Journal List > J Bacteriol Virol > v.43(3) > 1034090

Lee, Nam, Shin, Choi, Choi, Kwon, Park, and Jang: A Survey on Laboratory Biosafety Status of Public Healthcare Centers in Korea

Abstract

The purpose of this study was to explore the laboratory biosafety status of Public Health Centers (PHCs) in Korea during Oct.7∼26, 2012. We surveyed the environment of biosafety management, especially for the recognition level for biosafety of workers in the organizations. The questionnaires given out to 98 workers who are working for PHCs are to research the recognition level of workers for the knowledge of biosafety, related laws and regulations. The level was the highest in the Research Institute of the Public Health & Environment (RIPHE) followed by quarantine station, and the health center was assessed as the last. It was turned out that the biosafety educational program in the RIPHE was implemented on a regular basis (65.2%) with irregular cases (21.7%), and some outsourcing chances (8.7%). However, quarantine stations and health centers didn't practice actively biosafety training programs compared to RIPHE. In addition, there was a majority of opinions that the most important thing to improve biosafety level of PHCs is to strengthen current poor training and education system. In conclusion, it is necessary to develop more improved training system for biosafety on exposure risks including injuries, personal protective equipment, and chemical hazards.

REFERENCES

1). Shaw K. The 2003 SARS outbreak and its impact on infection control practices. Public Health. 2006; 120:8–14.
crossref
2). Zhao Z, Zhang F, Xu M, Huang K, Zhong W, Cai W, et al. Description and clinical treatment of an early outbreak of severe acute respiratory syndrome (SARS) in Guangzhou, PR China. J Med Microbiol. 2003; 52:715–20.
crossref
3). Gatherer D. The 2009 H1N1 influenza outbreak in its historical context. J Clin Virol. 2009; 45:174–8.
crossref
4). Tellier R. Aerosol transmission of influenza A virus: a review of new studies. J R Soc Interface. 2009; 6:783–90.
crossref
5). Summary of human infection with highly pathogenic avian influenza A (H5N1) virus reported to WHO, January 2003-March 2009 cluster associated cases. Wkly Epidemiol Rec. 2010; 85:13–20.
6). Pinto VN. Bioterrorism: Health sector alertness. J Nat Sci Biol Med. 2013; 4:24–8.
crossref
7). Inglesby TV, O'Toole T, Henderson DA, Bartlett JG, Ascher MS, Eitzen E, et al. Anthrax as a biological weapon, 2002: updated recommendations for management. JAMA. 2002; 287:2236–52.
8). Henderson DA, Inglesby TV, Bartlett JG, Ascher MS, Eitzen E, Jahrling PB, et al. Smallpox as a biological weapon: medical and public health management. Working Group on Civilian Biodefense. JAMA. 1999; 281:2127–37.
9). Jank B, Gaugitsch H. Decision making under the Cartagena Protocol on Biosafety. Trends Biotechnol. 2001; 19:194–7.
crossref
10). Lee JY, Eun SJ, Park KD, Kim JK, Im JS, Hwang YS, et al. Biosafety of microbiological laboratories in Korea. J Prev Med Public Health. 2005; 38:449–56.
11). Martini GA, Schmidt HA. Spermatogenic transmission of the “Marburg virus”. Klin Wochenschr. 1968; 46:398–400.
12). Oliphant JW, Parker RR. Q fever: Three cases of laboratory infection. Public Health Rep. 1948; 63:1364–70.
crossref
13). Beeman EA. Q fever; An epidemiological note. Public Health Rep. 1950; 65:88–92.
crossref
14). Holmes GP, Hilliard JK, Klontz KC, Rupert AH, Schindler CM, Parrish E, et al. B virus (Herpesvirus simiae) infection in humans: epidemiologic investigation of a cluster. Ann Intern Med. 1990; 112:833–9.
crossref
15). Barton Behravesh C, Mody RK, Jungk J, Gaul L, Redd JT, Chen S, et al. 2008 outbreak of Salmonella Saintpaul infections associated with raw produce. N Engl J Med. 2011; 364:918–27.
crossref
16). Cho A, Seok SH. Ethical Guidelines for Use of Experimental Animals in Biomedical Research. J Bacteriol Virol. 2013; 43:18–26.
crossref
17). Barkham TM. Laboratory safety aspects of SARS at Biosafety Level 2. Ann Acad Med Singapore. 2004; 33:252–6.
18). Lim W, Ng KC, Tsang DN. Laboratory containment of SARS virus. Ann Acad Med Singapore. 2006; 35:354–60.
19). MacNeil A, Reynolds MG, Damon IK. Risks associated with vaccinia virus in the laboratory. Virology. 2009; 385:1–4.
crossref
20). Chong PY, Chui P, Ling AE, Franks TJ, Tai DY, Leo YS, et al. Analysis of deaths during the severe acute respiratory syndrome (SARS) epidemic in Singapore: challenges in determining a SARS diagnosis. Arch Pathol Lab Med. 2004; 128:195–204.
crossref
21). Koh D, Sng J. Lessons from the past: perspectives on severe acute respiratory syndrome. Asia Pac J Public Health. 2010; 22:132S–6S.
crossref
22). Orellana C. Laboratory-acquired SARS raises worries on biosafety. Lancet Infect Dis. 2004; 4:64.
crossref
23). Jiang TJ, Zhou XZ, Zhao M, Zhou ZP, Jiang SC, Ye WH, et al. Analysis of severe acute respiratory syndrome in Beijing. Zhonghua Nei Ke Za Zhi. 2003; 42:369–72.
24). Lee HW, Johnson KM. Laboratory-acquired infections with hantaan virus, the etiologic agent of Korean hemorrhagic fever. J Infec Dis. 1982; 146:645–51.
crossref
25). Kim JS, Lee HW. Studies on microbiololgical laboratory biosafety a survey on biosafety status in laboratory department of training. Report NIH Korea. 1986; 23:139–60.
26). Cho SH, Ju YS, Kang D, KiM S, Kim IS, Hong ST. Laboratory-acquired infection with hantavirus at a research unit of medical school in Seoul, 1996. Korean J Prev Med. 1999; 32:269–75.
27). U.S. Department of Health & Human Services, Center for Disease Control and Prevention, National Institutes of Health. Biosafety in Microbiological and Biomedical Laboratories (BMBL). 5th ed.Washington D.C.: CDC/NIH;2009. Available from: URL:. http://www.cdc.gov/biosafety/publications/bmbl5/BMBL.pdf.
28). World Health Organization. Laboratory biosafety manual. 3rd ed.Geneva: World Health Organization;2004. Available from: URL:. http://www.who.int/csr/resources/publications/biosafety/Biosafety7.pdf.
29). Hui Z, Jian-Shi H, Xiong H, Peng L, Da-Long Q. An analysis of the current status of hospital emergency preparedness for infectious disease outbreaks in Beijing, China. Am J Infect Control. 2007; 35:62–7.
30). Salman MD. Controlling emerging diseases in the 21st century. Prev Vet Med. 2004; 62:177–84.
crossref
31). Lau JT, Yang X, Leung PC, Chan L, Wong E, Fong C, et al. SARS in three categories of hospital workers, Hong Kong. Emerg Infect Dis. 2004; 10:1399–404.
crossref

