Laboratory Acquired Infections (LAIs)

1. Physical Security Information Security Personnel Security Material Control & Accountability Transport Security Laboratory Acquired Infections(LAIs) BEP Advanced Biorisk Officers TrainingPilot Certificate Program in the Philippines International Biological Threat Reduction Program Global Security Programs Sandia National Laboratories Albuquerque, NM USA SAND No. 2011-4549P Sandia National Laboratories is a multi-program laboratory managed and operated by Sandia Corporation, a wholly owned subsidiary of Lockheed Martin Corporation, for the U.S. Department of Energy's National Nuclear Security Administration under contract DE-AC04-94AL85000

2. Learning Objectives By the end of the unit, participants should be able : • Define Laboratory Acquired Infections and describe how they are acquired • Understand how Biorisk Management can be used to define practices to prevent LAIs • Examine your laboratory/facilities for gaps in protecting against LAIs

3. What are LAIs? • Definition • All infections acquired through laboratory or laboratory-related activities regardless whether they are symptomatic or asymptomatic in nature. • Examples?

4. Symptomatic LAIs by Time Period and Agent Category Source: Harding, A.L., Brandt Byers, K.. Epidemiology of laboratory–associated infections. In Fleming, D.O. and Hunt. D.L. Biological Safety: Principles and Practices. 4th edition. Washington, DC: ASM Press, 2006; 53-77.

5. Most Frequently Reported LAIs Source: Harding, A.L., Brandt Byers, K.. Epidemiology of laboratory–associated infections. In Fleming, D.O. and Hunt. D.L. Biological Safety: Principles and Practices. 4th edition. Washington, DC: ASM Press, 2006; 53-77.

6. How are they acquired? • Inhalation (aerosols) • Percutaneous inoculation (needle and syringe, cuts or abrasions from contaminated items, and animal bites) • Contact between mucous membranes and contaminated material (hands or surfaces) • Ingestion (aspiration through a pipette, smoking or eating) Inhalation Ingestion Contact Percutaneous

7. Class Exercise: Protecting Against LAIs • In your groups, discuss how you prevent LAIs • Please write your answers on ‘post it’ note and place on your flip chart. • Report to the class • Now group these methods into categories: • Please write your answers on ‘post it’ note and place the on your flip chart. • Report to the class

8. Hierarchy of Controls (HOC) • Elimination or Substitution • Engineering Controls • Administrative Controls • Practices and Procedures • Personal Protective Equipment Control methods at the top of the list are in general more effective and protective than those at the bottom.

9. Cataract University Example • Individually, carefully read the Cataract University exercise • Divide into groups • Identify problems with Biorisk Management. These problems could be associated with assessment, mitigation or performance • Use post-it notes, one for each problem • Place post-it notes on your flip chart • How have these problems affected the university? • Report results to full group

10. Summary • What are some of the key considerations for protecting against LAIs? • How can we ensure they are being implemented as intended?