Containment Level 3 BENCHMARKING LABORATORY PRACTICES FOR BLOOD-BORNE VIRUSES
Introduction Research scientist turned BSO u >15 years experience at CL3 & CL4 u Who are you? Primarily government based (APHA, PHE, u DSTL) And why did you bother us all Wrote CL3 Code of Practice for current with your e-mail? u employer Became unpopular with the CL3 users! u
Organisations involved 12 Universities u 1 NHS Trust u 2 Research Institutes u
Benchmarking questions Engineering and Waste management Training, competence, process controls and PPE and behavioural attributes Where does the lab What disinfectant(s) does What lone and out of u u u maintain it’s containment the lab use? hours working are in use? barriers? i.e., Concentration, contact i.e., buddy systems, “man time, in house validations? down” alarms, CCTV etc. i.e., decontaminating at front of MSC, lids on centrifuge buckets etc. What waste routes exist in How does the u u the lab? organisation assess How does the lab monitor i.e., everything autoclaved? competence? u the engineering controls? Liquid disposed of to drain? i.e., specified number of i.e., airflows in MSCs, hours, written competency recording room pressures on assessments, supervision, what What is the lab PPE u entry etc. is considered supervision etc. policy? i.e., double gloves?
Common practices Barrier maintained at aperture of open u fronted MSCs Engineering and Lids used on centrifuge buckets & u buckets opened within MSC process controls Two organisations validate disinfectant u efficacy in house Common principles or ways of working shared across Most organisations monitor airflows in u organisations MSCs monthly Exact and technical details may vary from organisation to organisation
MSC Monitoring? How often do you check the inward airflows MSCs used at CL3 Every use u Weekly u Monthly u Never u
Common practices Virkon most widely used disinfectant u Waste Most organisations rely on manufacturers u management and instructions and validation PPE Contact times range from 10-30 mins u Two organisations don’t have defined u Common principles or ways of contact times for disinfectants working shared across organisations ~80% organisations use double gloves u Exact and technical details Approximately half u may vary from organisation to autoclave all waste, and organisation half dispose of liquid to drain following chemical decontamination
What method is used to render CL3 waste non-infective? Autoclaving everything u Waste Solid waste autoclaved/liquid waste u chemically inactivated management If chemically inactivation is used, what is the disinfectant of choice at CL3? Distel u Microsolve u Virusolve u IMS/EtOH u Virkon u Other u
Common practices >90% organisations operate a buddy u Training, system to protect lone workers competence, and Approx. 25% use alarms, CCTV, motion u sensors etc. in addition to the buddy behaviour Almost all organisations have written u competency assessments for working at Common principles or ways of working shared across CL3 organisations Almost half also have u Exact and technical details written assessments at may vary from organisation to CL2 organisation Almost all required u >3 months experience at CL2 prior to starting training at CL3
How do you monitor the safety of lone Lone working workers at CL3? Buddy system u Buddy system plus alarms/monitors u Alarms/monitors u No system in place u
Unanswered questions and inconsistencies For discussion Further points raised Risk assessment for shut downs when not Decontamination of porous materials (ie A. u fumigating labs, particularly when concerning ELISpot plates) for analysis at lower use of open fronted MSCs and cryptic containment contamination Flow cytometry at CL3 u Variable advice on disposal of chemically B. Can you enforce immunisation on users? u inactivated waste to the drain Can you use statistical calculation to show u What are the best ways of getting staff who C. decontamination (i.e., repeated dilution or want to work ‘fast’ in CL3 to buy in to the washing) controls and management processes that ‘slow them down’? Also if controls differ between employers when staff change jobs In house validation of disinfectants and the D. requirement for defined contact times
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