scholarly journals Laboratory safety: handling B. pseudomallei isolates without a biosafety cabinet

2021 ◽  
Author(s):  
Ian Gassiep ◽  
Michelle J Bauer ◽  
Patrick N. A. Harris ◽  
Mark D. Chatfield ◽  
Robert Norton
Keyword(s):  
Risk Factors ◽  
Risk Assessment ◽  
Microbiology Laboratory ◽  
Risk Of Infection ◽  
Laboratory Safety ◽  
Routine Work ◽  
Tier 1 ◽  
Environmental Air ◽  
Routine Handling ◽  
Biosafety Level

B. pseudomallei is a tier 1 select agent that is associated with laboratory-acquired melioidosis, with international guidelines recommending isolate handling within a class II biosafety cabinet (BSC) in a Biosafety Level (BSL) 3 facility. In low-resource settings this may not be practical, and therefore the authors aimed to assess the risk of laboratory-acquired melioidosis during routine work. Prior exposure to the organism was determined with a questionnaire and concomitant serology. Of 30 laboratory scientists handling B. pseudomallei on 1,267 occasions outside a biosafety cabinet, no infections were documented and all participants remained seronegative. Additionally, we performed controlled environmental air sampling during 78 laboratory handling events including plate opening, oxidase testing, and McFarland suspension creation. None of the experiments demonstrated aerosolization of the organism. This study suggests the risk of laboratory-acquired melioidosis is likely to be low. However, individual laboratories will need to undertake a risk assessment including melioidosis endemicity, availability of resources for containment, the nature of routine handling to be undertaken, and the presence of predisposing risk factors for infection in the staff concerned. Additionally, laboratories should take region-specific guidelines into consideration. Further research is required to better inform on the overall risk of infection in the microbiology laboratory.

scholarly journals Biosafety Level at the Microbiology Laboratory of PT SCI

2021 ◽  
Vol 5 (2) ◽  
pp. 522-535
Author(s):  
Aulia Jauhari Rakhman ◽  
Sjahrul Meizar Nasri
Keyword(s):  
Risk Assessment ◽  
Data Collection ◽  
Primary Data ◽  
Competency Assessment ◽  
Microbiology Laboratory ◽  
Preventive Action ◽  
Laboratory Personnel ◽  
Biological Risk ◽  
Biosafety Level

Introduction: Protection of personnel in microbiological testing laboratories should be conducted. One of the efforts that can be used for preventive action is the determination of the biosafety level. This study was conducted with the aim of knowing how important the biosafety level is seen from the readiness level of laboratory personnel regarding knowledge, training, and competency assessment of laboratory personnel. Moreover, this study was also based on the application of biological risk assessment and the planned biosafety implementation program. Method: The sampling method used was secondary data with document review and data recording from the implementation of activities in the microbiology laboratory. Meanwhile, the primary data collection was done through in-depth interviews with respondents using questionnaires and direct interviews. Result: The results of data collection and data processing showed that 74% of laboratory personnel had the appropriate competence in carrying out the assessment by determining the biosafety level. This was supported by the biosafety program which might be planned and implemented with laboratory readiness. This had a percentage of 73% in terms of biological risk assessment and laboratory facilities. Conclusion: Determination of biosafety level is important for personnel who is working in dangerous facilities which is exposed to microbiological agents such as bacteria, viruses, fungi, and other microbiological products. This is because, determining the biosafety level not only protects laboratory personnel, but also the environment from biological hazards.

Fall Risk Assessment and Risk Factors of Inpatients in Armed Forces Hospital

2016 ◽  
Vol 34 (1) ◽  
pp. 42-53
Author(s):  
Kyung-Wan Seo ◽  
Jeong-Ok Lee ◽  
Sun-Young Choi ◽  
Min-Jung Park
Keyword(s):  
Risk Factors ◽  
Risk Assessment ◽  
Fall Risk ◽  
Armed Forces ◽  
Fall Risk Assessment

Diagnostic scales for suicide risk assessment

2020 ◽  
pp. 67-79
Author(s):  
L. Gelda ◽  
L. Nesterovich
Keyword(s):  
Risk Factors ◽  
Risk Assessment ◽  
Medical Research ◽  
Suicide Risk ◽  
General Medicine ◽  
Diagnostic Tools ◽  
Suicide Risk Assessment ◽  
Research And Practice ◽  
Psychometric Instruments ◽  
High Incidence

The problem of adequate diagnostic tools use for suicide risk assessment т medical research and practice is of extreme importance because of the high incidence of suicide in the population of psychotic patients and the high vulnerability of the latter to the known risk factors. The article provides ап overview of the existing psychometric instruments (scales) used to assess the risk of suicide in psychiatry as well as in general medicine.

