Dr.Nagwa Aref
الحيوية المخاطر على التعرفالتحكم وطرق
الحيوية المخاطر على التعرفالتحكم وطرق
Biohazard Recognition and Control
?
Dr.Nagwa Aref
Dr.Nagwa Aref
Dr.Nagwa Aref
Dr.Nagwa Aref
المخاطر المخاطر بعض بعضسنة األمريكية 1941دراسة الواليات حصر في المتموجة 74تم الحمى بمرض إصابة حالة brucellosis ميكروب على أجريت
طريق عن إما العينات تلك مزارع مع التعامل عند والحذر الحيطة أخذ وعدم اإلهمال أو استالمها عند المرضى عيناتمع التعامل في المتاحة التقنية ضعف أو المالمسة أو العينات تلك من المتموجة الحمى بميكروب ملوث غبار استنشاق
االنتشار والسريع الخطير الميكروب هذا مثل
– منها 222وجود ذكرت 1949سنة وأبحاث تحاليل معامل بسبب كانت فيروسي بمرض إصابة قاتلة 21حالة كانت وكان حالةالسل مرض حاالت المصابة الحيوانات أو األنسجة مع السليم التعامل عدم بسبب معظمها ،
– الفنزويلي الدماغ التهاب مرض وباألخص والدماغ الكبد تليف والتهابات والتيفويد المتموجة، 20 الحمى % , (Venezuelan
encephalitis) المسبب أن فيعتقد الباقي أما اإلصابة إلى وأدت معروفة للميكروب التعرض طريقة فيها الحاالت تلك منالمباشر باالستنشاق التعرض األمراض كان لتلك المسببة المعدية المواد عينات مع المصابين تعامل بحكم (Arboviruses)
عدة تضم المجموعة هذه و
– سنة عن تم 1967وفي لإلنسان 428الكشف تنتقل ممرضة فيروسات مجموعة مع التعامل بسبب بفيروسات إصابة حالةالحشرات طريق عن
– (arthropod-borne viruses الصفراء الحمى فيروسات بأنواعها (yellow fever) تشمل الدماغ التهاب المختلفة وفيروسات
(encephalitis) للمعامل ، قادمة عينات من متطايرة Zجدا صغيرة بقايا أو غبار أو لبخار التعرض بسبب كان معظمها للتشخيص
– البحثية بالمختبرات العاملين من بشرية أخطاء بسبب معظمها وكانت دراسات عدة في ذكرت Zأيضا الفطرية اإلصاباتمثل ممرضة بفطريات الجلد عبر ملوثة مواد وحقن وخدش العيون على فطرية مزارع من قطرات تناثر Sporothrix) منها
schenckii) التنفسي الجهاز إصابات الطبي أو العفن تناثر بسبب
– (Blastomyces dermatitidis) و (Histoplasma capsulatum)
– وراء السبب كانت الميكروب الالمباالة من مستحلب ح_ضر عندما وذلك السحايا التهاب بمرض أشخاص خمسة إصابة
(Neisseria
– meningitidis) العزل حجرة المرض (safety cabinet) خارج أعراض ظهور من أيام سبعة قبل ذلك وكانالطفيلية المعملية لLaboratory-acquired parasitic infections) واإلصابات
– النامية بالدول وخاصة ذلك من استثناء تكن م ،
– مناقشة تمت أخرى دراسة أدت 164وفي التي األسباب حيث من الطبية المختبرات بمجال للعاملين طفيلية إصابة حالة . طفيليات أمراض شملت إصابات ذلك إلى
Dr.Nagwa Aref
Dr.Nagwa Aref
Dr.Nagwa Aref
RISK LEVELS ASSOCIATED WITH
THE USE OF LABORATORY
ANIMALS
RECOMBINANT DNA AND GENETIC
MANIPULATION
CRITERIA FOR CLASSIFICATION OF
BIOLOGICAL AGENTS BY RISK GROUP
USE OF MAMMALIAN
CELLS IN CULTURE
Dr.Nagwa Aref
CRITERIA FOR CLASSIFICATION OF CRITERIA FOR CLASSIFICATION OF BIOLOGICAL AGENTS BY RISK GROUPBIOLOGICAL AGENTS BY RISK GROUP CRITERIA FOR CLASSIFICATION OF CRITERIA FOR CLASSIFICATION OF
BIOLOGICAL AGENTS BY RISK GROUPBIOLOGICAL AGENTS BY RISK GROUP
Risk Group
1
Risk Group
2
Risk Group
3
moderate individual risk,
limited community risk
high individual risk
low community risk
high individual risk
high community risk
Risk Group
4
low individual risk,
limited community risk
Dr.Nagwa Aref
Laboratory exposures rarely cause infection leading to serious disease
Effective treatment and preventive measures are available
The risk of spread is limited.
