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CIS 94-371 Guenzi C., Simon F., Abadia G.
Waste water purification by biological treatment: Notification of a high-fever syndrome among workers
Stations biologiques de traitements des eaux usées: enregistrement de syndromes fébriles [en francés]
A study by 43 French occupational physicians of waste water purification plants (see CIS 92-1370) covers the years 1990-1993. During the collection of data, a high-fever epidemic (headaches, shivers, muscle aches) broke out among workers of such a plant treating waste water from a chemical factory by biological means. Blood tests indicated an infectious origin of this epidemic, even though no viral or bacterial pathogen could be identified.
Documents pour le médecin du travail, 1st Quarter 1993, No.53, p.31-32. 2 ref.

CIS 93-2068 Davies P.T.G., Jahfar S., Ferguson I.T., Windl O.
Creutzfeldt-Jakob disease in individuals occupationally exposed to BSE
A case of Creutzfeldt-Jakob disease (CJD) is briefly reported in a dairy farmer who was directly exposed to cases of bovine spongiform encephalopathy (BSE) on his farm. This second such report still does not associate CJD and BSE on statistical grounds, although it does emphasise the continuing importance of accurate diagnosis and reporting of all cases of CJD, especially those from potentially at risk occupations.
Lancet, 11 Sep. 1993, Vol.342, No.8872, p.680. 1 ref.

CIS 93-2069 Olsen R.J., Lynch P., Coyle M.B., Cummings J., Bokete T., Stamm W.E.
Examination gloves as barriers to hand contamination in clinical practice
A study was made of 137 procedures during which a health care worker's gloved hand was in touch with a patient's mucous membranes and was thus potentially contaminated. 86 of the 135 gloves cultured after use had gram-negative rods or enterococci on the external surface and microbial contamination of the health worker's hand occurred in 11 of these 86 events. Glove leaks and hand contamination were more frequent with vinyl than with latex gloves. Results show that under conditions of routine use, gloves effectively function as a protective barrier even when leaks are present.
Journal of the American Medical Association, 21 July 1993, Vol.270, No.3, p.350-353. 23 ref.

CIS 93-1585 Hansen D.J.
The work environment. Volume 2. Healthcare, laboratories and biosafety
This manual discusses occupational hazards which may be encountered by laboratory or healthcare workers. Contents: laboratory and clinical environments (the laboratory safety standard; working with biohazards; research laboratory ventilation systems); healthcare provider exposures (occupational exposure to bloodborne pathogens, HBV and HIV; resurgence and control of tuberculosis; occupational health hazards in the dental office); laboratory spills and medical waste disposal; glossary. Appendices include the texts of relevant standards and recommendations.
Lewis Pubishers Inc., 121 South Main Street, Chelsea, Michigan 48118, USA, 1993. xii, 351p. Illus. Bibl.ref. Index. Price: GBP 44.00.


CIS 96-2065 Norma final de los agentes patógenos transmitidos por la sangre: sumario de disposiciones llave
Bloodborne pathogens final standard: Summary of key provisions [en inglés]
Nota informativa aparecida con ocasión de la publicación de la norma americana Bloodborne Pathogens Final Standard (Agentes patógenos transmitidos por la sangre) (CIS 93-371). Esta nota explica en un lenguaje simple los siguientes puntos: ámbito de la norma; preparación de planes de limitación de la exposición; control de la aplicación; reglas especiales aplicables en los laboratorios de investigación del SIDA y la hepatitis B y establecimientos de producción; vacunación contra la hepatitis B; evaluaciones y seguimiento tras la exposición; comunicación de riesgos; información y formación; seguimiento.
OSHA Publications Office, U.S. Department of Labor, 200 Constitution Avenue, NW, Room N3101, Washington, DC 20210, USA, 1992 (también en: INTERNET 1 doc.

