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OCR for page 213
Index
.
A
Absettarov virus, 128
Academic laboratories
design of laboratory exercises and experiments, 68-69
monitoring and recordkeeping, 69
orientation and training of students, 68
safety in laboratory courses, 68
safety program, 47-48
Accrediting bodies, 211-212
Acquired immunodef~ciency syndrome (AIDS)
autopsy precautions, 17, 159-160
health care workers with, 157
and tuberculosis morbidity, 10
see also Human immunodeficiency virus ~V)
Actinomycetes, animal sources and routes of infection,
177
Aerosols and droplets
containmentlcontrol equipment, 16, 25, 26, 28
handling of, 5, 22-25
HVB transmission in, 11
insect waste products in, 14
particulate size, 12, 22
procedures generating, 18, 19, 23, 50, 65-66,94
from sonicators, homogenizers, and mixers, 23-24,
26-28
from Stryker saw, 17, 122
African green monkeys, 15
Alcohol disinfection, 40
Allergies among laboratory workers
to aerosolized proteins, 57
arumal-associate~l, 14, 57
insect-associated, 14, 15,57
medical evaluation of, 14, 56, 57
to nematode antigenic components, 14, 107
prevalence of, 14-15
prevention of, 15, 58
to vaccine components, 57
American Association for Accreditation of Laboratory
Animal Care, 211
American Chemical Society, 53
American College of Physicians, 58
American Committee on Ardlropod-Bome Viruses, 123
American Industrial Hygiene Association, 30
American Occupational Medical Association, 59
American Society for Microbiology, 53
American Type Culture Collection, 21
Ammonium compounds, 40
Animal pathogens, restricted, 132-133
Animals, see Laboratory animals; and specific species
Anthrax, 60, 110
Arboviruses
Biosafety Level 2, 123-126
Biosafety Level 3, 12~128
Biosafety Level 4, 128-129
laboratory-associated infections, 85, 105
Arenavlruses
animal sources and routes of infection, 185
Biosafety Level 3, 126-128
Biosafety Level 4, 128-129
Ascaris spp., 107
Association of Practitioners in l~fection Control, 53
Autopsy/moriician services
cadaver/anatomical waste disposal, 17, 18, 36, 38, 42,
44
precautions against HIV transmission, 17, 159-160
tissue handling, 18
see also Necropsies
B
B-virus, 15, 119-120
Bacillus anthracis, 110
Bacillus subtilis, 69, 88
Bacterial agents, 11~117; see also specif c agents
Biological safety cabinets
air demand and energy requirements, 26
airflow patterns and operating velocities, 2~27,49
certification of, 31, 50, 97, 104, 129
characteristics, 129-131
213
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214
Class L 21,25-27,87,89,92,97,109,129
Class 0, 21,23,26,27,87,89,92,97,109,129
Class ~ 26, 87,95, 96, 103, 1Q4, 130-131
decontamination of, 65
equipment operation in, 23,28
exhaust air, 94, 97,102,104
failure alarms, 50
handling of incoming specimens in, 21-22,89
HEPA filter decontamination, 25,39,94,102,129-131
for HIV handling, 144
improper use of, 129
maintenance precautions, 51
testing and monitoring of, 25,31,97,104,129
Biosafety principles
animal Biosafety levels, 88-89
Biosafety levels, 11, 26,87-89
equipment, 86-87
facility design, 87
information sources, 86
laboratory practice and technique, 86
Biosafety Level 1
animals, 98-99
criteria, 89-go
laboratory design, 87
microorganisms assigned to, 88
principles, 88
Biosafety Level 2
animals, 89,99-100,149-150
arboviruses assigned to, 123-126
bacteria, 110, 112-117
criteria, 11, 90-92,145-147
electrical systems, 49
emergencies, 64
exposure routes under, 88
