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INF > BIOLOGICAL SAFETY IN CLINICAL AND RESEARCH LABORATORIES > Flashcards

BIOLOGICAL SAFETY IN CLINICAL AND RESEARCH LABORATORIES Flashcards

1
Q

WOOLSORTERS’ DISEASE

A
  • ONE OF THE EARLIEST RECORDINGS OF OCCUPATIONAL INFECTION (GETTING ILL AT A WORKPLACE)
  • CALLED WOOLSORTERS’ DISEASE BECAUSE PEOPLE DEALING WITH SHEEP WOOL GOT IT, NOW KNOWN AS INHALATIONAL ANTHRAX (THEN QUITE COMMON IN SHEEP PARTICULARLY)
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2
Q

LAIs?

A

Laboratory-acquired infections (LAIs) are defined as all infections acquired through laboratory or laboratory-related activities regardless of whether they are symptomatic or asymptomatic in nature.
- first became prevalent with emergence of microbiology (1890s)

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3
Q

HISTORICALLY, PEOPLE WORKING AT A LAB WERE AT HOW MUCH HIGHER RISK OF ACQUIRING TUBERCULOSIS THAN GENERAL PUBLIC?

A

8 TIMES

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4
Q

MOUTH PIPETTING IN LABORATORY SETTING?

A
  • RECOGNISED AS A SERIOUS HAZARD AND AN UNSAFE PRACTICE AS FAR BACK AS 1915
  • REGARDLESS OF THAT, WIDELY PRACTICE IN 1960s —> 62% OF LABS MOUTH PIPETTED
  • FIGURE IMPROVED IN 1977
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5
Q

THE ROBENS REPORT?

A
  • THE COMMITTEE ON HEALTH AND SAFETY AT WORK WAS APPOINTED IN 1970
  • IT WAS REQUIRED TO REVIEW AND MAKE RECOMMENDATIONS IN RELATION TO THE SAFETY AND HEALTH OF PERSONS AT WORK AND THTA OF THE PUBLIC IN CONNECTION WITH ACTIVITIES ON INDUSTRIAL, COMMERCIAL OR CONSTRUCTION SITES
  • THE COMMITTEE WAS CHAIRED BY LORD ALFRED ROBENS (AND COMPRISED OF 6 OTHER MEMBERS)
  • THE COMMITTEE REPORTED IN 1972 AND THE RECOMMENDATIONS WERE SUBSTANTIALLY ENACTED IN THE HEALTH AND SAFETY AT WORK, ETC ACT 1974
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6
Q

ADVISORY COMMITTE ON DANGEROUS PATHOGENS

A
  • FORMED AFTER A SMALLPOX INCIDENT (A WOMAN WORKING NEARBY A LAB GOT SMALLPOX AND DIED)
  • a UK-wide advisory committee
  • It was established in 1981, and the terms of reference were revised in 1991 to allow for a wider remit
    The Advisory Committee on Dangerous Pathogens’ (ACDP) role is to provide scientific advice on the risks of exposure to various pathogens.
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7
Q

HEALTH AND SAFETY AT WORK ETC ACT

A
  • 1974 (BUT STILL IN USE TODAY)
  • ETC RELATES TO SCENARIOS LIK EDUCATIONAL INSTITUTIONS, SHOPS, CULTURAL INSTITUTIONS…
  • REPLACED NUMEROUS INDIVIDUAL LEGISLATIONS; FOR THE FIRST TIME THE WHOLE OF HEALTH AND SAFETY LEGISLATION BROUGHT UNDER A SINGLE ACT
  • INTRODUCED THE CONCEPT OF RISK ASSESSMENT BEING A FOUNDATION FOR ALL LAB PRACTICES
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8
Q

INDIVIDUAL LEGISLATIONS INTRODUCED AFTER THE HEALTH AND SAFETY AT WORK ETC ACT (1974) THAT PROVIDE FURTHER/MORE SPECIFIC GUIDANCE?

