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jueves, 19 de octubre de 2017

Workplace Hazards to Reproduction and Development

This booklet contains information for those of you who are interested in identifying, evaluating, and reducing workplace reproductive and developmental health risks. The information provided ranges from descriptions of basic physiology and toxicology to specific guidance intended for health care providers, workplace health and safety personnel, workers, and employers.
REFERENCE:
Sharon L. Drozdowsky, B.S. and Stephen G. Whittaker, Ph.D.  Hazards to Reproduction and Development: A Resource for Workers, Employers, Health Care Providers, and Health & Safety Personnel. Safety and Health Assessment and Research for Prevention (SHARP). Washington State Department of Labor and Industries. Technical Report Number: 21-3-1999

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martes, 17 de octubre de 2017

Laboratory-acquired infections of Salmonella enterica serotype Typhi in South Africa

BACKGROUND: Workers in clinical microbiology laboratories are exposed to a variety of pathogenic microorganisms. Salmonella species is among the most commonly reported bacterial causes of laboratory-acquired infections. We report on three cases of laboratory-acquired Salmonella enterica serotype Typhi (Salmonella Typhi) infection which occurred over the period 2012 to 2016 in South Africa.
METHODS: Laboratory investigation included phenotypic and genotypic characterization of isolates. Phenotypic analysis included standard microbiological identification techniques, serotyping and antimicrobial susceptibility testing. Genotypic analysis included the molecular subtyping methodologies of pulsed-field gel electrophoresis analysis, multilocus sequence typing and whole-genome sequencing (WGS); with WGS data analysis including phylogenetic analysis based upon comparison of single nucleotide polymorphism profiles of isolates.
RESULTS: All cases of laboratory-acquired infection were most likely the result of lapses in good laboratory practice and laboratory safety. The following critical issues were highlighted. There was misdiagnosis and misreporting of Salmonella Typhi as nontyphoidal Salmonella by a diagnostic laboratory, with associated public health implications. We highlight issues concerning the importance of accurate fluoroquinolone susceptibility testing and interpretation of results according to updated guidelines. We describe potential shortcomings of a single disk susceptibility screening test for fluoroquinolone susceptibility and suggest that confirmatory minimum inhibitory concentration testing should always be performed in cases of invasive Salmonella infections. These antimicrobial susceptibility testing issues resulted in inappropriate ciprofloxacin therapy which may have been responsible for failure in clearance of pathogen from patients. Salmonella Typhi capsular polysaccharide vaccine was not protective in one case, possibly secondarily to a faulty vaccine.
CONCLUSIONS: Molecular subtyping of isolates proved effective to investigate the genetic relatedness of isolates. Molecular subtyping data interpreted together with epidemiological data allowed us to pinpoint the most likely sources for our cases of laboratory-acquired infection.
REFERENCE:
Smith AM, et al. Laboratory-acquired infections of Salmonella enterica serotype Typhi in South Africa: phenotypic and genotypic analysis of isolates. BMC Infect Dis. 2017 Sep 29;17(1):656.

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lunes, 16 de octubre de 2017

Prevalence of murine leukemia virus contamination in human cell lines

Contaminations of cell cultures with microbiological organisms are well documented and can be managed in cell culture laboratories applying reliable detection, elimination and prevention strategies. However, the presence of viral contaminations in cell cultures is still a matter of debate and cannot be determined with general detection methods. In the present study we screened 577 human cell lines for the presence of murine leukemia viruses (MLV). Nineteen cell lines were found to be contaminated with MLV, including 22RV1 which is contaminated with the xenotropic murine leukemia virus-related virus variant of MLV. Of these, 17 cell lines were shown to produce active retroviruses determined by product enhanced reverse transcriptase PCR assay for reverse transcriptase activity. The contaminated cell lines derive from various solid tumor types as well as from leukemia and lymphoma types. A contamination of primary human cells from healthy volunteers could not be substantiated. Sequence analyses of 17 MLV PCR products and five complete MLV genomes of different infected cell lines revealed at least three groups of related MLV genotypes. The viruses harvested from the supernatants of infected cell cultures were infectious to uninfected cell cultures. In the course of the study we found that contamination of human genomic DNA preparations with murine DNA can lead to false-positive results. Presumably, xenotransplantations of the human tumor cells into immune-deficient mice to determine the tumorigenicity of the cells are mainly responsible for the MLV contaminations. Furthermore, the use of murine feeder layer cells during the establishment of human cell lines and a cross-contamination with MLV from infected cultures might be sources of infection. A screening of cell cultures for MLV contamination is recommended given a contamination rate of 3.3%.
REFERENCE
Uphoff CC, Lange S, Denkmann SA, Garritsen HS, Drexler HG. Prevalence and characterization of murine leukemia virus contamination in human cell lines. PLoS One. 2015 Apr 30;10(4):e0125622. doi: 10.1371/journal.pone.0125622. eCollection 2015. PubMed PMID: 25927683; PubMed Central PMCID: PMC4416031.

