Biosafety Awareness Training

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Biosafety Awareness Training Presented by: Jay Majithia Biosafety Compliance Specialist For: Dr. Marianne Fenech s Lab Tuesday, November 25th 2014

Biosafety Regulations PATHOGENS Human Pathogens & Toxins Animal Pathogens & Toxins Human Pathogens and Toxins Act & Regulations (2009) Health of Animals Act & Regulations (1990)

What is a Biological hazard? A biological hazard (Biohazard) is a potentially infectious agent or hazardous biological material that presents a risk or a potential risk to the health of humans, animals, plants and/or the environment

Biological Hazards include Certain types of recombinant DNA/ RNA Organisms infectious to humans, animals or plants - bacteria, viruses, fungi, parasites, prions, viral vectors Biological active agents - toxins, allergens, venom Other potential biohazardous agents: Blood, bodily fluids, tissue samples (human or animal), diagnostic samples, live vaccines Various cell lines GMOs

Classification of Biological Agents Risk groups associated with a pathogen is based on the following risk factors: Pathogenicity/Virulence Route of infection Mode of transmission Survival in the environment Infectious dose Availability of effective preventative/therapeutic treatments Host range Natural Distribution Impact of introduction and/or release into the environment

Classification of Biological Agents Risk Group Individual Community Implications Example 1 Low Low Unlikely to cause disease in healthy workers or animals Earthworms E. Coli K-12 Asporogenic Bacillus subtilis

Classification of Biological Agents Risk Group Individual Community Implications Example 1 Low Low 2 Moderate Limited Unlikely to cause disease in healthy workers or animals Rarely cause serious human or animal disease Earthworms E. Coli K-12 Asporogenic Bacillus subtilis E. coli O157:H7 Influenza viruses types A, B, C HCV

Classification of Biological Agents Risk Group Individual Community Implications Example 1 Low Low 2 Moderate Limited Unlikely to cause disease in healthy workers or animals Rarely cause serious human or animal disease Earthworms E. Coli K-12 Asporogenic Bacillus subtilis E. coli O157:H7 Influenza viruses types A, B, C HCV 3 High Low May cause serious disease HIV, SIV Bacillus anthracis Prions

Classification of Biological Agents Risk Group Individual Community Implications Example 1 Low Low 2 Moderate Limited Unlikely to cause disease in healthy workers or animals Rarely cause serious human or animal disease Earthworms E. Coli K-12 Asporogenic Bacillus subtilis E. coli O157:H7 Influenza viruses types A, B, C HCV 3 High Low May cause serious disease HIV, SIV Bacillus anthracis Prions 4 High High Likely to cause very serious disease Ebola virus

Accountability YOU Lab Manager Supervisor Dean / Dept BSO

Roles and Responsibilities You: Ultimately responsible for all your work and results, compliance to safety policies, adherence to program requirements Lab/PI: Informs you of specific hazards, ensures lab is compliant with Biosafety program Faculty: Resources, services, guidance, support Office of Risk Management/Biosafety Compliance Specialist: Administration, training, management, compliance verification, guidance, developing and maintaining program according to regulations and conveying/translating information to you

Lab-Associated/-Acquired Infections Laboratory Acquired Infections (LAIs) are any infections, whether symptomatic or asymptomatic, acquired through laboratory or laboratoryrelated activities Top 5 laboratory incidents/accidents resulting in LAIs: Pseudomonas Cut from sharp object Spills and splashes Infected needlestick injuries Aspiration through pipette Laceration with a sharp object (e.g. broken glass) Bites or scratches from an infected animal Needlestick injury Mouse bite

Biological Hazards Routes of Entry o Inhalation o Absorption o Injection o Ingestion

Lab Acquired Infections LAB ACQUIRED INFECTION Source of infection Microorganisms Cells and tissues Blood and body fluids Any items contaminated with the above SOURCE HOST ROUTE Susceptible host Immune system Vaccination status Age Pregnancy Route of transmission Percutaneous inoculations Inhalation of aerosols Contact of mucous membranes Ingestion

BioRisk Assessment Agent Characteristics & Biological Material Personnel Supervising & Personnel Using the Material Environment: Laboratory, Facility, Government Regulations Experimental Protocols Lab Practices & Equipment

