Biosafety In The Laboratory -- Copyright -- Preface -- Contents -- 1 Introduction, Overview, and Recommendations -- A- INTRODUCTION -- B- OVERVIEW -- Chapter 2- Descriptive Epidemiology of Occupational Infections of Laboratory Workers -- Chapter 3- Safe Handling of Infections Agents -- Chapter 4- Safe Disposal of Infectious Laboratory Waste -- Chapter 5- Safety Management -- C- RECOMMENDATIONS -- 1- Immunization -- 2- Serum Bank -- 3- Avoiding Exposure to Infectious Agents -- 4- Transportation and Shipment of Specimens -- 5- Labeling of Specimens -- 6- Biosafety in Large-Scale Production -- 7- Safe Disposal of Infectious Laboratory Waste -- 8- Administrative Organization and Responsibility -- 9- Facilities -- 10- Medical Program -- 11- Emergencies -- 2 Descriptive Epidemiology of Occupational Infections of Laboratory Workers -- A- INTRODUCTION -- B- THE EPIDEMIOLOGIC TRIAD -- 1- The Host -- 2- The Infectious Agent -- 3- The Environment -- C- LABORATORY-ASSOCIATED INFECTIONS -- 1- Infectious Agents Presenting the Highest Risk -- 2- Infectious Agents Presenting the Lowest Risk -- 3- Other Infectious Agents -- 3 Safe Handling of Infectious Agents -- A- GUIDELINES FOR HANDLING PATHOGENIC MICROORGANISMS -- B- ORGANISMS POSING SPECIAL RISKS -- C- HAZARDS FROM VERTEBRATE ANIMALS AND INSECTS IN THE LABORATORY -- D- PRIMARY AND CONTINUOUS CELL CULTURES -- E- HANDLING OF NECROPSY AND SURGICAL SPECIMENS -- 1- Introduction -- 2- Necropsy -- a- Routine Necropsies -- b- Necropsies on Bodies Known to Be Infected -- 3- Surgical Pathology -- F- GOOD LABORATORY PRACTICES -- 1- Introduction -- 2- Routes of Exposure -- a- Contact Route -- b- Oral Route -- c- Ocular Route -- d- Inoculation Route -- e- Respiratory Route -- 3- Prevention of Exposure -- 4- The Seven Basic Rules of Biosafety -- 5- Summary -- G- TRANSPORTATION AND SHIPMENT OF SPECIMENS -- 1- Introduction.

2- Packaging. Shipping, and Handling of Biological Specimens -- H- LABELING OF SPECIMENS WITHIN THE LABORATORY -- I- PREVENTION OF AEROSOL AND DROPLET GENERATION -- 1- Introduction -- 2- Control of Aerosols and Droplets -- J- CONTAINMENT EQUIPMENT -- 1- Introduction -- 2- Biological Safety Cabinets -- 3- Pipetting Devices -- 4- Sonicators, Homogenizers, and Mixers -- 5- Clothing, Masks, and Face Shields -- K- BIOSAFETY IN LARGE-SCALE PRODUCTION -- 1- Introduction -- 2- Organization and Responsibilities -- 3- Containment -- 4- Inactivation -- 5- Disposal -- 6- Exposure -- 7- Conclusion -- L- BIOSAFETY IN PHYSICIANS' OFFICE LABORATORIES AND OTHER SMALL VOLUME CLINICAL LABORATORIES -- 4 Safe Disposal of Infectious Laboratory Waste -- A- INTRODUCTION -- B- INFECTIOUS POTENTIAL OF LABORATORY WASTE -- 1- Risks to the General Public's Health -- 2- Occupational Risks -- C- CHARACTERISTICS OF INFECTIOUS LABORATORY WASTE -- D- RESPONSIBILITY FOR THE SAFE HANDLING AND DISPOSAL OF INFECTIOUS WASTE -- 1- GENERATORS OF INFECTIOUS WASTE -- 2- Haulers and Waste Treatment Facilities -- E- WASTE HANDLING AND TREATMENT METHODS -- 1- Basic Principles -- 2- Containment -- 3- Personal Protection -- 4- Chemical Decontamination -- 5- Steam Autoclaving -- 6- Incineration -- 7- Validation of Decontamination Methods -- F- INFECTIOUS WASTE REQUIRING SPECIAL CONSIDERATION -- 1- Mixed Waste -- 2- Human Cadavers and Other Anatomical Waste -- 3- Animal Bedding materials -- 4- "Sharps" -- 5 Safety Management -- A- ADMINISTRATIVE ORGANIZATION AND RESPONSIBILITIES -- 1- Introduction -- 2- The Laboratory Safety Program -- a- Goals of a Laboratory Safety Program -- b- Responsibility for Laboratory Safety -- c- Safety Plans -- d- Safety Meetings and Safety Committees -- e- Safety Communications -- f- Monitoring Safety -- B- FACILITIES -- 1- Introduction -- 2- Laboratory Design.

