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Any of these workers who have chronic medical conditions or receive immunosuppressive therapy would be at increased risk for a laboratory-acquired infection (LAI) after a laboratory exposure.
Precise risk for infection after exposure is unknown because determining the source or the mode of transmission often is difficult. LAIs and exposures have been reported since early in the 20th century, but only in the 1970s were sufficient data available to attempt quantitative assessments of risk.
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.
Hepatitis B has been the most frequent laboratory-acquired viral infection, with a rate of 3.5–4.6 cases per 1000 workers, which is two to four times that of the general population.
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).
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.
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).
Members of the panel were either selected by the invited national laboratory organization they represented or were invited by CDC because of their roles in biosafety at the national level.
The organizations participating in the panel represented the majority of laboratory technologists in the United States.
This culture of safety is also supported by the Clinical and Laboratory Standards Institute (2). Bureau of Labor Statistics, in 2008, approximately 328,000 medical laboratory technicians and technologists worked in human diagnostic laboratories in the United States.
Work in a diagnostic laboratory entails safety considerations beyond the biological component; therefore, these guidelines also address a few of the more important day-to-day safety issues that affect laboratorians in settings where biological safety is a major focus. An estimated 500,000 persons in all professions work in human and animal diagnostic laboratories.