CIS 95-1656 Disciplinas científicas y seguridad
Practicing safe science [en inglés]
Este videocasete está dirigido a los investigadores en biología y medicina y a sus equipos técnicos. En él se contienen instrucciones relativas a los riesgos intrínsecos asociados a la investigación biomédica. Asimismo, presenta grupos de trabajo con preguntas, debates y demostraciones. Se trata sobre los riesgos químicos, físicos, radiológicos y biológicos.
Howard Hughes Medical Institute, 6701 Rockledge Drive, Bethesda, MD 28017. Videocasete. Duración: 29min. ###

CIS 94-1475 Biological agents [Sweden]
Biologiska ämnen [en sueco]
This notification came into force 1 January 1993. It applies to all work involving risk of exposure to biological substances (microorganisms, in-vitro cell cultures, human parasites). The employer has the responsibility of being aware, as far as possible, of the biological substances that are present and the hazards they might create. The tasks must be designed in a way that reduces the hazards to a minimum. If this is not possible, other safety measures must also be provided. The employer must inform and instruct the employees sufficiently so that they can carry out the work without risks. Containers and other equipment containing biological substances must be clearly marked. Suitable personal protection equipment must be used. Workplaces with quantities of dangerous substances above a certain level must be notified to the authorities. A classified list of common substances (bacteria, viruses) is provided. Ordinance AFS 1988:12 on microorganisms (CIS 90-393) is abrogated.
Publikationsservice, P.O. Box 1300, 171 25 Solna, Sweden, 1992. 36p. Illus.

CIS 94-654 Bauder R., Waldner-Sander S., Wölfle M., Urlaub G.
Bundesanstalt für Arbeitsschutz
Surveillance while working with special category waste. Exposure control on special waste disposal sites
Überwachungskonzepte bei der Sonderabfallentsorgung [en alemán]
In the special waste disposal industry the handling of multi-component mixtures is a normal operation. The composition of these is often unknown or constantly changing. In order to avoid risks to health, the German Ordinance concerning Hazardous Substances (see CIS 92-18) provides monitoring of adherence to maximum or recommended levels. In the report it is shown that monitoring of the workplace in the field of special category waste disposal in accordance with the Technical Guidance Rules for Chemical Substances (TRGS 402 and 403) is only achievable in conjunction with considerable expenditure and does not allow any assessment of future exposure levels. Suitable monitoring concepts for each area of special category waste disposal, based essentially on preventive measures for minimizing exposure to hazardous substances, are examined. Monitoring is shown to be neither sufficient nor practical, and protection of the workers and preventive measures are necessary. Suggested guidelines for practical procedures are presented. Summaries in English and French.
Wirtschaftverlag NW, Verlag für neuen Wissenschaft GmbH, Postfach 101110, 2850 Bremerhaven 1, Germany, 1992. x, 271p. Illus. 32 ref.

CIS 94-374
CSIRO Australia
The Class II bio-safety cabinet series
Four-part series designed to help in the training of staff responsible for the use, maintenance and management of biological safety cabinets. Video 1 (Introduction to bio-safety cabinets) outlines the function and design of the main types of containment devices used in microbiology for product and operator protection. Video 2 (Using the Class II bio-safety cabinet) demonstrates safe and correct procedures in working these cabinets, including preparation and safe working, shut-down and clean-up procedures. Video 3 is on decontamination and Video 4 on the testing of cabinets.
H and H Scientific Consultants Ltd., P.O. Box MT27, Leeds LS17 8QP, United Kingdom, 1992. 4 videotapes (11+17+10+14 min.). Price: GBP 160.00 + VAT + postage.

CIS 93-1073 Environmental Protection - The Genetically Modified Organisms (Deliberate Release) Regulations 1992, 1993 [United Kingdom]
These Regulations, together with Part VI of the Environmental Protection Act 1990, give effect in Great Britain to Council Directive 90/220/EEC. The Regulations define artificial techniques of genetic manipulation and the capacity of organisms for causing harm for purposes of the Regulations. They provide for mechanisms for the release of genetically modified organisms (consent for release and marketing of such organisms, applications for consent and the information to be provided therein, bringing such applications to the attention of the public); further duties in connection with the release; maintenance of registers of information. In the schedules: detailed information to be contained in consents to release and/or market genetically modified organisms. S.I. 1993 No.152 is a minor modification of S.I. 1992 No.3280.
HMSO Books, P.O. Box 276, London SW8 5DT, United Kingdom, 1992, 1993. 19p. Price: GBP 3.55.

