CONTROLLING CHEMICAL and BIOHAZARDS ASSOCIATED
WITH BT-WMD
INCIDENTS
Philip G. Hauck, MS, MSHS CIH, SM(NRM)
6/2005
Controlling Microbial Hazards
This presentation will address safety issues associated
with Bioterrorism agents, and how to protect personnel
taking samples in the field and processing samples in the
laboratory.
As part of the overall process of investigation,
environmental samples have to be taken at several
points in the investigation process. Final clearance also
has to be established before a space is reoccupied.
There may be human culture specimens that have come
into the lab for evaluation.
THESE AGENTS ARE PRESUMABLY HOT–
HOW DO WE HANDLE THESE MATERIALS SAFELY?
Risk Assessment
Risks of Exposure to BT Agents:
– Aerosolized Agents
– Sprays / Splatters
– Infected Individuals / animals
– Direct contact with deposited material
– Direct contact with contaminated articles
We can use the Industrial Hygiene Paradigm!!
Source - Pathway - Receiver
We Can select proper PPE
We Can use vaccines, antibiotics
We Can surround and Contain the Hazard
CATEGORY A and B
Bacterial Agents:
• Yersinia pestis
• Bacillus anthracis
• Brucella abortis; B. canis, B.suis
• Burkholderia mallei
• Francisella tularensis
• Chlamidia psittaci
• Coxiella burnetti
Viral Agents:
• Variola major (smallpox)
• Viral hemorrhagic fevers
• Viral encephalitis viruses
• Emerging viruses (Hanta, Nipah, Hendra,
• Hantavirus, SARS)
http://www.bt.cdc.gov/agent/agentlist-category.asp
CATEGORY A and B
Fungal Agents:
• Coccidioides immitis
• Histoplasma capsulatum (NOT ON LIST)
Toxins:
• Anthrax toxin(s)
• Botulinum Toxin
• Tetanus Toxin
• Epsilon Toxin
• Ricin
• Staphylocoocal Enterotoxin B
• Endotoxin (gram negative bacteria)
Water-Borne Agents (CATEGORY B’s):
• Salmonella typhi, Vibrio cholera,
Food-Borne Agents (CATEGORY B’s):
• E. coli toxigenic strains
1. Engineering Controls
The following are engineered devices used to control, or contain and
remove dangerous agents away from the individual handling these
materials.
“ Biological Safety Cabinets (BSCs) are among the most effective and
the most commonly used primary containment devices in laboratories
working with infectious agents.”
BMBL 4th Edition; page 200.
- Class I, II, III BSCs; Class Is have little utility today, IIs
and IIIs are preferred for Biosafety applications
- Class II Type A; Type B1; Type B2; Type B3 (Type A /
B3) BSCs; These are the workhorses of biosafety
- Class III BSC’s; Most protective of all the BSCs
- All use HEPA Filters – the “magic” of BSCs
Biosafety Cabinet Type II A / B3
A. front opening
B. sash
C. exhaust HEPA filter
D. rear plenum
E. supply HEPA filter
F. blower
Source: CDC / Primary Containment for
Biohazards: Selection, Installation and Use
of Biological Safety Cabinets; 2nd Edition
Class II, Type B2 Biological Safety Cabinet
A.
front opening,
B. sash,
C.
exhaust HEPA filter,
D. supply HEPA filter,
E. negative pressure exhaust
plenum,
F. filter screen
Note: The carbon filter in the building
exhaust system is not shown. The cabinet
exhaust needs to be connected to the
building exhaust system.
Class III Biological Safety Cabinet
A. glove ports with O-ring for attaching arm-length gloves to cabinet. B. sash,
C. exhaust HEPA filter, D. supply HEPA filter, E. double - ended autoclave or pass-through
box.
Note: A chemical tank may be installed which would be located beneath the work surface of the BSC with access from
above. The cabinet exhaust needs connection to the building exhaust system.
HEPA Filters and ULPA
Filters are challenged with a
0.3 micron, monodisperse
DioctylPhthalate (DOP)
aerosol, that mimics
particles in the breathable
zone. Note that capture
efficiency is high on both
sides of the curve
Almost all breathable
hazards are eliminated by
BSC use - the HEPA filter
effectively removing
particulates (but not
gases!!)
Source: The Baker Co.
BMBL: Comparison of Biological Safety Cabinets
Face velocity
Type
Class I *
(lfpm)
Airflow Pattern
Radionuclides/
Biosafety
Product
Toxic Chemicals
Level(s)
Protection
75
In at front; out thru rear and top through HEPA filter
No
2,3
No
75
70% recirculated through HEPA; exhaust through HEPA
No
2,3
Yes
100
30% recirculated through HEPA; exhaust
Yes
2,3
Yes
open front
Class II
Type A
Type B1
via HEPA and hard ducted
(Low levels/
volatility)
Type B2
100
No recirculation; total exhaust via HEPA and hard ducted
Yes
2,3
Yes
Type B3
100
Same as IIA, but plena under negative pressure
Yes
2,3
Yes
Yes
3,4
Yes
to room and exhaust air is ducted
Class III
NA
Supply air inlets and exhaust through 2 HEPA filters
*Glove panels may be added and will increase face velocity to 150 lfpm; gloves may be added with an inlet
air pressure release that will allow work with chemicals/radionuclides
Engineering Controls: (continued)
a. Engineered Laboratory Space:
i. Ventilation(Directional, 100% In / 100% Out)
ii. Negative Pressure within Lab Spaces (0.05-0.1” W.G.)**
iii. Safety Interlocks (double-door entry)
iv. Special floor/ wall surfaces
b. Other Safety Devices:
i.
Screw Cap Tubes
ii. Bucket enclosures / rotor enclosures on centrifuges
