1. Foundation Training in Biological Safety

2. Imperial College SafetyPage 2 Foundation training 4 modules 1.Principles of biological safety 2.Hazardous chemicals within the biological lab 3.Gases and cryogenics 4.Working with Genetically Modified Organisms

3. Module 1 Principles of biological safety

4. Imperial College SafetyPage 4 What are we trying to prevent?

5. Imperial College SafetyPage 5

6. Imperial College SafetyPage 6 Bl l

7. Imperial College SafetyPage 7

8. Imperial College SafetyPage 8

9. Imperial College SafetyPage 9

10. Imperial College SafetyPage 10

11. Imperial College SafetyPage 11

12. Imperial College SafetyPage 12 Laboratory-acquired infections at Imperial College Hepatitis A Vaccinia - 1991 Vaccinia - 2000 Meningococcal meningitis Accidents do happen

13. Imperial College SafetyPage 13 Threat from fatal bugs as labs breach safety rules (Observer) College fined for exposing staff to lethal virus (The Times) College exposed workers to death risk (Eastern Daily Press) Top research institution fined for ‘serious’ safety offences (Yorkshire Post)

15. Imperial College SafetyPage 15 Safety training Training Sexy stuff Time

16. Imperial College SafetyPage 16 Foundation training

17. Imperial College SafetyPage 17 Further training Training needs analysis –Identifies what training is required –Linked to work to be undertaken and the risk assessments Provision –Depends on what the training is DSOs Group Leaders / Principal Investigators Safety Department CBS etc

18. Compliance requirements

19. Imperial College SafetyPage 19 College policy Legislation

20. Imperial College SafetyPage 20

21. Imperial College SafetyPage 21 Lines of responsibility within Imperial College DSOs FSOs Safety dept Support services

22. Imperial College SafetyPage 22

23. Imperial College SafetyPage 23 The Health and Safety at Work Act 1974 Primary legislation The Control of Substances Hazardous to Health Regulations 2002 – general and biological agents provisions Genetically Modified Organisms (Contained Use) Regulations 2000 Secondary legislation & approved Codes of Practice The Management of Health and Safety Work Regulations 1999 The Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 1995 The Anti-Terrorism Crime and Security Act 2000 The law

24. Imperial College SafetyPage 24 Health and Safety at Work etc Act 1974 Key duties of the employer (Imperial College) -Ensure the Health and Safety of their employees -Ensure the Health and Safety of others Key duty of the employee (you) -Co-operate with the employer

25. The law COSHH “hazardous substances” Chemicals (incl toxins) Carcinogens Biological agents

26. Imperial College SafetyPage 26 The law COSHH - general provisions Reg. 6: Assess health risks Reg. 7: Prevent or control exposure Reg. 8: Use control measures Reg. 9: Maintain, examine and test control measures Reg. 10: Monitor exposure Reg. 11: Health surveillance Reg. 12: Information, instruction and training for persons who may be exposed Reg. 13: Arrangements to deal with accidents, incidents and emergencies

27. Imperial College SafetyPage 27 The law COSHH - biological agents Reg. 6: Assess health risks Reg. 7: Prevent or control exposure Reg. 8: Use control measures Reg. 9: Maintain, examine and test control measures Reg. 10: Monitor exposure Reg. 11: Health surveillance Reg. 12: Information, instruction and training for persons who may be exposed Reg. 13: Arrangements to deal with accidents, incidents and emergencies Schedule 3

28. Imperial College SafetyPage 28 All biological agents must be classified in one of four Hazard Groups Increasing hazard to human health The law COSHH Hazard Group 1 Hazard Group 2 Hazard Group 3 Hazard Group 4

29. Imperial College SafetyPage 29 Group 1 - unlikely to cause human disease The law COSHH Definition of Hazard Groups Group 2 - can cause human disease but is unlikely to spread to community and there is usually effective prophylaxis or treatment available Group 3 - causes severe human disease and may spread to community but there is usually effective prophylaxis or treatment available Group 4 - causes severe human disease and may spread to community and there is usually no effective prophylaxis or treatment available

