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PubMedDate not supplied

A 1993 update on biohazards affecting clinical engineers and BMETs.

In late 1993, a survey was sent to the subscribers of the Journal of Clinical Engineering to determine: (1) if employers were responding to the biohazards protection needs of BMETs and CEs; (2) if personal protective equipment was being utilized; (3) if occupational exposure perceptions and concerns had changed since a previous survey four years ago; and (4) if educational efforts targeting BMETs and CEs were still needed. The 267 respondents were divided into four groups according to certification status and job title. Results showed that employers were doing an excellent job of providing personal protective equipment, but 50% of the BMETs and CEs chose not to use it. Even though though the occupational exposure illness and disability rate increased to 21% from the 1989 survey rate of 18%, BMETs and CEs still feel confident in their abilities to recognize potential biohazard problems based on visual clues, which can be an error in judgement that can lead to serious adverse effects including illness, disability, or death.

Attitude of Health Personnel↗

PubMed1993

Retrovirus tests of human leukemia/lymphoma cell lines at DSM.

Permanently established human cell lines can produce several retroviruses. It is important to routinely test such cell lines for human T cell lymphotropic virus (HTLV) type I and II, and for human immunodeficiency virus (HIV) type 1 and 2 in order to exclude any potential biohazard from cell lines producing human retroviruses. Reverse transcriptase assay, polymerase chain reaction, and dot-blot hybridization of in-vitro amplified DNA with virus-specific probes are used.

Containment of Biohazards↗

PubMedDate not supplied

[Seroprevalence of viral markers of hepatitis B among health professionals. Multicenter study in Mexico].

To determine the prevalence of serological markers for hepatitis B infection among health care workers (HCW) in Mexico we surveyed 1072 volunteers from 26 hospitals in 12 states, from which only 1017 fulfilled the inclusion criteria: 82 patients (8.1%) were excluded because of lipemic and/or hemolyzed serum, leaving 935 persons in the study. The study population consisted of physicians, nurses, laboratory chemists, health laboratory technicians and odontologists. All of them had been working in their respective fields and in contact with biological materials for at least 12 months. None of them had been vaccinated for hepatitis B. We determined the presence of HBsAg and anti-HBs by the ELISA method. The participants' mean age was 31.4 years (range: 18-72) and their mean working time was 7.8 years. 615 were female and 320 male. The HBsAg was positive in 11 (1.2%) and the anti-HBs in 91 cases (9.7%). These results suggest that HCW in Mexico have a greater relative risk of becoming infected with the HB virus than the general population. Relative risks were particularly higher for the health laboratory technicians and the physicians. These results confirm that biohazard measures must be reinforced and that the application of HB virus vaccine could be recommended for health care workers.

Adolescent↗

PubMedDate not supplied

Occupational biohazards affecting clinical engineers & BMETs. Part II: Common biohazard questions.

Worldwide concern about AIDS has prompted concern over the prevention of, and protection from, a variety of biological hazards. Healthcare workers are at greater risk for contracting and/or transmitting certain types of contagious disease organisms because of the nature and environment of their work. In response to requests from BMETs, the author developed an educational presentation on work-related biohazards. This article, the second in a five-part series, addresses some questions commonly raised by more than 300 biomedical personnel who have attended the presentation. Recommendations are also made to help BMETs and CEs avoid occupationally acquired illnesses.

Biomedical Engineering↗

PubMed1993

Disposal of outdated anti-infective products.

After an unsuccessful search for guidelines to destroy outdated anti-infective products, a procedure was developed for pharmacy that uses currently available biohazardous materials. By using a blood/body-fluid absorbent, an inexpensive waste system was developed to avoid the negative public sentiment caused by use of public landfills and avoid the risk of disposing waste in hospital drainage systems.

Anti-Infective Agents↗

PubMedDate not supplied

Defining and managing biohazardous waste in U.S. research-oriented universities: a survey of environmental health and safety professionals.