iii. Pipettors
iv. Vacuum line safety flasks / line filter devices
v. Autoclaves
**1.0 “ W.G. = 250 Pa(scals); range is 12.5 to 25 Pa vacuum inside space
2. Administrative Controls
These are practice-based controls that control hazards through
established activities based on knowledge gained from working
with infectious agents.
a. Standard Laboratory Practices:
i. Direct contact control-“Good Housekeeping” and spill
management
ii. Aerosol control-limiting activities that can generate
aerosols
iii. “Sharps” control
iv. Waste decontamination and disposal
v. Surface disinfection
2. Administrative Controls: ( continued )
b. Vaccinations: there are a limited number of vaccines available
c. The CDC Biological Safety Levels: recommended practices and
equipment (go to: www.cdc.gov/od/ohs; BMBL)
i. BSL 1
ii. BSL 2
iii. BSL 3
iv. BSL 4
d. The NIH Risk Groups: implied practices and equipment
(have to use Appendix G in the NIH Guidelines) *
i. Risk Group 1
ii. Risk Group 2
iii. Risk Group 3
iv. Risk Group 4
*http://www4.od.nih.gov/oba/rac/guidelines/guidelines.html
BMBL Section III
Summary of Recommended Biosafety Levels for Infectious Agents
BSL
Agents
Practices
Safety Equipment
(Primary Barriers)
1
Not known
Standard
None required
to consistently
Microbiological
top sink required
cause disease in
Practices
Facilities
(Secondary Barriers)
Open bench
healthy adults
2
Associated with human
BSL-1 plus:
Primary barriers = Class I or
disease,
practice Limited access
II BSCs or other physical
hazard = percutaneous injury, Biohazard warning signs
containment devices used
ingestion,
"Sharps" precautions
for all manipulations
mucous membrane exposure
Biosafety manual
of agents that cause
defining any needed
splashes or aerosols
waste decontamination
of infectious materials;
or medical surveillance
PPEs: laboratory coats;
policies
gloves; face protection
as needed
BSL-1 plus:
Autoclave available
Summary of Recommended Biosafety Levels for Infectious Agents
BSL
Agents
Practices
Safety Equipment
(Primary Barriers)
3
Facilities
(Secondary Barriers)
Indigenous or exotic agents BSL-2 practice plus:
Primary barriers =
BSL-2 plus:
with potential for aerosol
Controlled access
Class I or II BCSs
Physical separation from
transmission; disease may
Decontamination of all waste or other physical
access corridors Self-closing,
have serious or lethal
Decontamination of lab
containment devices
double-door access
consequences
clothing before laundering
used for all open
Exhausted air not recircul-
Baseline serum
manipulations of agents;
ated Negative airflow into
PPEs: protective lab clothing;
laboratory
gloves; respiratory protection
as needed
4
Dangerous/exotic agents
BSL-3 practices plus:
Primary barriers = All procedures
BSL-3 plus:
which pose high risk of life-
Clothing change before
conducted in Class III BSCs
Separate building or
threatening disease,
entering
or Class I or II BSCs
isolated zone
aerosol-transmitted lab
Shower on exit
in combination with
Dedicated supply and exhaust,
infections; or related agents
All material decontam
full-body, air-supplied,
vacuum, and decon systems
with unknown risk of
-inated on exit from
positive pressure personnel suit
transmission
facility
NIH Guidelines: Basis for the Classification of Biohazardous
Agents by Risk Group (RG)
Risk Group 1
(RG1)
Risk Group 2
(RG2)
Risk Group 3
(RG3)
Risk Group 4
(RG4)
Agents that are not associated with disease in
healthy adult humans
Agents that are associated with human
disease which is rarely serious and for which
preventive or therapeutic interventions are
often available
Agents that are associated with serious or lethal
human disease for which preventive or therapeutic
interventions may be available (high individual risk
but low community risk)
Agents that are likely to cause serious or lethal
human disease for which preventive or therapeutic
interventions are not usually available (high
individual risk and high community risk)
Source: NIH Guidelines: http://www4.od.nih.gov/oba/rdna.htm
APPENDIX B. CLASSIFICATION OF HUMAN ETIOLOGIC AGENTS ON
THE BASIS OF HAZARD
Appendix B-I. Risk Group 1 (RG1) Agents
Appendix B-II. Risk Group 2 (RG2) Agents
Appendix B-II-A. Risk Group 2 (RG2) - Bacterial Agents Including Chlamydia
Appendix B-II-B. Risk Group 2 (RG2) - Fungal Agents
Appendix B-II-C. Risk Group 2 (RG2) - Parasitic Agents
Appendix B-II-D. Risk Group 2 (RG2) - Viruses
Appendix B-III. Risk Group 3 (RG3) Agents
Appendix B-III-A. Risk Group 3 (RG3) - Bacterial Agents Including Rickettsia
Appendix B-III-B. Risk Group 3 (RG3) - Fungal Agents
Appendix B-III-C. Risk Group 3 (RG3) - Parasitic Agents
Appendix B-III-D. Risk Group 3 (RG3) - Viruses and Prions
Appendix B-IV. Risk Group 4 (RG4) Agents
Appendix B-IV-A. Risk Group 4 (RG4) - Bacterial Agents
Appendix B-IV-B. Risk Group 4 (RG4) - Fungal Agents
Appendix B-IV-C. Risk Group 4 (RG4) - Parasitic Agents
Appendix B-IV-D. Risk Group 4 (RG4) - Viral Agents
Appendix B-V. Animal Viral Etiologic Agents in Common Use
Appendix B-V-1. Murine Retroviral Vectors
Emergency Management Issues
( Post-Incident)

