Quality Checks in Laboratory Accidents

By Shahidah Parveen

We think of laboratories and conjure mental images of white coats, researchers, test tubes, pipettes, autoclaves, benches, and more. We think of all the ways science is advancing and taking us to new heights. What will be the next wave of technology? The new revolution?

Time out! Before proceeding to the next wave, do we ever think of quality checks in our current work? We do pay heavily if the rules aren’t followed, if the human elements in our work aren’t accounted for. Laboratory accidents and resultant public health concerns are becoming
common news headlines, the topic of the next sci-fi movie, or as in this case, the perfect subject for an interesting article. The question is, in our learning curves, how are we gaining wisdom from our human mistakes and then taking precautions to prevent the next fiasco? Let’s study this from three recent occurrences.

Ebola is one of the deadliest viruses media has exposed so far (no pun intended). The movie, outbreak released in 1995 animated how researchers dealt with the near epidemic from a frictional ebola virus. Despite safe operational guidelines and stringent security measures, exposures are still occurring today. Associated Press recently reported in April, 2009 that a researcher was exposed in Hamburg, Germany while working on mice and mistakenly injecting herself with the virus. Luckily, she was given an experimental vaccine and kept under hospital watch for 21 days, hoping to have covered more than the virus’s incubation time, which is the time the virus would have taken to manifest itself through replication, symptoms, etc. Further analysis of the antibodies, or the presence of virus in the woman’s blood, would reveal her true status of infection and recovery.

Similarly Boston University’s (BU) name was tainted when lethal bacterium tularemia was exposed amongst the university’s researchers in 2005. It became so sensationalized that public health officials were held liable and some research employees were consequently let go. What made the situation worse was the exposure’s occurrence in a high risk safety lab with strict work guidelines due to usual dealings with contagious and deadly organisms like anthrax, plague, etc. It seems that a harmless research strain for tularemia vaccine was unknowingly contaminated with the tularemia strain itself. This is why both BU and local public health officials didn’t make a quick connection between sick researchers and the bacterium. As a result of the event, BU now intends for researchers to attend mandatory training sessions on personal protection, and public health officials intend to hire a lab safety inspector.


Finally, another sad story occurred at Harvard recently around Oct 26, 2009. Six people fell ill at a pathology lab, where they consumed coffee from the lab’s local coffee machine. The liquid tested positive for sodium azide, a chemical highly toxic by most routes including inhalational, ingestion, and skin absorption. In laboratory settings it’s generally used in stock solutions to prevent bacterial contamination and for the storage of purified antibodies. The chemical works by inhibiting cytochrome oxidase in cells and preventing the utilization of oxygen. In humans, oxygen is most critical for the proper functioning of the brain and heart; thus symptoms of any contact with this chemical are evident within minutes. In this case it could have been that the coffee was intentionally contaminated or that simply personal protective equipment or PPE weren’t properly utilized by someone, thus transferring the chemical to office coffee. Either way, Harvard plans to tighten laboratory security and of course, survey laboratory beverages as well.


In all three of the above incidences, protection rules had been established but human errors occurred in religiously following them. As always, we tend to get so wrapped up in our work that we forget to protect ourselves, contributing to a lower learning curve than would be expected in today’s intelligent world. One of the key lessons here is to establish and strictly adhere to, or make hard stops in, quality check protocols. This applies especially in laboratory settings where analysis and scrutiny are already present. These are some of the simple guidelines that organizations like CDC (Centers for Disease Control – US Government) and APIC (Association for Professionals in Infection Control and Epidemiology) call for, besides the universal rules of hand-washing, disinfecting workstations, and other safety measures like wearing proper PPE, operating under sufficient sleep, etc. Bearing these personal and public health ideals in mind, one can then imagine that it could be so very simple to achieve the next scientific revolution in our laboratories.

Citations:
- Wikipedia: http://en.wikipedia.org/wiki/Outbreak_(film)
- MSNBC: http://www.msnbc.msn.com/id/30009844/ns/health-infectious_diseases/
- Boston.com: http://www.boston.com/news/local/articles/2005/01/19/bacterium_infected_3_at_bu_biolab/
- ProMed Mail: http://www.promedmail.org/pls/otn/f?p=2400:1001:50943::NO::F2400_P1001_BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1000,79825
- CDC: http://www.bt.cdc.gov/agent/sodiumazide/basics/facts.asp
- APIC

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