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Warde Medical Laboratory, Ann Arbor, MI The material in this report originated in the National Center for Emerging and Zoonotic Infectious Diseases, Beth P. Telephone: 678-428-6319; Fax: 770-396-0955; E-mail: [email protected] Summary Prevention of injuries and occupational infections in U. BMBL-5, however, was not designed to address the day-to-day operations of diagnostic laboratories in human and animal medicine.

Michael Miller, Ph D, Microbiology Technical Services, LLC, Dunwoody, GA 30338. CDC and the National Institutes of Health addressed the topic in their publication Biosafety in Microbiological and Biomedical Laboratories, now in its 5th edition (BMBL-5).

Recent MMWR reports (3–11) have indicated that bacteria account for 37 species reported as etiologic agents in LAIs; however, other microbes are often implicated.

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Needle puncture, glass cuts, splash in eye, and bruises and cuts have the highest potential for infection from microbes.

In the hematology laboratory, the major causes of injuries are likely to be exposure to blood and body fluids; needle sticks, aerosols from centrifuge or removal of tube stoppers, tube breakage; or contaminated gloves (22).

In non-microbiology sections of the diagnostic laboratory, the primary mistake may be assuming that a given specimen contains no infectious agents and then working with little attention to risk for infection.

This scenario can be particularly problematic in laboratories developing new technologies, such as molecular and biochemical technologies, and in point-of-care diagnostics performed by staff unaccustomed to testing that requires biosafety considerations and use of barrier techniques such as personal protective equipment. However, there is a dearth of evidence-based research and publications focused on biosafety; particularly missing are studies documenting safe practices in the day-to-day operations of diagnostic laboratories.

In addition, some members of the panel were representatives of the biosafety community.

The Blue Ribbon Panel recommended that biosafety guidelines be developed to address the unique operational needs of the diagnostic laboratory community and that they be science based and made available broadly.

All functions of the human and animal diagnostic laboratory — microbiology, chemistry, hematology, and pathology with autopsy and necropsy guidance — are addressed.

A specific section for veterinary diagnostic laboratories addresses the veterinary issues not shared by other human laboratory departments.

Recommendations for all laboratories include use of Class IIA2 biological safety cabinets that are inspected annually; frequent hand washing; use of appropriate disinfectants, including dilutions of household bleach; dependence on risk assessments for many activities; development of written safety protocols that address the risks of chemicals in the laboratory; the need for negative airflow into the laboratory; areas of the laboratory in which use of gloves is optional or is recommended; and the national need for a central site for surveillance and nonpunitive reporting of laboratory incidents/exposures, injuries, and infections.

This report offers guidance and recommends biosafety practices specifically for human and animal clinical diagnostic laboratories and is intended to supplement the 5th edition of Biosafety in Microbiological and Biomedical Laboratories (BMBL-5), developed by CDC and the National Institutes of Health (1).

Most infected health-care workers acquired infection from needle sticks during preparation of blood smears or while drawing blood.

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