30. Imperial College SafetyPage 30 Available at http://www.hse.gov.uk/pubns/misc208.pdf

31. Imperial College SafetyPage 31 Classification of biological agent USUALLY determines minimum containment level required The law COSHH Hazard Group 1 Hazard Group 2 Hazard Group 3 Hazard Group 4 Containment Level 1 Containment Level 2 Containment Level 3 Containment Level 4

32. Imperial College SafetyPage 32 The law COSHH

33. Imperial College SafetyPage 33

34. Imperial College SafetyPage 34

35. Imperial College SafetyPage 35 But this is only the starting point … The principles of; –Good Occupational Safety and Hygiene –Good Laboratory Practice –Good Microbiological Practice –COSHH …..must all be applied when determining and applying a safe system of work The law COSHH

36. Imperial College SafetyPage 36 Risk assessment process Identify the hazard Consider the nature of the work Evaluate the risk Consider the control measures required Record and review the assessment The way in which the agent can harm health DEFINITION The likelihood and severity of harm occurring DEFINITION

37. Imperial College SafetyPage 37 COSHH 1st fundamental principle COSHH requires that exposure is prevented 1 controlled 2 If prevention not possible

38. Imperial College SafetyPage 38 How can exposure to an infectious agent be prevented?

39. Imperial College SafetyPage 39 Exposure to a particular biological agent is prevented by substitution with a less hazardous biological agent Prevention of exposure by substitution Use lab adapted strains wherever possible Avoid clinical isolates wherever possible If the science will allow it, substitute with a less hazardous species e.g. M. tb with BCG COSHH Reg 7

40. Imperial College SafetyPage 40 Prevention of exposure by segregation Prevent unnecessary and unauthorised access Keep doors locked/ secure Use appropriate signage (Biohazard) If substitution is not possible then start by considering whether the work is adequately isolated from other staff, students, contractors or visitors This will at least prevent exposure to those not doing the work

41. Imperial College SafetyPage 41 Prevent unnecessary and unauthorised access Keep doors locked/ secure Use appropriate signage (Biohazard) Permit-to-work systems Prevention of exposure by segregation If substitution is not possible then start by considering whether the work is adequately isolated from other staff, students, contractors or visitors This will at least prevent exposure to those not doing the work

42. Imperial College SafetyPage 42

43. Imperial College SafetyPage 43 Prevent unnecessary and unauthorised access Keep doors locked/ secure Use appropriate signage (Biohazard) Permit-to-work systems Write up areas in labs Prevention of exposure by segregation If substitution is not possible then start by considering whether the work is adequately isolated from other staff, students, contractors or visitors This will at least prevent exposure to those not doing the work

44. Imperial College SafetyPage 44

45. Imperial College SafetyPage 45 COSHH 2nd fundamental principle If PREVENTION is not possible then CONTROL exposure Work practices Engineering controls Suitable work equipment and materials 1 Control exposure at source Use PPE 2

46. Imperial College SafetyPage 46 Routes of laboratory infection Mouth –Eating, drinking and smoking in the laboratory –Mouth pipetting –Transfer of micro-organisms to mouth by contaminated fingers or articles Skin –Skin puncture by needle or other sharp –Bites and scratches by animals –Cuts, scratches Conjunctivae –Splashes of infectious material into the eye –Transfer to eye by contaminated fingers or articles Lungs –Inhalation of airbourne organisms

47. Imperial College SafetyPage 47 The work process and equipment What is the best way to do the research e.g. aerosol exposure of mice v. intranasal application Are you using/ making only what you need? (volumes/ titres/ concentrations) Can you change the work process/ technique so that even less is required? Are you using the right tool Design and use appropriate work processes, systems and engineering controls and use suitable work equipment and materials

