Abstract:
USAMRU-K Department of Emerging Infectious Diseases
(DEID) is a program consisting of eight facilities (laboratories)
that are centrally administered. It has instituted safety regulations
in the past 5 years under specific safety standard operating
procedures (SOPs) with a goal to minimize work-related
risks, injuries, or illnesses to laboratory and clinical workers by
ensuring that they have the recommended training, information,
support, and equipment to work safely. The programs
(Influenza [FLU], Acute Febrile Illness [AFI], Arthropod-borne
Virus, Enterics, Malaria Drug Resistance, Malaria Diagnostic
Center, and Entomology) respond to different health problems
including emerging and re-emerging diseases, some of which
could result from select agents such as Ebola virus, Marburg
virus, West Nile virus, Africa Swine Fever virus, Bacillus anthracis,
Yersinia pestis, and H1N1. The safety regulations are
meant to enhance awareness through education and to minimize
or prohibit possession, use, or transfer of dangerous microorganisms
to safeguard the employees, environment, and
communities from exposure. In Kenya the available government
safety regulations cover only genetically modified organisms
(GMO), and no data are available in most government
laboratories concerning occupational health, biosafety, and
biosecurity when working with such agents. In the laboratories
at USAMRU-K, no data existed before these regulations were
instituted. For the USAMRU-K to address these biorisk and
occupational health gaps, a Safety Officer was designated and
trained and embarked on vigorously training all employees and
carrying out biannual audits and surprise audits in all the
USAMRU-K laboratories to bring them to acceptable biosafety/
biosecurity and occupational health standards. The laboratories
were assessed in occupational health, safety training and
management, chemical safety, biorisk management, housekeeping,
shipping dangerous goods, and data management
using a structured questionnaire. The audits revealed that
employees are actively engaged in research and patient recruitment
with a wide variety of biological agents and disease
presentations. Moreover, analysis of the biosafety and biosecurity
data revealed biosafety was more prevalent than biosecurity,
that simple practices and techniques predominated,
and that perceptions of risk varied across the facilities as they
deal with different biological agents. These findings provided
unique insight into the variety of microorganisms studied in
various USAMRU-K laboratories and uncovered a consistent
weakness occupational health because vaccination was sporadic
and no follow-up was conducted to determine if protection
was achieved. Booster vaccinations were not documented.
USAMRU-K improved in biorisk management and occupational
health 2 years after implementation of the regulations