Meeting the Challenges of BSL-2+

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Meeting the Challenges of BSL-2+ When to Use it and How to Adapt it to Your Facility Agenda Introduction What is BSL-2+? Examples Risk Assessment Project Review Process BSL-3 Practices BSL-2 Facility What If Scenarios Case Study Summary Q&A eheinc.com 2 Page 1

Introduction EH&E conducted a survey in 2012 of academic, biotech, and healthcare institutions to gain an understanding of the challenges that institutions face when implementing BSL-2+ The 3 areas rated most challenging were: Determining what projects require BSL-3 practices Ensuring that researchers are properly trained Ensuring that the PI (or his/her designee) develops a project-specific SOP eheinc.com 3 What is BSL-2+? The use of selected BSL-3 practices/procedures in a BSL-2 laboratory facility. It is not: A recognized containment level but may be appropriate for certain research projects. To be used for any Risk Group 3 (RG3) pathogens that are infectious via inhalation. eheinc.com 4 Page 2

How Does One Arrive at BSL-2+? The risk assessment process must drive the decision to use BSL-2+. Engage in discussions with the Principal Investigator (PI). The Institutional Biosafety Committee (IBC) or other safety committee in conjunction with a biosafety officer should review and approve. eheinc.com 5 Examples Lentiviral vector with an oncogene or gene of unknown function HIV research, low titer, small volumes Neisseriameningitidis, i i itidi serogroup B eheinc.com 6 Page 3

Risk Assessment Basic Steps in the Risk Assessment Process: 1. Identify agent hazards and perform an initial assessment of risk: Capability to infect and cause disease in a susceptible human host, severity of disease, and the availability of preventive measures and effective treatments. 2. Identify laboratory procedure hazards: Agent concentration, suspension volume, equipment and procedures that generate small particle aerosols and larger airborne particles (droplets), and use of sharps. eheinc.com 7 Risk Assessment 3. Make a determination of the appropriate biosafety level and select additional precautions indicated by the risk assessment: 4. Evaluate the proficiencies of staff regarding safe practices and the integrity of safety equipment: Training, experience in handling infectious agents, proficiency i in the use of sterile techniques and BSCs, ability to respond to emergencies. 5. Review the risk assessment with a biosafety professional, subject matter expert, and the IBC. eheinc.com 8 Page 4

Risk Assessment The BMBL details the steps involved in the risk assessment process, and states that after determination of the appropriate biosafety level it is important to select additional precautions as idi indicated td by the risk ik assessment. One Size Fits All BSL-2+ is not recommended. eheinc.com 9 Project Review Process 1. Project registration document serves to detail the risk assessment. Project purpose and steps to be conducted with biohazardous material are detailed. 2. PI submits document to BSO. 3. Review and discussion of the project take place with the PI, BSO and perhaps selected members of the IBC (or equivalent). eheinc.com 10 Page 5

Project Review Process 4. Appropriate lab space is identified. 5. PI develops project-specific SOP with BSO s assistance. 6. IBC review and consensus. 7. Risk communication and training are conducted: Lab personnel plus others Written SOP is used as a training tool eheinc.com 11 BSL-3 Practices Are we talking about ALL BSL-3 practices from the BMBL? Not necessarily! Select the BSL-3 practices that enhance the safety of the work. eheinc.com 12 Page 6

BSL-2 Facility Selection of lab is based on many factors: Separation from non-bsl-2+ work Ability to accommodate equipment (BSCs, centrifuge, incubator, etc.) eheinc.com 13 BSL-2 Facility A BSL-2 tissue culture room may be ideal. Provides limited access. Consider nice to have features when renovating or new construction: Anteroom Hands-free sinks eheinc.com 14 Page 7

Example BSL-2+ Lab Layout eheinc.com 15 What If Scenarios What if a BSL-2 project needs to be conducted concurrently in the BSL-2+ lab? Consider: Defaulting to BSL-3 practices for all projects in the lab Training the non-bsl-2+ project staff eheinc.com 16 Page 8

What If Scenarios What if the BSL-2+ project occurs infrequently and lab space is at a premium? Consider: Signage, BSL-2+ to BSL-2 and vice versa SOP detailing switch Decontamination ti eheinc.com 17 Case Study Background on Agent Neisseria meningitidis, serogroup B strain No vaccine available Infectious dose unknown Infectious via injection, ingestion and droplet exposure to mucous membranes Risk Group 2 agent April 2012 death in California of a lab worker How did the Lab-Acquired Infection occur? eheinc.com 18 Page 9

Case Study Project Review PI proposes work with Neisseria meningitidis, serogroup B. BSL-3 practices in a BSL-2 lab was consensus of PI, BSO and IBC. Occupational Medicine provided input. eheinc.com 19 Case Study BSL-2 Facility Small BSL-2 room: Dedicated to BSL-2+ work, no other projects Keycard access for those registered on project, BSO/EHS Sink for hand washing 2 BSCs, incubator, tabletop centrifuge Phone and fax machine Hooks at door for disposable lab coats -80 C freezer in equipment room adjacent to lab eheinc.com 20 Page 10

Case Study Practices & Procedures BSL-2+ Laboratory Manager appointed by PI PPE Solid front disposable gown with cuffed sleeves Disposable gloves, double gloving when feasible Safety glasses Plastic! No glass! No sharps! Ready-Mix Bleach product and 70% ethanol Waste is autoclaved, no regular trash containers! SOP and emergency info on door, used for training In the Lab training conducted by the BSO eheinc.com 21 Summary BSL-2+ is a viable option for research projects that require enhanced practices and procedures for safe work. The risk assessment process is key to establishing BSL-2+. Select the BSL-3 practices and procedures that t enhance the safety of the project. eheinc.com 22 Page 11

Questions & Answers Betsy Gilman Duane bgduane@eheinc.com 800-825-5343 For more information: http://www.eheinc.com/strat _ biosafety.htm Page 12