Module: STANDARD BIOHAZARD CONTAINMENT - PowerPoint Presentation

1. Module:STANDARD BIOHAZARD CONTAINMENTbyIruobe Lauretta

2. outlineIntroductionObjectivesBiological Risks and Laboratory acquired infectionsRoutes of infectionsBreaking the chains of infectionsElements concerned by biological risks and personnel exposedDiseases under surveillance

3. IntroductionOne of the major concerns in public Health is the risk of transmission of infectionsThe consideration of this risk in medical Laboratory practices has been stimulated by the occurrence of highly publicized infections such as the HIV, Hepatits B, the Novel Corona Virus disease etc.Identifying the dangers and evaluating their subsequent risks and applying appropriate protective measures would go a long way to controlling the spread of infectionsBiological agents are widely found in the natural environment and as a result found in many work sectors such as the Laboratory Hospitals PHCs etc.Majority of these agents cause no or low risk while some have the potential to cause very serious disease. 

4. Objectives. Main Objective: To ensure the implementation of biosafety practices in a clinical and laboratoryii. Specific objectives: At the end of this training, Participants should be able to:Classify microorganisms according to risk  understand the risks of contamination with biohazardsExplain the routes of contamination and the preventive measures to be adopted.Maintain proper house keeping/ universal safety precautions

5. Types of Safety HazardsBiological: infectious agentsSharp: needles, lancets, broken glassChemical: reagents (toxic)Radioactive: radiation exposureElectrical: burns or shockFire: organic chemicals/burnsPhysical: wet floors, heavy boxes, falls

6. Biological Hazards/ BiohazardA biological hazard, or biohazard, is a biological substance that poses a threat to the health of living organisms, primarily humansIncludes infectious agents with possible injury: BacterialFungalViralParasitic infections

7. Examples of Biohazards Human blood and blood products. Animal waste. Animal carcasses and body parts, Human body fluids. Semen, cerebrospinal fluid, Microbiological wastes. specimen cultures, disposable culture dishes, Pathological waste. biopsy materials, anatomical parts from medical procedures or autopsiesSharps waste. Needles, glass slides and cover slips, scalpels, and IV tubing that has the needle attached

8. Biological Hazards/ Biohazard Cont’The biohazard symbol is normally found on substances, materials, and containers that have biohazards. it is used worldwide to indicate the presence of biohazard agent.Some engineering controls for biological hazards are: regular cleaning of the workplace,pest prevention/extermination,safety equipment be used and worn, proper disposal of materials and items that may pose a biological risk.

9. Biohazard LevelsThere are 4 levels of biohazards, based on their riskBiohazard Level 1: Agents that pose minimal threat to humans and the environment. Examples include E. coli, Bacillus subtilisBiohazard Level 2: Agents that can cause severe illness in humans and are transmitted through direct contact with infected material. Examples include HIV, hepatitis B, and salmonella.Biohazard Level 3: Pathogens that can become airborne and cause serious diseases. Examples include tuberculosis Biohazard Level 4: Pathogens that pose a high risk of life-threatening disease for which there are no treatments. Examples include the Ebola virus and Lassa virus.WHO/ CDC

10. Containment of BiohazardsContainment is defined by WHO as ‘set of measures, practices, safety equipment, and facility safeguards that protect workers, the community and the environment from exposure to and/or unintentional escape of biological material’ii. The purpose of containment is to reduce or eliminate exposure to potentially hazardous agents to Laboratory personnel, other health care workersCommunity the outside environmentThe three elements of containment are:laboratory practice and technique, safety equipment, facility design.

11. Biosafety and BiosecurityBiosafety is the application of safety precautions that reduce a laboratorian’s risk of exposure to a potentially infectious microbe and limit contamination of the work environment and, ultimately, the community.It can also be defined as he containment principles, technologies, and practices that are implemented to prevent the unintentional exposure to pathogens and toxins or their accidental release. Biosecurity is the protection, control, and accountability for biological agents and toxins within facilities in order to prevent their loss, theft, misuse, diversion, unauthorized access, or intentional unauthorized release.

12. Similarities Between Biosafety & BiosecurityBiosecurity is part of BiosafetyBiosecurity and Biosafety are components of good laboratory practice Biosafety and Biosecurity are complementary. Biosecurity relies on a sound biosafety program. Biosecurity practices reinforce and strengthen biosafety

13. Differences Between Biosafety & BiosecurityBiosafety: Reduce or eliminate accidental exposure of individuals and the environment to potentially hazardous and biological agents.• Protect people from dangerous pathogens.• Limited lab access while work is in progress Biosecurity: The protection of pathogens, toxins, and sensitive information from loss, theft and subsequent misuse.• Protect pathogens from dangerous people.• Limit access to labs that contain certain biological agents

14. Biosafety Levels ( BSL)Biosafety levels are a systematic approach to disrupting the chain of infection (or release). By disrupting or eliminating the pathways between an infectious source and a susceptible host (or environment), safety, containment, and security can be assured.The biosafety levels range from BSL-1 to BSL-4. Each level has specific controls for containment of microbes and biological agents.. The primary risks that determine levels of containment are: infectivity, severity of disease, transmissibility, iv. the biohazard in question, route of exposure are also important.