A
  • COSH: CONTROL OF SUBSTANCES HAZARDOUS TO HEALTH REGULATIONS 2002
  • THE GENETICALLY MODIFIED ORGANISMS (CONTAINED USE) REGULTIONS 2014
  • GUIDANCE FOR LICENCE HOLDRES ON CONTAINMENT AND CONTROL OF SPECIFIED ANIMAL PATHOGEN (MOSTLY REFERS TO AGRICULTURALLY IMPORTANT ANIMALS)
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9
Q

FOOT AND MOUTH DISEASE 2007 OUTBREAK

A
  • A LOT OF MEMBERW OR RURAL COMMUNITIES STILL SCARED PF THE IMPACT OF THE DISEASE ON AGRICULTURE FROM THE 2001 OUTBREAK
  • FOOT AND MOUTH DISEASE is an infectious and sometimes fatal viral disease that affects cloven-hoofed animals, including domestic and wild bovids. The virus causes a high fever lasting two to six days, followed by blisters inside the mouth and on the feet that may rupture and cause lameness. FMD has very severe implications for animal farming, since it is highly infectious and can be spread by infected animals comparatively easily through contact with contaminated farming equipment, vehicles, clothing, and feed, and by domestic and wild predators. Its containment demands considerable efforts in vaccination, strict monitoring, trade restrictions, quarantines, and the culling of both infected and healthy (uninfected) animals.
  • VIRUS ESCAPED FROM A LAB IN SURREY
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10
Q

EXMPLES OF STRATEGIES USED IN CONTAINMENT LABS TO MINIMISE RISK OF INFECTIONS?

A
  • CONTAINMENT LABS HAVE THE CAPACITY TO BE COMPLETELY SEALED
  • CONTROL OF AEROSOLS WITH MSCs (MICROBIOLOGICAL SAFETY CABINETS)
  • WASTE INACTIVATION (USE OF HIGH TEMP AND HIGH PRESSURE STEAM
  • NEGATIVE PRESSURE (AS THE AIR IN THE LAB IS POSIBLY CONTAMINATED, THE PRESSURE INSIDE THE LAB NEEDS TO BE LOWER THAN ON THE OUTSIDE, SO WHEN THE DOOR OPEN THERE IS AN INFLUX OF AIR RATHER THAN AIR LEAVING THE LAB)
  • ABILITY TO FUMIGATE (disinfect or purify (an area) with the fumes of certain chemicals) —> often using Formaldehyde
  • EFFLUENT DISINFECTION (Effluent disinfection is the disinfection of the outflowing of water or gas from structures such as wastewater treatment plant, sewer pipe or industrial outfall into a natural body of water)
  • SOMETIMES SHOWERS PRESENT FOR LAB WORKERS, SHOWER WATER IS LATER ALSO DISINFECTED
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11
Q

MOST COMMON FUMIGANT IN CONTAINMENT LABS?

A

Formaldehyde: Powerful enough to be a disinfectant and a preserver of bodies. Highly toxic to all living things. (after use released into the air highly diluted

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12
Q

ALL (PATHOGENIC) BIOLOGICAL AGENTS CAN BE CLASSIFIED INTO ONE OF HOW MANY HAZARD GROUPS? BASED ON WHAT ARE THEY CLASSIFIED?

A
  • 4 HAZARD GROUPS
    CLASSIFICATION BASED ON THE FOLLOWING CHARACTERISTICS:
    -SEVERITY OF DISEASE
  • RISK TO WORKERS
  • LIKELIHOOD OF COMMUNITY TRANSMISSION
  • AVAILABILITY OF VACCINES OR EFFECTIVE TREATMENTS
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13
Q

WHO WAS THE APPROVED LIST OF BIOLOGICAL AGENTS (CLASSIFIED EVERY BIO AGENT INTO ONE OF THE FOUR HAZARD GROUPS) MADE BY?