If you / your organization is involved in
making a response…..
Who are the players*?
–
Local Incident Command / Emergency Preparedness
Group (IC/EPG) for your Facility (Don’t have one-get one!!)
–
NYPD – 911 (and FDNY if fire/ explosion is involved OCT2900)
–
FBI (NYPD will notify)
–
NYC Health Department – (311) or
788-9830 (days); 764-7667 after-hours
–
NYS Health Department –
518 – 473 – 1730(d); 518-465-9720 (a-h)
–
CDC ( Local and State Health Authorities will call)
What needs to be in place?
– A Written, Response and Emergency Procedure
identifying the “who, how, what, where and
when” of each procedure, in detail, not outline
form. Scope and Limitations of activity must be
defined
– Contact numbers and names of key officials in the
agencies listed above are located in specific areas
for First Responder use.



Key Hospital / Laboratory Officials who will interact with
youry Representatives.
Local NYPD Precinct Commanders / Bioterrorism Liaison
officer(s; EMS; Disaster Response
Names of NYC health officials handling Chemical/
bioterrorism emergencies.
Training in the actual procedures used to initiate and follow
the Response and Emergency Response Plan (RERP).
a. Your staff must know beforehand:
– What constitutes a Chem / BT Incident?
– What degree of response will you participate in?
b. Client Institutional Officials must develop official policies.
– How will cases be recognized? Handled? Who responds?
c. NYC Health Dept. Guidance; NYSDOH, CDC
– What protective equipment will your Health Professionals use in handling /
treating cases?
– What practices for Protective Isolation will be used to quarantine BT-Agent
infected cases from other patients?
d. Safety and Health Personnel have plans developed.
– How will all equipment, instruments, clothing and PPE be decontaminated,
cleaned/discarded, re-used?
– Infection Control, Chemical exposure control; develop policies/procedures.
Have an Incident Command System in place
http://www.osha.gov/SLTC/etools/ics/index.html



