Biological agents include cell cultures, human endoparasites that could cause infection, allergy or toxicity of some kind, microorganisms (bacteria, viruses, parasites and fungi) and genetically modified organisms. DNA and RNA are also categorised as biological agents, as well as materials produced from plants and animals.
All biospecimens, whether blood samples, swabs or tissue samples, must be handled with the utmost care. Handle all such specimens as if they were highly infectious viruses. Body fluids include samples such as blood, amniotic fluid, synovial fluid, spinal fluid, vaginal mucous, semen and fluid from around the heart or other organs. Other biospecimens include sputum, stool, urine, vomit, tears, sweat and mucous from the respiratory system.
There are many transmission risks in the lab from the samples themselves, e.g. aerosols or particles may disperse and cause infection. Infections are generally caused by accidents, a moment's lapse or carelessness. Accidental infection is sometimes caused by the inhalation of aerosols, which may be produced when mixing samples, removing stoppers, or removing specimens from a centrifuge. Aerosols may also settle on surfaces which people then touch. Infections can otherwise be caused by accidents such as needle-stick or sharps injuries, animal bites, abrasions from damaged glassware, or spilling a sample. This means it is important for personnel in these work areas to wear gloves, lab coats and masks at all times.
In order to prevent infection, it is vital to stay alert, adopt the correct working practices and follow standardised procedures at all times. Investigations into infections in lab workers clearly reveal that the most common routes of transmission are accidents such as needle-stick or sharps injuries, samples coming into contact with skin (e.g. getting into a cut or abrasion), or drops and aerosols coming into contact with the person's mucous membranes (nose, mouth or eyes). Infections are also often caused by aerosols produced when stoppers are removed from glass containers. Needle-stick or sharps injuries must always be treated immediately.
Thorough hand washing with liquid soap and water removes 90% of the pathogens that may be on your hands, which is sufficient in normal circumstances. When working with dangerous biological agents, there are stricter requirements. You will need to use hand sanitiser to remove more of the bacteria present on your skin.
Hand washing is a simple and effective preventative measure. Wash your hands even if you have been working with gloves on. Wash your hands before eating, drinking, performing any personal grooming or going to the toilet. Wash your hands before shaking hands with anyone.
You must disinfect the work area before you start work and after you have finished. Before starting, the area must be disinfected in order to avoid contamination of the samples you will be working with and afterwords in order to keep the work area clean and reduce the risk of infection. All instruments (scissors, forceps, etc.) must be sterilised before use. After use, they must be disinfected, cleaned and sterilised again. Machines like centrifuges are cleaned regularly with disinfectant to avoid cross-contamination between samples and also protect lab workers from infection. Use the following procedures when working with biological agents:
- Any instruments that come into contact with the biological agent must be disinfected and sterilised.
- All cabinets, refrigerators and freezers used to store samples must be well labelled and regularly disinfected.
- When using a centrifuge, samples must be in tightly closed vessels and precautions taken to minimise the risk of contamination.
- Sample vials with rubber stoppers must be opened carefully to make sure droplets are not sprayed on you.
- It is strictly forbidden to suck up liquids with your mouth. All work stations must be equipped with electronic pipettes.
- Never touch your skin with your gloves. Do not adjust your hair, scratch your nose, rub your eyes or anything else.
- Do not apply lipstick or other makeup in the lab.
- All students and staff should know where the emergency eye wash and safety shower are.
Microorganisms are categorised using biosafety levels, reflecting the severity of the risk they present to humans. Some microorganisms rarely or never cause disease while others can be life-threatening, even in very small quantities (e.g. in aerosols). There are 4 biosafety levels. Laboratories are likewise categorised using 4 biosafety levels, depending on the level of precaution required to work with different microorganisms.
Work with microorganisms that are considered harmless or very unlikely to cause disease in humans. Personnel must receive basic training in this kind of lab work, but specialist education is not necessary. It is important that new personnel are supervised and receive guidance on their work. In biosafety level 1 laboratories, the following rules apply:
- Work areas in the lab must be smooth and easy to clean.
- A work area must be equipped with a washbasin. It is important to wash your hands with soap and, if hands are contaminated, disinfect them immediately.
- Personal protective equipment – lab coats and gloves – must be worn at all times. You must not leave the lab wearing your protective equipment.
- Appropriate disinfectants must be stored in the lab.
- Workbenches must be cleaned after use.
- In case of contamination, the entire area must be disinfected.
- Glassware and other instruments must be stored in a safe place until they have been disinfected.
- All waste must be decontaminated unless it is due to be incinerated immediately.
- All waste must be transported in secure, closed containers.
Work with microorganisms that may cause disease in humans and could infect lab workers, but are not likely to cause an epidemic. Contact with an infected sample rarely results in infection and active treatment or prophylaxis is available. Examples of microorganisms in this category are Salmonella, the Measles morbillivirus and Toxoplasma gondii. Personnel in biosafety level 2 laboratories must be educated and trained in the handling of biological agents. All the rules that apply in biosafety level 1 laboratories remain, with the following additional rules:
- Access must be limited to trained personnel working in the lab. Unauthorised personnel (e.g. guests) are not permitted to enter.