Risk Group 2
A pathogen that usually causes serious human or animal disease, or which can result in serious economic consequences
Does not ordinarily spread by casual contact from one individual to another
can be treated by antimicrobial or antiparasitic agents
Risk Group 3
A pathogen that usually causes serious human or animal disease,
can result in serious economic consequences but
does not ordinarily spread by casual contact from one individual to another, or that can be treated by antimicrobial or antiparasitic agents.
Risk Group 2
Dr.Nagwa Aref
BIOLOGICAL AGENTS BY RISK GROUPBIOLOGICAL AGENTS BY RISK GROUPBIOLOGICAL AGENTS BY RISK GROUPBIOLOGICAL AGENTS BY RISK GROUP
Risk Group 2Mycoplasma
Chlamydia
Bacteria
Parasites Viruses
Fungi
Agents listed in this group may be present in blood, CSF, central nervous system and other tissues ,
and infected arthropods, depending on the agent and the stage of infection .
parasites have caused laboratory infections by ingestion, skin or mucosal penetration or accidental injection .
Dr.Nagwa Aref
Bacteria Risk Group 2Bacteria Risk Group 2
Actinobacillus - all species
Actinomyces pyogenes (C. pyogenes)
Bacillus cereus
Bartonella bacilliformis, B. henselae, B. quintana, B.
elizabethae
Bordetella pertussis, B. parapertussis and B.
bronchiseptica
Borrelia recurrentis and B. burgdorferi
Campylobacter spp. (C. coli, C . fetus, C. jejuni)
Chlamydia pneumoniae, C. psittaci (non-avian strians),
C. trachomatis,
Clostridium botulinum, Cl. chauvoei, Cl. difficile, Cl.
haemolyticum,
Cl. histolyticum, Cl. novyi, Cl. perfringens, Cl. septicum,
Cl. sordellii, Cl. tetani
Corynebacterium diphtheriae, C. haemolyticum,
C. pseudotuberculosis, C. pyogenes (A. pyogenes)
Edwardsiella tarda
Erysipelothrix rusiopathae (insidiosa)
Escherichia coli enterotoxigenic/invasive/hemorrhagic
strains
Francisella tularensis Type B, (biovar palaearctica), F.
novocida
Fusobacterium necrophorum
Haemophilus influenzae, H. ducreyi
Helicobacter pylori
Legionella spp.
Leptospira interrogans - all serovars
Listeria monocytogenes
Mycobacteria - all species (except M. tuberculosis, and M. bovis
(non-BCG strain), which are in Risk Group 3)
Mycoplasma pneumoniae, M. hominis Neisseria gonorrhoeae, N.
meningitidis
Nocardia asteroides, N. brasiliensis
Pasteurella, all species (except P. multocida type B in Level 3)
Pseudomonas aeruginosa
Salmonella enterica (S. choleraesuis)
Salmonella enterica serovar arizonae (Arizona hinshawii)
Salmonella enterica ser. gallinarum-pullorum (S. gallinarum-
pullorum)
Salmonella enterica ser. meleagridis (S. meleagridis)
Salmonella enterica ser. paratyphi B (S. paratyphi B)
(Schottmulleri)
Salmonella enterica ser. typhi (S. typhi)
Salmonella enterica ser. typhimurium (S. typhimurium)
Shigella boydii, S. dysenteriae, S. flexneri, S. sonnei
Staphylococcus aureus
Streptobacillus moniliformis
Streptococcus spp. (Lancefield Groups A, B, C, D, G)
Treponema carateum, T. pallidum (including pertenue), T.
