Prevention

The plan should provide operational procedures for:

A written emergency preparedness plan for dealing with laboratory incidents and accidents is a necessity in any facility that works with or stores M. tuberculosis isolates.

• Staff should remove their gloves and thoroughly wash their hands before removing respirators. Only the straps should be handled; staff should avoid touching the front of the respirator.

Staff who use respirators must be trained. They should be taught to:

Respirators are not normally required for work in a TB laboratory. However, they may be recommended after a risk assessment if cultures are being manipulated within a TB-containment laboratory. Even if not worn regularly, respirators must be available in laboratories where culture manipulations are performed in case an accidental biohazard (such as a spill) occurs outside the BSC. Respirators should be included as part of a laboratory’s spill clean-up kit.

Respirators should never be used as a substitute for a properly maintained and functioning BSC.

Laboratory gowns should have long sleeves and open in the back. When the laboratory technician is standing, the gown must extend below the height of the workbench; the gown should fully cover the technician’s lap when he or she is sitting. Reusable gowns should be autoclaved before being washed. Gowns must not be taken home for washing; laundering services should be provided at or near the facility. Laboratory gowns should be changed at least once a week and immediately after being overtly contaminated.

During the centrifugation process, aerosols may be produced. Consequently, safety measures must be strictly followed when operating the centrifuge.

Owing to their small size, droplet nuclei aerosols may be generated by certain laboratory procedures without the laboratory worker’s knowledge; this may result in the inhalation of infectious agents or cross-contamination of work surfaces or materials. BSCs are designed to protect people and the environment from infectious agents and, depending on their classification, offer varying degrees of protection from contamination of specimens and cultures.

Safety equipment may be used to eliminate or reduce certain risks in TB laboratories (Table 4). Such equipment offers no assurance of protection unless the operator is competent and uses proper techniques. Equipment should also be tested regularly to ensure that it continues to perform safely.