumilus spore strips and vaccinia virus were used as more heat-resistant surrogates of the human immunodeficiency virus (HIV). These surrogates were used because HIV is difficult to grow under most conditions and is less heat tolerant than the surrogates. In addition, B. pumilus has defined cell death values, whereas such values have not been established for HIV. Both B. pumilus and vaccinia virus are less hazardous to work with. The autoclave method is time efficient and can be performed by laboratory personnel with minimal handling of the waste. Furthermore, waste site handlers are able to visually inspect the solid waste containers and ascertain that inactivation procedures have been implemented.

REFERENCE:

Stinson MC, et al. Model for inactivation and disposal of infectious human immunodeficiency virus and radioactive waste in a BL3 facility. Appl Environ Microbiol. 1990 Jan;56(1):264-8.

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Dead or Alive: Molecular Assessment of Microbial Viability

Nucleic acid-based analytical methods, ranging from species-targeted PCRs to metagenomics, have greatly expanded our understanding of microbiological diversity in natural samples. However, these methods provide only limited information on the activities and physiological states of microorganisms in samples. Even the most fundamental physiological state, viability, cannot be assessed cross-sectionally by standard DNA-targeted methods such as PCR. New PCR-based strategies, collectively called molecular viability analyses, have been developed that differentiate nucleic acids associated with viable cells from those associated with inactivated cells. In order to maximize the utility of these methods and to correctly interpret results, it is necessary to consider the physiological diversity of life and death in the microbial world. This article reviews molecular viability analysis in that context and discusses future opportunities for these strategies in genetic, metagenomic, and single-cell microbiology.
REFERENCE:
Cangelosi, Gerard A., and John S. Meschke. “Dead or Alive: Molecular Assessment of Microbial Viability.” Ed. H. L. Drake. Applied and Environmental Microbiology 80.19 (2014): 5884–5891. PMC. Web. 4 Sept. 2017.

Nucleic acid-based analytical methods, ranging from species-targeted PCRs to metagenomics, have greatly expanded our understanding of microbiological diversity in natural samples. However, these methods provide only limited information on the activities and physiological states of microorganisms in samples. Even the most fundamental physiological state, viability, cannot be assessed cross-sectionally by standard DNA-targeted methods such as PCR. New PCR-based strategies, collectively called molecular viability analyses, have been developed that differentiate nucleic acids associated with viable cells from those associated with inactivated cells. In order to maximize the utility of these methods and to correctly interpret results, it is necessary to consider the physiological diversity of life and death in the microbial world. This article reviews molecular viability analysis in that context and discusses future opportunities for these strategies in genetic, metagenomic, and single-cell microbiology.

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Schrödinger’s microbes: Tools for distinguishing the living from the dead in microbial ecosystems

While often obvious for macroscopic organisms, determining whether a microbe is dead or alive is fraught with complications. Fields such as microbial ecology, environmental health, and medical microbiology each determine how best to assess which members of the microbial community are alive, according to their respective scientific and/or regulatory needs. Many of these fields have gone from studying communities on a bulk level to the fine-scale resolution of microbial populations within consortia. For example, advances in nucleic acid sequencing technologies and downstream bioinformatic analyses have allowed for high-resolution insight into microbial community composition and metabolic potential, yet we know very little about whether such community DNA sequences represent viable microorganisms. In this review, we describe a number of techniques, from microscopy- to molecular-based, that have been used to test for viability (live/dead determination) and/or activity in various contexts, including newer techniques that are compatible with or complementary to downstream nucleic acid sequencing. We describe the compatibility of these viability assessments with high-throughput quantification techniques, including flow cytometry and quantitative PCR (qPCR). Although bacterial viability-linked community characterizations are now feasible in many environments and thus are the focus of this critical review, further methods development is needed for complex environmental samples and to more fully capture the diversity of microbes (e.g., eukaryotic microbes and viruses) and metabolic states (e.g., spores) of microbes in natural environments.
REFERENCE:
Emerson JB1,et al. Schrödinger's microbes: Tools for distinguishing the living from the dead in microbial ecosystems. Microbiome. 2017 Aug 16;5(1):86. doi: 10.1186/s40168-017-0285-3.