A

THE ADVISORY COMMITTEE ON DANGEROUS PATHOGENS (ACDP)

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14
Q

IF A BIOLOGICAL AGENT IS NOT LISTED ON THE APPROVED LIST OF BIOLOGICAL AGENTS (WHERE CORRESPONDING HAZARD GROUPS ARE INDICATED) WHAT COULD THAT MEANS?

A
  • UNLISTED SOMETIMES RESPONS TO HG1 (BUT THAT SHOULDN’T ALWAYS AUTOMATICALLY BE ASSUMED)
  • IF A SPECIES WITHIN GENERA IS NOT LISTED IT MIGHT NOT BE PATHOGENIC
  • IT COULD BE AN EMERGING PATHOGN –> NOT ENOUGH INFO
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15
Q

HOW MANY CONTAINMENT LEVEL 4 LABS ARE THERE CURRENTLY IN THE UK?

A

9

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16
Q

ACDP DEFINITIONS FOR HAZARD GROUPS?

A

GROUP 1: UNLIKELY TO CAUSE HUMAN DISEASE

GROUP 2: CAN CAUSE HUMAN DISEASE, MAY BE A HAZARD TO EMPLOYEES, UNLIKELY TO SPREAD IN THE COMMUNITY, USUALLY EFFECTIVE PROPHYLAXIS OR TREATMENT AVAILABLE

GROUP 3: CAN CAUSE SEVERE HUMAN DISEASE, MAY BE A SERIOUS HAZARD TO EMPLOYEES, CAN TO SPREAD TO THE COMMUNITY, USUALLY EFFECTIVE PROPHYLAXIS OR TREATMENT AVAILABLE

GROUP 4: CAUSES SEVERE HUMAN DISEASE, A SERIOUS HAZARD TO EMPLOYEES, LIKELY TO SPREAD IN THE COMMUNITY, USUALLY NO EFFECTIVE PROPHYLAXIS OR TREATMENT AVAILABLE

(EACH ONE REQUIRES CORRESPONDING CONTAINMENT LEVEL; SAME NUMBERS, E.G. HAZARD GROUP 1 —> CONTAINMENT LEVEL 1)

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17
Q

MYOBACTERIUM TUBERCULOSIS HAZARD GROUP?

A

3

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18
Q

E. COLI K12 (LAB STRAIN) & E. COLI GENERALLY & E. COLI O157 STRAIN –> HAZARD GROUPS

A

LAB STRAIN - HG 1, BECAUSE LAB STRAINS HAVE BEEN DISALED IN SEVERAL WAYS AND ARE MOSTLY USED FOR STUDYING GENETICS
E. COLI GENERALLY - HG2
O157 - HG3 (MOST PREVALENT STRAIN?)

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19
Q

PLASMODIUM FALCIPARUM (MALARIA) HAZARD GROUP?

A

UK: 3

BUT VARIES BASED ON COUNTRY, E.G. US –> 2

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20
Q

FOOT AND MOUTH DISESE VIRUS HAZARD GROUP?

A

HG 1 (RARELY CAUSES HUMAN DISEASE, AND THE HAZARD GROUP CATEGORISATION REFERS TO THE ABILITY TO CAUSE HUMAN DISEASE; HOWEVER, IN ANIMAL EQUIVALENT OF THIS RANKING, IT WOULD BE 4)

21
Q

WHICH FLU VIRUSES ARE CONSIDERED HAZARD GROUP 3?

A

CURRENTLY CIRCULATING PANDEMIC FLU VIRUSES

22
Q

EBOLA HAEMORRHAGIC FEVER VIRUS HAZARD GROUP?

A

4

23
Q

SARS CoV 2 HAZARD GROUP?

A

3

24
Q

SALMONELLA ENTERICA TYPHI HAZARD GROUP?