fungi 10~109
H]V handEng, 13,145-147
hospital laboratories, 68
laboratory design, 49, 50, 87
microorganisms assigned to, 88,123-126
parasites, 107-108
principles, 88
rickettsial agents, 117, 118
viral agents, 119-123
Biosafety Level 3
animals, 44, 100-102,150-152
arboviruses and arenaviruses assigned to, 126-128
bacteria, 110,111,114,115,117
containment requirements, 23
criteria, 92-94,147-149
emergencies, 55
exposure routes under, 88
fungi 108, 109
H]V handEng, 13, 147-149
laboratory design 49,50,87
INDEX
maintenance on equipment in, 51
microorganisms assigned to, 23,88,126-128
principles, 88
reproductive hoards, 56
rickettsial agents, 117, 118
viral agents, 121-123
Biosafety Level 4
animals, 102-104
arboviruses, arenavwses, and filoviruses assigned to,
127,128-129
criteria, 26,94-98
emergencies, 55
laboratory design, 49, 87
for large-scale production, 31
microorganisms assigned to, 88,128-129
principles, 88
reproductive hazards, 56
viral agents, 120
Biosafety levels
annals, 98-104,149-152
arbovinuses, 123-129
bacterial agents, 11~117
criteria, 11, 26,89-98,145-149
fungal agents, 108-110
human immunodeficiency viruses, 145-149
for large-scale production, 31
parasitic agents, 107-108
principles, 11, 26, 87~9
rickettsial agents, 117-119
selection of, 30, 10~105
Gaining requirements, 52
viral agents, 119-123
Blastomyces dermatidis, 108
Body fluids
CDC caution, 152
disposal of, 43~4
HBV exposure risk Tom, 10
spill cleanup, 17
universal precautions, 33, 142, 144, 169-170
Botulism, 60, 105
British Committee on Dangerous Pathogens, 17
Brucella spp., 13
abortus, 110
cants, 110
laboratory-associated infection 2, 9, 85
melitensis, 110
suds, 9, 69, 110
Bunyavirus, 184-185
C
Calomysspp. 128
Campylo:t~acter fetus jejune, 116
Canine }hepatitis virus, 88
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INDEX
Centers for Disease Control
guidelines for biosafety, 5,13, 30, 33, 52, 210
investigations of laboratory-associated tuberculosis, 10
universal precautions, 12, 22, 33
Cercopithecus spp., 128
Cestode parasites, 108, 181
Chickens, 15
Chimpanzees, hepatitis risk from, 10, 119
Chlamydiapsittaci 1 10-1 1 1
Chlamydia trachomatis, 110-111
Cholera, 12, 60, 85, 116, 131
Clostridium botulinum, 2, 12, 111
Clostridium tetani, 2, 11,12, 111-112
Clothing, masks, and face shields, 25, 28
Coccidia spp., 107
Coccidioides immitis, 13, 108-109
College of American Pathologists, 16,54, 211
Containment
approaches, 30-31
Biosafety Level 1,90
Biosafety Level 2,92, 146, 150
Biosafety Level 3,94, 148, 151
Biosafety Level 4, 26, 96
Biosafety principles, 86-87
clothing, masks, and face shields, 25, 28
defined' 86
experimental animals, 15, 99, 100, 101, 103, 150, 151
filters, IS, 23, 25
for HIV handling, 146, 148
laboratory, 87
maintenance work on, 26, 31
maximum containment laboratory, 87
packaging for shipment, 20-21
physical, 3~31, 86-87
pipetting devices, 23, 26-29
purpose of, 86
on sonicators, homogenizers, and mixers, 23-24, 26,
28, 87
testing and certification of, 26, 31
see also Biological safety cabinets
Coryr~acterium diphtherial, 112
Cowpox, 61, 122
Capella burnetti, 13, 88, 117
Creutzfeldt-Jakob agent
Biosafety criteria, 122-123
consequences of infection, 105
inactivation of, 17, 123
in necropsy/surgical specimens, 16, 17, 123
occupational risks, 2, 11-12
Cryptococcus neoform~s, 109
Cultures
biohazards from, 15, 24, 123
inactivation, 31-32,39, 41
large-scale, defined, 28
21S
regulation of imports of, 21