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Workplace Hazards to Reproduction and Development

This booklet contains information for those of you who are interested in identifying, evaluating, and reducing workplace reproductive and developmental health risks. The information provided ranges from descriptions of basic physiology and toxicology to specific guidance intended for health care providers, workplace health and safety personnel, workers, and employers.
REFERENCE:
Sharon L. Drozdowsky, B.S. and Stephen G. Whittaker, Ph.D.  Hazards to Reproduction and Development: A Resource for Workers, Employers, Health Care Providers, and Health & Safety Personnel. Safety and Health Assessment and Research for Prevention (SHARP). Washington State Department of Labor and Industries. Technical Report Number: 21-3-1999

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Laboratory-acquired infections of Salmonella enterica serotype Typhi in South Africa

BACKGROUND: Workers in clinical microbiology laboratories are exposed to a variety of pathogenic microorganisms. Salmonella species is among the most commonly reported bacterial causes of laboratory-acquired infections. We report on three cases of laboratory-acquired Salmonella enterica serotype Typhi (Salmonella Typhi) infection which occurred over the period 2012 to 2016 in South Africa.
METHODS: Laboratory investigation included phenotypic and genotypic characterization of isolates. Phenotypic analysis included standard microbiological identification techniques, serotyping and antimicrobial susceptibility testing. Genotypic analysis included the molecular subtyping methodologies of pulsed-field gel electrophoresis analysis, multilocus sequence typing and whole-genome sequencing (WGS); with WGS data analysis including phylogenetic analysis based upon comparison of single nucleotide polymorphism profiles of isolates.
RESULTS: All cases of laboratory-acquired infection were most likely the result of lapses in good laboratory practice and laboratory safety. The following critical issues were highlighted. There was misdiagnosis and misreporting of Salmonella Typhi as nontyphoidal Salmonella by a diagnostic laboratory, with associated public health implications. We highlight issues concerning the importance of accurate fluoroquinolone susceptibility testing and interpretation of results according to updated guidelines. We describe potential shortcomings of a single disk susceptibility screening test for fluoroquinolone susceptibility and suggest that confirmatory minimum inhibitory concentration testing should always be performed in cases of invasive Salmonella infections. These antimicrobial susceptibility testing issues resulted in inappropriate ciprofloxacin therapy which may have been responsible for failure in clearance of pathogen from patients. Salmonella Typhi capsular polysaccharide vaccine was not protective in one case, possibly secondarily to a faulty vaccine.
CONCLUSIONS: Molecular subtyping of isolates proved effective to investigate the genetic relatedness of isolates. Molecular subtyping data interpreted together with epidemiological data allowed us to pinpoint the most likely sources for our cases of laboratory-acquired infection.
REFERENCE:
Smith AM, et al. Laboratory-acquired infections of Salmonella enterica serotype Typhi in South Africa: phenotypic and genotypic analysis of isolates. BMC Infect Dis. 2017 Sep 29;17(1):656.

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Prevalence of murine leukemia virus contamination in human cell lines

Contaminations of cell cultures with microbiological organisms are well documented and can be managed in cell culture laboratories applying reliable detection, elimination and prevention strategies. However, the presence of viral contaminations in cell cultures is still a matter of debate and cannot be determined with general detection methods. In the present study we screened 577 human cell lines for the presence of murine leukemia viruses (MLV). Nineteen cell lines were found to be contaminated with MLV, including 22RV1 which is contaminated with the xenotropic murine leukemia virus-related virus variant of MLV. Of these, 17 cell lines were shown to produce active retroviruses determined by product enhanced reverse transcriptase PCR assay for reverse transcriptase activity. The contaminated cell lines derive from various solid tumor types as well as from leukemia and lymphoma types. A contamination of primary human cells from healthy volunteers could not be substantiated. Sequence analyses of 17 MLV PCR products and five complete MLV genomes of different infected cell lines revealed at least three groups of related MLV genotypes. The viruses harvested from the supernatants of infected cell cultures were infectious to uninfected cell cultures. In the course of the study we found that contamination of human genomic DNA preparations with murine DNA can lead to false-positive results. Presumably, xenotransplantations of the human tumor cells into immune-deficient mice to determine the tumorigenicity of the cells are mainly responsible for the MLV contaminations. Furthermore, the use of murine feeder layer cells during the establishment of human cell lines and a cross-contamination with MLV from infected cultures might be sources of infection. A screening of cell cultures for MLV contamination is recommended given a contamination rate of 3.3%.

REFERENCE

Uphoff CC, Lange S, Denkmann SA, Garritsen HS, Drexler HG. Prevalence and characterization of murine leukemia virus contamination in human cell lines. PLoS One. 2015 Apr 30;10(4):e0125622. doi: 10.1371/journal.pone.0125622. eCollection 2015. PubMed PMID: 25927683; PubMed Central PMCID: PMC4416031.