Blood Borne Pathogens Include infectious microorganisms that can be found in: Human blood products (whole blood, plasma, serum, platelets, white blood cells) Other human bodily fluids (semen, cerebrospinal fluid, vaginal secretions, urine, synovial fluid, pleural fluid, peritoneal fluid, amniotic fluid) Human tissue and/or organs Primary cell cultures

Blood Borne Pathogens Occupational exposure to bloodborne pathogens can occur: by infection of mucous membranes (e.g. splash to eye, nose, mouth) directly into the bloodstream through skin that is damaged (scraped, cut, abraded) by puncture wound (through needle-stick injury)

Patient/Clinical Samples Unless otherwise stated, patient samples and clinical specimens should be considered as infectious due to the potential presence of bloodborne pathogens Examples of patient/clinical samples can include: Blood Semen Urine Body fluids Tissues/biopsies

Blood Borne Pathogens Risk of Exposure depends on: Pathogen/biological agent involved Type of body fluid Route of exposure Duration of exposure Volume of blood involved in exposure Concentration of pathogen at time of exposure If appropriate PPE worn Other factors that can influence the risk of infection from a single significant exposure include: o HBV & HCV are more infectious than HIV o a deep injury is more risky than a splash to the eyes

Universal Precautions A set of strategies developed to prevent of transmission of blood borne pathogens (from blood, bodily fluids and secretions). There are 5 major components: 1. Risk Assessment 2. Hand Hygiene 3. PPE and safe work practices 4. Environmental/Engineering Controls 5. Administrative Controls

Universal Precautions Employee with lesions or contact dermatitis should avoid handling blood or bodily fluids Mucous membranes (eyes, nose, and mouth) should be rinsed with copious amounts of saline solution or water if splashed with blood or body fluids Needlestick injuries and non-intact skin exposed to blood or body fluids should be allowed to bleed freely, rinsed with saline solution or water, cleaned with soap and water and dried Seek medical care in care of an accident related to bloodborne pathogens Notify your Supervisor Complete accident report

Risks and Statistics The risk of transmission of HBV following a needlestick or cut exposure (from an infected source) is 6 to 30% The risk of acquiring HCV following a needlestick or cut exposure to an infected source is approximately 1.8% The risk of infection from an exposure to mucous membranes or nonintact skin is unknown, but is believed to be very small The risk of acquiring HIV following a needlestick or cut exposure to an infected source is currently estimated at 0.3 % (1 in 300) The risk after exposure of the eye, nose, or mouth to HIV-infected blood is estimated to be, on average, 0.1 % (1 in 1,000) The risk after exposure of non-intact skin to HIV infected blood is estimated to be less than 0.1%. A small amount of blood on intact skin likely poses no risk at all.

Work practices that may present a risk

Good Microbiological Practices Good Microbiological Practice is a basic code of practice that should be applied to all types of work involving microorganisms irrespective of containment level Good Microbiological Practice prevents: Contamination of laboratory workers and the environment Contamination of the experiment/samples

Good Microbiological Practices These include, but are not limited to: Uncluttered bench spaces and disinfection of work surfaces Use of Personal Protective Equipment Using the aseptic technique Proper use of Centrifuges Proper use of Biosafety Cabinets Spill response Handwashing Identification and preparation of biological waste

Office of Risk Management

Office of Risk Management

Work Surfaces Work surfaces have to be kept organised and clutter-free Over crowding your lab workspace can increase the risk of spills

Work Surfaces Work surfaces (bench tops, fume hoods, BSCs) have to be regularly cleaned with a suitable disinfectant: 10% Bleach 70% Ethanol Virox/Accel (bactericidal and virucidal) Some factors affecting proper surface decontamination: Contact time Preparation date/freshness of decontamination solution Amount of biological agent

Personal Protective Equipment PPE creates a barrier between the worker and the source of biological agents blocking routes of exposure Only effective if correctly selected, fitted and cared for Lab Coats and Gowns Gloves Eye Protection Masks and Respirators Footwear

Personal Protective Equipment Last line of defence against hazards in the lab (only offers a certain degree of protection) Users must be trained on the proper use of PPE Wearing PPE should be avoided in public areas - remember to remove your PPE before leaving the lab