- There must be a washbasin by the exit to the work area. Lab workers must be able to operate the taps without touching them with their hands.
- An autoclave must be present in order to sterilise contaminated waste.
- You must not use syringes, needles or other sharp objects unless strictly necessary. Sharps must be stored in a secure puncture-resistant container. Do not attempt to place sleeves on needles after use. Never bend needles or otherwise handle them in a risky way.
- Personal protective equipment intended to be worn in the work area must be stored separately from other work clothes. Ideally, lab coats should button at the side or back and have long sleeves. They must always be fully buttoned up.
- Work should generally take place inside a laminar flow cabinet in order to prevent contamination.
Authorised to work with microorganisms that could cause serious disease in humans and are extremely dangerous. Infection could potentially cause an epidemic, but treatment or prophylaxis is available. Examples include the bacteria that cause tuberculosis (Mycobacterium tuberculosis), typhoid fever (Salmonella typhi), anthrax (Bacillus anthracis), leprosy (Mycobactrium leprae), Hepatitis B and HIV. All contact with an infected sample is dangerous and requires immediate treatment. All personnel must be educated and trained in the handling of dangerous microorganisms and the use of personal protective equipment. Equipment must meet all the standards that apply in biosafety level 1 and 2 laboratories, with the following additional rules:
- The lab must be designed to enable fumigation and disinfection of all walls and floors.
- The lab must be isolated from all general traffic if at all possible. Doors to the work area must be locked at all times. The only access to the work area must be through two sets of doors, separated by a space where lab workers can change clothes.
- The entrance to the work area must be well labelled with the biohazard warning symbol.
- All work must take place inside a biosafety cabinet with a HEPA filter. All windows must be closed and sealed.
- Personnel must wear specialised lab coats in the work area. These should be a different colour to those normally worn.
- Equipment must not be removed from the lab. Equipment must not be shared with other labs, including refrigerators, freezers, centrifuges or measuring instruments.
Biosafety level 4 labs are appropriate for work with microorganisms that cause serious disease in humans and may cause serious epidemics, with no available treatment or prophylaxis. Only a few microorganisms fall under this category, all of them viruses. One example is the Ebola virus. There is only one research lab in Iceland that meets the standards of a biosafety level 4 facility. This lab is at Landspítali University Hospital.
Personnel working with biospecimens could become infected with the diseases with which they are working. It is generally recommended that personnel working with biospecimens should be vaccinated against Hepatitis B and get the annual influenza vaccination.
Personnel working with soil samples, plants and animals must be fully vaccinated against tetanus. Booster shots are required every 10 years.
Animal research and the care of laboratory animals are strictly regulated. Animal research may only be conducted with the authorisation of the Icelandic Food and Veterinary Authority. An Expert Advisory Board on Animal Welfare operates within the Icelandic Food and Veterinary Authority, in accordance with the Act on animal welfare no. 55/2013. The Expert Advisory Board reviews all proposals for animal research, evaluates the importance of the study and the nature of the impact on the animal's life. The principal investigator must meet strict requirements and be authorised to conduct experiments on animals. A veterinary surgeon must also oversee the animals' health and welfare (if the principal investigator is not a veterinary surgeon).
The most serious, and also most common, health hazards related to animal research are allergies and asthma. Various proteins in animal urine, dander, saliva and fur can induce allergic reactions or asthma symptoms. The urine of mice and rats (especially fully mature animals) contains a lot of these sensitising proteins. People with allergies are at greater risk in these labs than people without allergies. Other common risks associated with animal research include animal bites, scratches and needle-stick or sharps injuries. The principal investigator must teach all personnel how to correctly handle the animal before they do so. Proper handling helps the animal feel safe and reduces the risk of bites and scratches.
The Animal Research Committee sets requirements for animal housing, ventilation, cage size and care in labs where animals are kept and used. There are similar requirements for these rooms as there are for biosafety level 2/3 laboratories (see above). It must be easy to clean floors and walls. The air conditioning system must be powerful and must filter the air coming into the room. There must not be any objects that collect dust inside the animal facilities. Below are some of the requirements for these labs:
- Access must be limited to personnel who are authorised and trained to work with laboratory animals. Unauthorised personnel (e.g. guests) are not permitted to enter.
- Facilities must be separate from other facilities, where possible, and not in an area open to general traffic.
- Work areas must be smooth and easy to clean.
- The lab must be equipped with a laundry room.
- There must be a changing room where personnel change clothes before entering any room where animals are kept. It is important to wash hands with soap before entering a room where animals are kept and before leaving the work area.
- Personal protective equipment – lab coats and gloves – must be worn at all times. You must not leave the work area wearing your protective equipment.
- Syringes, needles and other sharp objects must be put away in a secure, puncture-resistant container after use. Do not attempt to place sleeves on needles after use. Never bend needles or otherwise handle them in a risky way.
- Appropriate disinfectants must be stored in the lab.
- Workbenches must be cleaned after use.
- In case of contamination, the area must be disinfected.
- All waste must be incinerated or go to landfill.
- All waste must be transported in secure, closed containers.
- Lab coats and other personal protective equipment intended to be worn in the work area must be washed separately from other work clothes.
- Lab coats must always be fully buttoned up.