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miércoles, 11 de octubre de 2017

Triage and Management of Accidental Laboratory Exposures to Biosafety Level-3 and -4 Agents

The recent expansion of biocontainment laboratory capacity in the United States has drawn attention to the possibility of occupational exposures to BSL-3 and -4 agents and has prompted a reassessment of medical management procedures and facilities to deal with these contingencies. A workshop hosted by the National Interagency Biodefense Campus was held in October 2007 and was attended by representatives of all existing and planned BSL-4 research facilities in the U.S. and Canada. This report summarizes important points of discussion and recommendations for future coordinated action, including guidelines for the engineering and operational controls appropriate for a hospital care and isolation unit. Recommendations pertained to initial management of exposures (ie, immediate treatment of penetrating injuries, reporting of exposures, initial evaluation, and triage). Isolation and medical care in a referral hospital (including minimum standards for isolation units), staff recruitment and training, and community outreach also were addressed. Workshop participants agreed that any unit designated for the isolation and treatment of laboratory employees accidentally infected with a BSL-3 or -4 pathogen should be designed to maximize the efficacy of patient care while minimizing the risk of transmission of infection. Further, participants concurred that there is no medically based rationale for building care and isolation units to standards approximating a BSL-4 laboratory. Instead, laboratory workers accidentally exposed to pathogens should be cared for in hospital isolation suites staffed by highly trained professionals following strict infection control procedures.
REFERENCE:
Jahrling, Peter et al. “Triage and Management of Accidental Laboratory Exposures to Biosafety Level-3 and -4 Agents.” Biosecurity and Bioterrorism : Biodefense Strategy, Practice, and Science 7.2 (2009): 135–143. PMC. Web. 9 Oct. 2017.

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martes, 10 de octubre de 2017

La gestión de cadáveres en situaciones de desastre #bioseguridad

La gestión adecuada de los cadáveres es uno de los aspectos más complejos en la respuesta a las situaciones de desastre. Los desastres causan miles de muertes a nivel mundial cada año; sin embargo, no se le da atención al cuidado de los fallecidos en las actividades de planificación y la falta de guías para los primeros en responder se ha puesto de relieve después de varias grandes catástrofes. Esta guía de campo para personal no especializado ofrece orientaciones prácticas que facilitarán la recuperación, identificación básica, almacenamiento, la disposición, y en conjunto, la gestión adecuada de los cadáveres después de los desastres. También hace sugerencias sobre la forma de brindar ayuda a los familiares y de comunicarse con el público en general y con los medios de comunicación.
Este manual será de ayuda durante la respuesta inmediata a un desastre cuando aún no se cuenta con ayuda forense. Además podrá ser usado en la preparación de planes de desastres para el manejo de víctimas en masa. Las recomendaciones son relevantes para autoridades locales, regionales y nacionales, además de organizaciones no gubernamentales. Los principios y directrices enunciados en este documento ya se están ejecutando y promoviendo por varias organizaciones internacionales, incluidas las que han patrocinado la publicación del mismo: la Organización Panamericana de la Salud, la Organización Mundial de la Salud, el Comité Internacional de la Cruz Roja y la Federación Internacional de las Sociedades de la Cruz Roja y la Media Luna Roja.
El manual fue extensamente revisado por un grupo de expertos en el tema. Recibimos comentarios de ocho revisores técnicos: el dirigente del comité DVI de INTERPOL, el patólogo forense principal del Home Office en el Reino Unido, un especialista en medicina forense de Sri Lanka, dos administradores de desastres del Caribe, un acádemico experto en desastres del Reino Unido, un especialista en derechos humanos del Comité Internacional de la Cruz Roja (CICR) y un profesional internacional de desastres. Además, el manual fue revisado por los participantes de una reunión de especialistas forenses en Colombia, 15 líderes en salud pública de nueve países asiáticos en una reunión regional sobre el manejo de víctimas en masa, y expertos de medicina forense de Jordania que participaron en un taller del CICR. Asimismo, la versión preliminar del manual fue usada en el campo después del terremoto en Pakistán en 2005 y los deslizamientos de lodo en las Filipinas el mismo año.
La nueva edición en inglés refleja avances científicos y técnicos en el campo de gestión de víctimas en masa, y lecciones aprendidas del uso del manual.


