Containment Level 3 BENCHMARKING LABORATORY PRACTICES FOR - - PowerPoint PPT Presentation

Containment Level 3

BENCHMARKING LABORATORY PRACTICES FOR BLOOD-BORNE VIRUSES

Introduction

u

Research scientist turned BSO

u

>15 years experience at CL3 & CL4

u

Primarily government based (APHA, PHE, DSTL)

u

Wrote CL3 Code of Practice for current employer

u

Became unpopular with the CL3 users!

Who are you? And why did you bother us all with your e-mail?

Organisations involved

u

12 Universities

u

1 NHS Trust

u

2 Research Institutes

Benchmarking questions

Engineering and process controls

u

Where does the lab maintain it’s containment barriers?

i.e., decontaminating at front

• f MSC, lids on centrifuge

buckets etc.

u

How does the lab monitor the engineering controls?

i.e., airflows in MSCs, recording room pressures on entry etc.

Waste management and PPE

u

What disinfectant(s) does the lab use?

i.e., Concentration, contact time, in house validations?

u

What waste routes exist in the lab?

i.e., everything autoclaved? Liquid disposed of to drain? u

What is the lab PPE policy?

i.e., double gloves?

Training, competence, and behavioural attributes

u

What lone and out of hours working are in use?

i.e., buddy systems, “man down” alarms, CCTV etc.

u

How does the

• rganisation assess

competence?

i.e., specified number of hours, written competency assessments, supervision, what is considered supervision etc.

Common practices Engineering and process controls

u

Barrier maintained at aperture of open fronted MSCs

u

Lids used on centrifuge buckets & buckets opened within MSC

u

Two organisations validate disinfectant efficacy in house

u

Most organisations monitor airflows in MSCs monthly

Common principles or ways of working shared across

• rganisations

Exact and technical details may vary from organisation to

• rganisation

MSC Monitoring?

How often do you check the inward airflows MSCs used at CL3

u

Every use

u

Weekly

u

Monthly

u

Never

Common practices Waste management and PPE

u

Virkon most widely used disinfectant

u

Most organisations rely on manufacturers instructions and validation

u

Contact times range from 10-30 mins

u

Two organisations don’t have defined contact times for disinfectants

u

~80% organisations use double gloves

u

Approximately half autoclave all waste, and half dispose of liquid to drain following chemical decontamination

Common principles or ways of working shared across

• rganisations

Exact and technical details may vary from organisation to

• rganisation

Waste management

What method is used to render CL3 waste non-infective?

u

Autoclaving everything

u

Solid waste autoclaved/liquid waste chemically inactivated If chemically inactivation is used, what is the disinfectant of choice at CL3?

u

Distel

u

Microsolve

u

Virusolve

u

IMS/EtOH

u

Virkon

u

Other

Common practices Training, competence, and behaviour

u

>90% organisations operate a buddy system to protect lone workers

u

• Approx. 25% use alarms, CCTV, motion

sensors etc. in addition to the buddy

u

Almost all organisations have written competency assessments for working at CL3

u

Almost half also have written assessments at CL2

u

Almost all required >3 months experience at CL2 prior to starting training at CL3

Common principles or ways of working shared across

• rganisations

Exact and technical details may vary from organisation to

• rganisation

Lone working

How do you monitor the safety of lone workers at CL3?

u

Buddy system

u

Buddy system plus alarms/monitors

u

Alarms/monitors

u

No system in place

Unanswered questions and inconsistencies

For discussion

A.

Risk assessment for shut downs when not fumigating labs, particularly when concerning use of open fronted MSCs and cryptic contamination

B.

Variable advice on disposal of chemically inactivated waste to the drain

C.

What are the best ways of getting staff who want to work ‘fast’ in CL3 to buy in to the controls and management processes that ‘slow them down’?

Also if controls differ between employers when staff change jobs

D.

In house validation of disinfectants and the requirement for defined contact times Further points raised

u

Decontamination of porous materials (ie ELISpot plates) for analysis at lower containment

u

Flow cytometry at CL3

u

Can you enforce immunisation on users?

u

Can you use statistical calculation to show decontamination (i.e., repeated dilution or washing)