Lab Coats and Gowns Lab coats are long-sleeved, knee-length with snaps and fitted cuffs Gowns are back-closing Must always be worn closed Never wash with regular clothing Never wear your lab coat in offices, conference rooms, lunch rooms or outside Echovirus type 9

Why you should wear a lab coat? Lab Coat (200x) vs. T-shirt (200x)

Gloves they ARE mandatory Use gloves appropriate for the task Glove selection: latex, nitrile, rubber & vinyl Herpes simplex virus (HSV) Avoid wearing them for longer than 2 hours Wash hands once gloves have been removed Disposable gloves must be discarded once removed - Do not save for future use Dispose of gloves into the proper container NOT in regular garbage Do not wear gloves outside the lab or when touching personal items If for any reason a glove fails, resulting in skin contact, consider it an exposure and wash hands immediately - seek medical attention as required Video: https://www.youtube.com/watch?v=uwje_k3qgxu

Eye Protection Safety glasses are adequate when the potential for splashing is minimal They do not seal to the face, and have gaps at the top, bottom and sides Safety goggles provide protection from significant chemical splashes. Face shields are required when working with large volumes of hazardous materials Protection from splashes and flying particles. Face shields must be used in conjunction with safety glasses or goggles. A UV-coated face shield, not safety goggles, is required when working with UV light.

Eye Protection Avoid the use of contact lenses. Epstein-Barr Virus Infection Proper handwashing is important after working with biological agents

Masks and Respirators Masks may be used for some laboratory applications to prevent the inhalation of aerosolgenerating experimental procedures Any other special mask/respirator requirements have to be addressed to Biosafety Compliance Specialist Appropriate Footwear Its simple shoes worn in the lab must be: Closed toe Closed heel No exceptions

Procedures to Minimize Potential of Exposure Syringes/Needles Avoid use whenever possible use blunt needles instead of sharp needles when applicable Withdraw needles from bottles using disinfectant-soaked absorbent pads wrapped around bottle cap Fill syringes carefully; use locking syringes if available Use a BSC for all operations with infectious material (point needle away from you) Do not bend, shear or recap needles

Procedures to Minimize Potential of Exposure Mixing/Homgenizing/Vortexing Ensure when mixing you are using a leak-proof tubes with a lid After mixing, wait a few seconds before opening the lid Use a vortex instead of inverting tubes Centrifugation Centrifuge in closed containers. Placed in sealed safety cups or rotors Open samples in BSC Ensure that the centrifuges are well maintained and O-rings are not compromised

Procedures to Minimize Potential of Exposure Use of flasks Avoid the use of glassware where possible - use plastic tubes, flasks and bottles Use screw-capped tubes and bottles, rather than plugs or snap caps Pouring infectious material Perform work over plastic-backed absorbent pads Wipe rim of the tube with disinfectant-soaked absorbent paper to remove outer contamination

Safe use of Centrifuges Before use Check centrifuge rotors & tubes for cracks Avoid Overfilling Place caps or stoppers properly Balance loads Use sealed buckets (safety cups) or sealed rotors Before stepping away: ensure centrifuge achieves run conditions

Safe use of Centrifuges After run Centrifuge has to be completely stopped before opening the lid Check for spills or leaks before removing samples. Allow aerosols to settle and open samples inside a BSC Regular Maintenance Regular cleaning/decontamination Maintenance/use log Ensure that the centrifuges are well maintained and O-rings are not compromised

Biological Safety Cabinets It is the most important safety device for working with biological material. Protects the product (sterile working area) Protects the operator (from biological agents using directional airflows) Protects the environment (HEPA filters) Provides effective primary containment of biological agents It does not protect the user from chemical fumes or vapours Must use a chemical fume hood for working with chemicals

Differences between Laminar Flow and Biological Safety Cabinet Laminar Flow Hood Biological Safety Cabinet Product protection only Personnel, product and environment Potentially infectious aerosols can lead to exposure of the operator and the environment Aerosols exposure by blowing air out, into the room: Horizontal-flow Vertical-flow protection Potential aerosols can be contained within the BSC Aerosol exposure is minimal, if BSC is used properly Air circulated through HEPA filters