vincentii
Ureaplasma urealyticum
Vibrio cholerae (incl. El Tor), V. parahaemolyticus, V. vulnificus
Yersinia enterocolitica, Y. pseudotuberculosis
Dr.Nagwa Aref
– AdenoviridaeAdenoviruses, all serotypesArenaviridae
– Lymphocytic choriomeningitis virus (laboratory-adapted strains)
– Tacaribe virus complex: Tamiami, Tacaribe, PichindeBunyaviridae*
– Genus Bunyavirus
– Bunyamwera and related viruses
– California encephalitis group, including LaCrosse, Lumbo and snowshoe hareGenus Phlebovirus
– All species except Rift Valley fever virus Coronaviridae
– Human coronavirus, all strains
– Transmissible gastroenteritis virus of swine
– emagglutinating encephalomyelitis virus of swineGenus Lymphocryptovirus: Epstein Barr Virus (HHV 4) and EB-like isolates
– Genus Rhadinovirus: all isolates (except H. ateles and H. saimiri, see Risk Group 3)
– Genus Thetalymphocryptovirus: all isolatesUnassigned Herpesviruses: includes HHV 6 (human á-lymphotrophic virus), HHV 7, HHV 8, etc.Orthomyxoviridae
– Genus Influenzavirus:
– Influenza virus type A, all isolates
– Influenza virus type B, all isolates
– Influenza virus type C, all isolatesPapovaviridae
– Genus Papillomavirus: all isolates
– Genus Polyomavirus: all isolatesParamyxoviridae
– Mouse hepatitis virus– Bovine coronavirus– Feline infectious peritonitis virus– Avian infectious bronchitis virus– Canine, Rat and Rabbit coronaviruses
Flaviviridae*– Yellow fever virus (17D vaccine strain)– Dengue virus (serotypes 1,2,3,4)– Kunjin virus
Hepadnaviridae– Hepatitis B virus, includes Delta agen
Herpesviridae– Alphaherpesvirinae– Genus Simplexvirus: all isolates, including HHV 1 and HHV 2,
except Herpes B virus which is in Risk Group 4– Genus Varicellovirus: all isolates, including varicella/zoster virus
(HHV 3) and pseudorabies virus (see Table 1)Betaherpesvirinae
– Genus Cytomegalovirus: all isolates including CMV (HHV 5)– Genus Muromegalovirus: all isolates
GammaherpesvirinaeGenus Paramyxovirus: all isolates
– Genus Pneumovirus: all isolates
– Genus Morbillivirus: all isolates (except Rinderpest-see Table 1)ParvoviridaeGenus Parvovirus: all isolatesPicornaviridae
– Genus Aphthovirus - See Table 1
– Genus Cardiovirus - all isolates
– Genus Enterovirus - all isolates (see Table 1 for restrictions)
– Genus Hepatovirus - all isolates (Hepatitis A)
– Genus Rhinovirus - all isolates
– Poxviridae (see Table 1 for restrictions)
– Chordopoxvirinae (poxviruses of vertebrates)
– Genus Capripoxvirus
– Genus Molluscipoxvirus
– Genus Yatapoxvirus
– Genus Avipoxvirus - all isolates
– Genus Leporipoxvirus - all isolates
– Genus Orthopoxvirinae - all isolates (except Variola and Monkeypox in Level 4)
– Genus Parapoxvirus: all isolates
– vGenus Suipoxvirus: Swinepox (see Table 1 for restrictions)
– All other ungrouped poxviruses of vertebratesReoviridae
– Genus Orbivirus - all isolates (see Table 1 for restrictions)
Virus Risk Group 2
Dr.Nagwa Aref
BIOLOGICAL AGENTS BY RISK GROUPBIOLOGICAL AGENTS BY RISK GROUPBIOLOGICAL AGENTS BY RISK GROUPBIOLOGICAL AGENTS BY RISK GROUP
Risk Group 3
MycoplasmaChlamydia
Bacteria
Viruses
Fungi
Human immunodeficiency
viruses (HIV - all isolates
Bacillus anthracisBrucella - all species Burkolderia (Pseudomonas) mallei; B. pseudomalleiChlamydia psittaci - avian strains onlyCoxiella burnetiiFrancisella tularensis, type A (biovar tularensis)Mycobacterium tuberculosis; M. bovis (non-BCG strains)
Pasteurella multocida, type B
BunyaviridaeUnclassified Bunyavirus
Hantaan, Korean haemorrhagic fever and epidemic
nephrosis viruses including virus responsible for
Hantaviruspulmonary syndrome) Rift Valley fever virus
Flaviviridae*Yellow fever virus (Wild type)Japanese encephalitis virusMurray Valley encephalitis
virus
Dr.Nagwa Aref
BIOLOGICAL AGENTS BY RISK GROUPBIOLOGICAL AGENTS BY RISK GROUPBIOLOGICAL AGENTS BY RISK GROUPBIOLOGICAL AGENTS BY RISK GROUP