a- Ventilation -- b- Electrical -- c- Water -- d- Sewage -- e- Vacuum -- f- Waste Handling -- g- Safety Equipment -- h- Traffic Flow Pattern -- i- Laundry -- j- Storage Areas -- 3- Constructing, Remodeling, and Decommissioning a Laboratory -- 4- Maintenance -- 5- Housekeeping -- C- OPERATIONS -- 1- Introduction -- 2- Safety Orientation and Continuing Education for Employees -- 3- Evaluation of Laboratory-Associated Hazards -- 4- Policy and Procedure Manuals -- 5- Accident Reports and Investigations -- 6- Recordkeeping -- 7- Auditing -- 8- Registry of Agents -- 9- Waste Management -- 10- Signs -- D- MEDICAL PROGRAM -- 1- General Principles -- 2- Conditions Increasing Employee Risk of Adverse Health Outcome -- a- Deficiencies of Host Defenses -- b- Reproductive Hazards -- c- Allergies -- 3- Program Design -- 4- Preplacement Examination (PPE) -- a- Medical History -- b- Occupational Health History -- c- Physical Examination -- d- Laboratory and Other Testing -- e- Serum Bank -- 5- Immunizations -- 6- Periodic Monitoring Examination (PME) -- 7- Postemployment Evaluation (PEE) -- 8- Agent-Specific Surveillance -- 9- Accident Reporting -- 10- Recordkeeping and Result Notification -- 11- Resources -- E- EMERGENCIES -- 1- Preparation and General Procedures -- a- Preparation -- b- General Emergency Procedures -- 2- Evacuation Procedures -- a- Emergency Alarm System -- b- Evacuation Routes -- c- Shutdown Procedures -- d- Start-Up Procedures -- e- Drills -- f- Power failure -- 3- Fires -- 4- Spills and Releases -- a- Infectious Agents -- b- Handling of Spilled Solids -- c- Biological Radioactive Emergencies -- 5- Other Emergencies -- F- REGULATION AND ACCREDITATION -- G- TEACHING BIOSAFETY IN ACADEMIC SETTINGS -- 1- Introduction -- 2- Safety in Laboratory Courses -- 3- Orientation and Training of Students.

