The purpose of The GLI* Tuberculosis Laboratory Safety Handbook is to teach staff working in a TB culture and/or a drug susceptibility testing laboratory how to work safely in order to reduce the risk of infection or injury for you, your co-workers, and the community. (*GLI = Global Laboratory Initiative) Thank you to Ms. Maureen Ellis Director of IFBA for allowing us to spread this info.

General principles: Biosafety has three key parts, all of which are needed to handle TB bacilli safely:

1. Primary Safe working practices to minimize creation of infectious aerosols and prevent spills Equipment that is ‘fit for purpose’, correctly used and maintained
2. Secondary Infrastructure and layout to support the primary activities
3. Tertiary Buildings to contain the laboratory and its activities

Working safely: Personal protective equipment (PPE), fit-for-purpose equipment, and management of infectious waste all support good aseptic technique but do not replace it. These items help contain aerosol formation but may not prevent aerosols being formed due to unsafe work practices.

Aerosols and cross-contamination: Good aseptic technique to minimize aerosol formation is your best protection. The major risk of TB infection in the laboratory is associated with inhalation of aerosols generated by laboratory processes. Minimizing their production is arguably the most effective means of staying safe. All aerosols should be considered as potentially infectious. Less than 20% of laboratory acquired infections can be traced back to a recognised accident. The rest have no identifiable cause but aerosol formation is the most likely. Aerosols once settled onto a surface, do not re-aerosolize. However, they may contaminate specimens or cultures, consumables, reagents, equipment, or PPE creating a cross-contamination risk.

Protecting the patient: Laboratory results will have a profound impact upon the patient. Minimizing aerosol formation and cross-contamination will reduce the risk of the patient receiving a false-positive result. Being incorrectly diagnosed as having TB disease, or drug-resistant TB may be catastrophic for the patient and their family. This is a good companion to the WHO Tuberculosis Safety Manual of 2012, download here)

(Click on the picture to download your copy of the GLI manual)