CIS 93-1072 Environmental Protection - The Genetically Modified Organisms (Contained Use) Regulations 1992 [United Kingdom]
These Regulations give effect in Great Britain to Council Directive 90/219/EEC. Contents: interpretation and general; notification of and consent for activities involving genetic modification (prohibition of certain kinds of work with genetically modified organisms outside containment, risk assessment, notifications, consents); conduct of activities involving genetic modification; disclosure of information notified and publicity; additional duties of the Health and Safety Executive; exemptions, etc. In schedules: definition of genetic modification; criteria for the classification of organisms; parameters to be taken into account in risk assessments; information required for notifications; containment measures for micro-organisms of Group II (i.e. those not complying with guidelines set out in Part II of the schedule which gives effect to Commission Decision 91/448/EEC). The 1989 Genetic Manipulation Regulations (see CIS 89-1763) are revoked.
HMSO Books, P.O. Box 276, London SW8 5DT, United Kingdom, 1992. 23p. Price: GBP 4.00.

CIS 93-542 Collins C.H., Beale A.J.
Safety in industrial microbiology and biotechnology
This collection of papers presents the views of a number of scientists on the hazards involved in work with both naturally occurring and genetically-modified microorganisms along with outline precautions. Contents: overview of safety in microbiology; current legislation (UK, other European countries, EEC directives, USA, Japan) and regulatory frameworks; hazard groups and containment categories; assessment of risk; pathogenicity testing; recombinant plasmids; safe handling of mammalian cells on an industrial scale; recombinant DNA techniques in production; engineering for safe processing; containment in the development and manufacture of recombinant DNA-derived products; monitoring and validation in biotechnological processes; occupational health implications of industrial biotechnology.
Butterworth-Heinemann Ltd., Linacre House, Jordan Hill, Oxford OX2 8DP, United Kingdom, 1992. ix, 257p. Illus. Bibl.ref. Index. Price: GBP 60.00.

CIS 93-93 Malmros P.
Get wise on waste - A book about health and waste-handling
English version of a brochure for workers and managers, originally published as Nårskraldet skal ta's (CIS 92-1837). It summarises the physical, chemical and biological hazards encountered in waste sorting (microbial infections, allergies to microorganisms and postural problems are the most widespread). An overview of appropriate working methods and equipment is also presented. A list of Danish Working Environment Service reports, directives and guidelines giving more detailed background and instructions is appended.
Danish Working Environment Service, Landskronagade 33-35, 2100 Kobenhavn Ø, Denmark, 1992. 36p. Illus. 37 ref. Price: DKK 80.00 + VAT.

CIS 92-1837 Malmros P.
When it's time to take out the trash - A book on waste sorting
Når skraldet skal ta's - En bog om affaldssortering [en danés]
Brochure for workers and managers summarising the physical, chemical and biological hazards encountered in waste sorting; microorganisms (infection, allergy) and ergonomic problems (posture) are the most widespread. An overview of appropriate working methods and equipment is also presented. A list of Danish Working Environment Service reports, directives and guidelines giving more detailed background and instructions is appended.
Direktoratet for Arbejdstilsynet, Landskronagade 33-35, 2100 København Ø, Denmark, 1992. 36p. Illus. 10 ref. Price: DKK 80.00 + VAT.

CIS 92-2051 Arias Díaz V., Archanco López-Pelegrín C., Montes Ramos M.
La educación sanitaria. Una estrategia en el control del riesgo biológico de los trabajadores hospitalarios y de la infección nosocomial
A training programme on health education was carried out in a penal hospital in Spain with a view to the control and prevention of hospital infections and accidents. Courses were designed and given to various categories of workers with potential exposure to infection: sanitary assistants, clinical assistants, guards and cleaning staff. The programme was evaluated through a survey of the working processes and a questionnaire survey. The results showed that working processes were standardised and safety and health measures improved after the course.
Medicina y seguridad del trabajo, Jan.-Mar. 1992, Vol.39, No.155, p.3-20. 18 ref.


