Module 2

Principles
Definition

Biohazard
An agent of biological origin that has the capacity to produce deleterious effects on humans, i.e. microorganisms, toxins and allergens derived from those organisms; and allergens and toxins derived from higher plants and animals.

2.1

Introduction
Development of Biosafety Practices
n

1941 - Meyer and Eddie

n

74 lab associated brucellosis infections in US 222 viral infections (21 fatal) Only 27% related to known accidents

1949 - Sulkin and Pike

n n

2.1

Introduction
Development of Biosafety Practices
n

1951, 1965, 1976 - Sulkin and Pike

n n n n

Surveys for lab-associated infections More than 5,000 labs Cumulative total of 3,921 cases cited Most commonly reported:
Hepatitis Tuberculosis Typhoid Venezuelan Equine Encephalitis Brucellosis Tularemia
2.1

Introduction
Development of Biosafety Practices
n

1951,1965, 1976 - Sulkin and Pike

n

Fewer than 20% associated with known accidents Exposure to infectious aerosols plausible (but unconfirmed) for >80% of reported cases

2.1

Introduction
Why Biosafety Practices?

Protection: n workers n products n co-workers n lab support personnel n environment

2.1

Introduction
Chain of Infection Reservoir of pathogen Portal of escape Transmission
s/ ice t t rac men P ip Equ

E PP

sk Ri m ss se As

Route of entry/infectious dose Susceptible host

n atio z uni Imm ce lan il rve Su

2.1

t en

Incubation period

Principles
General Lab Requirements
n

Knowledgeable supervisor Knowledgeable personnel

n n

Aware of potential hazards Proficient in practices & techniques

Lab specific biosafety manual

2.2

Principles
General Lab Requirements
n n

Biosafety Levels (BSLs) Laboratory Practice and Technique

n n

Standard Practices Special Practices

n n

Safety Equipment (Primary Barriers) Facility Design and Construction

(Secondary Barriers)
2.1

Principles
General Lab Requirements
n n

Biosafety cabinets (BSCs) - BSL 2/3 Personal protective clothing

n n n

Gloves Gowns Eye and face protection

n n

Pipetting Devices Safety centrifuge cups and rotors

2.1

Principles
Definition

Biosafety
The application of combinations of laboratory practice and procedure, laboratory facilities, and safety equipment when working with potentially infectious microorganisms.

2.1

Principles
Biosafety Levels

n n

BSL1 - agents not known to cause disease. BSL2 - agents associated with human
disease. BSL3 - indigenous/exotic agents associated with human disease and with potential for aerosol transmission. BSL4 - dangerous/exotic agents of life threatening nature.
2.1

Biosafety Level 1
Introduction

uitable for work involving wellcharacterized agents not known to cause disease in healthy adult humans and of minimal potential hazard to laboratory personnel and the environment.
2.3

Biosafety Level 1
Introduction

Examples:
n n n n

Bacillus subtilis Naegleria gruberi Infectious canine hepatitis virus E. coli

2.3

Biosafety Level 1
Facility Design (Secondary Barrier)

2.3

Biosafety Level 1
Facility Design (Secondary Barrier)

Requirements: n Laboratories have doors n Sink for hand washing n Work surfaces easily cleaned n Bench tops are impervious to water n Sturdy furniture n Windows fitted with flyscreens

2.3

Biosafety Level 1
Facility Design (Secondary Barrier)

Easily cleaned and decontaminated

2.3

Biosafety Level 1
Facility Construction (Secondary Barrier)

Requirements:
n n n

Location - not separated Structure - normal construction Ventilation - none

2.3

Biosafety Level 1
Standard Microbiological Practices

Restrict or limit access when working Prohibit eating, drinking and smoking Prohibit mouth pipetting

2.3

Biosafety Level 1
Standard Microbiological Practices

Use mechanical pipetting devices

2.3

Biosafety Level 1
Standard Microbiological Practices

Wash hands

2.3

Biosafety Level 1
Standard Microbiological Practices

n n n n

Minimize splashes and aerosols Decontaminate work surfaces daily Decontaminate wastes Maintain insect & rodent control program

2.3

Biosafety Level 1
Safety Equipment (Primary Barriers)

Protective clothing n Lab coat n Gloves

2.3

Biosafety Level 1
Safety Equipment (Primary Barriers)

Personal protective equipment

n n

Face protection Eye protection

2.3

Biosafety Level 1
Special Practices

2.3

Biosafety Level 1
Training Requirements

Supervisor n Scientist with general training in microbiology or related science Lab Personnel n Specific training in lab procedures

2.3

Biosafety Level 2
Introduction

uitable for work involving agents of moderate potential hazard to personnel and the environment.

