3. LAI

Laboratory Acquired Infection
Common Biological Materials
• Biological agents (bacteria, virus, prions, parasites,

fungi, etc.)
• Human and Non-Human Primate (NHP) materials
(primary cells, blood, tissues, organs, and cell lines)
• Animals (experimentally inoculated or harboring
endemic zoonoses, animals engrafted with human cells,
transgenic animals etc.)
• Transgenic plants, weeds, plant pathogens
• Biological toxins
• rDNA – genetically modified versions of the above listed
materials.
Laboratory-Acquired Infections (LAIs)
Laboratory Acquired Infections do happen and for the most part
aren't linked to a specific accident.
• Studies by Pike (1979)/Harding and Byers (1999) found that:
• Only a small percentage of lab-acquired infections were
linked to a specific accident
• Over 80% did not know how exposure occurred,
• it is assumed that exposure happened via aerosol production in
routine procedures
• Of infections with known cause:
• 41% were from sharp objects
• 27% were from spills/sprays
• 13% were from animal bites
Exposure Factors in LAIs
Exposure to biological materials occurs through the same routes
as chemicals, including injection, ingestion, inhalation, and
mucous membrane contact.
An exposure does not always result in an infection or disease. If

we can eliminate any single link in the chain of infection, it is
possible to greatly minimize the risk of an infection if an
exposure occurs.
NO
DISEASE
Organism Ability to Cause Exposure Infectious Susceptible Host

Disease Dose
How Laboratory Associated Infections
Occur
Infection Source Susceptible Host

• Cultures and stocks • Vaccination status
• Research animals • Age
• Specimens • Immune-suppressed
• Items contaminated with
above
Route of Exposure
• Injection
• Inhalation of aerosols
• Contact of mucous membranes
• Ingestion
Risk Assessment
The safe handling of biological agents requires an

assessment of the potential hazards associated with all
aspects of an experiment, including the agent, a person’s
research experience, lab space and equipment used, and
specific procedures to be performed.
As risk increases, the

biosafety containment
level increases.
Questions during a Risk Assessment Addressed
During a Risk Assessment
• Can the agent cause disease in healthy adults?
• What is the infectious dose?
• Are vaccines available: e.g. Vaccinia, Hepatitis B, Rabies? What is the
availability of drugs or other treatment?
• How environmentally stable is the agent: Can it survive on the bench?
Extreme conditions?
• What is the route of exposure: Can you be exposed via multiple routes?
• What animals will be used? What species, do they shed the agent, do
they have endogenous zoonotic disease?
• What is the experience level of persons working with the agent and
performing the experiment?
BBP and
Other Potentially Infectious Material
OPIM includes: (OPIM)
• Blood products, semen, vaginal secretions
• Any body fluid that is contaminated with blood
• Any body fluid of an unknown sources
• Unfixed tissues or organs
• Untested cells or cultures (most commercially available cell lines unless
otherwise noted)
• Blood, organs or other tissues from experimental animals infected with BBP
• Introduction of human-derived materials (i.e. tumor cells, human xenografts)
into animals
• Any obscure red material from an unknown source where it is likely to have a
blood spill (i.e. red jelly like substance outside a hospital dumpster)
Hepatitis B and C
Hepatitis B and C cause liver disease and liver failure.
Symptoms are similar and include jaundice, fatigue, nausea.
Hepatitis B:
• 30% have no signs or symptoms
• 6% of infected adults become long-time carriers
(90% of infected infants)
• The Hepatitis B Virus can survive outside of the host
for more than 1 week
Hepatitis C:
• 80% have no signs or symptoms
• 70% become long-time carriers
Human Immunodeficiency Virus (HIV)
• HIV is an RNA virus that affects the immune