15. Biosafety Levels Cont’Each biosafety level has its own specific containment controls that are required for the following:Laboratory practicesSafety equipmentFacility constructionRoute of ExposureRoute of exposure is the way a microbe gains access to a living organism. There are four main routes of exposurePercutaneous, though broken or damaged skinInhalationMucous membranes of the eyes, nose, and mouthIngestion

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17. BSL-1Specific considerations for a BSL-1 laboratory include the following:Laboratory practicesStandard microbiological practices are followed.Work can be performed on an open lab bench Safety equipmentPersonal protective equipment(lab coats, gloves, eye protection) are worn as needed.Facility constructionA sink must be available for hand washing.The lab should have doors to separate the working space with the rest of the facility.

18. BSL-2In addition to BSL-1 considerations, BSL-2 laboratories have the following containment requirements:Laboratory practicesAccess to the laboratory is restricted when work is being conducted.Safety equipmentAppropriate personal protective equipment (PPE)is worn, including lab coats and gloves. Eye protection and face shields can also be worn, as needed.All procedures that can cause infection from aerosols or splashes are performed within a biological safety cabinet (BSC)An autoclave )Facility constructionThe laboratory has self-closing doors.A sink and eyewash )

19. BSL-3BSL-3 builds upon the containment requirements of BSL-2. the microbes in a lab that is designated BSL-3, can be either indigenous or exotic, and they can cause serious or potentially lethal disease through respiratory transmission. Respiratory transmission is the inhalation route of exposure. One example of a microbe that is typically worked with in a BSL-3 laboratory is Mycobacterium tuberculosis, the bacteria that causes tuberculosis.In addition to BSL-2 considerations, BSL-3 laboratories have the following containment requirements:Laboratory practicesLaboratorians are under medical surveillance and might receive immunizations for microbes they work with.Access to the laboratory is restricted and controlled at all times.Safety equipmentAppropriate PPE must be worn, and respirators might be required (Respirator A protective device that covers the nose and mouth or the entire face or head. Lab respirators filter out infectious or harmful particles; some supply the wearer with HEPA-filtered air. Appropriate respirators are chosen based on the type of work being performed)All work with microbes must be performed within an appropriate BSCFacility constructionA hands-free sink and eyewash are available near the exit.Exhaust air cannot be recirculated, and the laboratory must have sustained directional airflow by drawing air into the laboratory from clean areas towards potentially contaminated areas.Entrance to the lab is through two sets of self-closing and locking doors

20. BSL-4BSL-4 builds upon the containment requirements of BSL-3 and is the highest level of biological safety. Containment practiceIn addition to BSL-3 considerations, BSL-4 laboratories have the following containment requirements:Laboratory practicesChange clothing before entering.Shower upon exiting.Decontaminate all materials before exiting.Safety equipment

21. BSL 1 -4

22. Standard Microbiological Practices.Every microbiology laboratory, regardless of biosafety level, follows standard microbiological practices.These practices are common to all laboratories. They include:i. Not eating, drinking, or applying cosmetics in the labii. Washing hands after working with infectious materials and before leaving the labiii. Routinely decontaminating work surfaces

23. BIOSAFETY PRACTICES AND PROCEDURESThe most important element of containment is strict adherence to standard microbiological practices and techniques Persons working with infectious agents or potentially infected materials must be aware of potential hazards,must be trained and proficient in the practices and techniques required to handle such material safely The director or person in charge of the laboratory is responsible for providing or arranging the appropriate training of personnel

24. Chain of InfectionA Source: pathogen (potentially harmful)A Method of Transmission: direct contact, inhaling, droplet, ingesting contaminated food or vectorA Susceptible Host: Anyone; now the host is the source

25. Breaking the Chain of InfectionSourceTransmissionHost Hand WashingWearing GlovesIsolationAseptic TecDecontaminationImmunizationSterilizationInsect Control

26. Biosafety Levels: Breaking the Chain

27. How to Break the Chain of InfectionHandwashing: hand contact represents the number one method of infection transmissionEssential to wash hands and change gloves between each patientIsolation procedures: isolating the sourceUse of barriers gowns, masks, goggles and glovesDecontaminationImmunizationInsect ControlSterilizationEmployee ScreeningAntibioticsHealth Life Style