Risk assessment of Campylobacter species in shellfish: identifying the unknown

1997 ◽  
Vol 35 (11-12) ◽  
pp. 29-34 ◽  
Author(s):  
P. Teunis ◽  
A. Havelaar ◽  
J. Vliegenthart ◽  
G. Roessink
Keyword(s):  
Risk Assessment ◽  
Quantitative Risk Assessment ◽  
Contamination Level ◽  
Risk Of Infection ◽  
Worst Case ◽  
Considerable Uncertainty ◽  
Risk Estimates ◽  
Consumption Data ◽  
Campylobacter Infection ◽  
Campylobacter Spp

Shellfish are frequently contaminated by Campylobacter spp, presumably originating from faeces from gulls feeding in the growing or relaying waters. The possible health effects of eating contaminated shellfish were estimated by quantitative risk assessment. A paucity of data was encountered necessitating many assumptions to complete the risk estimate. The level of Campylobacter spp in shellfish meat was calculated on the basis of a five-tube, single dilution MPN and was strongly season-dependent. The contamination level of mussels (<1/g) appeared to be higher than in oysters. The usual steaming process of mussels was found to completely inactivate Campylobacter spp so that risks are restricted to raw/undercooked shellfish. Consumption data were estimated on the basis of the usual size of a portion of raw shellfish and the weight of meat/individual animal. Using these data, season-dependent dose-distributions could be estimated. The dominant species in Dutch shellfish is C. lari but little is known on its infectivity for man. As a worst case assumption, it was assumed that the infectivity was similar to C. jejuni. A published dose-response model for Campylobacter-infection of volunteers is available but with considerable uncertainty in the low dose region. Using Monte Carlo simulation, risk estimates were constructed. The consumption of a single portion of raw shellfish resulted in a risk of infection of 5–20% for mussels (depending on season; 95% CI 0.01–60%). Repeated (e.g. monthly) exposures throughout a year resulted in an infection risk of 60% (95% CI 7–99%). Risks for oysters were slightly lower than for mussels. It can be concluded that, under the assumptions made, the risk of infection with Campylobacter spp by eating of raw shellfish is substantial. Quantitative risk estimates are highly demanding for the availability and quality of experimental data, and many research needs were identified.

scholarly journals 1095. Investigation of Risk Factors Associated with Serious Bacterial, Viral and Invasive Fungal Infections in Hematologic Patients on Ibrutinib

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S576-S577
Author(s):  
Thomas Holowka ◽  
Harry Cheung ◽  
Maricar F Malinis ◽  
Sarah Perreault ◽  
Iris Isufi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Fungal Infections ◽  
Antimicrobial Prophylaxis ◽  
Hematologic Malignancy ◽  
Invasive Fungal Infections ◽  
Risk Of Infection ◽  
Factors Associated ◽  
Serious Infection ◽  
Increased Risk ◽  
Serious Infections

Abstract Background Ibrutinib is a tyrosine kinase inhibitor used to treat hematologic malignancies that may increase the risk of serious infection including invasive fungal infections (IFI). In a study of 378 patients with hematologic malignancy on ibrutinib, serious infection and IFI occurred in 11% and 4% respectively (Varughese et al. Clin Infect Dis). The primary aims of our study were to determine the incidence of serious infection and associated risk factors in patients on ibrutinib. Methods We performed a retrospective analysis of patients with hematologic malignancy prescribed ibrutinib for ≥ 1 week at Yale New Haven Hospital from 2014 to 2019 to identify serious infections defined as those requiring inpatient management. We collected demographic, clinical and oncologic data. Chi-squared tests were used to determine factors associated with an increased risk of infection. Results A total of 254 patients received ibrutinib including 156 with CLL, 89 with NHL and 9 with other leukemias. Among these, 21 underwent HSCT, 9 complicated by GVHD. There were 51 (20%) patients with serious infections including 45 (17.7%) bacterial, 9 (3.5%) viral and 5 (2%) IFI (1 pulmonary cryptococcosis, 4 pulmonary aspergillosis). Anti-mold prophylaxis was prescribed to 7 (2.8%) patients, none of whom developed IFI. Risk factors associated with serious infection included ECOG score ≥ 2 (OR 4.6, p < 0.001), concurrent steroid use (≥ 10 mg prednisone daily for ≥ 2 weeks; OR 3.0, p < 0.001), neutropenia (OR 3.6, p < 0.01), lymphopenia (OR 2.4, p < 0.05) and maximum ibrutinib dose of 560 mg (OR 2, p < 0.05). There was a dose dependent increase in infections based on number of chemotherapy regimens prior to ibrutinib initiation: 14.3% with 0, 19.7% with 1-2 and 28.7% with ≥ 3 prior treatments. Conclusion The incidence of serious infection in hematologic patients on ibrutinib was higher than previously reported (20% versus 11%) but the rate of IFI was lower (2% versus 4%). High ECOG score, leukopenia, steroids, and higher ibrutinib doses were associated with an increased risk for serious infection. Targeted antimicrobial prophylaxis should be considered for patients on ibrutinib with these risk factors. Improving functional status may also reduce the risk of infection in patients on ibrutinib. Disclosures All Authors: No reported disclosures