system.
• The virus may be passed through infected
blood or OPIM that comes in contact with
broken skin or mucous membranes.
• The virus attacks the CD4+ T cells and
depletes their population, irreversibly
destroying the immune system.
• AIDS is the symptomatic condition that
results from an infection by HIV
• Recent studies suggest the best independent
predictors of primary HIV infection are rash
and fever among individuals recently
exposed to HIV.
• HIV does not survive well outside the host.
(~90-99% reduction of virus particles within
several hours)
Minimize Exposure
The primary route of exposure to BBP is through
injection or contamination of a cut or skin that is not
intact.
The use of sharps should be minimized and
alternatives should be explored to reduce the risk of
accidental puncture wounds or cuts.
Universal Precautions
Appropriate Personal Protective Equipment (PPE) will
help protect you from exposure to splashes and
sprays for all biological material, including BBPs and
other infectious agents.
Engineering Controls such as a Biosafety Cabinet and
aerosol proof centrifuge rotors further decrease the
risk of exposure.
Minimize Exposure
Tissue specimens and cultures should be handled to avoid spreading contamination from
liquids to other areas and work surfaces.
• Avoid sprays from wet materials by opening containers pointed away from your
face.
• Avoid contaminating the outside of the container.
• Avoid flicking caps open to minimize aerosols.
• Disinfect the outside of container before work and before returning it to storage
• Close containers securely for transport
• Ensure biohazard labels are affixed to containers of waste, refrigerators, freezers,
other equipment and containers used with or to store or transport blood and OPIM.
There are no guarantees. Even dried blood could potentially transmit a BBP and cause
infection.
Commercial cell lines should be treated as infectious, even if they are tested. Most are
tested for HIV or Hepatitis B or C, but this limited testing does not ensure that other
disease causing agents are not present.
Exposure Control Plan
A written Exposure Control Plan is required by OSHA. An Exposure Control Plan

contains the following information:
• Review of job titles and specific job tasks where there is a reasonably
anticipated exposure
• Review of Universal Precautions and SOPs including:
• Engineering and work practice controls
• Personal Protective Equipment
• Housekeeping
• Labels and Signage
• Safer medical devices
Hepatitis B Vaccine
Although there is no vaccine for HIV or Hepatitis C, a vaccine exists for Hepatitis
B. Researchers who work with human materials have an occupational risk of
exposure to bloodborne pathogens and should be offered the Hepatitis B vaccine
before starting work. The vaccine is not required, but the offer must be made
and any declination of the vaccine documented. The Hepatitis B vaccine is:
• Safe and effective
• A series of 3 vaccine doses given at 0, 1, and 3 month time points
• Free of charge to any employee that may work with human blood, human
materials, or bodily fluids.
Employees must fill out an Acceptance/Declination Form.

Personal Exposures
Any needlestick or splash, spill, or spray onto your person should
be washed/rinsed for 15 minutes. Notify a colleague and use
their help.
Use an eyewash station if any biological material enters your
eye(s)
• activate eyewash and let it run for a few seconds before
aiming it at your eyes, hold your eyelids open, and flush
for 15 minutes
For large splashes or sprays onto your body use a safety shower
• pull the handle, remove contaminated clothing, and wash for
15 minutes
If you have been exposed or think you may have been, seek
medical attention and notify your supervisor.
Reporting Incidents
Report incidents involving exposure to recombinant or infectious
substances, animal bites, needle sticks, immediately!
There are no penalties/retaliation for reporting
Reporting ensures proper medical care, clean up, record
keeping, etc. Review helps prevent reoccurrence and improve
safety.
Follow-up to the incident will be conducted to help/advise of

preventative measures that can be used to prevent recurrence.

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Laboratory Acquired Infection

Common Biological Materials

• Biological agents (bacteria, virus, prions, parasites,

An exposure does not always result in an infection or disease. If

Organism Ability to Cause Exposure Infectious Susceptible Host

Infection Source Susceptible Host

The safe handling of biological agents requires an

As risk increases, the

• HIV is an RNA virus that affects the immune

A written Exposure Control Plan is required by OSHA. An Exposure Control Plan

Employees must fill out an Acceptance/Declination Form.

Follow-up to the incident will be conducted to help/advise of

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