Figure 1.
The routine inspection and disinfection check of the Laboratory equipment (N=98, %). The survey result on the routine inspection and disinfection check of the laboratory equipment. This research builds on previous study.
jbv-43-217f1.tif
Figure 2.
Holding the Personal protective Equipment, 2005 (N=98, %) (10). Filed bars represent the rate of holding the personal protective equipment in 2005, respectively.
jbv-43-217f2.tif
Figure 3.
The rate of use of Personal protective Equipment, 2012 (N=98, %). Filed bars represent the rate of use of personal protective equipment in 2012, respectively.
jbv-43-217f3.tif
Figure 4.
Requirements for strengthen the laboratory biosafety level (N=98, %). The survey result showed that requirements for strengthen the laboratory biosafety
jbv-43-217f4.tif
Table 1.
Biosafety level, BL (28)
Risk level Biosafety level Laboratory practices Safety equipment
1 BL1 Basic laboratory Open bench
2 BL2 BL1 + Protective clothing, Biohazard Sign Open bench + BSCa
3 BL3 BL2 + Special clothing, Controlled access, Directional airflow BSC + and/or other primary devices for all actives
4 BL4 BL3 + Air lock, Shower exit, Special Waste disposal Class III BSC, positive pressure suits, double-ended autoclave, filtered air

a BSC: Biological safety cabinet

Table 2.
The biosafety items used for estimating biosafety awareness
Categories Items
Required Biosafety level Risk group of pathogen (Bacteria, Virus, clinical specimen, etc)
Biosafety level: BL1, 2, 3
Infectious agents Culture, Diagnostics, Storage, Transportation.
Biosafety management of laboratory Biosafety committee, Biosafety officer
Risk assessment
Biosafety basic rules Responsibility for laboratory biosafety
Biosafety, Biosecurity, Facility, Equipment, PPEa, Risk, HDPsb
Equipment for biosafety Required equipment for biosafety
Appropriately used equipment
Personal protective equipment PPE-Research Requirements
Sufficient supplies of PPE
Availability and condition of lab equipment
Biosafety training Related laws and regulations
BL3 facility (Design/Management/Equipment/PPE/HDPs)
Improving laboratory biosafety Facility, Equipment, Biosafety management system, Provision of Safety Training