Client Organization’s RERP must overlap with your
RERP
re: Who, What, When, and Where; Who is
responsible? In charge? for what? When?Etc.
Clear definition of what is expected, scope of
operations, limitations
IH
IH
Securing An Incident Location
–
–
–
–
–
–
–
–
ACTIVATE
your Facility RERP - Notify Your IC/EPG!
COMMUNICATE with external agency officials*
EVACUATE
the victims from the release area
DECONTAMINATE
the victims (see 5. below!)
VACATE
the incident site and secure it
ISOLATE
the victims; control access to them
EVALUATE
the victims, primary / secondary contacts
ISOLATE
the incident site; seal-off and lock-out
access to the area
– INVESTIGATE
the incident site (Outside Agencies*)
– DECONTAMINATE
the incident site - only if told and when, to
do so!
– DOCUMENT(ate)
all activities, ie. Phone logs, lists
of people on premises, agencies, etc
Collecting / Preserving Evidence
– Protecting Health and Safety of Victims is first!!
– Collecting Personal Clothing and Effects – evidence!!
- agent may be present on these items


Need to contact NYPD at the beginning of the incident-they
have to establish chain-of-custody for collecting and holding
evidence
incident scene = crime scene!
– Try to obtain information about the incident as to
“who; what; when; where” was in the area.

Note: This is probably better left to the NYPD or FBI w/re:
their investigation. You may need to know this information in
order to determine if more than one release / one site is
involved on your premises for decontamination purposes.
– Limit Access to Agency representatives who have to
investigate the victims / incident site
FRP . . . at a glance What is it?



Signed agreement among 27 Federal departments and agencies,
including the American Red Cross, that:
Provides the mechanism for coordinating delivery of Federal
assistance and resources to augment efforts of State and local
governments overwhelmed by a major disaster or emergency




Supports implementation of the Robert T. Stafford Disaster Relief
and Emergency Assistance Act, as amended (42 U.S. Code 5121,
et seq.), as
well as individual agency statutory authorities
Supplements other Federal emergency operations plans
developed to address specific
FRP . . . at a glance

In anticipation of a significant event
likely to result in a need for Federal
assistance

In response to an actual event requiring
Federal assistance under a Presidential
declaration of a major disaster or
emergency
Federal Response Plan
http://www.fema.gov/pdf/rrr/frp/frp2003.pdf
a. FEMA http://www.fema.gov/
b. DofJustice http://www.dhs.gov/dhspublic/
and
http://www.usdoj.gov/jmd/ps/dojepm.htm
c. FBI* http://www.fbi.gov/ (LFA)
d. CDC / USDA www.cdc.gov and www.usda.gov
e. EPA www.epa.gov (clean-up activities, FIFRA)
f. Homeland Security
http://www.dhs.gov/dhspublic/ (LFA)
g. OSHA www.osha.gov
*http://www.fbi.gov/anthrax/amerithraxlinks.htm
State of NY Role:
(Regional Authority)
NYS Police
http://www.troopers.state.ny.us/
b. NYSDoH
http://www.health.state.ny.us/home.htm
l
c. NYS Emergency Management Office
http://www.nysemo.state.ny.us
C. NYC Role:

a. Mayor’s Office
– Office of Emergency Management (OEM)
http://www.nyc.gov/html/fdny/pdf/pr/2004/strategic_plan/
goal_1.pdf
– Department of Health www.nyc.gov/health. Or 311
http://www.nyc.gov/html/doh/pdf/bt/bt-emergencyguideemployers.pdf