A

3
9SALMONELLA ENTERICA IS A HUGE SPECIES, AND THE STRAINS CAUSING FOOD POISONING WOULD BE CONSIDERED HG 2, BUT THIS NE IS A MORE SEVERE FORM CAUSING TYPHOID FEVER)

25
Q

PATHOGENS CAUSING FOOD POISONING ARE GENERALLY INCLUDED INTO WHICH HAZARD GROUP?

A

2

26
Q

EXAMPLES OF REQUIREMENTS THAT APPLY TO ALL LABS REGARDLESS OF CONTAINMENT LEVEL?

A
  • BAN ON EATING, DRINKING, APPLYING COSMETICS ETC
  • COMPULSORY WEARING OF LAB COATS
  • VALIDATED INACTIVATION OF GM ORGANISMS
27
Q

AT WHICH CONTAINMENT LEVEL DOES NEGATIVE AIR PRESSURE STARTS BECOMING A REQUIREMENT IN LABS?

A

3

28
Q

WHICH CONTAINMENT LEVEL LAB DOESN’T REQUIRE RESTRICTED ACCESS?

A

ONLY LEVEL 1

29
Q

AT WHICH CONTAINMENT LEVEL DOES OBSERVATION WINDOW/CCTV BECOME A REQUIREMENT IN LABS?

A

AT LEVEL 3

30
Q

AT WHICH CONTAINMENT LEVEL DO WRITTEN TRAINING RECORDS FOR STAFF BECOME REQUIRED IN LABS?

A

LEVEL 2

31
Q

DESCRIBE THE 4 KEY ROUTES TO INFECTION?

A
  • INHALATION (AEROSOLES)
  • INCOLUTAION (SKIN BREAKS OR PUNCTURES, MOST OFTEN THROUGH NEELE STICKING OR BROKEN GLASS)
  • ABSORPTION (THE RAREST!, THROGH SKIN/OR EYES)
  • INGESTION (WATER-BORNE, FECAL-ORAL ROUTE)
32
Q

EXAMPLES OF DISEASE FOR WHICH THE ROUTE OF INFECTION CAN BE ABSORPTION?

A
  • OFTEN TROPICAL DISEASE, E.G. SCHISTOSOMIASIS

- CHLAMYDIA

33
Q

USE OF SHARPS IN THE LABORATORY SETTING?

A
  • SHARPS ARE THE MOST LIKELY WAY OF GETTING A PATHOGEN INTO YOUR SYSTEM
  • THEY CAN ALSO CAUSE NON-INFECTIVE INJURIES
  • CORRECT USE, STORAGE AND DISPOSAL OF SHARPS IS VITAL (THERE ARE OFTEN SHARP BUCKETS/BOXES WHERE CONTAMINATED SHARPS SHOULD BE PLACED AND LATER DESTROYED BY INCINERATION)
  • E.G. NEEDLES, RAZOR BLADES, SCALPELS, GLAS (INCLUDING PASTEUR PIPETTES)
  • DO NOT RESHEATH NEEDLES!!! (PUT THE NEEDLE STRAIGHT IN THE BOX/BUCKET AFTER USING IT, DON’T PUT THE LID BACK ON)
  • TRAINING FOR SHARPS —> FROM CONTAINMENT LEVEL 2!!
34
Q

IMMUNISATION AGAINST WHICH PATHOGENS ARE TYPICALLY RECOMMENDED FOR HCPs/ PEOPLE WORKING IN LABS?

A
  • HEPATITIS B
  • TUBERCULOSIS
  • HEPATITIS A
  • TYPHOID
35
Q

TECHNIQUES THAT GENERATE AEROSOLS IN THE LABS NEED TO BE MANAGED (MINIMISED OR PREVENTED) WHAT ARE SOME EXAMPLES OF TECHNIQUES THAT COULD PRODUCE AEROSOLES?

