7. Safety: a question of policy?

The first step in preventing infection in the workplace, and with any safety plan, is risk assessment. Afterwards, the action on the part of the management will depend on its policy pertaining to the level of prevention it wishes to adopt.

The management should determine its strategy (policy) by answering the following questions:

• Is it necessary to prevent all infections, including those that can be detected only by serological tests?
• Is it enough to prevent only those infections that can cause death or disablement?
• What kind of health plan must be provided?
• To what extent is it necessary to protect the people outside the institution?
• Is it imperative to avoid the escape of microorganisms to the environment?

According to the answers to the above questions, together with the risk assessment criteria, the management should plan a course of action to prevent infections. The strategy should include the following:

7.1 The suitability (aptness) of employees to their jobs

Points to consider under this heading include the character of the person, his tendency to be involved in accidents, his responsibility, reliability and attitude toward safety, etc. An unreliable person should not be employed in high risk jobs or in a critical position in production lines.

Physical and health characteristics should be taken into consideration as well. A person in poor physical health should not be employed in arduous jobs, and an allergic person should not be assigned to work with laboratory animals, or in conditions that will expose him to allergens.

7.2 Instruction and training programs in safety

The management should develop and execute a general program for instructing and training lab personnel, as well as addressing specific subjects of safety that pertain to the activity in the laboratory. Each new employee should receive orientation before starting work, and periodically thereafter. The program should include lectures, exercises and exams to measure the perception of the material taught.

7.3 Health plan

The management should determine whether there is a need for a health care team to be employed on the premises, or if it is preferable to obtain medical services from the outside. The health plan should include an epidemiological survey for those working with a biohazardous agent - namely taking blood samples at the beginning of the employment and periodically thereafter, and checking for seroconversion with respect to the agents to which there may be exposure.

The health plan should include an appraisal of the worker's health status, while looking for high risk factors such as disorders connected with the immune system, prescribed cytotoxic medications, or steroids that could affect the resistance to infection. The possibility of vaccinating employees in high risk groups with known and approved vaccines should be considered as well.

7.4 Supervising, reporting and investigating accidents

The management should apply methods for supervising the correct execution of safety procedures. This could be carried out by using check-lists supplied to the staff, or by routine check-ups of laboratories by safety officers. Since one always learns best from experience and from mistakes, procedures for reporting and investigating accidents should be applied.

7.5 Safety budget

At this point, the safety policy can be decided. A plant or company can spend only a certain percentage of its budget on safety, because too many expenses for safety measures could put it out of business. Still, moderate investment can improve the level of safety tremendously.

It is understood that a high level of biosafety, namely containment laboratories, require high levels of expense. Budgets for these expenses are not always available, and usually priorities dictate specific investments. However, investing in safety equipment will have good benefits by saving on workers' compensation, workday losses because of illness, and even shut down of production lines because of accidents.