2.4

Biosafety Level 2
Introduction

Examples:
n n n n

Measles virus Salmonellae Toxoplasma spp. Hepatitis B virus

* Immunization or antibiotic treatment is available

2.4

Biosafety Level 2
Introduction

Examples:
n n

Bloodborne pathogens Human body fluids/particularly when visibly contaminated with blood

* Extreme precaution with contaminated needles or sharp instruments

2.4

Biosafety Level 2
Facility Design (Secondary Barriers)

2.4

Biosafety Level 2
Facility Design (Secondary Barriers)

Requirements:
Laboratories have lockable doors Sink for hand washing Work surfaces easily cleaned Bench tops are impervious to water Sturdy furniture

2.4

Biosafety Level 2
Facility Design (Secondary Barriers)

Requirements (cont.):
Biological safety cabinets installed as needed Adequate illumination Eyewash readily available Air flows into lab without re-circulation to non-lab areas Windows fitted with flyscreens
2.4

Biosafety Level 2
Facility Design (Secondary Barrier)

Restricted access when work in progress

2.4

Biosafety Level 2
Laboratory Facilities (Secondary Barriers)
n

BSL-1 Facilities PLUS:

n

Autoclave available Eyewash station available

2.4

Biosafety Level 2
Facility Construction (Secondary Barrier)

Requirements:
n n n

Location - separated from public areas Structure - normal construction Ventilation - directional

2.4

Biosafety Level 2
Standard Microbiological Practices

2.4

Biosafety Level 2
Safety Equipment (Primary Barriers)

Use biosafety cabinets (class II) for work with infectious agents involving: n Aerosols and splashes n Large volumes n High concentrations

2.4

Biosafety Level 2
Safety Equipment (Primary Barriers)
n

Class II Biosafety Cabinet

n

Airflow

2.4

Biosafety Level 2
Safety Equipment (Primary Barriers)
n

Class II Biosafety Cabinet

n

Equipment layout

2.4

Biosafety Level 2
Safety Equipment (Primary Barriers)
n

Class II Biosafety Cabinet

n

Technique

2.4

Biosafety Level 2
Special Practices

Supervision
Supervisor is a competent scientist with increased responsibilities
Limits access if immunocompromised Restricts access to immunized

Lab Personnel
Aware of potential hazards Proficient in practices/techniques
2.4

Biosafety Level 2
Special Practices

Needles & Sharps Precautions

n
n

Use sharps containers DONT break, bend, re-sheath or reuse syringes or needles

2.4

Biosafety Level 2
Special Practices

Needles & Sharps Precautions (cont.)

n

DONT place needles or sharps in office waste containers

2.4

Biosafety Level 2
Special Practices

Needles and Sharps Precautions (cont.)

n

DONT touch broken glass with hands

2.4

Biosafety Level 2
Special Practices

Needles and Sharps Precautions (cont.)

n

Use plasticware

2.4

Biosafety Level 2
Special Practices
n n n n

Policies and procedures for entry Biohazard warning signs Biosafety manual specific to lab Training with annual updates

2.4

Biosafety Level 2
Special Practices

Use leak-proof transport containers

2.4

Biosafety Level 2
Special Practices
n n

Immunizations Baseline serum samples

2.4

Biosafety Level 2
Special Practices
n n n

Decontaminate work surfaces Report spills and accidents No animals in laboratories

2.4

Biosafety Level 3
Introduction

Suitable for work with infectious agents which may cause serious or potentially lethal disease as a result of exposure by the inhalation route.

2.5

Biosafety Level 3
Introduction

Exposure potential to pathogens spread by aerosol n Infection serious, possibly lethal n Examples:
n

M. tuberculosis n St. Louis encephalitis virus n Coxiella burnetii

n
2.5

Biosafety Level 3
Laboratory Facilities (Secondary Barriers)

2.5

Biosafety Level 3
Laboratory Facilities (Secondary Barriers)

BSL-1 and 2 Facilities PLUS:

n n n n

Separate building or isolated zone Double door entry Directional inward airflow Single-pass air; 10-12 air changes/hour

2.5

Biosafety Level 3
Laboratory Facilities (Secondary Barriers)