Proper Use of Biological Safety Cabinets Video: Proper use of Biological Safety Cabinets - http://vimeo.com/7642083 uottawa SOP for proper use of Biological Safety Cabinets uottawa Guideline for using UV lights inside Biological Safety Cabinets

Handwashing is an essential component to reducing the risk of LAIs. Before starting any manipulations Before leaving the lab Whenever the integrity of your gloves is questioned or your hands are obviously soiled Before and after completing any task in a BSC Every time gloves are removed Before contact with face or mouth At the end of the day Hand Hygiene The act of removing or destroying microorganisms on the hands while maintaining good hand integrity (keeping the skin healthy)

Proper Handwashing Technique Wet your hands with warm running water Add soap, and then rub your hands together, making a soapy lather Do this away from the running water for at least 15-20 seconds, being careful not to wash the lather away. Wash the front and back of your hands, as well as between your fingers and underyournails Rinse your hands well under warm running water Pat hands dry completely with a paper towel. Turn off water using same paper towel and dispose in a proper receptacle

Office of Risk Management

Biological Waste Treatment of biological waste depends upon the characteristics of the waste (i.e., solid, liquid, mixed) and the associated risk of the biological agent(s) The means of treatment for decontamination may involve chemical agents (bleach, ethanol), or physical means (autoclaving, incineration)

Biological Waste Diligence must be applied to ensure your own personal safety and that of others, as once treated this material will be directed into the public domain Consequently, there are many agencies which are concerned and regulate or set requirements regarding biological waste: City of Ottawa Health Canada Canadian Food Inspection Agency Ontario Ministry of the Environment Ministry of Transportation

Terminology There are three terms that are often referenced when discussing waste and it is important to understand the difference between them: Decontamination: The process of removing and/or inactivating infectious material/toxins/microorganisms to a lower level such that it removes danger of infection to individuals. This can be achieved by: Disinfection: Process that eliminates most forms of living microorganisms; can be by the use of agents (physical or chemical) to eliminate harmful microorganisms on inanimate objects (applies to most bacteria and viruses, not to spores) Sterilization: The complete destruction of all viable microorganisms (including bacterial spores)

Chemical Disinfection Generally for disinfection rather than sterilization Most common are chlorine compounds and alcohols (broad range) Choice depends on: Type of material to be disinfected Organic load Chemical characteristics Contact time is crucial

Preparation of Biological Waste All biological waste should be decontaminated prior to disposal Discarded biological material from teaching, clinical and research laboratories and operations is considered as biomedical waste This includes, but is not limited to: Solid waste gloves, pipettes, gowns, tubes, tips, flasks, petri dishes, agar, etc. Liquid cell culture media, bacterial cultures, reagents, samples Anatomical waste: Animal waste carcasses, faeces, food Human anatomical waste organs, tissues Human blood and products, body fluids Sharps

University of Ottawa Hazard Label Paste completed sticker on: Orange hazard bag (solid waste) Yellow pails Sharps container

Preparation of Biological Waste University of Ottawa has developed a number of procedures which will assist you in ensuring this waste is treated appropriately http://www.uottawa.ca/services/ehss/biosafety.htm All containers for biomedical waste must display the biohazard symbol and the words Biohazard in a colour contrasting the container.

Preparing Lab Biohazardous Waste 1. Separate waste Re-usable items (e.g. glass pipettes) from that which will be disposed Dry from liquid material 2. Use only approved autoclave bags (red/orange) 3. Add absorbent material around tube/flask if liquid exists 4. If outside of bag is contaminated, then double bag and well-sealed 5. Ensure items are labeled with U of O label and contact information 6. Do not overfill autoclave bags ¾ full

Liquid Waste Containers should be leak-proof Should contain maximum half its volume of liquid waste All liquid for autoclaving should be capped with aluminum foil and marked with autoclave tape Undiluted bleach (or appropriate disinfectant) should comprise 10% of final waste volume *** Waste should be discarded/treated on a daily/weekly basis (in compliance with sewer by-laws) *** Note: Bleach cannot be autoclaved, so plan your decontamination and waste preparation accordingly

Liquid Aspiration Aspiration through vacuum-traps should be serially set-up with 10% volume of bleach in both containers o In-line HEPA filters should be used to avoid contamination of vacuum lines o Vacuum-grade flasks should be fixed and be used inside secondary containers o Secondary containers should be high to contain the liquid in the case of a spill

