Download File - Tactical Hazmat

06/10/2016
Biohazards
Objectives
• Understand the unique nature and therefore
hazards relating to biohazards
• Understand the specific variations and
procedural additions from the GSOP based on
section C of the national guidance for those
applicable substances
• Overview of GRA 5.4: incidents involving
biological hazards
Terminology
• Pathogenic organisms
– Bacteria
– Viruses
– Protozoa
– Fungi and Spores
• Toxins
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Terminology
Term
Description
Virulence
Relative severity of the disease produced
Infectivity
Relative ease at which microorganisms establish themselves in host,
high infectivity – cause disease with few organisms
Toxicity
Pathogenicity
Incubation
period
Transmissibility
Lethality
Stability
Relative severity of illness or incapacitation produced
The capability of an organism to cause disease
Time between exposure and appearance of symptoms (time during
which organisms are multiplying)
Either direct (person to person) or indirect (via a vector – fleas),
also refers to ease at which agent is passed
Ease at which an organism causes death
Stability is affected by environmental factors, including
temperature, relative humidity, atmospheric pollution & sunlight
Biohazard Definition
• any micro organism, cell culture or human
endoparasite, including
• any that have been genetically modified, that
can cause infection, allergy, toxicity or
• otherwise create a hazard to human health.
Biological Weapons??
• Same thing just with malicious intent
– Or accidental….
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Bacteria
Single cell, free living organisms
Variety of sizes and shapes (0.01mm length)
Some can form spores which are much hardier
Many respond to antibiotics
• Bacterial cells outnumber
human cells
– 10:1
• However only 1-3% body
mass
– 1-3 kg
They are all around us!!!
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Bacteria
Bacteria & Viruses
Viruses
• Require living cells in order to
grow and replicate
• Simplest type of microorganism
• 100x smaller than bacteria
• Generally don’t respond to
antibiotic therapy but may be
treated with antivirals or immune
serum globulins
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Virus
Bacteria vs Viruses
Protozoa
• Not really used in modern taxonomy
• Unicellular organisms exhibiting animal-like
behaviour
• Relatively large
• Typically parasitic
– Malaria
– Chagas disease
– Sleeping Sickness
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Fungi & Spores
• There are thousands of species of mould
(4,000 to 50,000)
• Mould grows in “mats” from microscopic
spores
• They are everywhere - normally found in
buildings at lower levels than outdoors
• Some species produce mycotoxins –
mycotoxins are used by moulds to compete
with other moulds for food sources
Toxins
• Poisonous substances (chemicals) produced or
derived from living plants, animals or
microorganisms
• They are not living
• Effects of exposure typically faster than other
biological agents
• Examples: Botulinum toxin, Ricin
How common are Biohazard incidents?
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Where do we find them?
Hazard Classification
Advisory Committee on Dangerous Pathogens (ACDP)
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whether the agent is pathogenic for humans;
whether the agent is a hazard to employees;
whether the agent is transmissible to the community; and
whether there is effective treatment or prophylaxis available
Hazard
Group
Bacillus subtilis
1
unlikely to cause human disease
3
can cause severe human disease and may be a serious hazard to employees; it may
Hep B, Rabies
spread to the community,Bacillus
but thereanthracis,
is usually effective
prophylaxis or treatment
available
2
4
can cause human disease and may be hazard to employees; it is unlikely to spread to
Legionella, MRSA
the community and there is usually effective prophylaxis or treatment available
causes severe human disease and is a serious hazard to employees; it is likely to spread
Ebola, smallpox, lassa fever
to the community and there is usually no effective prophylaxis or treatment available
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Notifications, Control Measures & Hazards
• Notification where Biosafety Level (BSL) 4
exists
• Higher levels of security
• HG3 & 4 buildings required to be under
negative pressure
• Usually located above ground level
• Regular disinfection (what do they use?)
• Chemicals
• Radiation - sterilization
Historical Bioweapons
1346
Plague infected corpses catapulted over the city walls at Kaffa by Tarter army
1940
Japanese drop 5kg of plague-infected fleas on China, 109 plague deaths
reported
1763
1984
2001
Alleged the English gave Native Americans smallpox-infected blankets
Rajneeshees cult in Oregen contaminates salad bars to affect local elections
Letters containing Bacillus anthracis spores sent via mail
Sverdlovsk Anthrax Release
• 1979 (BWC signed
1972)
• 1.2 million people
downwind
• 77 cases – 66 Deaths
• Cause: missing filter
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Gruinard Island
• Biological warfare test site (1942)
• 1981 – Operation Dark harvest
• 2001 – SNLA
Fungi & Spores
Mould becomes a problem when amplification
occurs.
• Amplification - when the type and number of
species and level of mould in an indoor
environment become significantly different
(often greater) than outdoor levels.
• Amplification results when there is an increase in
the total number of spores, the establishment of
a dominant species, or the increase in population
of mould species, different (often greater) than
outdoor levels
How Can Amplification Occur?
Amplification is influenced by environmental
conditions:
• Light
• Water
• Humidity
• Temperature
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Nutrients
• Mould uses organic carbon for food
• Dwellings contain significant amounts of
organic materials such as sheetrock and
cellulose ceiling tiles. Any material with
organic carbon is a rich source of food for
mould and mould growth
Temperature
• Moulds require a certain amount of heat to
grow into a large mat
• Areas with little air movement create pockets
of heat necessary to facilitate mould growth
• Moulds also create heat when metabolizing
food (building materials)
Water & Humidity
• Water is the key or limiting
factor to amplification
• When mould spores normally
in the air, land on wet food
sources (e.g. building
materials) they grow rapidly,
usually within 48 hours.
