EOH 3202 BIOLOGICAL HAZARD & BIOSAFETY LEVEL

1. EOH 3202BIOLOGICAL HAZARD & BIOSAFETY LEVEL ANITA BINTI ABD. RAHMAN M.D. ; M.Comm. H [OH]; AOEMM DEPARTMENT of COMMUNITY HEALTH 7th November 2012

2. CONTENT • BIOLOGICAL HAZARD • Definition • Types & Exposure • Example - epidemiology • Prevention & Control • BIOSAFETY LEVEL

3. OCCUPATIONAL HAZARDS PSYCHOLOGICAL Stress, boredom CHEMICAL AGENTS dusts, gases, vapors, fumes, mists, etc. PHYSICAL AGENTS noise, vibration, radiation, defective illumination, temperature extremes BIOLOGICAL AGENTS viruses, bacteria, fungi, parasites, insects, etc. LACK OF ERGONOMIC PRINCIPLES exhaustive physical exertions, excessive standing, improper motions, lifting heavy load, job monotony, etc.

4. DEFINITION • BIOLOGICAL HAZARD @ BIOHAZARDS • A substance derived from an organism, that poses a threat to (primarily) human health. • A naturally occurring substance. • Example: • medical waste, samples of a microorganism, virus or toxin (from a biological source) • substances harmful to animals- zoonotic diseases

5. CONCERN? • Potential for acquiring a laboratory-acquired infections (LAIs) • Contamination of the environment • Contamination of research

6. TYPES • Divided into: • Body fluids pathogen – Bacteria, Viruses, Fungi, Protozoa, Parasites • Animal – insects, birds • Recombinant DNA – genetic engineering, cloning • Nano-technology

7. exposure

8. EXPOSURE • Direct contact • Broken skin – NSI • Allergy/Irritant • Inhalation • Ingestion

9. EXPOSURE Routes of Transmission • Infection Source • Specimens • Culture & stocks • Research animals • Item contaminated with above • Susceptible Host • Age • Immune system • Vaccination status • pre-morbid condition: • DM

10. WHO IS AT RISK? • Laboratory staff • Health Care Workers • Doctor, Nurses, Medical Assistant • Agricultural workers • Armed Forces

11. EXAMPLE • Occupational Exposure to blood borne pathogen • 2 million exposure per year • Among HCW: • 40% of Hepatitis B • 40% of Hepatitis C • 4% of HIV  Needle Stick Injury WHO Environmental Burden of Disease No .3

12. PREVALENCE Source : OHU, MOH

13. PREVALENCE Source : OHU, MOH

14. EXAMPLE • MALAYSIA • HEPATITIS B 1999 - 5295 cases reported & 9% were carriers • TB 2005 – 11 notification of HCW with MTB

15. LAB-ACQUIRED INFECTIONS (LAI’s)

16. OH- HIERARCHY OF CONTROL • Elimination/Substitution • Engineering control • Biosafety Cabinet (BSL) • Administrative control • Work Practice - SOP • Standard Precaution • PPE • Gloves, mask, gown

17. PREVENTION & CONTROL • WHO has long recognized that safety and in particular, biological safety are important international issues. • In 1983 - 1st edition of its Laboratory Biosafety Manualwhich encourages countries to prepare : • Specific Codes of Practice for the safe handling of pathogenic microorganisms in laboratories within their geographical borders & provide expert guidance for developing such codes of practice.

18. CONVENTION ON BIOLOGICAL DIVERSITY • At the 1992 Earth Summit in Rio de Janeiro, world leaders agreed on a comprehensive strategy for : "sustainable development“- • One of the key agreements adopted at Rio was the Convention on Biological Diversity. • The Convention establishes three main goals: • the conservation of biological diversity • the sustainable use of its components, and • the fair and equitable sharing of the benefits from the use of genetic resources.

19. CONVENTION ON BIOLOGICAL DIVERSITY • Revision : In accordance with the precautionary approach contained in Principle 15 of the Rio Declaration on Environment and Development • Ensuring an adequate level of protection in the field of thesafe transfer, handling and use of living modified organismsresulting from modern biotechnology that may have adverse effects on the conservation and sustainable use of biological diversity, taking also into account risks to human health, and specifically focusing on transboundary movements.