BSL-1 and 2 Facilities PLUS (cont.):

n

n n

Enclosures for aerosol generating equipment Room penetrations sealed Walls, floors and ceilings are water resistant for easy cleaning

2.5

Biosafety Level 3
Laboratory Facilities ( Secondary Barriers)
n

BSL-1 and 2 Facilities PLUS: n Vacuum lines protected with liquid disinfectant traps or HEPA filters

2.5

Facility Design
(Tertiary Barriers)

n n

Lab structure Lab ventilation

2.5

Biosafety Level 3
Standard Microbiological Practices

2.5

Biosafety Level 3
Safety Equipment (Primary Barriers)
n

BSL-1 and 2 Safety Equipment PLUS:

n

BSC class II or III to manipulate infectious material

2.5

Biosafety Level 3
Safety Equipment (Primary Barriers)
n

BSL-1 and 2 Safety Equipment PLUS:

n

Respiratory protection may be indicated

2.5

Biosafety Level 3
Special Practices
n

BSL-2 Special Practices PLUS:

n n

Work in certified BSC Use bioaerosolcontaining equipment Decontaminate spills promptly

2.5

Biosafety Level 3
Special Practices

Supervision
Supervisor is a competent scientist experienced working with agents Establishes criteria for entry Restricts access Develops policies/procedures Trains lab personnel
2.5

Biosafety Level 3
Special Practices

Lab Personnel
Strictly follow guidelines Demonstrate proficiency Receive appropriate training Report incidents Participate in medical surveillance
2.5

Biosafety Level 4
Introduction

Suitable for work with dangerous and exotic agents that pose a high individual risk of aerosoltransmitted laboratory infections and life-threatening disease.
2.6

Biosafety Level 4
Introduction

Exposure potential to pathogens spread by aerosol or with unknown risk of transmission n Infection possibly lethal n Examples:
n

Ebola Zaire n Sin Nombre virus n Rift Valley Fever

n

Ebola Zaire Ebola Zaire

2.6

Biosafety Level 4
Laboratory Facilities (Secondary Barriers)

2.6

Biosafety Level 4
Laboratory Facilities (Secondary Barriers)
n

BSL-1, 2, and 3 Facilities PLUS: n Separate building or isolated zone n Double door entry n Directional inward airflow n Single-pass air n Dedicated supply and exhaust, vacuum, and decon systems

BSL4

2.6

Biosafety Level 4
Laboratory Facilities (Secondary Barriers)
n

BSL-1, 2 and 3 Facilities PLUS (cont.): n Enclosures for aerosol generating equipment n Double door autoclaves n Room penetrations sealed n Walls, floors and ceilings are sealed to form an internal seal

2.6

Biosafety Level 4
Laboratory Facilities (Secondary Barriers)
n

BSL-1, 2 and 3 Facilities PLUS (cont.): n Connecting inner and outer doors interlocked to prevent simultaneous opening n Liquid effluents are decontaminated by an approved method and certified before discharge n Communication system between inside and outside of the lab
2.6

Biosafety Level 4
Laboratory Facilities ( Secondary Barriers)
n

BSL 1, 2, and 3 Facilities PLUS: n Emergency breathing air n Emergency generator n Emergency exit

2.6

Biosafety Level 4
Facility Design

Clean Hot

2.6

Biosafety Level 4
Standard Microbiological Practices

2.6

Biosafety Level 4
Safety Equipment (Primary Barriers)
n

BSL 1, 2, and 3 Safety Equipment PLUS:

n

Class II (B2) or III biological safety cabinets to manipulate infectious material

2.6

Biosafety Level 4
Safety Equipment (Primary Barriers)
n

BSL 1, 2, and 3 Safety Equipment PLUS:

n

Positive pressure personnel suit

2.6

Biosafety Level 4
Special Practices
n

BSL 3 Special Practices PLUS:

n

Decontaminate all liquid effluent Decontaminate all solid wastes

2.6

Biosafety Level 4
Special Practices

Controlled access Personnel enter facility through changing room where they are required to change into laboratory clothing Showers are required upon exit from the laboratory Supplies enter lab through double-door autoclave or fumigation chamber
3.5

Biosafety Level 4
Special Practices

Supervision
Supervisor is a competent scientist trained and experienced working with agents Establishes criteria for entry Restricts access Develops policies/procedures Trains lab personnel
2.6

Biosafety Level 4
Special Practices

Lab Personnel
Strictly follow guidelines Demonstrate proficiency Receive appropriate training Report incidents Receive available immunizations Participate in medical surveillance
2.6

