Biorisk Management Technical Training for the Veterinary sector in the Philippines (Final Report)

The BioRisk Association of the Philippines 2015, Inc. (BRAP2015) and the University of Philippines, Manila, National Institute of Health – National Training Center for Biosafety and Biosecurity (UPM-NIH-NTCBB) designed a 5-day technical workshop on the topic of biorisk management for up to 60 participants from the veterinary sector. The event is in partnership with the U.S. Department of State – Biosecurity Engagement Program and CRDF Global.

Dr. Miguel Martin Moreno II, founding and incumbent president of BRAP2015, in consultation with Dr. Rohani Cena, assistant director of the NTCBB, created a technical FLIER working file curriculum and facilitated a seminar for 60 participants from animal disease diagnostic laboratories. Participants who arrived at the venue included veterinarians and animal handlers from Luzon, Visayas and Mindanao islands. This project hopefully meet BEP’s objective of engaging the veterinary sector in the Philippines and extend threat reduction programs beyond the National Capital Region. It also hoped to encourage the various local biorisk management (BRM) champion organizations to develop stronger working relationships in the interest of improving BRM in all sectors of the Philippines. This is BRAP’s July 2018–June 2019 goal of focusing on One Health—the humans, animals and the environment.

Martin Moreno, MD, CBP

Rohani Cena, DVM, CBO

Drs. Moreno and Cena, both Advanced Biosafety Officers Training ([ABOT] now PhABOT) course graduates, teamed up and searched for the competent and the best lecturers for the task. The seminar–workshop ended on September 28, 2018, and we already saw the group as a very much interested entity in the project, and there are already requests of further creating a similar training class for the other far-flung veterinarians who did not have good access to the Internet to know about this first batch. We enrolled a few pharmacists who have been working in their own animal laboratories, and they showed a deep interest in the issue. One vet participant in the introductory meeting said “we are so happy that there is a seminar workshop like this because we honestly have no idea what biosafety, biosecurity and biorisk management are all about.”

Day 1 (by Dean Crislee Torio)

Dean Crislee Torio (left) and Mr. Romeo Lunar

A short presentation of BRAP’s beginnings and its collaboration with Philippine Association of Medical Technologists (PAMET). The collaboration has set the stage for important activities leading to biorisk management implementation in majority of the laboratories in the country. Collaboration with PAMET was chosen by BRAP Founding President Dr. Moreno because, according to him, PAMET covers more than 85% of laboratorians working in clinical and research labs nationwide. Their partnership goes way back late 2013.
The laboratory safety culture was discussed where lab at-risk behaviors, near misses, incidents and accidents leading to exposures and finally laboratory acquired infections were presented, convincing everyone that it is a must to ensure laboratory safety.
The difference between biosafety and biosecurity was delineated with emphasis on bioterrorism as a possible agenda and the need to do a robust biorisk management to bring down biosafety and biosecurity risks. This session further convinced participants to ensure the safety and security of the people using our laboratories and other people who are non-users but may be affected by any untoward incidents in the lab.
The group became aware of Philippine Association of Laboratory Animal Scientist’s (PALAS) initiatives to ensure not just the ethical and humane use of laboratory animals but also the safety of the animal handlers.
Laws governing and regulating the use of laboratory animals in both teaching and research were also presented. The organizers made sure this was inculcated in the laboratory culture of all the participants.
The last topic placed much emphasis on the role of the Institutional Animal Care and Use Committee (IACUC), its creation and its importance were also discussed. There was also a presentation of what seem to be a quick ‘tour’ of a reputable animal facility.

Day 2 (by Dr. Ms. Maria Catherine Otero)

Day 2 of the training focused on the role of the Institutional Biosafety Committee (IBC) and the basics of Biorisk Management (BRM). Participants were walked through the experiences and best practices of their Institutional Biosafety Committee at the Research Institute for Tropical Medicine (RITM). The talk gave the participants important insights on how to form and put in operation the IBC in their our own institutions, as guided by the references Biosafety for Medical and Biomedical Laboratories (BMBL), WHO, Canadian Biosafety Standards (CBS) and the CEN Working Agreement (CWA15793:2011). The challenge was to tailor-fit their own IBC to the needs and resources of our institutions. It was also emphasized that the IBC should not stop in assuring biosafety, but should also prepare biosecurity measures.
The next topic introduced the BRM concepts, highlighting the Assessment-Mitigation-Performance (AMP Model) for effective BRM. From identifying hazards, risk and threats, to formulating mitigation plans, and preparing for performance monitoring and evaluation. It was emphasized that mitigation plans should follow this hierarchy of importance: (1) elimination and substitution, (2) engineering controls, (3) administrative controls, (4) practices and procedures and (5) personal protective equipment.
In the afternoon session, each group put their heads together to apply what we learned from our BRM experts. Here, they did a risk assessment for specific related activities in one of their own laboratory for each group. They practiced how to identify hazards (physical, material, or activity), and how hazards become risks, and planned on how to mitigate these risks.
For biosecurity, they did threat identification, and specified the mean, motives, and opportunities when these threats happen. Overall, they had a full day of learning from the speaker experts, and from each other, with the ultimate goal of helping improve their institutions in the area of biosafety and biosecurity.