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lunes, 9 de octubre de 2017

Virus detection in Human and Other Primate Cell Lines

The high prevalence of contaminated cell cultures suggests that viral contaminations might be distributed among cultures. We investigated more than 460 primate cell lines for Epstein-Barr (EBV), hepatitis B (HBV), hepatitis C (HCV), human immunodeficiency virus type 1 (HIV-1), human T-cell leukemia/lymphoma virus I and II (HTLV-I/-II), and squirrel monkey retrovirus (SMRV) infections for risk assessment. None of the cell lines were infected with HCV, HIV-1, or HTLV-I/-II. However, one cell line displayed reverse transcriptase activity. Thirty-nine cell lines harbored EBV DNA sequences. Studies on the lytic phase of EBV revealed that five cell lines produce EBV particles and six further cell lines produced EBV upon stimulation. One cell line contained an integrated HBV genome fragment but showed no virus production. Six cell lines were SMRV-infected. Newly established cell lines should be tested for EBV infections to detect B-lymphoblastoid cell lines (B-LCL). B-LCLs established with EBV from cell line B95-8 should be tested for SMRV infections.
REFERENCE:
Uphoff, Cord C. et al. “Detection of EBV, HBV, HCV, HIV-1, HTLV-I and -II, and SMRV in Human and Other Primate Cell Lines.” Journal of Biomedicine and Biotechnology 2010 (2010): 904767. PMC. Web. 8 Sept. 2017.
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jueves, 5 de octubre de 2017

The Effects of Workplace Hazards on Female Reproductive Health

Many factors can affect a woman’s reproductive health and her ability to produce healthy children. We know that the health of an unborn child can suffer if a woman fails to eat right, smokes, or drinks alcohol during pregnancy. However, we know very little about the cause of most reproductive health problems such as infertility, miscarriage, and birth defects. We do know that some workplace hazards can affect a woman’s reproductive health, her ability to become pregnant, or the health of her unborn children. This document answers the following questions:

  1. What are reproductive hazards for female workers?
  2. How does the female reproductive system work?
  3. What reproductive problems might be caused by workplace exposures?
  4. How are workers and their babies exposed?
  5. How are families exposed?
  6. How can exposures be prevented?
  7. What additional information is available?
REFERENCE:
The Effects of Workplace Hazards on Female Reproductive Health. National Institute for Occupational Safety and Health. DHHS (NIOSH) Publication No. 99–104.

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miércoles, 4 de octubre de 2017

Hospital Decontamination Self-Assessment Tool

In 2011, through a contract with the Massachusetts Department of Public Health, the Harvard School of Public Health Emergency Preparedness and Response Exercise Program (HSPH EPREP) engaged Massachusetts’ hospitals in a series of regional tabletop exercises focused on response to a hazardous materials incident. The exercise series highlighted a significant degree of heterogeneity among hospital decontamination programs and capabilities. Subsequent on-site assessments of hospital decontamination systems conducted at a representative sample of facilities throughout the Commonwealth confirmed this finding. To begin to address this issue of heterogeneity, HSPH-EPREP developed structured tools and guides to assist hospitals develop, maintain, and augment their decontamination programs. The Hospital Decontamination Self Assessment Tool was developed to provide hospitals with a means of evaluating decontamination plans and capabilities against current regulatory standards, recommendations from subject matter experts, and national and international healthcare decontamination best practices. This tool provides scalable considerations based upon presently available guidance to assist hospitals plan for and respond to small and large-scale incidents requiring the decontamination of patients contaminated by and/or exposed to chemical, biological, radiological, and/or nuclear agents.
REFERENCE:
Hospital Decontamination Self-Assessment Tool. A resource to assist hospitals evaluate decontamination plans and capabilities. Harvard School of Public Health.  2014

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martes, 3 de octubre de 2017

Best Practices for Hospital-Based First Receivers

Employers are responsible for providing a safe and healthful workplace for their employees. OSHA’s role is to assure the safety and health of America’s workers by setting and enforcing standards; providing training, outreach and education; establishing partnerships; and encouraging continual improvement in workplace safety and health. This handbook provides a general overview of a particular topic related to OSHA standards. It does not alter or determine compliance responsibilities in OSHA standards or the Occupational Safety and Health Act of 1970. Because interpretations and enforcement policy may change over time, you should consult current OSHA administrative interpretations and decisions by the Occupational Safety and Health Review Commission and the Courts for additional guidance on OSHA compliance requirements.
REFERENCE:
Best Practices for Hospital-Based First Receivers of Victims from Mass Casualty Incidents Involving the Release of Hazardous Substances. Occupational Safety and Health Administration. U.S. Department of Labor. OSHA 3249-08N.  2005
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