DOI QR코드

DOI QR Code

Infection Risks Faced by Public Health Laboratory Services Teams When Handling Specimens Associated With Coronavirus Disease 2019 (COVID-19)

  • Wong, Chun-Kwan (Public Health Laboratory Services Branch, Centre for Health Protection, Department of Health) ;
  • Tsang, Dominic N.C. (Public Health Laboratory Services Branch, Centre for Health Protection, Department of Health) ;
  • Chan, Rickjason C.W. (Public Health Laboratory Services Branch, Centre for Health Protection, Department of Health) ;
  • Lam, Edman T.K. (Public Health Laboratory Services Branch, Centre for Health Protection, Department of Health) ;
  • Jong, Kwok-Kwan (Public Health Laboratory Services Branch, Centre for Health Protection, Department of Health)
  • Received : 2020.05.27
  • Accepted : 2020.07.01
  • Published : 2020.09.30

Abstract

Infection risks of handling specimens associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by public health laboratory services teams were assessed to scrutinize the potential hazards arising from the work procedures. Through risk assessments of all work sequences, laboratory equipment, and workplace environments, no aerosol-generating procedures could be identified except the procedures (mixing and transfer steps) inside biological safety cabinets. Appropriate personal protective equipment (PPE) such as surgical masks, protective gowns, face shields/safety goggles, and disposable gloves, together with pertinent safety training, was provided for laboratory work. Proper disinfection and good hand hygiene practices could minimize the probability of SARS-CoV-2 infection at work. All residual risk levels of the potential hazards identified were within the acceptable level. Contamination by gloved hands was considered as a major exposure route for SARS-CoV-2 when compared with eye protection equipment. Competence in proper donning and doffing of PPE accompanied by hand washing techniques was of utmost importance for infection control.