c. NYPD - 911

d. FDNY - OCT-2900
Personal Protective Equipment
PPE must protect the following:
–Eyes
–Nose and Mouth
–Respiratory Tract
–Skin
Personal Protective Equipment
PPE is:
–Respiratory Protection
–Eye Protection
(i.e. goggles, glasses, face shields)
–Boots
–“Bunny” and “Moon” Suits
Saranax - coated coveralls + Full enclosure suits
–Gloves
PPE
Know your PPE:
Level A Combination [RG-3,4]:
Airtight / Gastight Totally covering suit with SCBA,
Hoseline or oxygen-generating rebreather.
Level B Combination [RG2,3; +/- 4]:
Chemically resistant suit, with SCBA, Hoseline or
oxygen-generating rebreather. Sometimes PAPR’s
used.
Level C Suit [RG-2,3]:
Chemically resistant suit with an Air Purifying
Respirator(APR), Powered Air Purifying Respirator
(PAPR).
Source: Lab Safety Supply
Source: ILC Dover,Inc.
Respirator Types
Air – Purifying Respirators
Atmosphere – Supplying Respirators
Source: NIOSH
Small Scale Operations
(Room size clean-ups)
Basically we can borrow from available remediation technology.
Who handles respirable particles @ 5 u in length? Asbestos removers!
http://www.ci.nyc.ny.us/html/dep/pdf/asbestos.pdf
Plastic Drapes (6 mil), HEPA (Micro-) traps, Access Enclosures, walk-through
tanks, glove bags, HEPA vacuums - all of these can be adapted to small scale
decontamination procedures.
Personal Protective Equipment must be selected in order to protect users in
the “Hot Zone” or containment area. Usually designed for Particulates…can
protect against aerosols, too!
Disinfectants are available for decontaminating the space - have to know
what is effective as a space disinfectant and what is a surface active
disinfectant. Some common Disinfectants used:
Disinfectants
Paraformaldehyde and water in electric skillets
(aka Formaldehyde)
Vaporized Hydrogen Peroxide
Chlorine Dioxide
Glutaraldehyde
Ethylene Oxide
Sodium Hypochlorite
Fabrication of Containment Structures and
Aerosol Control
External Clean-ups
Basically we can borrow from available remediation technology. The “Occupational
Safety and Health Guidance Manual for Hazardous Waste Activities”
NIOSH/OSHA/USCG/EPA is a good model for setting up a site for remediation:
www.cdc.gov/niosh/85-115.html
–Establish an over-all control of the site with respect to controlling access, operational
activities, site emergencies, clearance criteria and turn-over of the site to owners. The size
of the incident will actually dictate who/which agency has overall control over the site.
–Firmly establish specific boundaries between zones, who is allowed into what zones, under
what conditions and with what training/PPE.
–Know what / How much PPE to have on site.
http://www.bt.cdc.gov/DocumentsApp/Anthrax/Protective/Protective.asp.
–Know what disinfectants to use, and order in sufficient quantity to do the job.
–Establish a clearance level if none of the agencies involved has a clearance
level.
http://www.cdc.gov/ncidod/EID/vol8no10/02-0398.htm
http://www.phppo.cdc.gov/nltn/pdf/LRN99.pdf
Follow-Up Testing
Several Agencies may set a clearance criteria or
value for a given agent:
Follow CDC recommended testing procedures if the agent has
been evaluated by the CDC.
Follow EPA recommended testing procedures if the agent has
been evaluated by the EPA.
Clearance criteria can come from several Gov’t
Agencies.…USDA, OSHA, FEMA, etc.
Laboratory Response Network
http://www.bt.cdc.gov/lrn
http://www.bt.cdc.gov/lrn/pdf/lrn-overview-presentation.pdf
http://www.bt.cdc.gov/lrn/ppt/lrn-overview-presentation.ppt
The CDC and several agencies have developed a Laboratory
Response Network to identify Biological and Chemical agents in
the event of a BT/CT attack.
The websites above detail the interplay between the CDC,
Homeland Security and the EPA.
Laboratory Response Network
Conclusion
By using a combination of engineering controls and administrative
controls, biohazardous agents can be contained safely. Unless
genetically modified, the Risk Group assessments and Biosafety
levels used for the naturally-occurring agent will also work for the
BT-WMD.
Work with biohazardous agents can proceed within a flexible
practice schedule that can be modified to address the hazards and
risks associated with the agent
NIH Risk Groups and CDC BSL’s can be used to perform risk
assessments and establish safe work practices with a given agent
Both Risk Group 4 and BSL-4 Practices are most protective against
unknown agents.