Day 3 (Dr. Hercules Baldos)

Hercules Baldos, DVM

Day 3 morning activity mainly focused on the presentation of the groups’ outputs regarding hazard, risk identification, characterization and evaluation which was a take away assignment for all the groups prior to the closing of the days activities.
We used the adult method of learning and we, the organizers, believe that this method was very much effective and as one participant said and I quote, “knowing that the reporting was our initial ordeal or baptism of fire when it comes to identification, characterization and evaluation of hazards and risk…..I believe that all the groups wished not to be drawn first because groups that will present at the end of the waiting line could refine their presentations. The drawing order of presentation however did not happen but true enough… Cluster 1 (Group1-4) particularly Group 4 presented the facility workflow and amazingly most of the Cluster 2 (Group 5 – 8) came up with better presentations that included facility floorplans and funny things like food hood (Group 7), James Bond 007, Circle group (Group 8 and the always late (Group 5).”
Continuing on this participant’s comment “Thank you so much Cluster 2 because all of you incorporated fun which made the reporting activity less stressful, more relaxed and worth remembering. There were some confusions and the facilitators however managed to professionally correct the issues… of course we learned a lot during the sharing of ideas that somehow…we have forgotten to take our lunch on time.”
Before the closing of the morning activity… one speaker shared the “I CAN HELP” clinching commitment….. “and I thought that CRDF Global and BRAP passed thru the same ordeal of saying WE CAN HELP… the veterinary institutions, the academe and others. A commitment, deserving a round of applause.”
“In the afternoon, we were introduced to Field Biosafety and Biosecurity coupled with Biosecurity Risk Mitigation and we equally learned a lot owing to the topic’s two-way or interactive manner of presentation. We particularly took note of the 5 pillars of Biosecurity mitigation because it was clearly implied that it will be part of the post training examination. Again, let us all have fun, learn and make this day a fruitful day.”

Day 4 (Dr. Mario Arriola)

Mario Arriola, DVM (Rt) with Pamela Tan, DVM (all photos owner)

The first lecture on day 4 was on biocontainment where we started in review by having to recall the definition of laboratory biosafety. We were reintroduced to the different levels of risk group and biosafety and its key consideration; the lecturer differentiated the primary from secondary barriers as well as the cleanroom from BSL laboratory, and the various animal biosafety levels and the special biosafety levels for agriculture. Towards the end of the lecture, the speaker shared what is biosecurity for biocontainment and principle of physical security. The session on biocontainment concluded on the cost to build, and maintain a BSL, the number of personnel working and the work done per hour and the security measure for the different levels BSL laboratories.
For the group activity, to apply what we learned, each group were given a scenario from which we will design a BSL laboratory considering all the principles on laboratory biosafety. Our group were tasked to prepare one for Bacillus anthracis. After lunch, the afternoon session on Field and Laboratory Necropsy was discussed from the focus of a biosafety officer. We were introduced to the processes and rules on necropsy, the hazard and risks factors in the necropsy laboratory and recommended necropsy practices for personnel, PPEs, equipment, and decontamination. On the other hand, same processes and rules on lab necropsy should be observed in field necropsy. However, the following considerations should be observed, such as the information of the place and site location, carcass disposal, storing and transport of sample and the importance of written standard operating procedures.
Proper donning and doffing of PPEs activity

The second group activity was given by another speaker and, as an introduction, we were briefed on the regulations, the different types of PPEs and requirements. We were introduced to the different types of gloves and its do’s and don’ts. The participants were given emphasis in the protection of body, eyes and face from hazards and the types of respirators. Finally a demonstration on the sequences of donning and doffing of PPEs. For the second group activity, we were provided with PPEs composed of overalls, a pair of gloves and respirator and instructed us to don and doff the PPEs as prescribed.
Testing for contamination using the fluorecent GlowGerm.

To evaluate the proper removal of gloves were observed, an ultraviolet light source was used to scan if the hands were contaminated with the solution sprayed over the gloves. Many found themselves protected from hazard.

Day 5

Day 5 began with a general overview of what was discussed during the entire week. Emphasis was given on topics that are “need to know” and the “good to know.”
A short review was given to the participants for other questions and inquiries was entertained. Then the comprehensive exam and survey about the project was given to the participants.
After the exam, a short acknowledgement of all speakers was given, thank you’s and good-byes preceded the graduation and giving of certificates of completion to all who passed the exam.