CIS 95-1128 del Carnen Martí Solé M., Obiols Quinto J.
Síndrome del edificio enfermo: enfermedades relacionadas y papel de los bioaerosoles
En el sumario de esta nota informativa de carácter técnico sobre la relación entre la presencia de bioaerosoles en suspensión aérea dentro de locales de oficinas y diversos problemas de salud agrupados bajo el denominado "síndrome del edificio enfermo": información general sobre bioaerosoles (definición, tamaño, composición, formación de aerosoles, prevención); evaluación médica preliminar; manifestación del síndrome del edificio enfermo (síntomas, fiebre y otros problemas); hipersensibilidad (inmunología, alveolitis alérgica, asma, rinitis alérgica, fiebre de los acondicionadores de aire); enfermedades infecciosas (legionellosis, fiebre de Pontiac); tabla presentando las características y fuentes de los bioaerosoles más comunes.
Instituto Nacional de Seguridad e Higiene en el Trabajo, Ediciones y Publicaciones, c/Torrelaguna 73, 28027 Madrid, España, 1991. 6p. 25 ref.

CIS 94-2106 Yassi A., McGill M.
Determinants of blood and body fluid exposure in a large teaching hospital: Hazards of the intermittent intravenous procedure
An analysis of all accidental blood and body fluid exposures reported by hospital workers over a two-year period was carried out. Of the 799 reported incidents, 82% were needlestick injuries and 18% were cutaneous or mucous membrane splashes. Groups incurring the greatest exposure were nurses and nursing students (78.8%), respiratory technologists and laboratory personnel, medical personnel and housekeeping, laundry, supply and distribution staff. The study revealed the hazardous nature of the intermittent intravenous procedure and highlighted the need for changes in the design of needles and provision of point-of-use disposal facilities.
American Journal of Infection Control, June 1991, Vol.19, No.3, p.129-135. 23 ref.

CIS 94-1474 Work with risk of infections [Sweden]
Smittfarligt arbete [en sueco]
Rules applied to work where there is a risk of contamination. The appended safety guide gives advice on how to deal with contamination likely to occur in workplaces. Particularly exposed workers are nursing home staff, rescue staff, hospital staff, people working with children, social workers, workers in refugee services, police, people working with microbiological organisms, workers with animals, and workers in the food industry and industries dealing with biological material.
National Swedish Board of Occupational Safety and Health, Publikationsservice, Box 1300, 171 25 Solna, Sweden, May 1991. 19p.

CIS 94-714 Baxter P.J.
Toxic marine and freshwater algae: An occupational hazard?
Editorial on the need for an investigation of hazards due to exposure (skin contact, ingestion) to toxic marine and freshwater algae. Occupations at risk include teachers of water sports, cleaners and maintainers of canals and rivers, water quality testers, park wardens and fish farmers.
British Journal of Industrial Medicine, Aug. 1991, Vol.48, No.8, p.505-506. 14 ref.

CIS 93-1415 Commission Decision No.91/448/EEC of 29 July 1991 concerning the guidelines for classification referred to in Article 4 of Directive 90/219/EEC [CEC]
Décision n°91/448/CEE de la Commission, du 29 juillet 1991, concernant les lignes directrices pour la classification visées à l'article 4 de la Directive 90/219/CEE [CCE] [en francés]
Guidelines for the classification of genetically modified micro-organisms into group I according to Article 4(3) of Directive 90/219/EEC (CIS 93-1075).
Official Journal of the European Communities - Journal officiel des Communautés européennes, 28 Aug. 1991, Vol.34, No.L.239, p.23-26.

