Health and medical surveillance监督
The employing authority,through the
laboratory director,is responsible for
ensuring that there is adequate surveillance
of the health of laboratory personnel,The
objective of such surveillance is to monitor
for occupationally acquired diseases,
Appropriate activities to achieve these
objectives are:
1,Provision of active or passive
immunization where indicated
2,Facilitation of the early detection of
laboratory-acquired infections
3,Exclusion of highly susceptible
individuals (e.g,pregnant women or
immuno- compromised individuals) from
highly hazardous laboratory work
4,Provision of effective personal protective
equipment and procedures.
Guidelines for the surveillance of
laboratory workers handling
microorganisms at Biosafety Level 1
Historical evidence indicates that the
microorganisms handled at this level are
unlikely to cause human disease or animal
disease of veterinary兽医 的 importance,
Ideally,however,all laboratory workers
should undergo a pre-employment health
check at which their medical history is
recorded,Prompt reporting of illnesses or
laboratory accidents is desirable and all staff
members should be made aware of the
importance of maintaining GMT.
Guidelines for the surveillance of
laboratory workers handling
microorganisms at Biosafety Level 2
1,A pre-employment or preplacement
health check is necessary,The person’s
medical history should be recorded and a
targeted occupational health assessment
performed.
2,Records of illness and absence should be
kept by the laboratory management.
3,Women of childbearing age should be
made aware of the risk to an unborn child
of occupational exposure to certain
microorganisms,e.g,rubella风疹 virus,The
precise steps taken to protect the fetus will
vary,depending on the microorganisms to
which the women may be exposed.
Training
Human error and poor technique can
compromise the best of safeguards to
protect the laboratory worker,Thus,a
safety-conscious staff,well informed about
the recognition and control of laboratory
hazards,is key to the prevention of
laboratory-acquired infections,incidents
and accidents,For this reason,continuous
in-service training in safety measures is
essential,
An effective safety programme begins with the
laboratory managers,who should ensure that safe
laboratory practices and procedures are integrated
into the basic training of employees,Training in
safety measures should be an integral part of new
employees’ introduction to the laboratory,
Employees should be introduced to the code of
practice and to local guidelines,including the
safety or operations manual,Measures to assure
that employees have read and understood the
guidelines,such as signature pages,should be
adopted,Laboratory supervisors play the key
role in training their immediate staff in good
laboratory techniques,The biosafety officer can
assist in training and with the development of
training aids and documentation.
Staff training should always include
information on safe methods for highly
hazardous procedures that are commonly
encountered by all laboratory personnel and
which involve:
1,Inhalation risks (i.e,aerosol production)
when using loops,streaking划线 agar plates,
pipetting,making smears涂片,opening
cultures,taking blood/serum血清 samples,
centrifuging,etc.
2,Ingestion risks when handling specimens,
smears涂片 and cultures
3,Risks of percutaneous皮肤 exposures
when using syringes and needles
4,Bites and scratches when handling
animals
5,Handling of blood and other potentially
hazardous pathological materials
6,Decontamination and disposal of
infectious material.
Waste handling
Waste is anything that is to be discarded:
In laboratories,decontamination of wastes and
their ultimate disposal are closely interrelated,
In terms of daily use,few if any contaminated
materials will require actual removal from the
laboratory or destruction,Most glassware,
instruments and laboratory clothing will be
reused or recycled,The overriding principle is
that all infectious materials should be
decontaminated,autoclaved or incinerated
within the laboratory.
The principal questions to be asked before
discharge of any objects or materials from
laboratories that deal with potentially
infectious microorganisms or animal tissues
are:
1,Have the objects or materials been
effectively decontaminated or disinfected
by an approved procedure?
2,If not,have they been packaged in an
approved manner for immediate on-site
incineration or transfer to another facility
with incineration capacity?
3,Does the disposal of the decontaminated
objects or materials involve any additional
potential hazards,biological or otherwise,
to those who carry out the immediate
disposal procedures or who might come
into contact with discarded items outside
the facility?
Decontamination
Steam autoclaving is the preferred method
for all decontamination processes,
Materials for decontamination and disposal
should be placed in containers,e.g,
autoclavable plastic bags,that are colour-
coded according to whether the contents
are to be autoclaved and/or incinerated,
Alternative methods may be envisaged only
if they remove and/or kill microorganisms.
Handling and disposal procedures for
contaminated materials and wastes,
An identification and separation system for
infectious materials and their containers
should be adopted,National and
international regulations must be followed,
Categories should include:
1,Non-contaminated (non-infectious) waste
that can be reused or recycled or disposed
of as general,“household” waste
2,Contaminated (infectious),sharps” –
hypodermic needles,scalpels解剖刀,knives
and broken glass; these should always be
collected in puncture-proof containers
fitted with covers and treated as infectious
3,Contaminated material for
decontamination by autoclaving and
thereafter washing and reuse or recycling
4,Contaminated material for autoclaving
and disposal
5,Contaminated material for direct
incineration.