• Prefer humid environments –
above 60%
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Health Implications of Mould
• Some mycotoxins are toxic, carcinogenic
and/or teratogenic to humans; some cause
serious fungal infections
• Not everyone is affected; necessary data is
lacking to understand why
• In general, individuals with compromised
immune systems, asthmatics and those
allergic to mould may be more susceptible
Septicemia
Toxigenic Species
• Large number of genus (e.g. Aspergillus) with
many toxigenic species (e.g. Aspergillus
fumigatus)
• Common genus found at cannabis farms:
– Stacybotrys
– Aspergillus
– Cladosporium
– Fusarium
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Stachybotrys
• Only one known species, has two names Stachybotrys atra or Stachybotrys chartarum –
labelled by media as “Black Mould”
• Produces tricothecene, one of the more deadly
mycotoxins, potential biological agent; toxin
present in spores; in high enough dose potential
to cause bleeding of the lungs and kill highly
sensitive individuals (young infants, elderly,
immuno-compromised individuals, etc.).
• Thrives on water damaged, cellulose-rich building
materials (e.g. sheet rock, paper)
Aspergillus
• Over 185 species; 20 potentially toxic to man; 2nd
most common fungal infection requiring hospitalization
• Dark green-black in colour, has a fuzzy appearance
• Can produce allergic reaction like asthma or severe
life-threatening infections
• Produces aflatoxin, toxic and one of the most
carcinogenic substances known and Ochratoxin which
damages kidneys, liver and a suspected carcinogen
• People with depressed immune system could develop
serious allergies and even contract disease
Aspergillosis
Cladosporium
• Found on decaying plants, food, paint, textiles
and fiberglass duct insulation
• Dark green to black in front and black on
reverse with velvety to powdery texture
• Over 30 species of Cladosporium genus
• Fungi cause skin lesions, keratitis, nail fungus,
sinusitis, asthma and pulmonary infections;
edema and bronchospasms may occur as well
as pulmonary emphysema from chronic
exposure
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Fusarium
• Common soil fungus found on various of plants;
often found in humidifiers, water-damaged
carpets and variety of building materials
• Human exposure occurs through ingestion of
contaminated grains and possibly through
inhalation of spores
• Produces haemorrhagic syndrome in humans
(nausea, vomiting, diarrhoea, dermatitis and
internal bleeding); similar to Stachybotrys,
produces trichothecene, one of more deadly
mycotoxins and zearalenone, a mycotoxin similar
to estrogen that targets reproductive organs
Penicillium
• Common in soil, food, cellulose, grains, paint,
carpet, wallpaper, interior fiberglass duct
insulation, and decaying vegetation; several
species exist
• May cause hypersensitivity, pneumonitis, asthma,
and allergic alveolitis in susceptible individuals;
has been isolated from patients with keratitis, ear
infections, pneumonia, endocarditis, peritonitis
and urinary tract infections
• Can produce Ochratoxin A which is toxic,
damaging the kidneys, liver and a suspected
carcinogen as well as Verrucosidin, a neurotoxin
Effects of Mould
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Transportation
• UN 2814, 2900, 3373 or 3291
• Category A:
– Transported in a form that is capable of
causing permanent disability, lifethreatening or fatal disease to human or
animal
• Category B:
– doesn’t meet category for Category A
Transportation
Labelling & Marking
• All substances should be triple
packaged and incorporate a
waterproof and leak proof
system
• Everything except HG4 can be
posted
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Routes of Entry
Skin Contact
Puncture wounds & cuts
Inhalation
Ingestion
PPE
• Level of PPE determined by:
– Nature of biohazard present
– Potential of exposure
– Presence of biohazard expert
• Liquid-tight suit and BA adequate even up to
hazard group 4
PPE
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Post Exposure Prophylaxis
• Varies between hazard
– HIV / Hep recommend within an hour of exposure
– Anthrax can be longer
• Exposure records for HG3 & 4
– 10 years
– 40 years (agents with delayed effects)
• Recent Ebola victim
Identification
• Lateral Flow Assay
Identification
• DSTL have Mobile PCR
– Results within an hour
– Recurring discussion with NR but no plans for near
future
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Decontamination
• Most die in fire!!!
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– Above 60°C
Bleach solution (fresh)
Virkon, etc
Formaldehyde, Chlorine Dioxide
Hydrogen Peroxide Vapour (HPV)
Biohazard Pre-planning
• Contacts and Planning
– HG3 & 4 premises must have written plans
– HG4 premises must have expert advice at all times
• Planning documents should include
– Nature of hazards
– Extent of hazards
– Exact location
UK Biohazard sites
• 9 Containment Level 4
(CL4) sites
– All in south east
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Colindale
London
Pirbright (2x)
Warwick
Addlestone
Potters Bar
Porton Down (2x)
• 600 Containment Level 3
(CL3) sites
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Incidents involving Biohazards
• Approach uphill & upwind
• “Controlled burn” tactic
• Consider impact of potentially infectious run
off
• Control risk of exposure
– PEP?
• Specialist decon or just bleach or similar
• Records of any exposures and health
surveillance monitoring
Zoonotic disease outbreaks
Ebola
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Review
• Understand the unique nature and therefore
hazards relating to biohazards
• Understand the specific variations and
procedural additions from the GSOP based on
section C of the national guidance for those
applicable substances
• Overview of GRA 5.4: incidents involving
biological hazards
19