20. CARTAGENA PROTOCOL ON BIOSAFETY • The Conference of the Parties to the Convention on Biological Diversity adopted a supplementary agreement to the Convention known as the Cartagena Protocol on Biosafety on 29 January 2000. • The Protocol seeks to protect biological diversity from the potential risks posed by living modified organisms (LMO) resulting from modern biotechnology.

21. PRINCIPLE OF BIOSAFETY • Containment • Safe management of infectious agent in a laboratory • Purpose • Reduce/eliminate exposure to workers, persons & environment

22. PRINCIPLE OF BIOSAFETY • PRIMARY CONTAINMENT • Protection of workers & environment from exposure to hazard • Good microbiological technique • Appropriate safety equipment • Vaccination • SECONDARY CONTAINMENT • Combination of facility design & operational practices; 3 elements: • Lab practices & technique • Safety equipment • Facility design

23. BIOSAFETY LEVEL (BSL) • Combination of agent involved, lab practices & techniques, safety equipment & facilities. • Microorganisms are categorized in risk groups (relative risk) based on the following factors: • Pathogenicity of the organism • Mode of transmission and host range • Availability of effective preventive measures (e.g. vaccines) • Availability of effective treatment (e.g. antibiotics) • Other factors

24. BIOSAFETY LEVEL (BSL) • LABORATORY BIOSAFETY MANUAL 2ND EDITION (REVISED) WHO, Geneva 2003 • References are made to the relative hazards of infective microorganisms by WHO Risk Groups 1, 2, 3 & 4. • This risk group classification is to be used for laboratory work only. • The risk assessment of the work to be done with a specific agent will determine the appropriate combination of these elements.

25. CLASSIFICATION OF INFECTIVE MICROORGANISMS BY RISK GROUP • RISK GROUP 1 (low individual and community risk) This group includes those microorganisms which are unlikely to cause disease in healthy workers or animals (pose little or no risk) – Lactobacillus sp, Bacillus subtilis • RISK GROUP 2(moderate individual risk, low community risk) Can cause human disease, but under normal circumstances is unlikely to be a serious hazard to laboratory workers, the community, livestock or the environment . Effective treatment and preventive measures are available and the risk of spread is limited. E. Coli 0157, Measles, Mumps, Hepatitis B, HIV

26. CLASSIFICATION OF INFECTIVE MICROORGANISMS BY RISK GROUP • RISK GROUP 3 (high individual risk, low community risk) A pathogen that usually causes serious human or animal disease, or which 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. Mycobaterium TB, Anthrax, Small Pox, • RISK GROUP 4 (high individual risk, high community risk) A pathogen that usually produces very serious human animal disease, often untreatable, and may be readily transmitted from one individual to another, or from animal to human or vice-versa directly or indirectly, or casual contact – H5N1, Ebola virus

27. BIOSAFETY LEVEL (BSL) • Laboratories are designated according to their design features, construction and containment facilities as : • Basic - Biosafety Level 1 • Basic - Biosafety Level 2 • Containment - Biosafety Level 3 • Maximum containment - Biosafety Level 4. • NIH & CDC : 4 biosafety levels (BSLs) are described which comprise all of the elements of containment. Each combination is specifically appropriate for : • the operations performed • the documented or suspected routes of transmission of the infectious agents • for the laboratory function or activity.

28. BIOSAFETY LEVEL (BSL) _ • As the level  so does ; • the risk of the organism to humans, animals, plants and/or the environment • the procedural and facility requirements • the level of containment required • the degree of protection for personnel, the environment and the community. BSL 4 BSL 3 BSL 2 BSL 1 _

29. Summary of Recommended Biosafety Level for Infectious Agent

30. Recommended Guidelines

31. REMEMBER… Every incident (no matter how small) must be investigated to determine if the risk of exposure exists, and what could be done to prevent the possibility of reoccurrence.

32. THANK YOU