scholarly journals Cumulative Risks from Stressor Exposures and Personal Risk Factors in the Workplace: Examples from a Scoping Review

2021 ◽  
Vol 18 (11) ◽  
pp. 5850
Author(s):  
Mary A. Fox ◽  
Richard Todd Niemeier ◽  
Naomi Hudson ◽  
Miriam R. Siegel ◽  
Gary Scott Dotson
Keyword(s):  
Risk Factors ◽  
Risk Assessment ◽  
Scoping Review ◽  
Multiple Stressors ◽  
Cumulative Risk ◽  
Real Life ◽  
Personal Factors ◽  
Exposure Limits ◽  
Personal Risk ◽  
Personal Risk Factors

Protecting worker and public health involves an understanding of multiple determinants, including exposures to biological, chemical, or physical agents or stressors in combination with other determinants including type of employment, health status, and individual behaviors. This has been illustrated during the COVID-19 pandemic by increased exposure and health risks for essential workers and those with pre-existing conditions, and mask-wearing behavior. Health risk assessment practices for environmental and occupational health typically do not incorporate multiple stressors in combination with personal risk factors. While conceptual developments in cumulative risk assessment to inform a more holistic approach to these real-life conditions have progressed, gaps remain, and practical methods and applications are rare. This scoping review characterizes existing evidence of combined stressor exposures and personal factors and risk to foster methods for occupational cumulative risk assessment. The review found examples from many workplaces, such as manufacturing, offices, and health care; exposures to chemical, physical, and psychosocial stressors combined with modifiable and unmodifiable determinants of health; and outcomes including respiratory function and disease, cancers, cardio-metabolic diseases, and hearing loss, as well as increased fertility, menstrual dysfunction and worsened mental health. To protect workers, workplace exposures and modifiable and unmodifiable characteristics should be considered in risk assessment and management. Data on combination exposures can improve assessments and risk estimates and inform protective exposure limits and management strategies.

Tier-1 Ecological Risk Assessment of booster biocides in sediments of the Brazilian Coastal Areas

Chemosphere ◽  
2021 ◽  
pp. 130155
Author(s):  
Fiamma Eugênia Lemos Abreu ◽  
Samantha Eslava Martins ◽  
Gilberto Fillmann
Keyword(s):  
Risk Assessment ◽  
Ecological Risk ◽  
Ecological Risk Assessment ◽  
Coastal Areas ◽  
Tier 1

scholarly journals Comparative risk assessment for the development of cardiovascular diseases in the Hungarian general and Roma population

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Peter Piko ◽  
Zsigmond Kosa ◽  
Janos Sandor ◽  
Roza Adany
Keyword(s):  
Risk Factors ◽  
Risk Assessment ◽  
Cardiovascular Risk ◽  
Cardiovascular Diseases ◽  
High Risk ◽  
Risk Group ◽  
High Risk Group ◽  
Average Risk ◽  
Cvd Risk ◽  
Roma Population