4- Design of Safe Laboratory Exercises and Experiments -- 5- Monitoring and Recordkeeping -- References -- Appendixes -- Appendix A Biosafety in Microbiological and Biomedical Laboratories -- CONTENTS -- SECTION I- INTRODUCTION -- SECTION II- PRINCIPLES OF BIOSAFETY -- SECTION III- LABORATORY BIOSAFETY LEVEL CRITERIA -- SECTION IV- VERTEBRATE ANIMAL BIOSAFETY LEVEL CRITERIA -- SECTION V- RECOMMENDED BIOSAFETY LEVELS FOR INFECTIOUS AGENTS AND INFECTED ANIMALS -- AGENT SUMMARY STATEMENTS -- Parasitic Agents -- Agent: Nematode parasites of humans -- Agent: Protozoal parasites of humans -- Agent: Trematode parasites of humans -- Agent: Cestode parasites of humans -- Fungal Agents -- Agent: Blastomyces dermatitidis -- Agent: Coccidioides immitis -- Agent: Cryptococcus neoformans -- Agent: Histoplasma capsulatum -- Agent: Sporothrix schenckii -- Agents: Pathogenic members of the genera Epidermophyton, Microsporum , and Trichophyton -- Bacterial Agents -- Agent: Bacillus anthracis -- Agent: Brucella (B. abortus, B. canis, B. melitensis, B. suis) -- Agent: Chlamydia psittaci, C. trachomatis -- Agent: Clostridium botulinum -- Agent: Clostridium tetani -- Agent: Corynebacterium diphtheriae -- Agent: Francisella tularensis -- Agent: Leptospira interrogans-all serovars -- Agent: Legionella pneumophila -- other Legionella -like agents -- Agent: Mycobacterium leprae -- Agent: Mycobacterium spp. other than M. tuberculosis, M. bovis, or M. Leprae -- Agent: Mycobacterium tuberculosis, M. bovis -- Agent: Neisseria gonorrhoeae -- Agent: Neisseria meningitidis -- Agent: Pseudomonas pseudomallei -- Agent: Salmonella cholera-suis, S. enteritidis -all serotypes -- Agent: Salmonella typhi -- Agent: Shigella spp. -- Agent: Treponema pallidum -- Agent: Vibrionic enteritis ( Campylobacter fetus subsp. jejuni, Vibrio cholerae, V. parahaemolyticus ) -- Agent: Yersinia pestis.

Rickettsial Agents -- Agent: Coxiella burnetii -- Agent: Rickettsia akari, Rochalimaea quintana , and Rochalimaea vinsonii -- Agent: Rickettsia prowazekii, Rickettsia typhi (R. mooseri), Rickettsia tsutsugamushi, Rickettsia canada and Spotted Fever… -- Agent: Rickettsia rickettsii -- Viral Agents -- Agent: Hepatitis A virus -- Agent: Hepatitis B, hepatitis non-A non-B -- Agent: Herpesvirus simiae (B-virus) -- Agent: Herpesviruses -- Agent: Influenza virus -- Agent: Lymphocytic choriomeningitis (LCM) virus -- Agent: Poliovirus -- Agent: Poxviruses -- Agent: Rabies virus -- Agents: Transmissible spongiform encephalopathies (Creutzfeldt-Jakob and kuru agents) -- Agent: Vesicular stomatitis virus (VSV) -- ARBOVIRUSES -- Arboviruses Assigned to Biosafety Level 2 -- Arboviruses and Arenaviruses Assigned to Biosafety Level 3 -- Arboviruses, Arenaviruses, or Filoviruses Assigned to Biosafety Level 4 -- APPENDIX A BIOLOGICAL SAFETY CABINETS -- APPENDIX A IMMUNOPROPHYLAXIS -- APPENDIX A SURVEILLANCE OF PERSONNEL FOR LABORATORY-ASSOCIATED RICKETTSIAL INFECTIONS -- APPENDIX A IMPORTATION AND INTERSTATE SHIPMENT OF HUMAN PATHOGENS AND RELATED MATERIALS -- APPENDIX A RESTRICTED ANIMAL PATHOGENS -- APPENDIX A.6 RESOURCES FOR INFORMATION -- LITERATURE CITED -- Appendix B 1988 Agent Summary Statement for HIVs, Including HTLV-III, LAV, HIV-1, and HIV-2 -- CONTENTS -- 1988 AGENT SUMMARY STATEMENT FOR HIVS, INCLUDING HTLV-III, LAV, HIV-1, AND HIV-2 -- INTRODUCTION -- HIV AGENT SUMMARY STATEMENT AGENT: HIVS INCLUDING HTLV-III, LAV, HIV-1, AND HIV-2 -- LABORATORY HAZARDS -- RECOMMENDED PRECAUTIONS -- ADDENDUM 1 -- LABORATORY BIOSAFETY LEVEL CRITERIA -- Biosafety Level 2 -- Biosafety Level 3 -- VERTEBRATE ANIMAL BIOSAFETY LEVEL CRITERIA -- Animal Biosafety Level 2 -- Animal Biosafety Level 3 -- ADDENDUM 2- CDC CAUTIONARY NOTICE -- REFERENCES.

Appendix C Recommendations for Prevention of HIV Transmission in Health-Care Settings.