In part two of this first module, I’m going to give you five simple reasons of why biosafety and biosecurity risk management should be important to you. First – preventing the potential for people or animals in your facility from acquiring a laboratory associated or acquired infection. No one wants to get sick from their work. Second – preventing contamination of the environment, both within and outside your facility. You do not to contaminated the building you work in or have a pathogen release from your facility to the surrounding community of people and the animals. Third – compliance with local, national and international regulations, standards and guidelines. You do not want to break the law and you should follow all international guidance documents. Fourth – prevent contamination of the work product. You do not want cross contamination, false test results or contaminated reagents. Finally, number five, public perception. If the public doesn’t believe you’re doing things well in your facility they’re not going to have confidence in what you do. Let’s now look at all five of these in more detail.

Reason number one – preventing people or animals in your facility from acquiring an infection – basically keeping you and your family safe.

In part one of this module, I gave you several examples of people getting sick or dying from infectious diseases or laboratory acquired infections. Here’s just another example about the death of a twenty-five-year-old researcher studying a strain of bacteria which highlights the hazards of dealing with infectious diseases. As you see, people have died or have gotten very sick when working in the laboratory or a biomedical facility. Occupationally acquired infections have to be prevented.

Laboratory acquired infections are just like any other infection. There has to be an infectious source, such as cultures, stocks, research animals, or specimens. There has to be a route of transmission, such as through percutaneous inoculation, inhalation of aerosols, contact through mucous membranes or ingestion. Finally, there has to be a receptive host (you or the animals that you work with) that are susceptible to infection. It is important to be aware of this triad of infection because understanding this chain of infection can help with implementing biosafety practices and procedures that break this chain.

Here I give you a few examples and some statistics regarding laboratory acquired or associated infections. This is a vast under reporting, because it’s very difficult to get people to recognize how many times they get sick while they’re at work. Because, it’s very difficult to differentiate a laboratory acquired infection from a community acquired infection, because they exist in both places. Therefore, people don’t report when they get sick at work, because they think they got sick at home or when they went out to a restaurant. Since there is no official or legal requirement to report, it’s very, very difficult to keep track of how many people actually get occupationally acquired infections in biomedical facilities.

In this article from Harding and Byers, from 1978-1998 they found 1,267 overt laboratory acquired infections, resulting in 22 deaths (2%). Five were fetal deaths, as a consequence of maternal laboratory acquired infections. The top ten pathogens, accounted for 85% of the 1,267 LAIs. In addition to the obvious infections, there were an additional 663 subclinical infections also reported. These subclinical infections have mild common symptoms (nausea, vomiting, diarrhea) and are therefore very difficult to associate with a laboratory acquired infection.

In the top ten list of pathogens from 1979-2004 causing laboratory acquired infection, the number one was Mycobacterium tuberculosis (no surprise). Arboviruses were number two, followed by Coxiella brunette, hantaviruses, Brucella, hepatitis B, Shigella, salmonella, hepatitis C, and Neisseria meningitis. This was published in the book Biological Safety Principles and Practices in 2006. When you have time, you should look up more about these laboratory acquired infections in that book.

If we look into the cause of these laboratory acquired infections, we find that in only 20 percent of the cases there is an association with some kind of accident or incident. The top known causes are shown here. However, since these accidents and incidents only account for 20% of the laboratory acquired infections, the cause of the remaining 80 % of LAIs are absolutely unknown. All we know is that there was work being done somewhere in the facility with that agent which caused that infection. Therefore, there is a lot of work that needs to be done when it comes to trying to understand what causes of these laboratory acquired infections so we can start preventing them.

Now, let’s look quickly at vivarium acquired infections. A vivarium is a place where animals are being used and there’s a potential for animals to infect animals and animals to infect humans. Here I show you three examples: 1) where an animal (infected or normal) infects humans with a pathogen; 2) an infected animal infects a control animal, or 3) a normal control animal infects another normal control animal. As you see, in addition to LAIs there are a variety of potential vivarium acquired infections that can occur as well.

So, in review, I just to summarize where we’ve gotten to so far. There have been lots of documented laboratory acquired infections and they continue to occur. But, as I mentioned, they are very, very under reported. There’s no requirement to report them and people are reluctant to report accidents and incidents, let alone recognize that they’ve been infected in the laboratory. It’s very difficult to differentiate a laboratory acquired infection from a community acquired infection because most of the pathogens we deal with in the laboratory come from the community. Therefore, when you get sick, you don’t really know if you got sick from something you did in the community or some activity you are undertaking in the laboratory. There is definitely an occupational hazard when working in a biomedical facility. But, the risk can be minimized or prevented through good biorisk management practices. That’s why you’re here, to learn what those are so you won’t get sick when doing your work.

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