48. Imperial College SafetyPage 48 Sharps: Percutaneous exposure One example of controlling exposure through appropriate work processes

49. Imperial College SafetyPage 49

50. Imperial College SafetyPage 50 Controlling the risks of percutaneous exposure by controlling the use of sharps Stop the unnecessary use of sharps, for example; –Tissue homogenisation with a sharp needle –Aliquoting of hazardous substance from septum sealed vial –Use of glass pipettes for tissue culture

51. Imperial College SafetyPage 51

52. Imperial College SafetyPage 52

53. Imperial College SafetyPage 53 Where sharps must be used; –Ensure their proper use –Ensure their proper disposal –Ensure that there is an agreed needlestick response –Ensure the risk assessment is carried out Ensure that the policy on the use of sharps in any particular lab is clear Controlling the risks of percutaneous exposure by controlling the use of sharps

54. Imperial College SafetyPage 54

55. Imperial College SafetyPage 55

56. Imperial College SafetyPage 56 COSHH 2nd fundamental principle If PREVENTION is not possible then CONTROL exposure Work practices Engineering controls Suitable work equipment and materials 1 Control exposure at source Use PPE 2

57. Imperial College SafetyPage 57 Aerosols / droplets Splashes and inhalation One example of controlling exposure at source using engineered control measures

58. Imperial College SafetyPage 58 Secondary control measure Primary control measure the worker

59. Imperial College SafetyPage 59

60. Imperial College SafetyPage 60 Microbiological safety cabinets Required for work at CL2 and 3 if the work presents a risk of aerosol exposure Must be correctly selected (type and make) Must be correctly installed Must be correctly used Must be correctly maintained

61. Imperial College SafetyPage 61 USER HEPA filter Class I cabinet

62. Imperial College SafetyPage 62 Class II cabinet USER Exhaust HEPA filter Downflow HEPA filter

63. Imperial College SafetyPage 63 Class III cabinet USER HEPA filter

64. Imperial College SafetyPage 64 MSC 1000 mm Keep pedestrian traffic away from the front of the MSC MSC 300 mm Keep clear of adjacent wall MSC Keep clear of door openings MSC 1500 mm Position clear of bench opposite bench MSC 2000 mm Position well clear of wall opposite Do not have another worker at an adjacent bench MSC bench MSC Allow adequate room for workers at nearby benches bench 300 mm MSC 3000 mm Keep well clear of safety cabinet opposite MSC Siting

65. Imperial College SafetyPage 65 Siting Do not have another worker at an adjacent bench MSC bench MSC Allow adequate room for workers at nearby benches bench 300 mm Siting

66. Imperial College SafetyPage 66 What can a Class II MSC be used for? Changing the media on TB infected cells? Homogenising human tissues Chloroform / methanol extractions of bacterial suspension Aliquoting of 20 ml methanol from a 2.5 litre winchester bottle

67. Imperial College SafetyPage 67 What’s the difference between a fume cupboard and an MSC? MSC is HEPA filtered Fume cupboard has usually no filter MSC may not be spark proof Fume cupboard is Class II MSC recirculates 70% of the air within the work space Fume cupboard is 100% extract

68. Imperial College SafetyPage 68 Advantages and limitations of safety cabinets Vaccinia incident What if this has happened outside of the cabinet? Limitations of open fronted cabinets

69. Imperial College SafetyPage 69 Proper use: before you start work Plan your work thoroughly Put on appropriate PPE Switch on cabinet and remove night door Ensure that cabinet is running correctly – gauge must be in SAFE zone Ensure that cabinet is clean and free of clutter Prepare thoroughly for work. Plastics, reagents, samples must be at hand Have appropriate disinfectant(s) at hand Place work in the cabinet, ensuring that clean and dirty materials are kept separate