see also Large-scale production
Cutaneous leishmaniasis, 107
Cytomegalovirus, 56
D
Decontamination
animal cages, 99, 101
Biosafety Level 2,91, 99
Biosafety Level 3,50-51, 93
Biosafety Level 4,50-51, 95, 96,97
compounds and target organisms, 39, 40
freezers, 51
of HEPA filters, 39
of patient care equipment, 161
personnel, 65, 102, 131
validation of, 42
of wastes for disposal, 31-32, 33,35, 39-42, 104
of work surfaces, 6, 19,93, 144
Dentistry, precautions against HIV transmission, 159-160
Dialysis, precautions against HIV transmission, 160
Diphtheria, 60,105,112
Disinfectants
formalin, 17-18
germicides, 17, 144
iodine-based, 18, 39
iodophors, 40
for radioactive spills, 66
sodium hypochlorite solution, 16, 17, 39, 40, 66
in vacuum system, 50
DNA viruses, animal sources and routes of infection, 186
E
Eastern Equine Encephalomyelitis, 60, 124, 125, 126
Echinococcusgranulosus, 108
Emergencies
alarm system, 50, 63~4, 97, 104
Biosafety Levels 3 and 4, 55
damaged shipments, 22
decontamination, 50
drills, 7, 63, 64
evacuation procedures, 63 64
fires, 63, 64
medical, 63
power failure, 49, 64, 67
preparation and general procedures, 7, 47, 63
shutdown procedures, 64
small-scale accidents, 63
spills and releases, 64 67
start-up procedures, 64
Entamaeba histolytica, 107
Enteroviruses, 56; see also specif c viruses
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216
Environmental Protection Agency, 43, 46, 209-210
Epidemiology of occupational infections
environment, 9
infectious agents, 2, 9-12
laboratory workers, 8-9
Epidermophyton spp., 109-110
Equipment
aerosol-generating, 23-24, 26, 28
cell sorters, 25
centrifuges and ultracentrifuges, 24, 32, 65, 87
clean benches, 25, 129
decont~n~nation of, 39
eye wash fountains, 48, 50
inoculating loops, 24
pipetting devices, 26
respirators, 15, 58, 111
safety, 15, 47, 50, 86-87
sonicators, homogenizers, and mixers, 23, 26, 28
see also Biological safety cabinets; Containment
Escherichia colt, 65
Ethylene oxide, 41
Exposure
contact route, 12, 18-19, 22
ocular rouse, 11,12, 19
inoculation route, 1 1,12, 19
management and reporting of, 17
monitoring, 32-33
from necropsy/surgical specimens, 16, 18
oral route, 11, 12, 19
prevention of, 4-5, 18-19
respiratory route, 10, 19, 22
during waste disposal, 36
F
Facilities
Biosafety Level 1, 90
Biosafety Level 2, 21, 92, 147, 150
Biosafety Level 3, 94, 148-149, 151-152
Biosafety Level 4, 96-98
constructing, remodeling, and decommissioning, 7, 51
e~imental animals, 48, 99, 100, 101-102, 103-104,
150, 151-152
for HIV handling, 147, 148-149
housekeeping, 51
laboratory design' 44, 48, 49-51, 87
maintenance, 51
specimen receiving areas, 21
traffic flow pattems, 48, 49, 50
Fasciola spp., 107
Ferrets, 120
Filoviruses, Biosafety Level 4, 128-129
Flavivirus, 182-183
Food and Drug A&ninistration, 210
INDEX
Formaldehyde, 39, 40
Pormalin, 17
Francisella tularensis, 112
Fungal agents, 108-110, see also specif c agents
G
Giardia spp., 107
Glanders, 85
Glutaraldehyde, 40
Gonorrhea, 114
Gram negative bacteria, 176
Gram positive bacteria, 176-177
H
Hantasn virus, 126, 127
Health Care Financing Administration, 211
Health care workers
with AIDS/HIV infection, 142, 143, 157, 16~166
definition of, 156
exposure routes for, 16
HIV infection risks, 157-158
precautions to prevent HIV transmissions, 158-166
serologic testing for HIV, 165
Hemorrhagic fever, 89
HEPA falters
for air recirculation in animal rooms, 104
