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Biosafety level 3 laboratory for autopsies of patients with severe acute respiratory syndrome: principles, practices, and prospects.
Clin Infect Dis. 2005 Sep 15; 41(6):815-21.CI

Abstract

BACKGROUND

During the outbreak of the emergent severe acute respiratory syndrome (SARS) infection, >30% of the approximately 8000 infected persons were health care workers. The highly infectious nature of SARS coronavirus (SARS-CoV) compelled our pathologists to consider biosafety issues in the autopsy room and for tissue processing procedures.

METHODS

A specially designed biosafety level 3 (BSL-3) autopsy laboratory was constructed and divided into a clean area, a semicontaminated area, a contaminated area, and 2 buffer zones. High-efficiency particulate air filters were placed in the air supply and exhaust systems. Laminar air flow was from the clean areas to the less clean areas. The negative pressures of the contaminated, semicontaminated, and clean areas were approximately -50 pa, -25 pa, and -5 pa, respectively. Personal protective equipment, including gas mask, impermeable protective clothing, and 3 layers of gloves worn during autopsies; the equipment was decontaminated before it was allowed to exit the facility. Strict BSL-3 practices were followed.

RESULTS

When a given concentration of particulate sarin simulant was introduced into the contaminated area, it could not be detected in either the semicontaminated area or clean area, and particles >0.3 microm in size were not detected in the exhaust air. A total of 16 complete postmortem examinations for probable and suspected SARS were performed during a 2-month period. Of these, 7 reported confirmed cases of SARS. None of the 23 pathologists and technicians who participated in these autopsies was infected with SARS-CoV.

CONCLUSIONS

Our experience suggests that BSL-3 laboratory operating principles should be among the special requirements for performing autopsies of contaminated bodies and that they can safeguard the clinicians and the environment involved in these procedures.

Links

PMC Free PDF

Authors+Show Affiliations

Li L
Department of Pathology, Health Science Center, School of Basic Medical Sciences, Peking University, Beijing, China.
Gu J
No affiliation info available
Shi X
No affiliation info available
Gong E
No affiliation info available
Li X
No affiliation info available
Shao H
No affiliation info available
Shi X
No affiliation info available
Jiang H
No affiliation info available
Gao X
No affiliation info available
Cheng D
No affiliation info available
Guo L
No affiliation info available
Wang H
No affiliation info available
Shi X
No affiliation info available
Wang P
No affiliation info available
Zhang Q
No affiliation info available
Shen B
No affiliation info available

MeSH

AutopsyContainment of BiohazardsEnvironment, ControlledHumansInfection ControlInfectious Disease Transmission, Patient-to-ProfessionalInhalation ExposureLaboratoriesOccupational ExposurePathology, ClinicalProtective ClothingProtective DevicesRisk FactorsSafetySevere Acute Respiratory SyndromeSpecimen Handling

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16107979

Citation

Li, Ling, et al. "Biosafety Level 3 Laboratory for Autopsies of Patients With Severe Acute Respiratory Syndrome: Principles, Practices, and Prospects." Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, vol. 41, no. 6, 2005, pp. 815-21.
Li L, Gu J, Shi X, et al. Biosafety level 3 laboratory for autopsies of patients with severe acute respiratory syndrome: principles, practices, and prospects. Clin Infect Dis. 2005;41(6):815-21.
Li, L., Gu, J., Shi, X., Gong, E., Li, X., Shao, H., Shi, X., Jiang, H., Gao, X., Cheng, D., Guo, L., Wang, H., Shi, X., Wang, P., Zhang, Q., & Shen, B. (2005). Biosafety level 3 laboratory for autopsies of patients with severe acute respiratory syndrome: principles, practices, and prospects. Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, 41(6), 815-21.
Li L, et al. Biosafety Level 3 Laboratory for Autopsies of Patients With Severe Acute Respiratory Syndrome: Principles, Practices, and Prospects. Clin Infect Dis. 2005 Sep 15;41(6):815-21. PubMed PMID: 16107979.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Biosafety level 3 laboratory for autopsies of patients with severe acute respiratory syndrome: principles, practices, and prospects. AU - Li,Ling, AU - Gu,Jiang, AU - Shi,Xicheng, AU - Gong,Encong, AU - Li,Xingwang, AU - Shao,Hongquan, AU - Shi,Xueying, AU - Jiang,Huijun, AU - Gao,Xiaoqiang, AU - Cheng,Daiyun, AU - Guo,Lizhu, AU - Wang,Hao, AU - Shi,Xiaohong, AU - Wang,Peizhi, AU - Zhang,Qianying, AU - Shen,Bing, Y1 - 2005/07/29/ PY - 2005/01/18/received PY - 2005/04/11/accepted PY - 2005/8/19/pubmed PY - 2006/9/26/medline PY - 2005/8/19/entrez SP - 815 EP - 21 JF - Clinical infectious diseases : an official publication of the Infectious Diseases Society of America JO - Clin Infect Dis VL - 41 IS - 6 N2 - BACKGROUND: During the outbreak of the emergent severe acute respiratory syndrome (SARS) infection, >30% of the approximately 8000 infected persons were health care workers. The highly infectious nature of SARS coronavirus (SARS-CoV) compelled our pathologists to consider biosafety issues in the autopsy room and for tissue processing procedures. METHODS: A specially designed biosafety level 3 (BSL-3) autopsy laboratory was constructed and divided into a clean area, a semicontaminated area, a contaminated area, and 2 buffer zones. High-efficiency particulate air filters were placed in the air supply and exhaust systems. Laminar air flow was from the clean areas to the less clean areas. The negative pressures of the contaminated, semicontaminated, and clean areas were approximately -50 pa, -25 pa, and -5 pa, respectively. Personal protective equipment, including gas mask, impermeable protective clothing, and 3 layers of gloves worn during autopsies; the equipment was decontaminated before it was allowed to exit the facility. Strict BSL-3 practices were followed. RESULTS: When a given concentration of particulate sarin simulant was introduced into the contaminated area, it could not be detected in either the semicontaminated area or clean area, and particles >0.3 microm in size were not detected in the exhaust air. A total of 16 complete postmortem examinations for probable and suspected SARS were performed during a 2-month period. Of these, 7 reported confirmed cases of SARS. None of the 23 pathologists and technicians who participated in these autopsies was infected with SARS-CoV. CONCLUSIONS: Our experience suggests that BSL-3 laboratory operating principles should be among the special requirements for performing autopsies of contaminated bodies and that they can safeguard the clinicians and the environment involved in these procedures. SN - 1537-6591 UR - https://www.unboundmedicine.com/medline/citation/16107979/Biosafety_level_3_laboratory_for_autopsies_of_patients_with_severe_acute_respiratory_syndrome:_principles_practices_and_prospects_ DB - PRIME DP - Unbound Medicine ER -