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Are We Doing Enough to Protect Our People in the Lab?

Even with proper procedures, lab workers are still at risk for becoming infected. Discover some ways to reduce laboratory-acquired infections below.

Mysterious Illnesses

Two documented cases of laboratory-acquired infections (LAI) have made it into the popular media this year alone, one in Europe and one at the CDC. In both of these cases, workers doing routine work with standard procedures somehow became infected with biological materials they handled and nobody knows how.  

We would all like to think that LAI are quite rare, but they still happen, so the risk is still there for all laboratory workers, both in the clinical and the research setting.

The CDC says that in cases like these two this year, where no needle stick or other infectious incident was noticed, that inhalation of infectious droplets or aerosols are the most likely route of infection1. FACS cell sorters are notorious for generating droplets and aerosols2. Some 3D printers can generate up to 20 billion particles/minute 3. However, often overlooked is the fact that even everyday manual cell or sample handling can also expose laboratory workers to droplets and aerosols 1.

Infectious Droplets and Aerosols are Generated by Manual Cell Processing

Many different routine activities in the cell culture laboratory can generate infectious droplets, even routine cell handling, like pipetting. Any time a film exists between two surfaces that are abruptly separated, such as in uncapping a container, aerosols and tiny droplets can be generated4.  There is one well-documented case of a worker contracting HIV from a droplet of serum that sprayed into the eye while uncapping a vacutainer tube 5.

Droplets fall out of the air onto gloves, sleeves, work surfaces, and the mucous membranes of workers1. Aerosols are more insidious in that they remain airborne and can spread readily through a room to infect others in the lab if there is no protective barrier present. One laboratory worker has been documented as contracting scrub typhus after sonicating a sample of cells infected with it6. These are real dangers to our employees and students.

Common Containment Mechanisms

Biological safety cabinet (BSC) use has been credited with reducing the numbers of LAIs since the 1970’s4. However, since LAIs are still occurring, laboratory workers are still being exposed to infectious droplets and aerosols. BSCs and other containment equipment are often not used properly. It is very common practice for workers to place their arms or pipettes over the front grille of a BSC. This interrupts laminar air flow and introduces particles from the BSC into the room air near the workers’ mucus membranes1. Flow sorter operators, rushing to clear clogged nozzles, often open aerosol containment mechanisms and stick his or her face in to get a look at it before aerosols have been completely evacuated. This creates an obvious risk of infection7.

Complacency

The natural human tendency is to downplay risks when they are constantly present. It is easy for workers to become complacent when they become confident of their daily actions. Even in our nation’s high-containment laboratories, where biosafety is the prime concern, many disturbing gaps have recently been identified by the GAO.

New Techniques, New Unknowns, New Risks

Genetic modification can alter virulence characteristics of pathogens in unanticipated ways1.In this new era of new and powerful gene modification methods such as TALEN, CRISPR, and NgAgo, there are new risks in the cells our people are handling. The technological possibility of gene drives means that the human host genome can be permanently and heritably changed. This is a new risk not only for our people in the lab, but for all of their descendants. Because we really don’t know much about the exposure risks of handling cells modified with these techniques, it is better to be prudent.

Provide Physical Barriers to Infection for Even Routine Work

The use of aerosol containment mechanisms for FACS sorters has become common because they decrease the chance of workers being infected 7. It’s just applying good biosafety practices to use them for every sort.

The use of barrier isolators for routine laboratory work provides an extra layer of protection for laboratory workers doing other types of work that generates infectious aerosols. Just as with the cell sorter, placing a physical barrier between workers and infectious materials during aerosol-generating procedures such as sonication, 3D bioprinting, even routine cell handling steps such as uncapping and pipetting, may likewise reduce the risks of LAIs.

Nobody wants to think that they could have done something else to protect one of their employees or students from a life-altering laboratory-acquired infection. Following these tips to reduce laboratory-acquired infections will help to add another layer of protection for them.

 

1          1. CDC. Biosafety in Microbiological and Biomedical Laboratories. HHS Publications No. (CDC) 21-112 5th Edition (2009).

2          2. Schmid, I. et al. International Society for Analytical Cytology biosafety standard for sorting of unfixed cells. Cytometry. Part A : the journal of the International Society for Analytical Cytology 71, 414-437, doi:10.1002/cyto.a.20390 (2007).

3          3. Stephens, B. A. P. E. O., Z.; Ramos, T. Ultrafine particle emissions from desktop 3D printers. Atmospheric Environment 79 (2016).

4          4. Sewell, D. L. Laboratory-associated infections and biosafety. Clin Microbiol Rev 8, 389-405 (1995).

5          5. Eberle, J., Habermann, J. & Gurtler, L. G. HIV-1 infection transmitted by serum droplets into the eye: a case report. Aids 14, 206-207 (2000).

6          6. Oh, M. et al. Scrub typhus pneumonitis acquired through the respiratory tract in a laboratory worker. Infection29, 54-56 (2001).

7          7. Holmes, K. L. Characterization of aerosols produced by cell sorters and evaluation of containment. Cytometry. Part A : the journal of the International Society for Analytical Cytology 79, 1000-1008, doi:10.1002/cyto.a.21163 (2011).

 


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About The Author

Alicia D Henn, PhD, MBA

Alicia D Henn, PhD, MBA

Chief Scientific Officer of BioSpherix, Ltd

 

 

Alicia Henn has been the Chief Scientific Officer of BioSpherix, Ltd since 2013. Previously, she was a researcher at the Center for Biodefense Immune Modeling in Rochester, NY. Alicia obtained her PhD in molecular pharmacology and cancer therapeutics from Roswell Park Cancer Institute in Buffalo, NY and her MBA from the Simon School at University of Rochester in Rochester, NY.

ahenn@biospherix.com

 

 

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