CIS 93-1404 Legislative decree No.277 of 15.8.1991 - Implementation of Directives 80/1107/EEC, 82/605/EEC, 83/477/EEC, 86/188/EEC and 88/642/EEC on the protection of workers from the risks related to exposure to chemical, physical and biological agents at work, according to Art.7 of Law 212 of 30.7.1990 [Italy]
D.L. 15.8.1991: Attuazione delle direttive ... della CEE, in materia di protezione dei lavoratori contro i rischi derivanti da esposizione ad agenti chimici, fisici e biologici durante il lavoro, a norma dell'art.7 della legge 30.7.1990, n.212 [en italiano]
This decree implements into Italian legislation, as directed by Law No.212 of 1990 (see CIS 91-701), the provisions of certain EEC directives (see CIS 81-1610, 83-1783, 84-327, 87-45 and 90-1430) dealing with the protection of workers against various hazards. Contents: general provisions; definitions; protective measures; obligations of employers, management, supervisors, workers and occupational physicians; removal of workers from exposure; particular protective measures (hazard evaluation, information of workers, medical surveillance, technical prevention, etc.) relating to metallic lead (Pb) and its ionic compounds (8h TWA TLV = 150µg/m3 air), asbestos (8h TWA TLV = 1f/cm3 for chrysotile, 0.2f/cm3 for other types), noise (requirement to wear hearing protection when exposure >90dB(A), hearing examination obligatory when exposure > 85dB(A)); penalties. In annex: list of jobs where Pb exposure is common; indicators for clinical control of Pb exposed workers; analytical methods for evaluation of Pb exposure and for measuring Pb and asbestos concentration in air; criteria for noise measurement and for evaluating hearing damage; methods for evaluating exposure to chemicals.
Gazzetta ufficiale, 27 July 1991, No.200, Supplement, 24p.

CIS 93-796 Simons J., Sotty P.
Biological hazards - Prevention in research laboratories
Risques biologiques - Prévention en laboratoire de recherche [en francés]
The purpose of this training manual is to teach research laboratory personnel the best means to reduce or eliminate biological risks in their work. The main biological hazards present in such work are surveyed. Five principal approaches to safety are detailed: correct hazard evaluation (taking into consideration the microorganism and establishing a protocol for its handling); proper laboratory design; equipment adapted to the risks (microbiological safety station etc.); safe laboratory practices; effective medical surveillance.
INRA Editions, Route de Saint Cyr, 78026 Versailles Cedex, France, 1991. 248p. Illus. Bibl.ref. Index. Price: FRF 170.00.

CIS 93-371
Department of Labor - Occupational Safety and Health Administration (OSHA)
Occupational Exposure to Bloodborne Pathogens: Final Rule [USA]
This standard (effective 6 Mar. 1992), aimed at eliminating or minimising occupational exposure to bloodborne pathogens (particularly Hepatitis B Virus (HBV) and Human Immunodeficiency Virus (HIV)), concerns: definitions; exposure controls; methods of compliance (engineering and work practice controls, personal protective equipment, housekeeping); HIV and HBV research laboratories and production facilities; Hepatitis B vaccination and post-exposure evaluation and follow-up; communication of hazards to employees (labels and signs, information and training); recordkeeping. The introduction to the standard includes a very detailed discussion of: events leading to the standard; health effects of exposure to bloodborne pathogens (epidemiology and symptoms of Hepatitis B and AIDS; other bloodborne pathogens: syphilis, malaria, babesiosis, brucellosis, leptospirosis, arboviral infections, relapsing fever, Creutzfeldt-Jacob disease, human T-lymphotropic virus type I, viral haemorrhagic fever); quantitative risk assessment (principally among health-care workers); significance of risk; regulatory impact/flexibility analysis; environmental impact.
Federal Register, 6 Dec. 1991, Vol.56, No.235, p.64003-64182. Illus.

CIS 93-672 Fängmark I., Wikström L.E., Henningson E.W.
Collection efficiency of a personal sampler for microbiological aerosols
A modified personal impinger (MPI) for sampling airborne microorganisms was tested for collection efficiency with the jet nozzle placed at various positions above and below the liquid surface. Results showed that the MPI functions according to impactor theory when operated with the flask bottom as the impaction surface, e.g. when the jet nozzle is positioned 4mm from the flask bottom. Also, impaction in the liquid or on the liquid surface will result in less efficient collection of small particles.
American Industrial Hygiene Association Journal, Dec. 1991, Vol.52, No.12, p.516-520. Illus. 8 ref.