A
  • CENTRIFUGATION
  • SONICATION (the process of applying sound energy to agitate particles or discontinuous fibers in a liquid)
  • FLOW CYTOMETRY AND CELL SORTING (FACS)
  • VIGOROUS PIPETTING ACTION
36
Q

MOST EFFECTIVE WAY TO CONTROL AEROSOLES IN A LAB?

A

USE OF MSCs; MICROBIOLOGICAL SAFETY CABINETS

37
Q

CLASS II MSCs (MICROBIOLOGICAL SAFETY CABINETS)?

A
  • PROVIDE BOTH OPERATOR PROTECTION AND SAMPLE PROTECTION
  • CAN BE USED UP TO CONTAINMENT LEVEL 3
  • MOST COMMON MODE OF PRIMARY CONTAINMENT
  • BEST WAY OF CONTROLLING INFECTIOUS AEROSOLES
  • CORRECT SET UP AND USE ESSENTIAL FOR EFFECTIV OPERTION (E.G. NOT TO COVER THE AIR GRILLES BY CLUTTER/OTHER EQUIPMENT…)
38
Q

MSC DEFINITION?

A

A microbiological safety cabinet (MSC) is a ventilated enclosure intended to offer
protection, to the user and the environment, from aerosols generated when handling
biological agents or material that may contain such agents

39
Q

RULES FOR USING MSCs CLASS II (MICROBIOLOGICAL SAFETY CABINETS)

A

ONLY EFFECTIVE WHEN AIRFLOW UNDISTURBED, SO:

  • KEEP CLUTTER TO A MINIMUM
  • KEEP CENTRIFUGES ETC OUT (EQUIPMENT THAT PRODUCES ITS OWN AIR)
  • DO NOT USE CONSTANT BURNERS
  • KEEP GRILLES CLEAR (COMPONENTS OF THE MACHINE THAT ALLOW AIR CIRCULATION, THERE ARE FRONT, BACK AND SIDE GRILLES USUALLY)
  • KEEP LAB DOORS SHUT

===> CHECK AIRFLOW INDICATOR

  • —-> DO NOT USE IF ALARM SOUNDS
  • —-> CLEAN DOWN FREQUENTLY
  • —–> LEAVE EMPTY WHEN FINISHED
  • —–> THE MACHINES GET TESTED EVERY 6 MONTS AND HAVE A ‘STICKER’ INDICATING TEST HAS BEEN PASSED AND WHEN THE NEXT ONE IS DUE!!
40
Q

CLASS I MSC (MICROBIOLOGICAL SAFETY CABINET)

A
  • OFFERS HIGH LEVEL OF OPERATOR PROTECTION, BUT NOT DESIGNED TO PROVIDE SAMPLE PROTECTION
  • CAN BE USED UP TO CONTAINMENT LEVEL 3
  • NO CIRCULAR AIRFLOWS (AIR GOES THROUGH A FILTER AND THEN OUT TO THE ATMOSPHERE)
  • LESS SENSITIVE TO DISRUPTION THAN CLASS II
41
Q

CLASS III MSC (MICROBIOLOGICAL SAFETY CABINET)

A
  • MAXIMUM OPERATOR PROTECTION
  • SAMPLE PROTECTION
  • ENVIRONMENT PROTECTION
  • CAN BE USED AT CONTAINMENT LEVEL 4
  • USED WITH VERY HIGH HAZARD MATERIALS
42
Q

GENETIC MODIFICATION DEFINITION?

A

INTRODUCTION OF FOREIGN DNA INTO ANY ORGANISM BY A METHOD THAT DOESN’T OCCUR NATURALLY (E.G. TRANSFORMATION OF PLASMIDS INTO ANY BACTERIA, TRANSFECTION/TRANSDUCTION OF TISSUE CULTURE CELLS, MUTAGENESIS (OTHER THAN BY RANDOM MECHANISMS), GROWTH/STORAGE/TRANSPORT OF ANY RESULTING ORGANISM)

43
Q

DESCRIBE A RISK ASSESSMENT REQUIRED BY GMO (CONTAINED USE) REGULATIONS?