Keywords

References

  1. Public Health England. COVID-19: safe handling and processing for samples in laboratories; 2020. Available from: https://www.gov.uk/government/publications/wuhan-novel-coronavirus-guidance-for-clinical-diagnosticlaboratories/wuhan-novel-coronavirus-handling-and-processing-oflaboratory- specimens. accessed April 06, 2020 and May 02, 2020.
  2. World Health Organization. Laboratory biosafety guidance related to coronavirus disease (COVID-19). Interim guidance; 2020 March 19. Available from: https://apps.who.int/iris/bitstream/handle/10665/331500/WHO-WPE-GIH-2020.2-eng.pdf?sequence=1&isAllowed=y. [Accessed 12 February 2020] (accessed March 19, 2020) [previous version accessed].
  3. US CDC. Interim laboratory biosafety guidelines for handling and processing specimens associated with coronavirus disease 2019 (COVID-19); 2020. Available from: https://www.cdc.gov/coronavirus/2019-nCoV/lab/labbiosafety-guidelines.html. [Accessed 2 February 2020] (accessed March 15, 2020 and March 31, 2020) [previous version accessed].
  4. European CDC. Disinfection of environments in healthcare and non-healthcare settings potentially contaminated with SARS-CoV-2. Stockholm: ECDC. 2020. Available from: https://www.ecdc.europa.eu/sites/default/files/documents/Environmental-persistence-of-SARS_CoV_2-virus-Options-for-cleaning2020-03-26_0.pdf. [Accessed 26 March 2020].
  5. HA Committee on Infectious Diseases. Guideline on transport of clinical specimens and infectious substances. Hospital Authority, Hong Kong; 2006. Available from: https://www.ha.org.hk/haho/ho/conjoint/124711e.pdf. [Accessed 30 January 2020].
  6. Public Health Laboratory Services Branch. Safety guidelines on transport of clinical specimens and infectious substances for courier team. China: Centre for Health Protection, Department of Health of Hong Kong Special Administrative Region. 2006. Available from: https://www.chp.gov.hk/files/pdf/safety_guidelines_for_courier_team_2009nov.pdf. [Accessed 30 January 2020].
  7. Public Health Laboratory Services Branch. Guidelines on biosafety in the clinical laboratory. Edition. China: Centre for Health Protection, Department of Health of Hong Kong Special Administrative Region. February 2008. 2008. Available from:. http://www.chp.gov.hk/files/pdf/Guidelines_on_Biosafety_in_the_Clinical_Laboratory_2nd_Edn.pdf. [Accessed 30 January 2020].
  8. Anderson EL, Turnham P, Griffin JR, Clarke CC. Consideration of the aerosol transmission for COVID-19 and public health. Risk Anal 2020;40(5):902-7. https://doi.org/10.1111/risa.13500.
  9. Wang J, Feng H, Zhang S, Ni Z, Ni L, Chen Y, Zhuo L, Zhong Z, Qu T. SARS-CoV-2 RNA detection of hospital isolation wards hygiene monitoring during the Coronavirus Disease 2019 outbreak in a Chinese hospital. Int J Infect Dis 2020;94:103-6. https://doi.org/10.1016/j.ijid.2020.04.024.
  10. Cook TM. Personal protective equipment during the COVID-19 pandemica narrative review. Anaesthesia 2020 April 04. https://doi.org/10.1111/anae.15071.
  11. Chin AWH, Chu JTS, Perera MRA, Hui KPY, Yen H, Chan MCW, Peiris M, Poon LLM. Stability of SARS-CoV-2 in different environmental conditions. Lancet Microbe 2020 April 02. https://doi.org/10.1016/S2666-5247(20)30003-3.
  12. Henwood AF. Coronavirus disinfection in histopathology. J Histotechnol 2020 March 01. https://doi.org/10.1080/01478885.2020.1734718.
  13. Kampf G. Potential role of inanimate surfaces for the spread of coronaviruses and their inactivation with disinfectant agents. Inf Prev Prac 2020;2:100044. https://doi.org/10.1016/j.infpip.2020.100044.
  14. Kampf G, Todt D, Pfaender S, Steinmann E. Persistence of coronaviruses on inanimate surfaces and their inactiviation with biocidal agents. J Hosp Infect 2020;104:246-51. https://doi.org/10.1016/j.jhin.2020.01.022.
  15. van Doremalen N, Bushmaker T, Morris DH, Holbrook MG, Gamble A, Williamson BN, Tamin A, Harcourt JL, Thornburg NJ, Gerber SI, Lloyd-Smith JO, de Wit E, Munster VJ. Aerosol and surface stability of SARS-CoV-2 as compared with SARS-CoV-1. N Engl J Med 2020;382(16):1564-7. https://doi.org/10.1056/NEJMc2004973.
  16. Ong SWX, Tan YK, Chia PY, Lee TH, Ng OT, Wong MSY, Marimuthu K. Air, surface environmental, and personal protective equipment contamination by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) from a symptomatic patient. JAMA 2020;323(16):1610-2. https://doi.org/10.1001/jama.2020.3227.
  17. Wang W, Xu Y, Gao R, Lu R, Han K, Wu G, Tan T. Detection of SARS-CoV-2 in different types of clinical specimens. JAMA 2020;323(18):1843-4. https://doi.org/10.1001/jama.2020.3786.
  18. Lu C, Liu X, Jia Z. 2019-nCoV transmission through the ocular surface must not be ignored. Lancet 2020;395(10224):e39. https://doi.org/10.1016/S0140-6736(20)30313-5.
  19. Zhang X, Chen X, Chen L, Deng C, Zou X, Liu W, Yu H, Chen B, Sun X. The evidence of SARS-CoV-2 infection on ocular surface. Ocul Surf 2020;18:360-2. https://doi.org/10.1016/j.jtos.2020.03.010.
  20. Ye G, Lin H, Chen L, Wang S, Zeng Z, Wang W, Zhang S, Rebmann T, Li Y, Pan Z, Yang Z, Wang Y, Wang F, Qian Z, Wang X. Environmental contamination of the SARS-CoV-2 in healthcare premises: an urgent call for protection for healthcare workers. medRxiv 2020. https://doi.org/10.1101/2020.03.11.20034546.

Cited by

  1. High Seroprevalence of SARS-CoV-2 (COVID-19)-Specific Antibodies among Healthcare Workers: A Cross-Sectional Study in Guilan, Iran vol.2021, 2020, https://doi.org/10.1155/2021/9081491
  2. Overview of Legal Measures for Managing Workplace COVID-19 Infection Risk in Several Asia-Pacific Countries vol.12, pp.4, 2021, https://doi.org/10.1016/j.shaw.2021.08.003