on biological safety cabinets, 25, 94, 102, 129-131
decontamination of, 39
on fer.mentors, 32
in personnel suit areas, 131
on sewer and ventilation lines, 49, 96, 101
on Stryker saws, 17
on ultracentrifuges, 24
on vacuum cleaners/lines, 66, 93, 97
Hepatitis A virus
biosafetylevels, 119
immunization, 60
incidence of infection, 10
laboratory hazards of, 10
Hepatitis B virus (HBV)
Biosafety levels, 88, 119, 144
body fluid sources, 16, 169-170
c~riers, 11
containment equipment for animals, 144
decontamination procedures, 144
immunization against, 4, 14, 58, 60
inactivation of, 17-18
incidence of infection, 10, 85
laboratory contamination, 11
monitoring employees for, 58, 144
mortality rates, 11
prevalence in general population, 9
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INDEX
prevalence in laboratory workers, 10, 11, 119
protective barriers, 170-171
protective clothing, 143-144
recommended precautions, 143-145
reproductive risks, 56
risk to laboratory workers, 2, 10-11, 13, 105
routes of occupational infection, 11, 56, 144
universal precautions, 144, 168-172
viability and infectiousness, 11
Hepatitis, non-A/non-B, 10, 119
Herpesviruses, 56, 120
[lerpesvirus simian (B-virus), 15, 119-120
Ilistoplasma capsulatum, 109
HIV, see Human immunodeficiency virus
Hookworms, 107
Hospital laboratories
isolation precautions, 68
unsupervised, 68
ventilation of, 49
Host defense deficiencies, in employees, 56, 57, 105
Housekeeping
HIV infection precautions, 162
personnel safety measures, 51
waste disposal, 45
Human immunodef~ciency virus JIIV)
animal biosafety level criteria, 149-152
autopsy/mortician service precaution, 160
biosafety level criteria, 13, 145-149
body fluid sources, 16, 169-170
containment equipment, 146, 148
dentistry precautions, 159-160
dialysis precautions, 160
exposure management, 166
federal health advisory, 11
guidelines for handling, 12, 13, 143-145
housekeeping precautions, 162
inactivation of, 17-18, 144
invasive procedure precautions, 159
laboratory hazards, 143
laboratory facilities, 147, 148-149
laboratory precautions, 13, 145-149, 16Q-161
laundry precautions, 162-163
management of infected workers, 165-166
medical surveillance programs, 144 145
occupationalrisk from, 2, 11, 12, 13, 142-143, 156
prevention of transmission in health care settings, 156,
158-161
protective barriers, 170-171
reproductive risks, 56
routes of exposure, 56, 143, 156, 157-158
seroconversions in laboratory workers, 12, 142-143
serological testing for, 163-165
spill cleanup/decontamination, 162
sterilization and disinfection, 161
2~7
survival in the environment, 162
universal precautions, 158-159, 168-172
in waste, 163
see also Health care workers
I
Ibaraki, 127
Immunization of workers
allergies precluding, 57
documented evidence of, 14, 58
with experimental vaccines, 14
recommendations, 4, 58, 60-63, 131
see also Vaccinationslvaccines
Importation of biologicals, 21, 89, 132-133, 189-2Q4
Inactivation
Creutzfeldt-Jakob agent, 17, 123
botulinum toxin 111
of cultures, 31-32
hepatitis B virus, 17-18
human immunodeficiency virus, 17-18, 144, 161-162
Mycobacterimnspp., 17, 18, 114
of parasites, 108
Q fever, 10
tissue samples, 17
validation of, 32
of waste, 43
see also Decontamination; Disinfectants
Infectious agents
bacterial, 110-117
descriptive epidemiology, 9
fung al, 108-110
highest risk, 2, 9-11, 13-14
lowest risk, 2, 11-12
parasitic, 107-108
rickettsial, 117-119
spills and releases, 6~66
viral, 119-123