Principles of Biosafety
Summary
n

BSL 1 - 4
n n n n

Standard Practices Special Practices Safety Equipment (Primary Barriers) Laboratory Facilities (Secondary Barriers) Building (Tertiary Barriers)
2.6

2.7

Biological Safety Cabinets

Purpose

n n n

Product protection Personal protection Environmental protection

2.7

Biological Safety Cabinets

Types

A. Class I
n n

inward airflow protects worker exhaust to outside (w/wo HEPA filter) worker, product, environmental protection sterile work area use for work with aerosol-transmissible microorganisms use also for tissue culture/ virology totally enclosed, ventilated, air-tight suitable for work with BSL3/4 agents

B. Class II
n n n

C. Class III
n n
2.7

Biological Safety Cabinets

Types

Class II
n n n n

Type A Type B3 Type B1 Type B2

30% exhausted to room 30% exhausted to outside 70% exhausted to outside 100% exhausted to outside

2.7

Biological Safety Cabinets

Component

HEPA Filter n High efficiency particulate air filter n Traps particulates only; chemicals, fumes, vapors pass through n Traps particulates 0.3u

2.7

Biological Safety Cabinets

Component

HEPA Filter n Metal or wood framed n Continuous sheet of flat filter medium with aluminum separators n Gasket sealed n Adhesive bond between filter pack and frame
2.7

Biological Safety Cabinets

Operating Location

Isolated from other work areas Removed from high traffic areas Away from airflow ducts Away from laboratory entry doors

2.7

Biological Safety Cabinets

Airflow Typical Class II
Exhaust

Intake 100 ft/min

2.7

Biological Safety Cabinets

Operating Procedure

1. 2. 3. 4. 5. 6. 7. 8.

Load BSC with all needed supplies. Turn BSC on and allow to run for 10-15 minutes. Check inward airflow with a piece of tissue. Enter straight into cabinet and perform work in a slow, methodical manner. At end of work, decontaminate all items to be taken out of cabinet. Decontaminate interior of BSC. Allow cabinet to run for 10-15 minutes. Shut off.
2.7

Biological Safety Cabinets

Safe Operation
s s s s s

Always enter straight into cabinet - no sweeping motions Place materials well within the cabinet - not on front grill Place discard pan within cabinet Watch for disruptions of laminar air flow Decontaminate materials before removal from cabinet

2.7

Biological Safety Cabinets

Safe Operation
s s s
s

Not designed for chemical use May use for non-volatile toxic chemicals or low-level radioactive materials May use for minute amounts of volatile chemicals Ensure annual certification Place all work materials into cabinet before starting

2.7

Biological Safety Cabinets

Safe Operation

CAUTIONS n Chemicals may damage HEPA filter

n

Exposure risk - chemical/infectious agents

Volatile chemicals NOT retained by HEPA filter

n

Exposes personnel if not exhausted Chemical use may result in fire/ explosion Never use NFPA 4 flammables
2.7

BSC fans NOT spark proof

n n

2.8

Centrifuges

Types Microcentrifuges Low/high speed Ultracentrifuges

Speeds (rpm) ~15,000 2,000 20,000 ~ 120,000

2.8

Centrifuges
Hazards
n n n n

Mechanical failure of machine Lab equipment failure (tubes etc.) Aerosol generation Operator error

2.8

Centrifuges
Operating Procedure

1. 2. 3. 4.

Check tubes for cracks/chips. Use matched sets of tubes, buckets etc. Tightly seal all tubes and safety cups. Ensure that rotor is locked to spindle and bucket seated. 5. Close lid during operation. 6. Allow to come to complete stop before opening.
2.8

Centrifuges
Safe Operation

Use safety cups whenever possible Disinfect weekly and after all spills or breakage's Lubricate O-rings and rotor threads weekly Do not use rotors that have been dropped Contact your centrifuge rep for specific information
2.8

2.9

Shipping Biological Specimens

Guideline Documents
n

Recommendations of the United Nations Committee on Dangerous Goods

2.9

Shipping Biological Specimens

Regulations
n n n

PHS: 42 CFR Part 72. DOT: 49 CFR Part 171-178 USPS: Domestic Mail Manual IATA: International Air Transport Association ICAO: International Civil Aviation Organization
2.9