Risk Group 4
Viruses
Arenaviridae
Lassa, Junin, Machupo viruses, Sabia, GuanaritoBunyaviridae*
Genus Nairovirus
Crimean-Congo hemorrhagic feverFiloviridae
Marburg virus
Ebola virusFlaviviridae*
Tick-borne encephalitis complex, including -Russian Spring-Summer Encephalitis
Kyasanur forest virus
Omsk hemorrhagic fever virusHerpesviridae
Alphaherpesvirinae
Genus Simplexvirus: Herpes B virus (Monkey virus)Poxviridae
Genus Orthopoxvirinae
Variola
Monkeypox
Dr.Nagwa Aref
• Pathogenicity of material – disease incidence and severity
• Routes of Transmission – parenteral, airborne or ingestion
• Agent Stability – ease of decontamination • Infectious Dose – LD50 • Concentration – infectious organisms/vol. & working
volume • Origin of material - Wild Type, exotic, primary cells • Availability of effective prophylaxis – Hep. B vaccine • Medical surveillance – exposure management • Skill level of staff
Dr.Nagwa Aref
Risk AssessmentRisk Assessment
• Risk of Activity – same agent can have different containment levels at different stages of protocol: – Procedures that produce aerosols have higher risk – Procedures using needles or other sharps have higher risk – Handling blood, serum or tissue samples may have lower risk – Purified cultures or cell concentrates may have higher risk – Larger volumes (10 L) have higher risk
Dr.Nagwa Aref
Primary ContainmentPrimary Containment
• Lab practices – standard lab practice, limited access, biohazard warning sign, sharps/needle precautions, SOPs for decon, waste, medicals.
• Safety equipment – biosafety cabinets (BSC), sharps containers, sealed rotors.
• Personal protective equipment (PPE) – lab coat, gloves, goggles. • Host-vector for rDNA
Dr.Nagwa Aref
Dr.Nagwa Aref
Dr.Nagwa Aref
Four Levels of BiosafetyFour Levels of Biosafety
• BSL 1: Material not known to consistently cause disease in healthy
adults.
• BSL 2: Associated with human disease. Hazard is from percutaneous
injury, ingestion, or mucous membrane exposure.
• BSL 3: Indigenous or exotic agents with potential for aerosol
transmission; disease may have serious or lethal consequences.
• BSL 4: Dangerous/exotic agents which pose a high risk of life-
threatening disease, aerosol-transmitted lab infections or related
agents with unknown risk of transmission.
Dr.Nagwa Aref
Human Blood, Tissue and FluidHuman Blood, Tissue and Fluid
• Occupational Exposure to Bloodborne Pathogens • Occupational Safety & Health Administration (OSHA) 29 CFR
1910.1030
• Use BSL 2 work practices and procedures. • Additional requirements for HIV work. • Everyone needs to be offered the Hepatitis B vaccine. • Develop specific exposure plan SOPs. • Specific training is required. • Review needle/syringe use and replace with “safe” devices. • Exposure incidents must be followed up.
Dr.Nagwa Aref
Aerosol PrecautionsAerosol Precautions
• Use BSC for all procedures
that may generate aerosols. • Use centrifuges with
biosafety covers. • Do not use a syringe for
mixing infectious fluids. • Cultures, tissues, specimens
of body fluids, etc., are placed in a container with a cover that prevents leakage during collection, handling, processing, storage, transport or shipping.
Dr.Nagwa Aref
Select AgentsSelect Agents
• Possession, use and transfer of specific biological agents requires registration
• “Restricted Persons” are not allowed to have access to these agents.
• High security and containment must be maintained.
• Web site: http://www.cdc.gov/od/ohs/lrsat.htm
Dr.Nagwa Aref
• Control access to areas where biological agents or toxins are used and stored.
• Keep biological agents and toxins in locked containers.
• Know who is in the lab. • Know what materials are being brought into
the lab. • Know what materials are being removed from
the lab. • Have a protocol for reporting incidents. • Have an emergency plan.