see also specific agents
l~fluenza virus, 60, 105, 12Q-121
Insects, hazards to laboratory workers from, 1~15, s7
International Civil Aviation Organization, 20
Invasive procedures
precautions against HIV transmission, 159
wastes from, 36
see also Surgical pathology
Israel turkey meriingoencephalitis, 127
J
Japanese encephalitis, 60, 126, 127
Joint Commission for Accreditation of Health Care
Organizations, 49, 54, 211
Justin virus, 128
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218
K
Kumlinge virus, 128
Kuru agents, 122-123
Kyasanur Forest disease, 128
L
Labeling
of bodies, 17
and levels of laboratory practice, 22, 91,93, 95
shipments of biological materials, 20-21, 188, 200
of specimens within the laboratory, 6, 22,47
Laboratory animals (vertebrate)
Biosafety Level 1,98-99
BiosafetyLevel2,99-100,108,109,111,114,149-150
Biosafety Level 3,10~102, 117,150-152
Biosafety Level 4,102-104
containment equipment for, 15, 99,100,103, 150, 151
facility design for,48,99,100, 101-102, 103-104, 150,
151-152
hazards to workers from, 14-15, 57, 85
HIV-related precautions, 144, 149-152
safety procedures, 54, 88~9, 98-100, 149-151
sources of human infection, 10, 108, 109, 110
waste handling from, 36,38, 44, 99, 101, 104
see also specific animals
Laboratory environment/design
access control 50,87, 91, 93, 94,96
electrical power, 49-50
guidelines, 31
HBV contamination, 11
laundry, 50-51
physical features, 9
regulation of, 9
safety equipment, 50
sewage system, 50
storage ~eas,51
vacuum system, 50,93, 97
ventilation, 20,49, 87, 94, 96,97
voluntary code of practice, 9
waste handling, 44, 50,96
water supply system, 32, 50
see also Facilities
Laboratory practices
academic laboratories, 68-69
Biosafety Level 1,90
Biosafety Level 2,11, 91-92, 145-146, 149-150
Biosafety Level 3,92-94, 147-148
Biosafety Level 4,95-96
Biosafety principles, 86
CDCuniversalprecautions, 12
experimental animals, 98-101, 102-103
HIV handling precautions, 145-146, 147-148, 160-161
INDEX
prevention of exposure, l9
routes of exposure, 1~19
rules of biosafety, 4-5, 19-20
standard operating procedures, 28, 32, 54
training of personnel, 33, 67-69, 86
voluntary code of, 9
Laboratory waste
animal bedding materiel, 44
body fluids, 43~4
cadavers and anatomical parts, 44
characteristics of, 36
chemotherapeutic agents, 43
decontamination of, 33, 37-39, 42
generators of, 37
infectious potential of, 35-36
minimization of, 43
mixed, 39, 42~4
needles and other "sharps," 44 45
segregation of, 37,43, 45, 50
see also Waste handling and disposal
Large-scale production
containment, 6, 3~31
disposal of wastes, 32, 36
exposure monitoring, 12,32-33
of HIV, 143, 144
inactivation of cultures, 31-32
organization and responsibilities, 30
risk associated with, 31,32
safety communications, 48
Lassa fever virus, 88, 128
Laundry
Biosafety Levels 3 and 4 clothing, 50-51
REV precautions for, 162-163
infection of workers from, 85-86
laboratory facilities for, 50-51
Legionella pneurnophila, 113
Leisiun~ia spp., 107
Leprosy, 113
Leptospires, 13
Leptosp~ra ulterrogans, 112-113
Liponyssoidessanguineus, 118
Lymphadenitis, 113
Lymphocytic choriomeningitis virus, 15, 121, 127
Lymphogranuloma venereum, 11() 111
M
Macaques, 15, 119-120
Machupo virus, 128
Marburg disease, 15, 85, 12~129
Mastomys natalensis, 128
Material Safety Data Sheets, 48
Measles, 61
Medical program
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INDEX
assessment of employee risk, 7, 14, 55-57
design, 57