70. Imperial College SafetyPage 70 Proper use: whilst at the cabinet Do not overcrowd the cabinet Work only within the constraints placed upon the use of the cabinet e.g. microfuges Know the limitations of the protection afforded by open-fronted cabinets Regularly check that the airflow gauges are in the SAFE zone (For open-fronted cabinets) always work towards the rear of the cabinet (For Class II cabinets) do NOT obstruct the airflow grilles at the front or back of the cabinet Keep other workers out of your non-disturbance zone Do not mix sterile and infected materials Do NOT use a cabinet if its safe operation is in doubt

71. Imperial College SafetyPage 71 Proper use: after completion of the work Check that the airflow gauges are in the SAFE zone Remove samples for incubation, etc after wiping down flasks, etc with appropriate disinfectant Only remove contaminated materials from the cabinet as directed by your Code of Practice Remove all your equipment and waste Wipe all surfaces with disinfectant or fumigate, as appropriate. Use disinfectants in a manner that will not affect the cabinet. (For Class II cabinets) clean thoroughly under the grilles Switch off cabinet and replace night door where local procedures direct

72. Imperial College SafetyPage 72 Training and competence No person should be allowed to work at an MSC unless proper training has been given and the person is competent to do the work Such training should include –Classification of cabinets –Appropriate and inappropriate use of cabinets –Mode of operation and function of all controls and indicators –Limitations of performance –How to work safely at the cabinet –How to decontaminate after use –Principles of airflow and operator protection tests

73. Imperial College SafetyPage 73

74. Imperial College SafetyPage 74

75. Imperial College SafetyPage 75

76. Imperial College SafetyPage 76

77. Human blood and tissues

78. Imperial College SafetyPage 78 Universal precautions All blood and certain other materials must be considered infected, unless known to be otherwise Main infection hazard is HIV, HepB,and HepC

79. Imperial College SafetyPage 79 In the context of universal precautions what is meant by ‘known not to be infected’? You are asked to handle blood taken from all three of these donors Which can you consider to be safe? Workshop exercise

80. Imperial College SafetyPage 80

81. Imperial College SafetyPage 81 Answer None of them They must all be handled the same without other evidence Don’t judge a book by its cover (or the person next to you by the clothes they wear)

82. Imperial College SafetyPage 82 Routes of transmission Percutaneous transmission refers to any transmission by penetration of the skin with needles and other sharps. Mucocutaneous transmission occurs through broken or apparently intact skin or through the mucous membranes of the eyes, nose or mouth.

83. Imperial College SafetyPage 83 What are Universal Precautions Transport samples in robust containers. Use secondary containment. Wear gloves when handling blood Use a safety cabinet if generating aerosols or splashes Do not mouth pipette Minimise use of sharps If sharps are required - use them properly Dispose of waste appropriately Know what to do in the event of an exposure Get HepB vaccination

84. Imperial College SafetyPage 84 Other potentially infectious material Any body fluid containing visible blood Semen Vaginal secretions Cerebrospinal fluid Synovial fluid Pleural fluid Peritoneal fluid Pericardial fluid Amniotic fluid

85. College procedures

86. Imperial College SafetyPage 86 College procedures Pro-forma risk assessments available on Spectrum –DP1 – Deliberate work –DP2 – Unintentional work

87. Imperial College SafetyPage 87

88. Imperial College SafetyPage 88

89. Guidance

90. Imperial College SafetyPage 90 The Health and Safety at Work Act 1974 Primary legislation The Control of Substances Hazardous to Health Regulations 2002 – general and biological agents provisions Genetically Modified Organisms (Contained Use) Regulations 2000 Secondary legislation & approved Codes of Practice Biological agents: Managing the risksInfection risks to new and expectant mothers in the workplace A guide to the Regulations Biotechnology: Health and Safety in education Management, design and operation of microbiological containment laboratories Research animals, including simians Large-scale contained use of biological agents General guidance Clinical laboratories Disposal of clinical waste Blood borne viruses Transmissible spongiform encephalo- pathies Viral haemorrhagic fevers Guidance on containment and control measures Guidance on work with specific agents ACGM Compendium of guidance