A
  • IDENTIFY ANY HAZARDS FROM HOSTS, VECTORS AND INSERTED DNA
  • WHAT COULD HAPPEN WHEN YOU COMBINE THEM (FORSEEABLE EFFECTS, NOTH TO HUMANS AND THE ENVIRONMENT)
  • WHAT CONTAINMENT MEASURES ARE NEEDED TO CONTROL THE RISK
  • ASSIGN THE APPROPRIATE CONTAINMENT LEVEL AND CLASS OF ACTIVITY
  • SEEK ADVICE FROM A GM SAFETY COMMITTEE
44
Q

% OF ALCOHOL REQUIRED IN DISINFECTANT FOR IT TO BE EFFECTIVE AGAINST SARS CoV 2?

A

64%

percentage varies based on the pathogen

45
Q

WASTE DISPOSAL ROUTES IN LAB SETTINGS

A
  • INCORRECT DISPOSAL OF WASTE CAN PUT PEOPLE AND THE ENVIRONMENT AT RISK
    INACTIVATION OF BIOLOGICAL AGENTS IS VITAL!!!!!!!!!!!! VIA:
  • PHYSICAL METHODS (E.G. AUTOCLAVING; USE OF HIGH PRESURE STEAM)
  • CHEMICAL METHODS (E.G. DISINFECTANTS)
    —> THE METHODS NEEDS TO BE VALIDATED —> NEED EVIDENCE THAT IT IS EFFECTIVE
  • WORKERS NEED TO KNOW THE CORRECT DISPOSAL STREAMS FOR ANY WASTE THEY GENERATE
46
Q

SUMMARY OF SAFE WORK PRACTICES IN A LAB/

A
  • DO YOU KNOW WGAT THE RISK ASSESSMENT SAYS?
  • IS THE LAB THE CORREC CONTAINMENT LEVEL?
  • HAVE YOU RECEIVED TRAINING IN THE TECHNIQUES AND SOPs? (Standard Operating Procedures, a document, falls below risk assessment)
  • IS THE USE OF SHARPS MINIMISED OR JUSTIFIED?
  • ARE PROCEDURES IN PLACE TO CONTROL AEROSOL PRODUCTION?
  • WHAT PPE IS REQUIRED, AND ARE YOU USING IT? (PPE considered the last resort because it’s not completely reliable, everything else/every other measure needs to be implemented before, but use of disposable gloves is quite common)
  • DO YOU KNOW WHICH WASTE DISPOSAL ROUTE TO USE (physical or chemical)?
  • IS THE CORRECT VALIDATED!!!! DISINFECTANT AVAILABLE?
  • DO YOU KNOW HOW TO REACT IF THINGS GO WRONG? (ESP IF SPILLS HAPPEN —> 1st thing to do is to stop your work and tell people around you + prepare to evacuate the lab)
47
Q

ANTI TERRORISM, CRIME AND SECURITY ACT - YEAR?

A

2001

48
Q

BIOSECURITY IN LAB SETTINGS

A
  • HIGHLY INFECTIOUS HUMAN AND ANIMAL PATHOGENS ARE CONSIDERED A SECURITY RISK
  • PREVENT THEM FROM FALLING INTO ‘WRONG HANDS’ (more concerned with keeping people out than keeping bugs in)
    MUST BE USED IN ‘SECURE LABS’:
  • ROBUST PHYSICAL SECURITY MEASURES (WALLS, DOOR, ROOF)
  • STAFF SCREENED DURING RECRUITMENT + EXTRA TRAINING
  • APPROVAL AND INSPECTIONS BY ANTI TERRORISM POLICE
    —> DON’T TALK ABOUT TOPICS THTA COULD BE CONSIDERED A SECURITY RISK PUBLICLY
    —-> DON’T ALLOW ACCESS TO ANYONE UNAUTORISED

INF (40 decks)

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