CIS 92-2010 Pillière F., Falcy M.
Exposure to genotoxic chemical products: Biological markers used in the monitoring of workers
Exposition aux produits chimiques génotoxiques - Marqueurs biologiques pour la surveillance des salariés [en francés]
This information note surveys the scientific literature on genotoxic products, i.e. those that are liable to induce cancers or genetic mutations. The advantages and disadvantages of current methods used for the monitoring of workers exposed to such products are discussed. These methods are: 1. Detection of mutagenic activity in biological fluids (the Ames test). 2. Tests that detect cytogenetic changes (chromosomal aberrations, micronuclei, sister-chromatic exchanges) in human cells. 3. Protein and DNA adducts. 4. Unscheduled DNA synthesis (UDS). All these tests are subject to very sensitive interpretation, and there are actually few laboratories able to carry them out. As far as choice is concerned, it makes more sense to use a short-time test (sister-chromatic exchanges, adducts) when monitoring recent exposure, and a long-term test (chromosomal aberrations) when monitoring ancient or cumulative exposure.
Documents pour le médecin du travail, 4th Quarter 1991, No.48, p.329-336. Illus. 40 ref.

CIS 92-1427 Commission Directive of 29 May 1991 on establishing indicative limit values by implementing Council Directive 80/1107/EEC on the protection of workers from the risks related to exposure to chemical, physical and biological agents at work [CEC]
Dir. de la Commission du 29.5.91, relative à la fixation de valeurs limites de caractère indicatif par la mise en œuvre de la dir. 80/1107/CEE du Conseil concernant la protection des travailleurs contre les risques liés à une exposition à des agents chimiques... pendant le travail [CCE] [en francés]
This Directive lists in the Annex the indicative limit values, of which Member States shall take account, when establishing the limit values referred to in Article 4(4)(b) of Directive 80/1107/EEC (CIS 81-1610). The Member States shall bring into force the provisions necessary to comply with this Directive by 31 December 1993.
Official Journal of the European Communities - Journal officiel des Communautés européennes, 5 July 1991, Vol.34, No.L.177, p.22-24.

CIS 92-1586 Tan C.C.
Occupational health problems among nurses
Nurses are an integral component of the health care delivery system. In discharging their duties, nurses encounter a variety of occupational health problems which may be categorised into biological, chemical, physical and psychosocial hazards. A review of some examples of each of these four types of hazards is presented. Particular attention has been devoted to hepatitis B, acquired immunodeficiency syndrome, tuberculosis, cytotoxic drugs, anaesthetic agents, needlestick injury, back pain, and stress.
Scandinavian Journal of Work, Environment and Health, Aug. 1991, Vol.17, No.4, p.221-230. 102 ref.

CIS 92-1717 Simons C.G.
Specifying the correct biological safety cabinet
Laboratories must now be designed to handle both chemical fume hoods and biological safety cabinets (BSCs). These devices provide different types of containment, therefore they cannot be substituted for each other. The article discusses the mechanical requirements of various categories of BSCs. Design issues include: physical dimensions; power requirements; location of the BSC in the laboratory; adjacency of peripheral equipment. Strategies for biohazard protection and chemical and radioisotopic hazard protection are outlined.
ASHRAE Journal, Aug. 1991, Vol.33, No.8, p.31-34. Illus. 3 ref.

CIS 92-1720 Malmberg P.
Nordic Expert Group for Documentation of Occupational Exposure Limits - 99. Microorganisms
Nordiska Expertgruppen för Gränsvärdesdokumentation - 99. Mikroorganismer [en sueco]
Relevant literature was reviewed and evaluated. Inhalation of microorganisms may cause non-infectious diseases by activation of immune and non-immune defence mechanisms. The symptoms include allergic alveolitis, fever, chronic inflammatory changes in the airways, mucous membrane irritation, allergic asthma and rhinitis. Inflammatory cells have receptors which recognise and respond to components of microorganisms, such as endotoxin, peptidoglycan, bacterial peptides and fungal glucans. These substances can produce the "toxic" inflammatory reaction which has been reported from many work environments. On repeated intense exposure, the reaction is compounded by immune reactions that result in allergic alveolitis. Immune, non-immune or both types of reaction have been reported from the cotton industry, farming, animal husbandry, grain handling, wood handling, composting and office work (contaminated humidifiers).
Arbetsmiljöinstitutet, Förlagstjänst, 171 84 Solna, Sweden, 1991. 29p. 142 ref.

