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Chapter 15.7 : Management of Laboratory Accidents

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Management of Laboratory Accidents, Page 1 of 2

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Abstract:

Despite improved control measures (engineering controls, safe work practices, and PPE), laboratory workers remain at risk for acquiring laboratory-associated infections. Reported cases of fatal meningococcemia in clinical laboratory workers underscore the potential risks of handling clinical samples ( ). Every laboratory (e.g., anatomic pathology, clinical diagnostic, reference, and research laboratories) should implement a biosafety plan. The essential components of the plan should include written procedures to reduce risks of occupational exposure and mandatory training, health assessment of employees, and record keeping of all exposures and treatments. A risk assessment of the procedures carried out on samples, including the frequency of positive samples, should be determined. The potential risk of disease should also be evaluated along with the availability of postexposure prophylaxis (PEP) and preventive vaccines. The benefits and side effects of PEP and immunization must also be considered.

Citation: Leber A. 2016. Management of Laboratory Accidents, p 15.7.1-15.7.7. In Clinical Microbiology Procedures Handbook, Fourth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555818814.ch15.7
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References

/content/book/10.1128/9781555818814.chap15.7
1. Centers for Disease Control and Prevention. 2002. Laboratory-acquired meningococcal disease—United States, 2000. MMWR Morb Mortal Wkly Rep 51:141144.
2. Centers for Disease Control and Prevention. 2001. Updated U.S. Public Health Service guidelines for the management of occupational exposures to HBV, HCV, and HIV and recommendations for postexposure prophylaxis. MMWR Morb Mortal Wkly Rep 50(RR-11):142.
3. Centers for Disease Control and Prevention. 2005. Updated U.S. Public Health Service guidelines for the management of occupational exposures to HIV and recommendations for postexposure prophylaxis. MMWR Morb Mortal Wkly Rep 54:117.
4. Bolyard EA, Tablan OC, Williams WW, Pearson ML, Shapiro CN, and Deitchman SD, The Hospital Infection Control Practices Advisory Committee. 1998. Guidelines for infection control in health care personnel. Am J Infect Control 26:289354 and Infect Control Hosp Epidemiol. 19:407463.
5. Beltrami EM, Williams IT, Shapiro CN, Chamberland ME. 2000. Risk management of blood-borne infections in health care workers. Clin Microbiol Rev 13:385407.
6. Centers for Disease Control and Prevention. 2008. Update: potential exposures to attenuated vaccine strain Brucella abortus RB51 during laboratory proficiency test—United States and Canada, 2007. MMWR Morb Mortal Wkly Rep 57:3639.
7. Centers for Disease Control and Prevention. 2007. Recommended adult immunization schedule—United States, October 2007September 2008. MMWR Morb Mortal Wkly Rep 56:Q1Q4.
8. Centers for Disease Control and Prevention. 1997. Immunization of health-care workers: recommendations of the Advisory Committee on Immunization Practices (ACIP) and the Hospital Infections Control Practices Advisory Committee (HICPAC). MMWR Morb Mortal Wkly Rep 46(RR-18):142.
9. CLSI. 2005. Protection of Laboratory Workers from Occupationally Acquired Infections. Document M29-A3. CLSI, Wayne, PA.
10. Peacock SJ, Schweizer HP, Dance DAB, Smith TL, Gee JE, Wuthiekanun V, DeShazer D, Steinmetz I, Tan P, Currie BJ. 2008. Management of accidental laboratory exposure to Burkholderia pseudomallei and B. mallei. Emerg Infect Dis 14:e2.
11. Sejvar JJ, Johnson D, Popovic T, Miller JM, Downes F, Somsel P, Weyant R, Stephens DS, Perkins BA, Rosenstein NE. 2005. Assessing the risk of laboratory-acquired meningococcal disease. J Clin Microbiol 43:48114814.

Tables

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Recommended PEP for exposure to HBVa

Recommended PEP for exposure to HBV

Citation: Leber A. 2016. Management of Laboratory Accidents, p 15.7.1-15.7.7. In Clinical Microbiology Procedures Handbook, Fourth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555818814.ch15.7
Generic image for table
Recommended HIV PEP for percutaneous injuriesa

Recommended HIV PEP for percutaneous injuries

Citation: Leber A. 2016. Management of Laboratory Accidents, p 15.7.1-15.7.7. In Clinical Microbiology Procedures Handbook, Fourth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555818814.ch15.7
Generic image for table
Recommended HIV PEP for mucous membrane exposures and nonintact skina exposuresb

Recommended HIV PEP for mucous membrane exposures and nonintact skin exposures

Citation: Leber A. 2016. Management of Laboratory Accidents, p 15.7.1-15.7.7. In Clinical Microbiology Procedures Handbook, Fourth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555818814.ch15.7
Generic image for table
Immunization available for laboratory workers in special circumstancesa

Immunization available for laboratory workers in special circumstances

Citation: Leber A. 2016. Management of Laboratory Accidents, p 15.7.1-15.7.7. In Clinical Microbiology Procedures Handbook, Fourth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555818814.ch15.7

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