Shipping Biological Specimens

Infectious Substance

Definition n Contains or has high probability of containing an infectious materialknown or reasonably believed to cause disease in humans or animals
n n

virus, prion, genetic elements bacterium, rickettsia, parasite, fungus

Contains a microbial toxin known to be pathogenic

2.9

Shipping Biological Specimens

Infectious Substance

Packaging n Primary Container

n

Positive seal

Absorbent material

2.9

Shipping Biological Specimens

Infectious Substance

Packaging n Secondary packaging

Watertight/leakproof

2.9

Shipping Biological Specimens

Infectious Substance

Packaging n Between Secondary and Outer Container

n n

List of Contents Shippers label

n n n

Name Address Phone number

2.9

Shipping Biological Specimens

Infectious Substance

Packaging n Outer container

2.9

Shipping Biological Specimens

Infectious Substance

Packaging n Performance tests

n

49 CFR 178.609

2.9

Shipping Biological Specimens

Infectious Substance

Packaging label

2.9

Shipping Biological Specimens

Infectious Substance

Containers

2.9

Shipping Biological Specimens

Clinical Specimen

Definition Human or animal materialcollected for the purpose of diagnosis or [Link] known to contain viable infectious agents

2.9

Shipping Biological Specimens

Clinical Specimen

Packaging n Primary receptacle

n

Positive seal Biohazard label Absorbent material

2.9

Shipping Biological Specimens

Clinical Specimen

Packaging n Between the secondary and outer packaging

n

List of contents

2.9

Shipping Biological Specimens

Clinical Specimen

Packaging n Outer packaging

2.9

Shipping Biological Specimens

Clinical Specimen

Package Label

2.9

Shipping Biological Specimens

Clinical Specimen

Packaging n Performance test

2.9

Biosafety Manuals
Components
n

Biosafety Level Descriptions

n n n n

Standard Practices & Principles Special Practices & Procedures Containment Devices Facility Design

n n

Animal Safety Practices Agent Summary Statements

2.9

Biosafety Manuals
Components
n n n n n

Equipment Descriptions Specimen Handling Security Waste Special Lab Practices

n n

Tissue culture Toxins

2.9

2.10

Decontamination
Definition n

Sterilization
The use of a physical or chemical procedure to destroy all microbial life, including large numbers of highly resistant bacterial spores.

2.10

Decontamination
Definition n

Disinfection
The use of a physical or chemical procedure to virtually eliminate all recognized pathogenic microorganisms but not all microbial forms (bacterial endospores) on inanimate objects.

2.10

Decontamination
Definition n

Antisepsis
A germicide that is used on skin or living tissue for the purpose of inhibiting or destroying microorganisms.

2.10

Decontamination
Agent Selection

Degree of microbial killing required n Nature of item/surface to be treated n Ease of use n Safety n Cost
n

2.10

Decontamination
Agent Efficacy
n n n n n n n n

Type of organism Number of organisms Amount of organic material present Type & configuration of material to be treated Type & concentration of germicide Time and temperature or exposure pH Humidity
2.10

Decontamination
Methods

Heat n Chemical n Radiation

n

2.10

Decontamination
Heat n

Types
n n n

Moist steam Dry Incineration

*The most effective method of sterilization

2.10

Decontamination
Heat n

Steam sterilization practices

n n n n

Ensure proper functioning of autoclave Vessels should not be capped or plugged Large loads require longer contact time Excessive amounts of liquid should not be added to load

2.10

Decontamination
Heat n

Steam sterilization verification

n n n n

Direct assay Thermocouples Chemical indicators Biological indicators (Bacillus stearothermophilis)

2.10

Decontamination
Heat n

Dry heat sterilization

n

Denaturation of proteins: 1600 1700 C/2-4 hours Effective on impervious non-organic materials like glass

2.10

Decontamination
Heat n

Incineration
n

Method of choice for animal carcasses Requires certified incinerator

2.10

Decontamination
Chemical n

Types
n

Liquids, I.e. chlorox, hydrogen peroxide Gases, I.e. ethylene oxide

2.10

Decontamination
Chemical

Agent selection - complexity

n n n

Over 14,000 registered products Over 300 active ingredients 14 ingredients present in 92% of products

2.10

Decontamination
Chemical n

Agent selection - activity

n n n

HLD high level disinfection ILD intermediate level disinfection LLD low level disinfection

2.10

Decontamination
Chemical n

High level disinfection - sporocides

n

n n

Kills all microorganisms except high numbers of bacterial spores Require 5-10 min. exposure Examples: aldehydes, hydrogen peroxide, paracetic acid

