Safety associated with the handling of potentially infectious agents has historically been achieved through adherence to recommended safety practices rather than through strict compliance with codified regulations. In the absence of a codified regulatory structure, there is also an absence of compliance inspections, so an objective assessment of the level of conformity with recommended biosafety practices is not generally available. In this study, the outcomes of 768 biosafety level 2 (BSL-2) safety surveys were analyzed for commonalities and trends. The data from a subset of 190 BSL-2 laboratories, which were subjected to sequential safety surveys, were examined for temporal changes and trends in compliance levels. The most frequent items of noncompliance encountered during the study time frame were the failure to recertify biosafety cabinetry, followed by ventilation not being negative to the hallway, disorderly general housekeeping, and lack of appropriate hazard communication labeling and postings. Not surprising, the bulk of noncompliance issues encountered were practice-related. Of greater interest was the finding that the five most frequently cited issues represented 68% of the total number of instances of noncompliance recorded during the study period. The findings described in this study are significant because, for the first time, the outcomes of compliance with recommended biosafety practices are characterized and can be used as the basis for focused interventions. Since biosafety is heavily reliant on adherence to specific safety practices, the ability to focus interventions on objectively identified practice-related items of noncompliance can assist in the reduction of worker risk in a field likely to experience tremendous growth in the wake of the 2001 terrorist attacks in the United States.
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