Unit Biological Safety, CRISP, FHML, MUMC
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1 Introduction
This work instruction is based on the Health and Safety decree. Certainly pathogenic micro organisms (PMO) like for instance the Epstein Barr virus, and cell lines that contain PMO, like Hela cells (humane papilloma virus) can cause disease for man and animal. In the Arbo decree the PMO’s are classified in risk category 1 to 5, in which 1 is the lowest risk category.. The suppliers of the cell lines use the same classification, depending on the PMO in the cells. If the cell lines have been extracted from primary human or animal cells the risk classification can be gathered from the tissue of the cells, f.i human liver cells can be contaminated with the hepatitis virus, human white blood cells with HIV. Through the catalogue of DSMZ (www.dsmz.de) one can find out on which PMO various cell lines have been tested. With the aid of commercially attainable gear cells can be tested for contaminations.
( http://www.Qiagen.com/products/assays/pathogenendetection/default.aspx
)
Apart from this work instruction there is a secondary document with back ground information about the risks of working with PMO and cell lines. The forms that go with this instruction have been included on the Bio Safety website under Forms.
2 Orders, risk analysis, storage and internal transport
When ordering or when purchases from a third party, ask for a safety sheet, or at least for the risk classification. If the risk classification is unknown one should work according to the instruction for risk class 2 (see next)
Hand in a if your order Risk Assessment system requires you to. (organisms or cells of risk class 3 or 4)
Store the delivered products in a closed storage supply
Register the delivered goods in such a way that is apprehensible for in- and external inspectors.
Move samples internally conforming the Work Instruction Transport
3 Risk classification 1 organisms or cell lines
With these activities follow the Work Instruction Laboratory and take the following additional hygienic measures:
wear a closed lab coat, that will stay behind in the lab
Make sure the lab coat is autoclaved before washing when the coat has been contaminated with PMO or cell lines.
Use approved by EN 374 (symbol for bio hazard) gloves if your skin is not intact
Prevent dust- and aerosol forming, f.i. with freeze dried samples or pipetting
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Unit Biological Safety, CRISP, FHML, MUMC
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Disinfect the work surface and materials that leave the room with an appropriate disinfectant, f.i. 70% ethanol. See: Work Instruction Disinfection
At the end of the activities be sure to wash your hands with water and soap or disinfect with a permitted. Hand alcohol. See: Work Instruction Disinfection
Transport micro organism contaminated materials in the barrel for biological waste. Transport needles through special, yellow needle containers.
Work with spore-forming organisms, f.i. Clostridium Bacillus bacteria or fungus, in a microbiological safety cabinet type II (MVK)
4 Risk classification 2 micro organisms or cell lines
Make a work place Risk Assessment instruction card in accordance with the model in attachment 1. If needed ask the BVF for help. Adjust the Risk
Assessment if there are any changes in the activities.
Work in accordance with the instructions from paragraph 1 and 2 and the measures in the and work space Risk Assessment instruction card
Work with micro organisms that are resistant to certain antibiotics must be done in a MVK
Disintegrate with a sonificator that has been placed in a fume hood or microbiological safety cabinet
Internal transport of the PMO must take place in a closed, shatterproof and leak proof container
External transport of stems must be done in triple containment packaging and must be provided with labeling in accordance with the Transport procedure (see procedure Transport)
Report the use of antibiotics, immune suppressive medication like prednisone, skin disease and (wanted) pregnancy to the company doctor
When pregnant follow the dedicated procedure: for activities with PMO this will most certainly mean exemption for activities with CMV, Vaccinia of Listeria, this in accordance with legal legislation
Also appeal to the company doctor for other health issues concerning consequences of certain activities
Do not allow co-workers or interns younger than 18 years old do activities
5 Risk classification 2 micro organisms or cell lines in combination with laboratory animals
Include existing data in the about; Risk Assessment
Shedding through respiratory tract, urine, faeces including the time after infection
Prevention in blood and tissue including the time after infection
Whether or not to apply perfusion to eliminate blood as much as possible
Contamination results from sentinel animals
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Unit Biological Safety, CRISP, FHML, MUMC
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Work in accordance with the instructions for organisms of risk class 1 and the measures in the and the work Risk Assessment place instruction card
6 Risk classification 3 micro organisms or cell lines
Make a and submit t Risk Assessment his with the BVF before putting in an order
Keep a journal in which the arrival and use of the organism is registered and updated
Make sure the employees involved fill in the form (Approval as PMO worker) and send this to the BVF
Work in accordance with the instructions for organisms of risk class 1 and 2 and the measures from the and the work Risk Assessment place instruction card
Check the amount of stored samples on the basis of a journal kept about the use of the samples
7 Incidents, accidents and calamities
in case of spillage, wipe it up with paper, cover with paper drenched in a suitable disinfectant (see; Work Instruction Disinfection) , leave to soak for 10 minutes and finally clean with water and soap. Dismiss the paper in a barrel for biological waste.