A survey was conducted of environmental health and safety professionals responsible for biohazardous waste management at 122 institutions. The overall response rate was 82.6 percent (100 out of 122). Results indicate that university policies for biohazardous waste are heavily influenced by state environmental regulations, the Occupational Safety and Health Administration Bloodborne Pathogens Standard, and the biosafety guidelines of the Centers for Disease Control and Prevention and the National Institutes of Health. With respect to definition of waste, 84 percent of the universities treat non-infectious human-cell-culture waste as biohazardous. Sharp items, including hypodermic needles, syringes with needles, and scalpel blades, are commonly treated (by 85 percent of universities) as biohazardous sharps regardless of contamination status. Importantly, while 90 percent of universities use autoclave sterilization for waste treatment, only 52 percent use a biological indicator to validate the process. On-site incineration is currently used by 42 percent of universities. Twenty-two of 42 incinerators are hospital/medical/infectious-waste incinerators, and 10 of these will continue to operate under the U.S. Environmental Protection Agency's revised incinerator regulations. Eighty-seven percent of the respondents indicated that some portion of their university's biohazardous waste is treated and disposed of through a licensed medical waste hauler (MWH). To ensure compliance with institutional policy, most universities segregate and package waste, train waste generators, and conduct inspections.

Centers for Disease Control and Prevention, U.S.↗

PubMed1986

Infection with human immunodeficiency virus in the hospital. Epidemiology, infection control, and biosafety considerations.

Infection with the human immunodeficiency virus (HIV) (formerly HTLV-III/LAV) is transmitted by sexual contact, by blood and blood products, and perinatally. There is no evidence for casual transmission. The risk to health care workers is low but appropriate infection control precautions should be taken. Specimens should be transported to the laboratory in plastic bags labeled with an easily recognized biohazard warning. Placing patients in private rooms is unnecessary unless a patient has an additional illness that requires such an arrangement. Disinfection, sterilization, housekeeping, and waste management must be done according to recommended guidelines. Asymptomatic hospital personnel with HIV antibody can safely engage in direct patient care. Routine HIV serologic screening of personnel or patients is not recommended. Counseling and HIV antibody testing should be offered to pregnant high-risk women. Laboratories that process specimens potentially containing HIV virus should adhere to maximum containment procedures. An intensive and continuing educational program on the epidemiology of HIV infection and appropriate infection control practice is recommended.

Acquired Immunodeficiency Syndrome↗

PubMed1990

[Biologic risk].

In the biotechnology development, the biohazard become an important field of environmental medicine. After evaluation of biological agents, the laboratory organization in different security steps in achieved. One chapter "Health and Security" must be included in every scientific or industrial scheme of procedures. One example is given with the schedule for Hepatitis B and AIDS prevention.

Acquired Immunodeficiency Syndrome↗

PubMed2000

[Present status of nosocomial infections and biohazard of medical waste].

Nosocomial infections are already major problems and are a growing concern to all medical staff and among the general public. Therefore, an effective infection control program, especially against transmission mode of infection, is essential for the well-being of the patients and the safety of hospital personnel. Various categories of medical waste should be segregated adequately and appropriate management(treatment and disposal) is necessary. Adequate handling techniques can protect personnel from injury(occupational infection), and the biosafety manual should be available to prevent injury.

Containment of Biohazards↗

PubMed2005

Improving the biosafety of cell sorting by adaptation of a cell sorting system to a biosafety cabinet.