AbstractCardiovascular diseases (CVDs) are the number one cause of death globally, and the early identification of high risk is crucial to prevent the disease and to reduce healthcare costs. Short life expectancy and increased mortality among the Roma are generally accepted (although not indeed proven by mortality analyses) which can be partially explained by the high prevalence of cardiovascular risk factors (CVRF) among them. This study aims to elaborate on the prevalence of the most important CVD risk factors, assess the estimation of a 10-year risk of development of fatal and nonfatal CVDs based on the most used risk assessment scoring models, and to compare the Hungarian general (HG) and Roma (HR) populations. In 2018 a complex health survey was accomplished on the HG (n = 380) and HR (n = 347) populations. The prevalence of CVRS was defined and 10-year cardiovascular risk was estimated for both study populations using the following systems: Framingham Risk Score for hard coronary heart disease (FRSCHD) and for cardiovascular disease (FRSCVD), Systematic COronary Risk Evaluation (SCORE), ACC/AHA Pooled Cohort Equations (PCE) and Revised Pooled Cohort Equations (RPCE). After the risk scores had been calculated, the populations were divided into risk categories and all subjects were classified. For all CVD risk estimation scores, the average of the estimated risk was higher among Roma compared to the HG independently of the gender. The proportion of high-risk group in the Hungarian Roma males population was on average 1.5–3 times higher than in the general one. Among Roma females, the average risk value was higher than in the HG one. The proportion of high-risk group in the Hungarian Roma females population was on average 2–3 times higher compared to the distribution of females in the general population. Our results show that both genders in the Hungarian Roma population have a significantly higher risk for a 10-year development of cardiovascular diseases and dying from them compared to the HG one. Therefore, cardiovascular interventions should be focusing not only on reducing smoking among Roma but on improving health literacy and service provision regarding prevention, early recognition, and treatment of lipid disorders and diabetes among them.

scholarly journals POS0303 PREVENTION OF CHRONIC DISEASES DUE TO INFLAMMATION IN INFLAMMATORY ARTHRITIS: RESULTS OF A DELPHI PROCESS TO SELECT CARE RECOMMENDATIONS FOR AN ELECTRONIC MEDICAL RECORD (EMR) INTERVENTION

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 377.1-377
Author(s):  
I. Sheriff ◽  
A. Lima ◽  
O. Tseng ◽  
A. Aviña ◽  
M. Dawes ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Assessment ◽  
Chronic Diseases ◽  
Inflammatory Arthritis ◽  
Family Physicians ◽  
Delphi Process ◽  
Lifestyle Modifications ◽  
Cvd Risk ◽  
Level Of Evidence ◽  
Bmd Testing

Background:Inflammatory arthritis (IA) predisposes patients to several chronic conditions including cardiovascular diseases (CVD), diabetes (DM), osteoporosis (OP) and infections, likely due to systemic effects of inflammation. Studies have found that patients with IA often receive suboptimal care for screening and managing these conditions.Objectives:This is the first phase of a study which will develop and pilot test automated EMR reminders for family physicians. The reminders will prompt family physicians to screen for and address risk factors for these conditions. We conducted a Delphi process to select care recommendations to be addressed by the EMR reminders.Methods:We conducted a review of current BC, Canadian and international guidelines for screening and addressing risk factors for CVD, DM, OP and infection. A list of 22 care recommendations, including their level of evidence and risks/benefits of implementation, was reviewed by a panel of six family physicians, three rheumatologists and three IA patients, in a three-round online modified Delphi process. Panelists rated each care recommendation, using 9-point scales, on 1) their clinical importance, 2) their likelihood of improving outcomes, and 3) implementation feasibility. Results were discussed in an online forum. Panelists then rated slightly revised care recommendations, modified based on feedback from the discussion. Care recommendations were retained if the median rating was ≥7 with no disagreement as defined by the RAND/UCLA Method handbook.Results:A list of 15 care recommendations was selected by the Delphi process for EMR integration, including recommendations that address CVD risk assessment (1), hypertension screening (1), DM screening (2), fracture risk assessment (1), BMD testing (1), osteoporosis prevention (1) and treatment (1) with bisphosphonates, preventing infections through immunization (2), minimizing steroids (1) and hepatitis screening (1), screening for hydroxychloroquine retinal toxicity (1), and counselling for lifestyle modifications (2). We excluded 7 recommendations which addressed lipid testing (1), BMD testing in steroid users (1), immunizations (2), weight management (1), and DMARD laboratory test monitoring (2). Recommendations were excluded on the basis of importance (1) or feasibility (6).Conclusion:The results of the Delphi process will inform the development of reminders, integrated in EMRs, that will support family physicians in their efforts to engage IA patients in addressing risk factors for chronic diseases related to inflammation. We hope to improve the prevention of these diseases, which represent an important cause of morbidity and mortality for people with inflammatory arthritis.Acknowledgements:Iman Sheriff’s work on this project was funded by the CRA summer studentship programme. Dr. Lacaille is supported by the Mary Pack Chair in Arthritis Research from UBC and The Arthritis Society of Canada. Thank you to all who participated in the Delphi survey.Disclosure of Interests:None declared

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