Assessment of Risk of Human Infection in the Microbiological Laboratory

Wedum, Arnold G.; Kruse, Richard H.

doi:10.21236/ad0693258

Cited by 13 publications

(5 citation statements)

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“…The most frequently reported laboratory-acquired infections through 1989 are listed in Table 1. For surveys completed in 1969 (151) and 1976 (110), the three most frequently reported infections were brucellosis, Q fever, and typhoid fever. Of the bacterial infections in Pike's survey (110), 64% were caused by Brucella spp., Salmonella typhi, Franciscella tularensis, and Mycobacterium tuberculosis.…”

Section: Survey Of Laboratory-associated Infectionsmentioning

confidence: 99%

Laboratory-associated infections and biosafety

Sewell¹

1995

Clin Microbiol Rev

264

141

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An estimated 500,000 laboratory workers in the United States are at risk of exposure to infectious agents that cause disease ranging from inapparent to life-threatening infections, but the precise risk to a given worker unknown. The emergence of human immunodeficiency virus and hantavirus, the continuing problem of hepatitis B virus, and the reemergence of Mycobacterium tuberculosis have renewed interest in biosafety for the employees of laboratories and health care facilities. This review examines the history, the causes, and the methods for prevention of laboratory-associated infections. The initial step in a biosafety program is the assessment of risk to the employee. Risk assessment guidelines include the pathogenicity of the infectious agent, the method of transmission, worker-related risk factors, the source and route of infection, and the design of the laboratory facility. Strategies for the prevention and management of laboratory-associated infections are based on the containment of the infectious agent by physical separation from the laboratory worker and the environment, employee education about the occupational risks, and availability of an employee health program. Adherence to the biosafety guidelines mandated or proposed by various governmental and accrediting agencies reduces the risk of an occupational exposure to infectious agents handled in the workplace.

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Section: Survey Of Laboratory-associated Infectionsmentioning

confidence: 99%

Laboratory-associated infections and biosafety

Sewell¹

1995

Clin Microbiol Rev

264

141

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“…In 1969, Wedum and Kruse (220) provided four "indicators of risk" to serve as guidelines for the safe handling of microorganisms to protect laboratory personnel. Each indicator hypothesized the presence of aerosolized infectious microorganisms.…”

Section: Laboratory-acquired Infections Historical Perspectivementioning

confidence: 99%

Biological safety cabinetry

Kruse¹,

Puckett²,

Richardson³

1991

Clin Microbiol Rev

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The biological safety cabinet is the one piece of laboratory and pharmacy equipment that provides protection for personnel, the product, and the environment. Through the history of laboratory-acquired infections from the earliest published case to the emergence of hepatitis B and AIDS, the need for health care worker protection is described. A brief description with design, construction, function, and production capabilities is provided for class I and class III safety cabinets. The development of the high-efficiency particulate air filter provided the impetus for clean room technology, from which evolved the class II laminar flow biological safety cabinet. The clean room concept was advanced when the horizontal airflow clean bench was manufactured; it became popular in pharmacies for preparing intravenous solutions because the product was protected. However, as with infectious microorganisms and laboratory workers, individual sensitization to antibiotics and the advent of hazardous antineoplastic agents changed the thinking of pharmacists and nurses, and they began to use the class II safety cabinet to prevent adverse personnel reactions to the drugs. How the class II safety cabinet became the mainstay in laboratories and pharmacies is described, and insight is provided into the formulation of National Sanitation Foundation standard number 49 and its revisions. The working operations of a class II cabinet are described, as are the variations of the four types with regard to design, function, air velocity profiles, and the use of toxins. The main certification procedures are explained, with examples of improper or incorrect certifications. The required levels of containment for microorganisms are given. Instructions for decontaminating the class II biological safety cabinet of infectious agents are provided; unfortunately, there is no method for decontaminating the cabinet of antineoplastic agents.

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“…A useful approach to the assessment of risk as a working guide for laboratories was devised by Wedum & Kruse (195). In addition to the number of laboratory infections recorded for various agents, they consid ered the minimal human infectious dose, which has been determined for some disease agents, the recovery of microorganisms from the urine and feces of infected animals, and the frequency of cage-mate infection.…”

Section: Assessment Of Riskmentioning

confidence: 99%