BACKGROUND: The jet-in-air cell sorters currently available are not very suitable for sorting potentially biohazardous material under optimal conditions because they do not protect operators and samples as recommended in the guidelines for safe biotechnology. To solve this problem we have adapted a cell sorting system to a special biosafety cabinet that satisfies the requirements for class II cabinets. With aid of this unit, sorting can be performed in conformance with the recommendations for biosafety level 2. METHODS: After integrating a modified fluorescence-activated cell sorter (FACS) Vantage into a special biosafety cabinet, we investigated the influence of the laminar air flow (LAF) inside the cabinet on side stream stability and the analytical precision of the cell sorter. In addition to the routine electronic counting of microparticles, we carried out tests on the containment of aerosols, using T4 bacteriophage as indicators, to demonstrate the efficiency of the biosafety cabinet for sorting experiments performed under biosafety level 2 conditions. RESULTS: The experiments showed that LAF, which is necessary to build up sterile conditions in a biosafety cabinet, does not influence the conditions for side stream stability or the analytical precision of the FACS Vantage cell sorting system. In addition, tests performed to assess aerosol containment during operation of the special biosafety cabinet demonstrated that the cabinet-integrated FACS Vantage unit (CIF) satisfies the conditions for class II cabinets. In the context of gene transfer experiments, the CIF facility was used to sort hematopoietic progenitor cells under biosafety level 2 conditions. CONCLUSIONS: The newly designed biosafety cabinet offers a practical modality for improving biosafety for operators and samples during cell sorting procedures. It can thus also be used for sorting experiments with genetically modified organisms in conformance with current biosafety regulations and guidelines.

Aerosols↗

PubMed1997

Sectioning fresh human bone: the reduction of aerosol and physical hazards.

Musculoskeletal research demands an accurate model on which to work, and fresh frozen human bone is an ideal material. However, there is increasing concern over the biohazard that this represents. A method is reported that reduces the biohazard, and two research situations are described. Both use polymethylmethacrylate (PMMA) bone cement as an interface between the human tissue and the cutting device, which allows solid and suitable geometry for vice fixation. A method of bone cutting that enables remote operation is described; this method may reduce the risk of disease transmission by aerosol, and prove useful to all in this field of research.

Aerosols↗

PubMedDate not supplied

[Vaccine prophylaxis: contribution for the control of biologic risk in exposed workers].

Working activities with exposure to biological agents have become a matter of discussion especially after the introduction in Italy of the Law 626/94, in conformity with the EU directive 90/679/EEC. There are many important biological agents that can have infectious, allergic, toxic or carcinogenic effects on the working population. Large occupational groups are exposed to these biohazards, both in agriculture and industry. Vaccination is one of the most beneficial medical practices, which has led to the eradication of such a devastating human disease as smallpox and the almost total elimination of poliomyelitis. Vaccination is also one of the most cost effective prevention measures applicable in this respect. This paper describes the possible vaccinations that employers should make available to employees exposed to biological risk, according to article 86 of Law 626/94.

Containment of Biohazards↗

PubMedDate not supplied

Occupational biohazards affecting clinical engineers & BMETs. Part IV: Respiratory and gastrointestinal systems.

A previously published survey indicated that clinical engineers and BMETs may not be aware of the scope of biological hazards they may encounter in their work (Baker, 1989). In this third article of a four-part series, various pathogens affecting the respiratory and gastrointestinal systems are discussed. Infection hazards and methods of transmission are examined, and recommendations are provided to help ensure the safety of CEs, BMETs, and patients. The recommendations presented include suggested disinfection procedures for contaminated equipment. Persons interested in further information are advised to contact the infection control officer at their facility, or the Centers for Disease Control.

Air Pollutants, Occupational↗

PubMedDate not supplied

Occupational biohazards affecting clinical engineers & BMETs. Part I: Preliminary survey of perceived hazards.

The authors developed this preliminary survey in order to collect current information to answer three questions: 1) Is there reason to be concerned about the occupational health and safety of BMETs; 2) Is a larger study needed; and 3) Is continuing education about certain classes of hazards desirable? Of the 136 BMETs completing the questionnaire, 18.4% reported illnesses or disabilities believed to be job related. More than 90% of the respondents indicated a need for additional training on biological hazards in the workplaces of BMETs; likewise, 86% desired additional training on hazards related to chemicals, fire, and explosion.