a PPE: Personal protective equipment

b HDPs: Highly dangerous pathogens

Table 3.
The general characteristics of the survey respondents
General characteristics Total RIPHE Quarantine station Health centers
Affiliation RIPHE 23 (23.5) 23 (100) 0 0
Quarantine station 17 (17.4) 0 17 (100) 0
Health centers 58 (9.2) 0 0 58 (100)
Position Administrator 0 0 0 0
Researcher 23 (23.5) 13 (56.5) 2 (11.8) 8 (13.8)
Principle investigator 2 (2.0) 0 0 2 (3.4)
Biosafety officer 16 (16.3) 10 (43.5) 4 (23.5) 2 (3.4)
Biosafety responsible official 3 (3.1) 0 1 (5.9) 2 (3.4)
Safety manager 1 (1.0) 0 0 1 (1.7)
Department manager 1 (1.0) 0 0 1 (1.7)
Chief 0 0 0 0
Other 52 (53.1) 0 10 (58.9) 42 (72.4)
Work period Up to one year 5 (5.1) 1 (4.3) 2 (11.8) 2 (3.4)
1∼3 years 7 (7.14) 2 (8.7) 1 (5.9) 4 (6.9)
3∼5 years 7 (7.14) 1 (4.3) 2 (11.8) 4 (6.9)
5∼10 years 16 (16.3) 4 (17.4) 4 (23.5) 8 (13.8)
More than 10 years 63 (64.3) 15 (65.2) 8 (47.1) 40 (69.0)
Purpose of Laboratory Diagnosis 76 (77.6) 22 (95.7) 9 (52.9) 45 (77.6)
Investigation 1 (1.2) 1 (1.2) 1 (5.9) 0
Research 0 0 0 0
Surveillance 10 (10.2) 1 (4.3) 6 (35.3) 3 (5.2)
Other 11 (11.2) 0 1 (5.9) 10 (17.2)

a RIPHE: Research institute of the public health & environment

Table 4.
Biosafety Management of public healthcare centers [Total n=98, n (%)]
Categories Yes No Don't know
Biosafety organization (Biosafety committee, Biosafety officer) 42 (42.9) 36 (36.7) 20 (20.4)
Healthcare providers 34 (34.7) 45 (45.9) 19 (19.4)
Obtaining baseline serum 26 (26.5) 65 (66.3) 7 (7.1)
Medical checkup 66 (67.4) 26 (26.5) 6 (6.1)
Immunization of staff 37 (37.8) 54 (55.1) 7 (7.1)
Standard operating procedure 36 (36.7) 45 (45.9) 17 (17.4)
Biological risk assessment 22 (22.5) 61 (62.2) 15 (15.3)
Training in emergency response procedures 78 (79.6) 15 (15.3) 5 (5.1)
Separate building or facility 64 (65.3) 28 (28.6) 6 (6.1)
Laboratory biosafety manual 56 (57.1) 32 (32.7) 10 (10.2)
Attach the name and number of responsible person 39 (39.8) 54 (55.1) 5 (5.1)
Emergency contact point 58 (59.2) 34 (34.7) 6 (6.1)
Biohazard warning symbol and sign 55 (56.1) 39 (39.8) 4 (4.1)
First aid kit, Spill kit 44 (44.9) 51 (52.0) 3 (3.1)
Poster for laboratory biosafety rule 41 (41.8) 53 (54.1) 4 (4.1)
Written protocols or SOP or operations manuals 41 (41.8) 50 (51.0) 7 (7.1)
Biosafety manual defining any needed waste contamination 53 (54.1) 39 (39.8) 6 (6.1)
Table 5.
An awareness and compliance of biosafety in Laboratories (N=98, %)
Item Awareness Compliance
Know Don't know Compliance Sometimes Non-compliance
Limited access 94 (95.9) 4 (4.08) 65 (66.3) 28 (28.6) 5 (5.1)
Minimize the creation of aerosols 84 (85.7) 14 (14.3) 61 (62.2) 27 (27.6) 10 (10.2)
Do not pipette by mouth 84 (85.7) 14 (14.3) 79 (80.6) 17 (17.4) 2 (2.0)
Using the dedicated waste container 93 (94.9) 5 (5.1) 88 (89.8) 9 (9.2) 1 (1.0)
Using sterilization tape for autoclave 87 (88.8) 11 (11.2) 73 (74.5) 16 (16.3) 9 (9.2)
Using a biological indicator for operation of the autoclave 69 (70.4) 29 (29.6) 49 (50.0) 21 (21.4) 28 (28.6)
Wash hands after using any substances hazardous to health, on leaving the laboratory 97 (99) 1 (1.0) 93 (94.9) 5 (5.1) 0
Do not eat, drink or smoke in the laboratory under any circumstances 96 (98) 2 (2.0) 79 (80.6) 19 (19.4) 0
TOOLS
Similar articles