CIS 92-428 Woolley A., Buttolph M.A.
Biological agents at work
Contents of this module usable for an OSH training course or for private study, accompanied by question-and-answer tests: basic information on health hazards due to biological agents (viruses, bacteria, protozoa and fungi; the process of infection); defence systems of the body (primary defences; the immune system); allergies; controls and legal requirements in the UK. In annex: fact sheets on common infectious diseases of concern in the workplace (hepatitis B, Legionnaires' disease, humidifier fever, leptospirosis, AIDS, aspergillosis, anthrax, brucellosis, glanders).
OHSOL Unit, Buckingham Building, Lion Terrace, Portsmouth PO1 3HE, United Kingdom, 1991. 41p. Illus.

CIS 92-665 Wong E.S., Stotka J.L., Chinchilli V.M., Williams D.S., Stuart C.G., Markowitz S.M.
Are universal precautions effective in reducing the number of occupational exposures among health care workers? - A prospective study of physicians on a medical service
In a questionnaire survey 277 physicians were queried concerning incidents of exposure to blood and body fluids and barrier use before and after the implementation of universal precautions. Implementation increased the frequency of barrier use during exposure incidents, decreased the number of exposure incidents that resulted in direct contact with blood and body fluids and increased averted exposures in which direct contact was prevented by barrier devices. Thus, universal precautions were effective in reducing the risk of occupational exposures among physicians.
Journal of the American Medical Association, 6 mar. 1991, Vol.265, No.9, p.1123-1128. 28 ref.

CIS 92-326
Health and Safety Commission
Safe working and the prevention of infection in the mortuary and post-mortem room
This guidance supercedes that given in the Code of Practice for the prevention of infection in clinical laboratories and post-mortem rooms: the Howie Code, first published in 1978. Contents: duties of employers and employees under the Health and Safety at Work etc. Act 1974; identification and assessment of risk; mortuary accommodation and engineering services; body storage and reception and arrangements for viewing; post-mortem examination (safety standards, supervision of safety procedures, staff training, protective clothing, preparing the examination room, safe working practices, waste disposal); model rules for staff and visitors. Appendices include: labelling, transport and reception of specimens; training pathology technicians; safe use of disinfectants and disinfection.
HMSO Books, P.O. Box 276, London SW8 5DT, United Kingdom, 1991. v, 36p. 42 ref. Price: GBP 5.00.

CIS 92-320 Wright J.G., McGeer A.J., Chyatte D., Ransohoff D.F.
Mechanisms of glove tears and sharp injuries among surgical personnel
In this study, operating room personnel were interviewed immediately after a glove tear or sharp injury had occurred over a period of 3 months. During 2292 surgical procedures there were found to be 249 glove tears and 70 sharp injuries. The mechanism causing the tear could be identified in only 81 cases (33%), while 3 mechanisms accounted for 57% of the sharp injuries. It was concluded that the majority of glove tears have an unknown mechanism and routine wearing of double gloves may reduce the risk of exposure. The identification of specific mechanisms of sharp injuries should lead to effective strategies to prevent exposure.
Journal of the American Medical Association, 25 Sep. 1991, Vol.266, No.12, p.1668-1671. 23 ref.

CIS 91-2069 Occupational diseases affecting persons who work in contact with animals and their products and wastes
Al-amrāḍ ul-mihniyya allati tasaadifu ladaa l-aškhaas allathiina yu(amaluun bi tamaass ma(a l-hayawaanaat wa muntajaatiha wa fadlaatiha [en árabe]
Review emphasising the infectious diseases associated with animal husbandry. The diseases, the causative organisms, routes of infection and preventive measures are mentioned.
Arab Labour Office, Arab Institute for Occupational Health and Safety, P.O. Box 5770, Damascus, Syria, 1991. 34p.