28. Hand washingThe single most important factor in preventing the spread of infection is handwashingit is important in preventing Laboratory /hospital acquired infections Minimizes the spread of infectious materials.Before and after patient contactBetween different procedures on the same patientBefore and after putting on glovesBefore leaving the lab

29. Hand washing procedureWash hands for 15 secondsSoap with a good latherRub hands create a good friction, scrub between fingersRinse downward, dry with a clean towelClose faucet with a clean towel

30. Handwashing –Waterless/hand sanitizersWhen using a hand sanitizer:Ensure that the active ingredients include > 60% alcohol (ethanol or isopropanol)Apply quantity recommended by manufacturerThoroughly distribute as if you were washing your hands (paying attention to palms, backs of hands, finger webbing, cuticle beds, and wrists)Rub until completely dryWash your hands with soap and water once available.Hand sanitizers may be used as a temporary means of reducing contamination until a source of running water and soap can be reached.

31. Standard Microbiological Practices/Standard “universal” Precautions (SMP/SUP)The foundation of each biosafety level is standard microbiological practices BSL-1 labs employ SMP as the baseline criteria for biological safety & containment. Subsequent BSLs build upon SMP with more specialized design, equipment, and practices.Basic Elements of SMP at BSL-1:Restricting access to laboratoriesHand washing after handling biologicals and potentially hazardous materials, after taking off gloves and before leaving the lab.Avoiding hand-to-face (or mouth) contact. No eating, drinking, smoking, or applying cosmetics in the lab.

32. Standard Microbiological Practices/Standard “universal” Precautions (SMP/SUP)Disinfecting work surfaces daily and decontaminating after spills.Prudent handling, management, and disposal of sharps.Using procedures that minimize the formation of aerosols and splashesWearing appropriate personal protective equipment (PPE), e.g., lab coats, gloves, safety glasses, safety goggles, etc.Using primary and secondary containment when transporting materials.Disposal of all non-sharps solid biological waste in a proper container lined with an autoclavable bag for disposal. Liquid biological waste must be disinfected or autoclaved before sink disposal

33. Standard Microbiological Practices/Standard “universal” PrecautionsAll patients and specimens should be assumed to be infectious for blood borne pathogensWash hands when changing gloves between patientsWear gloves during blood collectionWear protective lab coat over clothingWear mask and eye protection when dealing with body fluidsPlace intact needle with holder in a biohazard container

34. Biosafety Level 2 practices (BSL-2)Biosafety Level 2 practices (BSL-2) consist of SMP plus:Hazard communication through: door signs/signages and biohazard labellingMore stringent PPE requirements, (typically gloves, long-sleeved lab coat and protective eyewear.Aerosol control and containmentEnhanced engineering controls:Biological safety cabinetsEmergency eyewashesIntegrated pest management programMedical surveillance programs as indicated by risk assessment

35. Hazard Communication - Equipment Labels

36. Eliminate Routes of EntryInjection (percutaneous)Contaminated sharp objects (e.g. needle, scalpel)Animal bites, scratchesThrough broken or abraded skin (including rashes, eczema, split cuticles, etc.)Absorption (mucous membrane contact)Splashes to the eyes, nose, mouthHand to face movements (i.e., applying cosmetics, cell phone usage, etc.)3. IngestionEating/drinkingApplying cosmeticsContact with tear ducts4. Inhalation (aerosols)Liquid disturbanceSyringe preparationDried animal excretionsLeakage from injection site

37. Eliminate Routes Of Entry

38. Donning & Doffing Gloves

39. Fomite Transmission

40. SHARPS MANAGEMENTIn the laboratory / health facility, a sharp refers to any object that is contaminated with a biologically hazardous agent and is sharp enough to puncture the skin without excessive applied pressure of force.Needles,LancetsBroken glasswareSerological pipettes (especially if broken or damaged)Pasteur pipettesMetal edgesUnpolished glass (slides and cover slips)Penetration of the skin with a biologically contaminated sharp device is one of the most efficient means of transmitting infection.

41. SHARPS MANAGEMENTIn order to minimize the risk of a sharps injury the following guidelines must be followed:Use disposable sharps when possible Have a sharps container readily available within arm’s reach for disposal of sharps immediately afterNeedles must not be bent, sheared, broken, recapped, removed from disposable syringes, or otherwise manipulated by hand before disposalDo not pass a sharp to another personWhen cleaning and processing reusable sharps, use cleaning tools that limit the potential for contact between your hands and the sharp surfaceDon’t leave sharps unattendedDo not leave sharp devices in your pockets

42. CONCLUSIONSafety is a matter of common sense Adhere to laid down guidelines in order to prevent infections in the Laboratory, Wards and other work stations

43. Acknowledgment

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