Attitude of Health Personnel↗

PubMedDate not supplied

Occupational biohazards affecting clinical engineers & BMETs. Part III: Blood and other body fluids.

Results of a previously reported survey of BMETs and CEs indicated a need for further education of these professionals concerning work-related biohazards. In this third article of a five-part series, the dangers of disease transmission by blood and other body fluids are discussed. Susceptibility factors are cited to indicate those persons at greatest risk of infection, and recommendations are provided to assist BMETs and CEs in effectively protecting both themselves and other clinical and nonclinical personnel from infection. The recommendations presented include suggested disinfection procedures for contaminated equipment. Persons interested in further information are advised to contact the infection control officer at their facility, or the Centers for Disease Control.

Acquired Immunodeficiency Syndrome↗

PubMed1995

Human tissue retrieval at post-mortem for musculoskeletal research.

Laboratory experimentation must attempt to reduce animal involvement, and human cadaveric tissue can be a suitable alternative; however, this tissue is a potential biohazard, with the transmission of human immunodeficiency and hepatitis viruses presenting a very serious problem. In this paper we discuss how human tissue can be obtained at hospital post-mortem, and how it can then be stored and handled in a laboratory environment, focusing particularly on safety issues. We discuss the way in which the Department of Orthopaedic Surgery at Leicester University obtained human tissue for research into hip replacement. It is hoped that the article will serve as a 'blue-print' for other related research projects, where human tissue is required for experimentation.

Autopsy↗

PubMed1994

Controlling ambient biohazards; what you can't see can hurt.

The effective control of ambient biohazards is clearly a team effort. This team includes the EM, the risk manager, the infection control practitioner, purchasing, facilities management, and others. Control measures relate to many different risk factors, such as the environment at the healthcare facility, the healthcare personnel, the procedure, the use of certain devices, or the actual infection host (patient). Usually, only environment-related risk factors are of concern to the EM. For fungal infections, such as Aspergillus, CDC recommends that control of environmental risk factors requires routine maintenance of hospital air-handling systems and the rooms of immunosuppressed patients, as well as extra protection designs when there is new construction. This can be very costly. For Legionella infections, CDC recommends proper design, placement, and maintenance of cooling towers; routine maintenance of water-supply systems; and when contaminated water supplies are identified, appropriate decontamination. CHEM believes that the CDC recommendations are a good way to control these ambient biohazards, but is concerned about some of the costs to meet all the Aspergillus recommendations. Hospitals must weigh costs before proceeding, especially with Category II recommendations that are only "suggested for ... many hospitals." For example, at facilities with no cases of infection, if following the CDC recommendations means that filters need to be changed and ducts cleaned more frequently than usual, the costs may not be worth it. On the other hand, if there have been a series of confirmed cases of nosocomial Aspergillus pneumonia, the cost of HVAC retrofitting or using a portable HEPA filtration systems may be worth it.(ABSTRACT TRUNCATED AT 250 WORDS)

Air Pollution↗

PubMed1994

[Recommendations for preventing transmission of infection with biohazard in the practice of legal medicine (2). Equipment and practical applications. The Medico-Legal Society of Japan, Committee on Expert Opinions].

In May, 1993, our committee of the Medico-Legal society of Japan published an article entitled "Recommendations for Preventing Transmission of Infection with Biohazard in the Practice of Legal Medicine" in The Japanese Journal of Legal Medicine. Concerning this article, we received a lot of useful comments and opinions from many members of the society, for which we are very grateful. We also received a lot of requests for further information concerning details on the equipment and its practical applications. Since a lot of departments of Legal Medicine at several universities throughout Japan at present are remodelling their facilities in order to be able to perform autopsies, with respect to such circumstances, our committee felt the need to provide information on basic conditions concerning the prevention of transmission of infections with hazards.

Containment of Biohazards↗