Report incidents and accidents to the Armico (UM) and together fill in the digital report form
Reporting to azM through their Vrijwillig Incent Melding system.
8 References
Arbo information sheet 9: Biologische Agentia, SDU Publishers, 2010
CEN Workshop Agreement Bioriskmanagement, 2008
9 Attachment
1 Form for Work Place Risk Assessment Instruction
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Unit Biological Safety, CRISP, FHML, MUMC
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Pathogenic micro-organisms and cells are classified under the definition of the Biological
Agentia in the Arbo law and Arbo decree. The Arbo information sheet 9 (Biological
Agentia) also pays attention to both. On the basis of that a blue print has been made of the legal obligatory Risk Assessment (including the management measures in normal situations and incidents) in this area. On the basis of information about the specific kind and root of the micro-organism (commercially obtainable or primary cells, amount of samples per day, volume of tissue culture, used materials etc) the Risk Assessment can be finalized, including the plan of action for the residual risks.
At the……unit of the Department of……….activities are being done with…….(name organism and stem), commercially attainable cells with catalogue number….cultivated for the research of……They have been graded on Bio safety level by…….on the basis of….
The risks of working with pathogenic micro organisms are found from the formula drawn up by Hagelen and others (see ref 1), concluded from the base formula
Risk=chance x effect:
The risk of spreading (and therefore the secondary contamination risk) and route of contamination (f.i. blood-blood contact) of the organism concerned is also taken into account in the equation.
In order to organize the risks of the various components, different values are designated to all the different parts of the formula and the risk is calculated by multiplying the values with each other. The sums are used for drawing up priorities for the components of the
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Unit Biological Safety, CRISP, FHML, MUMC
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Plan of Action of the concerning Risk Assessment. While setting these priorities next to the calculated risk meeting with the legal obligations is also plays a part. For equal risk or fouls of the legislation priorities are set by the number of employees involved, cost of the measures as opposed to the benefits, duration of realization of a measure and the already planned changes (ref. 2). The measures already taken will be stated in the Risk
Assessment, to make sure that they will be executed at all times.
Meaning of the calculated risk number
Risk number
R>20
Risk Assessment
Important risk (high priority)
10<R<20
R<10
Possible risk (medium priority)
Risk possibly acceptable (low priority)
In the following table de necessary information has been included. The measures that are taken in accordance with the work instruction Safe working with pathogenic micro organism or cell lines, have not been described anew, but these are hereby cited in the paragraph concerned of the work instruction.
Activity Frequency
And duration
<4x/year=1
Contamination risk or
Performers Risk number
Preventive measures
1-
3x/quarterly=2
1x per
Risk of spreading
Barely=03.5
Some chance=2
(Frequency x
Risk class of month=4
1x weekly=8
Substantial chance=5
Organism)
Risk class
2=2
Risk class3=5
1…….(action),….(performer),…..target date (….)
2 ……
3……
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Unit Biological Safety, CRISP, FHML, MUMC
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Chlamydia pneumonia is a gram negative bacterium that can only live within cells. From an acute infection the bacteria can remain present within the cells in a metabolic inactive form. The bacterium is sensitive to 70% ethanol, 0.1% active chloride solution and iodine containing ethanol solution. C. pneumonia is a risk class 2 organism
Transference takes place through aerosols and hands. The incubation time is 2 to 4 weeks. Outside the body the bacterium dies quickly. Sensitive groups are the immune compromised and persons with chronic respiratory problems. Syndromes: respiratory infections, long term coughing, exhaustion, pneumonia, hart- and vascular complications.
At a young adult age 60% of the people have antibodies against C. pneumonia. There does not seem to be a build up of immunity, because of this re-infection and reactivation is possible.
Work in a safety cabinet class II and wear gloves. Wear a P3 mouth mask outside the safety cabinet. Disinfection of work surface: 70% ethanol, contact time 1 minute
In case of spillage : Use tissue to soak up material, inactivation of bacterium with the aid of 0.1% active chloride solution (1 tablet on 1,2 l); contact time 10 minutes; clean with water, disinfect again with chloride solution.
When inhaling contaminated aerosol: contact SEH azM, take the work place instruction card with you. Treatment in consultation with expert internist/infectologist. F.i. measurement of anti bodies on t =0 and t =-4 weeks. In case of positive IgM on t = 4 treatment with erythromycin (also in case of pregnancy) or tetracycline (only in 1e trimester of pregnancy).
In case of contamination of skin: disinfect with 70% ethanol or iodine solution.
Reference: http://www.rivm.nl/cib/infectieziekten-A-
Z/infectieziekten/chlamydophila/index.jsp
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Unit Biological Safety, CRISP, FHML, MUMC
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1 AI blad 9 Biological Agentia, SDU Publishers, The Hague, 2010, prevention employee,
Kluwer, 2009
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