Sharps
After use,hypodermic needles should not
be recapped,clipped剪下 or removed from
disposable syringes,The complete assembly
should be placed in a sharps disposal
container,Disposable syringes,used alone
or with needles,should be placed in sharps
disposal containers and incinerated,with
prior autoclaving if required.
Sharps disposal containers must be
puncture-proof/-resistant and must not be
filled to capacity,When they are three-
quarters full they should be placed in
“infectious waste” containers and
incinerated,with prior autoclaving if
laboratory practice requires it,Sharps
disposal containers must not be discarded
in landfills垃圾,
Contaminated (potentially infectious)
materials for autoclaving and reuse:
No precleaning should be attempted of any
contaminated (potentially infectious)
materials to be autoclaved and reused,Any
necessary cleaning or repair must be done
only after autoclaving or disinfection.
Contaminated (potentially infectious)
materials for disposal:
Apart from sharps,which are dealt with
above,all contaminated (potentially
infectious) materials should be autoclaved
in leakproof containers,e.g,autoclavable,
colour-coded plastic bags,before disposal,
After autoclaving,the material may be
placed in transfer containers for transport
to the incinerator,
If possible,materials deriving from healthcare
activities should not be discarded in landfills even
after decontamination,If an incinerator is
available on the laboratory site,autoclaving may
be omitted,the contaminated waste should be
placed in designated containers (e.g,colour-coded
bags) and transported directly to the incinerator,
Reusable transfer containers should be leakproof
and have tight-fitting covers,They should be
disinfected and cleaned before they are returned
to the laboratory for further use.
Discard containers,pans or jars,preferably
unbreakable (e.g,plastic),should be placed at
every work station,When disinfectants are
used,waste materials should remain in
intimate contact with the disinfectant (i.e,not
protected by air bubbles) for the appropriate
time,according to the disinfectant used,
The discard containers should be
decontaminated and washed before reuse.
Incineration烧灼 of contaminated waste
must meet with the approval of the public
health and air pollution authorities,as well
as that of the laboratory biosafety officer.
Chemical,fire,electrical,radiation and
equipment safety:
A breakdown in the containment of pathogenic
organisms may be the indirect result of chemical,
fire,electrical or radiation accidents,It is
therefore essential to maintain high standards of
safety in these fields in any microbiological
laboratory,Statutory法令的 rules and regulations
for each of these will normally be laid down by
the competent national or local authority,whose
assistance should be sought if necessary,
The employing authority,through the
laboratory director,is responsible for
ensuring that there is adequate surveillance
of the health of laboratory personnel,The
objective of such surveillance is to monitor
for occupationally acquired diseases,
Appropriate activities to achieve these
objectives are:
1,Provision of active or passive
immunization where indicated
2,Facilitation of the early detection of
laboratory-acquired infections
3,Exclusion of highly susceptible
individuals (e.g,pregnant women or
immuno- compromised individuals) from
highly hazardous laboratory work
4,Provision of effective personal protective
equipment and procedures.
Guidelines for the surveillance of
laboratory workers handling
microorganisms at Biosafety Level 1
Historical evidence indicates that the
microorganisms handled at this level are
unlikely to cause human disease or animal
disease of veterinary兽医 的 importance,
Ideally,however,all laboratory workers
should undergo a pre-employment health
check at which their medical history is
recorded,Prompt reporting of illnesses or
laboratory accidents is desirable and all staff
members should be made aware of the
importance of maintaining GMT.
Guidelines for the surveillance of
laboratory workers handling
microorganisms at Biosafety Level 2
1,A pre-employment or preplacement
health check is necessary,The person’s
medical history should be recorded and a
targeted occupational health assessment
performed.
2,Records of illness and absence should be
kept by the laboratory management.
3,Women of childbearing age should be
made aware of the risk to an unborn child
of occupational exposure to certain
microorganisms,e.g,rubella风疹 virus,The
precise steps taken to protect the fetus will
vary,depending on the microorganisms to
which the women may be exposed.
Training
Human error and poor technique can
compromise the best of safeguards to
protect the laboratory worker,Thus,a
safety-conscious staff,well informed about
the recognition and control of laboratory
hazards,is key to the prevention of
laboratory-acquired infections,incidents
and accidents,For this reason,continuous
in-service training in safety measures is
essential,
An effective safety programme begins with the
laboratory managers,who should ensure that safe
laboratory practices and procedures are integrated
into the basic training of employees,Training in
safety measures should be an integral part of new
employees’ introduction to the laboratory,
Employees should be introduced to the code of
practice and to local guidelines,including the
safety or operations manual,Measures to assure
that employees have read and understood the
guidelines,such as signature pages,should be
adopted,Laboratory supervisors play the key
role in training their immediate staff in good
laboratory techniques,The biosafety officer can
assist in training and with the development of
training aids and documentation.