Liquid Aspiration Both flasks have to be vacuum grade Secondary container and clamped Common labs - responsibility Degradation of bleach smaller volumes Date when it was made and who made it

Office of Risk Management

Anatomical waste Preparation of Biological Waste Placed in a red biohazard bag Black garbage bags are used if the waste will immediately be stored in a barrel lined with red biohazard bags. Label: Each bag must be tagged with a completed yellow necropsy tag, detailing contents of the bag Anatomical waste is discarded in Animal Care carcass disposal fridge

Infected Sharps waste Include items that are capable of causing punctures or cuts (e.g. scalpels, broken glass, pipettes, test tubes, microscope slides, blood vials or any other material that has come in contact with biohazardous material Must be placed in a rigid, leak proof, puncture resistant and sealable container University currently uses 4.5L yellow containers Larger 22.5L containers are also available upon request Label: University of Ottawa Hazardous Waste label Sharps container pickup at both campuses can be coordinated with Biosafety Compliance Specialist Sharps waste is NOT treated at University of Ottawa

Autoclaving Autoclaving uses high pressure and steam to sterilize biomedical waste Proper sterilization depends on various factors: Nature of waste (solid/liquid) Material load size/volume Moisture versus dry load cycle Sterilization time

Autoclaving Many autoclaves are now run by dedicated staff, however, if you are operating an autoclave: Learn how to use it Ensure proper PPE is worn Recognize and prepare acceptable material and packaging Proper loading and unloading All users/operators must take autoclave training

Items that CAN be autoclaved Culture dishes, plates and related lab supplies Cultures and stocks of infectious material Discarded live and attenuated vaccines Contaminated solid items (petri dishes, eppendorf tubes, tips, pipettes, gloves, paper towels)

Items that CANNOT be autoclaved Chemicals (flammables, oxidizers, phenols, acids, alkalides) Chemotherapeutic or radioactive waste Bleach (or other chlorinated products) Certain kinds of plastics Sharps (not autoclaved at the University of Ottawa)

Treated/Untreated Waste Treated waste is no longer considered biomedical (i.e. microbiological waste, blood and bodily fluid waste) and can be disposed of in the regular waste stream. University of Ottawa places a NON-HAZARDOUS sticker on all biomedical treated waste Any waste that cannot be treated (i.e. sharps, carcasses, tissues and body parts) remains biomedical waste and must be treated off-site.

Planning your experiment fail to plan, plan to fail Risk assessment can foresee and mitigate the chance of an emergency Follow pre-planned work procedures (experimental protocols and SOPs) Modifications should be reviewed by supervisor Be familiar with emergency spill procedures and location of spill stations, adsorbents, and disinfectants Be familiar with emergency escape routes, locations of fire extinguishers, eye wash stations, safety showers and first-aid kits Carefully planning your experiments, following laboratory safety guidelines and understanding emergency procedures could save your life! University of Ottawa Protection Services Ext. 5411

Emergency Response Emergencies can happen. Situations you may encounter: Splashes/Aerosols generated Spills Spills inside a centrifuge Spills inside a Biosafety Cabinet

Was anyone exposed? What is the route of exposure? Are aerosols still suspended? Is the biological agent contained? University of Ottawa Spill Response Plan: http://www.uottawa.ca/services/ehss/docs/spillresponseplan.pdf

Emergency Showers and Eyewash Stations Know location of emergency showers and eyewash stations Become familiar with their operation. You need to be able to find them and know how to use them with your eyes closed Emergency showers are tested by physical resources Eyewash stations should be tested monthly by your Laboratory Safety Representative

Biological Hazards Routes of Entry

Questions?

University of Ottawa Biosafety http://www.uottawa.ca/services/ehss/biosafety.htm Office of Risk Management Bureau de la Gestion du risque University of Ottawa Université d'ottawa 1 Nicholas St. Suite 840 Ottawa ON K1N 7B7 Jay D. Majithia Biosafety Compliance Specialist / Spécialiste préposé aux règlements de Biosécurité Tel: 613-562-5800 ext. 3153 (Mon, Tue, and Thurs) ext. 8081 (Room 1135 at RGN - Wed, Fri) E-mail : bio.safety@uottawa.ca