TB KaSPar
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In addition to the general risks that are addressed by the biosafety measures described in Chapter 2 (such as unauthorized persons in the laboratory, mouth pipetting, cluttered work stations, improper waste disposal), the TB laboratory classified as moderate risk also faces the following challenges, all of which increase risks:
In a laboratory where there is a moderate risk of infection, there are two levels of containment: the BSC (primary containment) and the laboratory itself (secondary containment). To address the specific risks associated with a moderate-risk laboratory, the following mitigation and control measures should be established.
A code of practice describes the laboratory practices and procedures essential for implementing good (that is, safe) microbiological technique. The laboratory manager should use the code of practice to develop written descriptions of procedures that should be followed to perform work safely. This safety or operations manual should also identify known and potential hazards, and specify practices and procedures to minimize the risks associated with such hazards.
TB laboratory facilities can be classified into three main levels of procedural risk, based on the activities being performed and their associated risks:
Risk is the combination of the likelihood that a specific hazard will be encountered and the consequences of an event related to that specific hazard. Risks should be identified and categorized, and a determination should be made about which risks need to be controlled or minimized. The analysis of aerosolization risks described in this manual has led to the development of minimum biosafety requirements necessary for performing different procedures in TB laboratories.
Personal protective equipment and clothing may act as barriers to minimize the risk of exposure to aerosols, splashes and accidental inoculation. The choice of clothing and equipment depends on the nature of the work. Protective clothing should be worn whenever staff work in the laboratory (see Box 6). Before leaving the laboratory, staff should remove their protective clothing, and wash their hands. Table 5 summarizes the types of personal protective equipment used in laboratories and the protection each type offers.
A2.1 Scope and objectives
The WHO consolidated guidelines on tuberculosis: tuberculosis preventive treatment make recommendations for the four milestones of the cascade of preventive care, namely, identification of risk groups, TB screening and ruling out TB, testing for TBI and choice and administration of the TPT regimen. The second edition of the TPT guidelines covers the same milestones.