Dr.Nagwa Aref
Waste DisposalWaste Disposal
• “Red bag” or “Regulated Medical Waste”: – All mammalian cells or anything that came in contact with mammalian
cells – All BSL 2 material or anything that came in contact with BSL 2 material – All needles/syringes regardless of use
• No need to autoclave this waste prior to disposal in EH&S red bag/box (material is incinerated).
Dr.Nagwa Aref
Dr.Nagwa Aref
المخلفات فرز نظام(Segregation System of )
المخلفات فرز نظام(Segregation System of )
المعدية المعدية الطبيةالطبيةالمخلفات المخلفات . 1 المعدية المعدية الطبيةالطبيةالمخلفات المخلفات . 1
البشرية . 2 واألنسجة األعضاء مثل األخرى المعدية الطبية البشرية المخلفات واألنسجة األعضاء مثل األخرى المعدية الطبية البشرية . 2 المخلفات واألنسجة األعضاء مثل األخرى المعدية الطبية البشرية المخلفات واألنسجة األعضاء مثل األخرى المعدية الطبية المخلفات
الحادة . 3 الحادة المخلفات الحادة . 3 المخلفات الحادة المخلفات المخلفات
والكيماوية . 4 الصيدالنية والكيماوية المخلفات الصيدالنية والكيماوية . 4 المخلفات الصيدالنية والكيماوية المخلفات الصيدالنية المخلفات
المشعة . 5 المشعة المخلفات المشعة . 5 المخلفات المشعة المخلفات المخلفات
الطبية . 6 الغير الطبية المخلفات الغير الطبية . 6 المخلفات الغير الطبية المخلفات الغير المخلفات
Dr.Nagwa Aref
العالمـــــــات العالمـــــــات الدولـــــــــيةالدولـــــــــية
العالمـــــــات العالمـــــــات المخلفات الطبية المشعةالدولـــــــــيةالدولـــــــــية
البيولوجية المخلفاتالمعدية والطبية
المخلفات الكيماوية السامة
مخلفات كيماوية حارقة
للمخلفات للمخلفات
البيولوجية البيولوجية
والطبيةوالطبية
للمخلفات للمخلفات
البيولوجية البيولوجية
والطبيةوالطبية
مخلفات سريعة االشتعالمخلفات سريعة االشتعال
مخلفات أدوية سامة
المخلفات الطبية ذات األضرار البيئية
المخلفات الكيماوية شديدة التفاعل مع الماء
Dr.Nagwa Aref
• OSHA Bloodborne Pathogens • http://www.osha.gov/SLTC/bloodbornepathogens/index.html • CDC Select Agents • http://www.cdc.gov/od/ohs/lrsat.htm • NIH Guidelines for Research Involving Recombinant DNA
Molecules • http://www4.od.nih.gov/oba/rac/guidelines/guidelines.html • DOT/CDC Shipping • http://www.cdc.gov/od/ohs/biosfty/shipregs.htm • CDC Import Permits • http://www.cdc.gov/od/ohs/biosfty/imprtper.htm • USDA/APHIS Permits • http://www.aphis.usda.gov/vs/ncie/
Dr.Nagwa Aref
• CDC: a permit is required to import etiologic agents of human disease and any materials, including live animals or insects, that may contain them. Unsterilized specimens of human and animal tissues (such as blood, body discharges, fluids, excretions or similar material) containing an infectious or etiologic agent require a permit in order to be imported.
• APHIS: a USDA veterinary permit is needed for materials derived from animals or exposed to animal-source materials.
Dr.Nagwa Aref
• Develop and practice plans for: • Spills: large spills, spills inside BSC
– Accidental exposures: needlesticks, eye/mucous membrane splash, breathing aerosols
– Power/Utility failures: BSC, freezers, ventilation, lights, water
– Fires – Medical emergencies
Dr.Nagwa Aref
ResourcesResourcesResourcesResources
• CDC Biosafety in Microbiological and Biomedical Laboratories
• http://www.cdc.gov/od/ohs/biosfty/bmbl4/bmbl4toc.htm
• ABSA Risk Groups • http://www.absa.org/
riskgroups/index.htm
• Canadian MSDSs • http://www.hc-
sc.gc.ca/pphb-dgspsp/msds-ftss/index.html
• Environmental Health & Safety – Lab Safety
• http://www.ehs.sunysb.edu or 2-9672