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Día mundial del lavado de manos, Octubre 15, 2017

nuestras manos, nuestro futuro!

https://globalhandwashing.org/global-handwashing-day/

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Triage and Management of Accidental Laboratory Exposures to Biosafety Level-3 and -4 Agents

The recent expansion of biocontainment laboratory capacity in the United States has drawn attention to the possibility of occupational exposures to BSL-3 and -4 agents and has prompted a reassessment of medical management procedures and facilities to deal with these contingencies. A workshop hosted by the National Interagency Biodefense Campus was held in October 2007 and was attended by representatives of all existing and planned BSL-4 research facilities in the U.S. and Canada. This report summarizes important points of discussion and recommendations for future coordinated action, including guidelines for the engineering and operational controls appropriate for a hospital care and isolation unit. Recommendations pertained to initial management of exposures (ie, immediate treatment of penetrating injuries, reporting of exposures, initial evaluation, and triage). Isolation and medical care in a referral hospital (including minimum standards for isolation units), staff recruitment and training, and community outreach also were addressed. Workshop participants agreed that any unit designated for the isolation and treatment of laboratory employees accidentally infected with a BSL-3 or -4 pathogen should be designed to maximize the efficacy of patient care while minimizing the risk of transmission of infection. Further, participants concurred that there is no medically based rationale for building care and isolation units to standards approximating a BSL-4 laboratory. Instead, laboratory workers accidentally exposed to pathogens should be cared for in hospital isolation suites staffed by highly trained professionals following strict infection control procedures.
REFERENCE:
Jahrling, Peter et al. “Triage and Management of Accidental Laboratory Exposures to Biosafety Level-3 and -4 Agents.” Biosecurity and Bioterrorism : Biodefense Strategy, Practice, and Science 7.2 (2009): 135–143. PMC. Web. 9 Oct. 2017.

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La gestión de cadáveres en situaciones de desastre #bioseguridad

La gestión adecuada de los cadáveres es uno de los aspectos más complejos en la respuesta a las situaciones de desastre. Los desastres causan miles de muertes a nivel mundial cada año; sin embargo, no se le da atención al cuidado de los fallecidos en las actividades de planificación y la falta de guías para los primeros en responder se ha puesto de relieve después de varias grandes catástrofes. Esta guía de campo para personal no especializado ofrece orientaciones prácticas que facilitarán la recuperación, identificación básica, almacenamiento, la disposición, y en conjunto, la gestión adecuada de los cadáveres después de los desastres. También hace sugerencias sobre la forma de brindar ayuda a los familiares y de comunicarse con el público en general y con los medios de comunicación.
Este manual será de ayuda durante la respuesta inmediata a un desastre cuando aún no se cuenta con ayuda forense. Además podrá ser usado en la preparación de planes de desastres para el manejo de víctimas en masa. Las recomendaciones son relevantes para autoridades locales, regionales y nacionales, además de organizaciones no gubernamentales. Los principios y directrices enunciados en este documento ya se están ejecutando y promoviendo por varias organizaciones internacionales, incluidas las que han patrocinado la publicación del mismo: la Organización Panamericana de la Salud, la Organización Mundial de la Salud, el Comité Internacional de la Cruz Roja y la Federación Internacional de las Sociedades de la Cruz Roja y la Media Luna Roja.
El manual fue extensamente revisado por un grupo de expertos en el tema. Recibimos comentarios de ocho revisores técnicos: el dirigente del comité DVI de INTERPOL, el patólogo forense principal del Home Office en el Reino Unido, un especialista en medicina forense de Sri Lanka, dos administradores de desastres del Caribe, un acádemico experto en desastres del Reino Unido, un especialista en derechos humanos del Comité Internacional de la Cruz Roja (CICR) y un profesional internacional de desastres. Además, el manual fue revisado por los participantes de una reunión de especialistas forenses en Colombia, 15 líderes en salud pública de nueve países asiáticos en una reunión regional sobre el manejo de víctimas en masa, y expertos de medicina forense de Jordania que participaron en un taller del CICR. Asimismo, la versión preliminar del manual fue usada en el campo después del terremoto en Pakistán en 2005 y los deslizamientos de lodo en las Filipinas el mismo año.
La nueva edición en inglés refleja avances científicos y técnicos en el campo de gestión de víctimas en masa, y lecciones aprendidas del uso del manual.

• Descargue la nueva versión en inglés
• Descargue el documento en español (761.17 kB)
• Gestion des dépouilles mortelles lors de catastrophes - Télécharger la version française
• Descargue la versión en japonés

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