HIV surveillance programs, 144, 163-166
host defense deficiencies, 56, 57
immunizations, 14, 58, 60-62, 131
laboratory and other testing, 58, 69, 92, 94, 104, 144
management of HlV-infectedlexposed workers, 165-166
medical history, 14, 57
occupational health history, 57
periodic monitoring examination, 55, 58-59, 63
physical examination, 57-58
postemployment evaluation, 55, 59
preplacement examination, 14, 55, 57-58
reproductive hazards, 13, 56-57
resources, 59, 63
serum bank, 4, 14, 58
surveillance of personnel for rickettsial infections,
131-132
treatment and documentation of exposures, 55
Medical Research Council of Canada, 30
Melioidosis, 115
Meningococcal meningitis, 61, 115
Mice, 15, 109
Microsporum, 109~110
Monitoring
accident reporting, 59, 96, 103
agent-specific surveillance, 58, 59
exposure in large-scale production facilities, 32-33
postemployment evaluation, 59
recordkeeping and result notification, 59
safety program compliance, 47, 48
ventilation characteristics, 49
Monkeypax, 61, 121,122
Mycobacterium
animal sources and routes of infection, 177
atypical, 113-114
avium, 10
basis, 10, 114
contamination of cultures, 24
inactivation of, 17, 18
leprae, 113
tuberculosis, 10, 13, 16, 18, 65, 88, 105, 114; see also
Tuberculosis
Mycoses, animal sources and routes of infection, 178-179
N
Naegleriafowleri, 107
Naegleria gruberi, 88
National Animal Disease Center, 85
National Committee for Clinical Laboratory Standards, 16
National Institute for Occupational Safety and Health 209
National Institutes of Health
guidelines for biosafety, 5, 13, 30, 31, 33, 52, 210
2~19
National Sanitation Foundation, 129
Necropsies
on bodies known to be infected, 16-18
routine, 16
see also Autopsy/mortician services
Needles and over "sharps"
Biosafety Level 2, 91-92, 9~100
Biosafet',r Level 3, 93, 101
Biosafety Level 4, 96, 103
disposal of, 17, 33, 35, 38, 44 45
exposure rouses, 19
infections related to, 85
limiting use of, =5, 19, 143
reporting of accidents with, 59
Neisseriagonorrhocae, 114-115
Neisseria meningitidis, 11~115
Nematode parasites, 107, 180-181
Newcastle Disease virus, 15
Nuclear Regulatory Commission, 43, 46, 52, 210
o
Occupational infections
assessment of risk, 35, 53
highestriskorganisms,9-11, 13-14
incidence and mortality rates, 8-11, 85-86
potential for, 1, 8, 18
risk in large-scale production facilities, 28-29
routes of exposure, 18-19, 36
from waste disposal, 37
see also specif c infectious agents
Occupational Safety and Health Administration, 46, 48,
54, 209
Office of Science and Technology Policy, 211
Old World monkeys, 15, 119
Orbivirus, 185
p
Packaging of biological materials
for disposal 33
needles and other "sharps," 33
for shipment, 20-21, 1B8
Paraformaldehyde, 40
Parasitic agents
cestodes, 108
nematodes, 107
protozoa, 107
trematodes, 107-108
Pedicul~ h. hurnaru", 118
Phenolic compounds, 40
Physician laboratory/small-volume laboratory, 33, 54
Picomavirus, 185
Pipetting devices
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220
hazards of, 4, 18, 19, 23, 26, 85
safety aids, 26, 28-29
Plague, 61, 117
Plasmodimn cynomolgi, 107
Plasm~dium spp. 107
Poliomyelitis, 61,105, 121, 131
Potomac fever agent, 113
Pox viruses, 61, 121-122
Presbytis spp., 128
Programs In laboratory safety
academic laboratories, 68-69
accident reporting and investigation, 54, 69
auditing, 54-55
communications, 48
design, 3, 46
employee orientation and education, 47, 50, 52-53
evaluation of hazards, 53