Staff training should always include
information on safe methods for highly
hazardous procedures that are commonly
encountered by all laboratory personnel and
which involve:
1,Inhalation risks (i.e,aerosol production)
when using loops,streaking划线 agar plates,
pipetting,making smears涂片,opening
cultures,taking blood/serum血清 samples,
centrifuging,etc.
2,Ingestion risks when handling specimens,
smears涂片 and cultures
3,Risks of percutaneous皮肤 exposures
when using syringes and needles
4,Bites and scratches when handling
animals
5,Handling of blood and other potentially
hazardous pathological materials
6,Decontamination and disposal of
infectious material.
Waste handling
Waste is anything that is to be discarded:
In laboratories,decontamination of wastes and
their ultimate disposal are closely interrelated,
In terms of daily use,few if any contaminated
materials will require actual removal from the
laboratory or destruction,Most glassware,
instruments and laboratory clothing will be
reused or recycled,The overriding principle is
that all infectious materials should be
decontaminated,autoclaved or incinerated
within the laboratory.
The principal questions to be asked before
discharge of any objects or materials from
laboratories that deal with potentially
infectious microorganisms or animal tissues
are:
1,Have the objects or materials been
effectively decontaminated or disinfected
by an approved procedure?
2,If not,have they been packaged in an
approved manner for immediate on-site
incineration or transfer to another facility
with incineration capacity?
3,Does the disposal of the decontaminated
objects or materials involve any additional
potential hazards,biological or otherwise,
to those who carry out the immediate
disposal procedures or who might come
into contact with discarded items outside
the facility?
Decontamination
Steam autoclaving is the preferred method
for all decontamination processes,
Materials for decontamination and disposal
should be placed in containers,e.g,
autoclavable plastic bags,that are colour-
coded according to whether the contents
are to be autoclaved and/or incinerated,
Alternative methods may be envisaged only
if they remove and/or kill microorganisms.
Handling and disposal procedures for
contaminated materials and wastes,
An identification and separation system for
infectious materials and their containers
should be adopted,National and
international regulations must be followed,
Categories should include:
1,Non-contaminated (non-infectious) waste
that can be reused or recycled or disposed
of as general,“household” waste
2,Contaminated (infectious),sharps” –
hypodermic needles,scalpels解剖刀,knives
and broken glass; these should always be
collected in puncture-proof containers
fitted with covers and treated as infectious
3,Contaminated material for
decontamination by autoclaving and
thereafter washing and reuse or recycling
4,Contaminated material for autoclaving
and disposal
5,Contaminated material for direct
incineration.
Sharps
After use,hypodermic needles should not
be recapped,clipped剪下 or removed from
disposable syringes,The complete assembly
should be placed in a sharps disposal
container,Disposable syringes,used alone
or with needles,should be placed in sharps
disposal containers and incinerated,with
prior autoclaving if required.
Sharps disposal containers must be
puncture-proof/-resistant and must not be
filled to capacity,When they are three-
quarters full they should be placed in
“infectious waste” containers and
incinerated,with prior autoclaving if
laboratory practice requires it,Sharps
disposal containers must not be discarded
in landfills垃圾,
Contaminated (potentially infectious)
materials for autoclaving and reuse:
No precleaning should be attempted of any
contaminated (potentially infectious)
materials to be autoclaved and reused,Any
necessary cleaning or repair must be done
only after autoclaving or disinfection.
Contaminated (potentially infectious)
materials for disposal:
Apart from sharps,which are dealt with
above,all contaminated (potentially
infectious) materials should be autoclaved
in leakproof containers,e.g,autoclavable,
colour-coded plastic bags,before disposal,
After autoclaving,the material may be
placed in transfer containers for transport
to the incinerator,
If possible,materials deriving from healthcare
activities should not be discarded in landfills even
after decontamination,If an incinerator is
available on the laboratory site,autoclaving may
be omitted,the contaminated waste should be
placed in designated containers (e.g,colour-coded
bags) and transported directly to the incinerator,
Reusable transfer containers should be leakproof
and have tight-fitting covers,They should be
disinfected and cleaned before they are returned
to the laboratory for further use.
Discard containers,pans or jars,preferably
unbreakable (e.g,plastic),should be placed at
every work station,When disinfectants are
used,waste materials should remain in
intimate contact with the disinfectant (i.e,not
protected by air bubbles) for the appropriate
time,according to the disinfectant used,
The discard containers should be
decontaminated and washed before reuse.
Incineration烧灼 of contaminated waste
must meet with the approval of the public
health and air pollution authorities,as well
as that of the laboratory biosafety officer.
Chemical,fire,electrical,radiation and
equipment safety:
A breakdown in the containment of pathogenic
organisms may be the indirect result of chemical,
fire,electrical or radiation accidents,It is
therefore essential to maintain high standards of
safety in these fields in any microbiological
laboratory,Statutory法令的 rules and regulations
for each of these will normally be laid down by
the competent national or local authority,whose
assistance should be sought if necessary,
