Operational Handbooks

• The laboratory should be divided into “functionally clean” and “potentially contaminated” areas, with the clean areas reserved for administrative and preparatory work. Access to the clean areas and the contaminated areas must be controlled and enforced by the laboratory’s manager.
• The laboratory should be kept neat, clean and free of materials and equipment not used for performing routine work.

• Protective laboratory clothing must be worn at all times while staff are working in the laboratory. Protective clothing must not be worn outside the laboratory area (for example, in canteens, coffee rooms, offices, libraries, staff rooms and toilets).Laboratory coats and gowns must be stored separately from personal clothing. Clean gowns and used gowns must be stored in different areas of the laboratory.

• It is the responsibility of the laboratory manager to ensure that a biosafety management system is developed and adopted, as well as a safety or operations manual and a set of standard operating procedures.
• The manager should ensure that staff are trained and their technical competence evaluated for performing different procedures.
• Personnel should be advised of special hazards and be required to read the safety (or operations) manual as well as follow standard practices and procedures.

• The international biohazard warning symbol and sign must be displayed on the laboratory door.
• Only authorized persons should be allowed to enter the laboratory’s working areas.
• Children should not be authorized or allowed to enter the laboratory’s working areas.

All TB laboratories, regardless of the procedures being undertaken, should enact a set of essential biosafety measures to minimize risks. These measures affect:

1. codes of practice

2. equipment

3. laboratory design and facilities

4. health surveillance

5. training

6. waste handling.

Employee occupational health programmes should promote a safe and healthy workplace. This is accomplished by minimizing any exposures, promptly detecting and treating exposures, and using information gained from laboratory incidents and accidents to enhance safety precautions. A baseline medical checkup and provision for regular follow-up should be considered for all staff prior to commencing work in the TB laboratory.

The laboratory manager should conduct regular audits to monitor risks and control measures. These can be done by reviewing reports of corrective actions taken after problems were identified earlier, thoroughly investigating incidents or accidents and implementing preventive measures, and ensuring that adequate resources are provided to maintain the necessary level of precautions. Documenting the risk assessment process and identifying mitigation measures are integral and important steps to ensure that biosafety measures selected and implemented are constantly improved.

A hazard is anything that has the potential to cause harm, regardless of how likely or unlikely it might be to occur. A hazard may be a physical situation (such as a fi re or explosion), an activity (such as pipetting) or a material (such as aerosols containing infectious bacilli). Unless hazards are identified effectively, it is not possible to accurately assess the risks associated with the facility and its activities.

Laboratory biosafety is the process of applying a combination of administrative controls, containment principles, practices and procedures, safety equipment, emergency preparedness, and facilities to enable laboratory staff to work safely with potentially infectious microorganisms; biosafety also aims at preventing unintentional exposure to pathogens or their accidental release. This manual describes the minimum biosafety measures that should be implemented at the different levels of tuberculosis (TB) testing laboratories to reduce the risk of a laboratory-acquired infection.