goals, 46
meetings and committees, 47-48
monitoring, 47, 48
plans, 47
policy and procedure manuals, 3, 7, 47, 53-54, 86
recordkeeping, 46, 54, 69
registry of infectious agents, 55
responsibility for safety, 46-47
signs for hazardous areas, 55
waste management, 55
Protective clothing
activities requinng, 87
Biosafety Level 2, 91
Biosafety Level 3, 93
Biosafety Level 4, 95, 96
for cleanup and disposal tasks, 17, 39, 64-65, 66
dispersal of contaminants on, 19
facial 19
gloves, 25, 39, 143, 171-172
for HIV handling, 143, 144
for necropsy/surgical specimen handling, 16-17
for phlebotomy, 171
positive pressure personnel suits, 95, 96, 131
precautions against HIV or HBV transmission, 170-171
for vivanum operations, 15, 99, 100, 101
for waste handling, 39
Protozoal parasites, 107, 182
Pseu~naspseudomallei, 115
Pulmonary diseases, Myc~acterium spp., 113
Q
Q fever
animal hosts, 117
immunization, 61
resistance to inactivation, 10
INDEX
route of infection, 10, 85-86
risk of infection from, 2, 9, 10, 117
R
Rabies virus, 2, 11, 58, 61, 122, 131
Radioactive materials
emergencies, 63, 66-67
isotopes posing external and internal hazards, 66
regulation of, 46
safety training, 52
waste disposal, 39, 42-44
Regulations
agency-specific responsibilities, 209-211
definitions, 20~209
emergency plar~iing, 63
importation of biological specimens, 5, 21, 89, 132,
189-204
information sources on, 67
recordkeeping requirements, 67
shipment of biologicals, 5, 20, 21, 89, 132, 188
teaching laboratories, 68
waste disposal, 37, 42-43
Reovirus, 185
Reproductive hazards, to employees, 56-57, 107
Rhabdovirus, 185
Rhesus monkey kidney cells, 15
Rickettsia
Atari, 117-118
animal sources and routes of infection, 177-178
Biosafety levels, 117-119
Canada, 118
prowazekii, 118
ricketsii, 11~119, 131
risk to laboratory workers, 13
ruminantium, 132
surveillance of laboratory personnel for infections,
131-132
tsutsugamushi, 1 18
typhi, 118
Rift Valley fever virus, 12~128, 132
RNA viruses, animal sources and routes of infection,
182-186
Rochalimaeaquintana, 117-118
Rochalimaeavinsonii, 117-118
Rocky Mountain spotted fever, 118
Rubella virus, 56, 58, 62
S
Safety management
administrative organization and responsibilities, 3, 7,
46J,8
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INDEX
emergency plans, 47, 63-67
facilities, 4~51
information resources, 133
job analysis, 47
In laboratory courses, 68
medical program, 55-63
operations, 51-55
regulation and accreditation, 67
responsibility for, 46
training programs, 7, 33, 67-69, 86
see also Programs in laboratory safety
Salmonella spp., 13
Biosafety level required for, 88
cholera-suds, 115
enteritidis, 115
typhi,69, 115-116
Schistosoma spp., 107-108
Scrub typhus, 131
Semiliki Forest virus, 127, 128
Serum-derived reagents, caution, 152
Shigella spp., 13, 116
Shigellosis, in laboratory workers, 11, 85
Shipment of biologicals
receiving and unpacking specimens, 21
regulation of, 5, 20, 21, 89, 132, 201-204
Skin ulcers, 113-114
Smallpox, 85, 121
Soft tissue wound infections, 113-114
Spills and releases
in biological safety cabinets, 65
Biosafety Level 2, 92
Biosafety Level 3, 93-94
chemicaVbio log ic al , 66
disinfection, 17
disposal of materials used for cleanup, 32
emergency plans, 6~67
infectious agents, 64-66,162
protective clothing for cleanup, 64-65
radioactive biologicals, 66-67
solid materials, 66
Spirochetes, animal sources and routes of infection, 178
Sporothrixscheneb~i, 109