2.10

Decontamination
Chemical n

Intermediate level disinfection tuberculocides

n

n n

Kills M. tuberculosis var. bovis and all vegetative bacteria, fungi, and most viruses Require minimum 20 min. exposure Examples: phenolics, iodophores, chlorine compounds, alcohols
2.10

Decontamination
Chemical n

Low level disinfection hospital germicides used for housekeeping

n

n n

Kills most vegetative bacteria and some fungi, but not M. tuberculosis var. bovis Require minimum 20 min. exposure Examples: quartenary ammonium compounds
2.10

Decontamination
Summary
Bacterial Spores B. subtilis Mycobacterium MTB var. bovis Non-lipid Viruses PolioRhinoFungi Cryptococcus sp, Candida sp. Vegatative Bacteria Pseudomonas sp. Staphylococcus sp. Salmonella sp. Lipid Viruses Herpes CMV HBV HIV

Sterilization HLD ILD LLD

2.10

Decontamination
Chemical n

General Lab Use - Hypochlorite Solutions

n

Large Spills/Large Organic Load

n

undiluted from bottle 10% - 1:9 1% - 1:99

Small Spills/Virus Inactivation

n

General Surface Disinfection

n

2.10

Decontamination

2.10

2.11

Biological Waste
n

Types
n n

n n n

cultures, stocks, isolates materials containing or contaminated with blood sharps pipettes, wrappers, tips All materials used in the lab

2.11

Biological Waste
nDisposal
n

n n

puncture-proof, leak-proof, sealable receptacles avoid over-filling dispose properly

2.11

Biological Waste
Disposal
- Never place lab waste into office waste containers - Place sharps into sharps container - Line discard containers with autoclave bag - Decontaminate discard pans before they leave the lab: 1. Disinfect outside 2. Label 3. Tape ends with autoclave 4. Tape 5. Secure for transport to autoclave

2.11

Biological Waste
Decontamination
n

To render the object/material safe by reducing or removing the bioburden Methods

n
n n n

chemical ... match, contact time physical ... Heat, steam and pressure incineration other choices, i.e. shredding + chemical
2.11

2.12

Medical Surveillance
Criteria
n n

Based on risk assessment Pre-placement n evaluate physical requirements Periodic review

2.12

Medical Surveillance
Risk Assessment
n n n

The probability of infection Implies an estimate of numbers exists Predict an outcome given similar events

2.12

Medical Surveillance
Risk Assessment
n n n n n

What is the natural host? Does agent cross species barriers? Wild-type agent or attenuated? Infectious for normal healthy adult? What if adult is immunocompromised?

2.12

Medical Surveillance
Risk Assessment
n

Mode of transmission? n contact n fomites n mucous membrane exposure n ingestion n inoculation or insect bites n inhalation n sex
2.12

Medical Surveillance
Risk Assessment
n n n n n

Volume being manipulated? Concentration of agent? Infectious dose? Past history of lab-associated infection? Secondary spread in community?

2.12

Medical Surveillance
Risk Assessment
n

Prophylaxis
n n n

Immunizations available? Pharmaceuticals? Effectiveness? Anti-microbial agents? Pharmaceuticals? Effectiveness?

2.12

Post-Exposure
n n n

Medical Surveillance
Risk Assessment
n

Dealing with an unknown agent? n epidemiological data n patterns parallel to other agents n data from animal studies n route of infection

2.12

Medical Surveillance
Risk Management
n

Top management
n n

overall safety policy resource allocation implement policies training, practices & procedures, access strict & rigorous attention to details of practices and procedures report incidents and exposures
2.12

Supervisor
n n

Workers
n

Medical Surveillance
Risk Management
n n n n n

Occupational Health Clinic Immunizations, chemotherapy Medical surveillance programs Incident (emergency) response Incident investigation

2.12

2.13

Emergency Response
Personal Contamination

1. Alert co-workers 2. Clean exposed surface with soap/water, eyewash (eyes), or saline (mouth) 3. Apply first aid and treat as an emergency 4. Notify supervisor or security desk (after hours) 5. Report to medical clinic for treatment/counseling

2.13

Emergency Response
Surface Contamination 1. 2. 3. 4. 5. Alert co-workers Define/isolate contaminated area Put on appropriate PPE Remove glass/lumps with forceps or scoop Apply absorbent towel(s) to spill; remove bulk & reapply if needed 6. Apply disinfectant to towel surface 6. Allow adequate contact time (20) 8. Remove towel, mop up; clean with alcohol or soap/water 9. Properly dispose of materials 10. Notify supervisor
2.13