Spotted Fever Group agents, 118
St. Louis encephalitis, 88, 127, 128
Sterilization
autoclaving, 17, 39, 44, 50
biological safety cabinets, 31
large-scale production vessels, 31
of waste, 39
see also Disinfectants
Streptococcal infections, 85
Strongyloides spp., 107
Surgical pathology, 18
Syphilis, 56, 116
221
T
Tacnia solium, 108
Tanapax virus, 121
Tetanus, 58, 60, 85, 105, 112
Tissue samples
cryostats, 18
disposal of, 18
inactivation of, 17
Togavirus, 183-184
Toxoplasma spp., 56, 88, 107
Training in Biosafety
academic setting, 67-59
Biosafety Level 2, 91
Biosafety Level 3, 92
Biosafety Level 4, 94-95
courses, 207
responsibility for, 86
teaching aids, 205-207
use of containment equipment, 26, 129
Transmissible spongiform encephalopathies, 122-123
Transportation
importation and interstate shipment of biologicals, 5,
89,132
Trematode parasites, 107-108, 179-180
Trench fever, 118
Treponema pallidum, 56, 116
Trichophyton spp., 109-110
Trypanosoma cruzi, 107
Trypanosoma spp., 107, 132
Tuberculosis
and AIDS, 10
cases in human population, 9
cases in laboratory workers, 10
exposure routes, 10
immunization, 62
infectiousness of, 20
monitoring employees for, 58
risk of infection from, 9, 10, 11
Tularenua, 62, 85,112,131
Typhoid fever, 2, 9, 62, 85, 115, 131
Typhus, 118, 131
U
U.S. Department of Agriculture, 21, 30, 89, 133, 210
U.S. Department of Health and Human Services, warning
to laboratory workers, 11
U.S. Deparunent of Labor, warning to laboratory workers,
11
U.S. DeparOnent of Transportation, 21, 89, 210
U.S. Postal Service, 21, 210
U.S. Public Heals Service
regulation of import and transport of etiologic agents,
20, 21, 89
OCR for page 222
222
V
Vaccinations/vaccines, prophylactic, 14, 22, 60-62, 105,
111,112,114,116,126,127,131
Vaccinia virus, 61, 121, 122
Varicella virus, 56
Venezuelan equine encephalitis, 62, 85, 124, 126-128
Vesicular stomatitis virus, 123, 124, 126
Vibrio cholerae, 2, 11, 116
Vibrioparah~ernolyticus, 116
Vibrionic enteritis, 116
Viral agents
biosafety levels, 119-123; see also specif c agents
immunization of workers against, 14
Viral hepatitis
risk of infection from, 9, 10,11
see also Hepatitis A virus; Hepatitis B virus (HBV);
Hepatitis, non-Alnon-B
W
Waste handling and disposal
animal bedding matenal, 38, 44, 99
basic principles, 37-38
Biosafety Level 2,91
Biosafety Level 4,97
cadavers and anatomical waste, 17,18,38, 42, 44,101
chemical decontamination, 33, 39, 43; see also
Disinfectants
containment/packaging, 7, 19,32, 35, 3~39, 43-45
cultures, 31-32
dioxin compounds, 44
INDEX
haulers and waste disposal facilities, 36,37
HIV precautions, 163
human excrete, 33, 34, 43
incinerations, 6,18, 32, 35, 36,39, 41-42, 44
laboratory design for, 50
liquid waste, 33,38, 97, 104
mixed waste, 39, 42-44
needles and other "sharps," 17, 33, 35,38,41 45
personnel protection, 3,37, 39, 45
radioactive materials, 18,39, 42-44, 67
recordkeeping, 37
regulation of, 37, 42-43
responsibility for, 36-37, 55
risks from, 3, 6, 37, 50
in sanitary Landfills, 3, 6,3~35, 36
sewage system, 3, 6, 32-35, 43,50, 108
solid waste, 32, 38
steam autoclaving, 33, 39, 41-44
validation of decontamination methods, 42,43
Water
emergency requirements, SO
treatment and filtering, 32
Westem equine encephalomyelitis, 62, 124, 126
y
Yaba virus infection, 121
Yellow fever, 62, 126-128
Yers~uaPestis, 117
z
Zooq~otic pathogens, 14, 48, 17~186
Representative terms from entire chapter:
laboratory workers