CIS 91-2073
Health and Safety Commission
Safe working and the prevention of infection in clinical laboratories - Model rules for staff and visitors
These model rules cover the main work activities undertaken in clinical laboratories and associated workplaces; they should be read in conjunction with the main document Safe working and the prevention of infection in clinical laboratories. The guidance includes general precautions (personal hygiene, use of protective clothing, safe work practices) along with model rules for clinical, scientific, technical and medical laboratory staff, phlebotomists and venepuncturists, laboratory office staff, porters and messengers, cleaning and maintenance staff and visitors.
HMSO Books, P.O. Box 276, London SW8 5DT, United Kingdom, 1991. iii, 11p. Price: GBP 2.50.

CIS 91-2072
Health and Safety Commission
Safe working and the prevention of infection in clinical laboratories
This guidance is intended primarily to cover working practices in clinical pathology laboratories, and supersedes that given in the Code of Practice for the prevention of infection in clinical laboratories and post-mortem rooms: the Howie Code, first published in 1978. Contents: duties of employers and employees under the Health and Safety at Work etc Act 1974 (see CIS 74-2099); staff welfare and accommodation; safety guidelines for use in clinical laboratories; operation and maintenance of equipment; fire precautions. Appendices include a list of relevant British Standards, provisions of the Control of Substances Hazardous to Health (COSHH) Regulation 1988 (see CIS 89-1092), and guidance on the labelling, transport and reception of specimens.
HMSO Books, P.O. Box 276, London SW8 5DT, United Kingdom, 1991. v, 38p. 41 ref. Price: GBP 5.50.

CIS 91-1013 Stimpfel T.M., Gershey E.L.
Design modifications of a class II biological safety cabinet and user guidelines for enhancing safety
Design modifications to permit internal waste collection and to optimise the available work area are described. Improvements, including an internal recessed well for the waste receptacle, relocation of petcocks and electrical duplex, and installation of a new vacuum trap, make operation of the cabinet more efficient and potentially safer. To correct poor work practices, which can compromise the protective features of any biological safety cabinet, it is advised that precise guidelines and training programmes should be followed.
American Industrial Hygiene Association Journal, Jan. 1991, Vol. 52, No.1, p.1-5. Illus. 17 ref.


CIS 95-2276 Calidad del aire en el interior de los edificios - Contaminantes biológicos
Indoor air quality - Biological contaminants [en inglés]
Informe de resultados de un grupo de trabajo sobre calidad del aire en el interior de los edificios y los biocontaminantes que se ha reunido en Ravtavaara, Finlandia, del 29 de agosto al 2 de septiembre de 1988. En el sumario: naturaleza y definición de los efectos de la morbilidad; evaluación de los riesgos; controles del ambiente; muestreo y análisis; fuentes de los contaminantes microbiológicos; factores medioambientales y biológicos en el interior de los locales; estrategias para el control de los biocontaminantes (diseño de los edificios, ventilación y limpieza); conclusiones y recomendaciones. Resúmenes en Francés, Alemán y Ruso.
Bureau régional de l'OMS pour l'Europe, Scherfigsvej 8, 2100 København Ø, Dinamarca, 1990. v, 67p. 40 ref. Precio: CHF 9,00.

CIS 93-1075 Council Directive 90/219/EEC of 23 April 1990 on the contained use of genetically modified micro-organisms [CEC]
Directive 90/219/CEE du Conseil, du 23 avril 1990, relative à l'utilisation confinée de micro-organismes génétiquement modifiés [CCE] [en francés]
This Directive lays down common measures for the contained use of genetically modified microorganisms with a view to protecting human health and environment. After a definition of the scope of the Directive and a classification of microorganisms and related operations, provisions specify principles of good occupational safety and hygiene practice, users' obligations (notifications with detailed information about the content of the notification, record keeping of work carried out), the role and attributions of the competent authorities, the obligation to provide information to the public, and in case of an accident to persons liable to be affected by the accident, to the competent authorities and to the Commission. Annexes: techniques of genetic modifications, criteria for classifying genetically modified microorganisms, safety assessment parameters to be taken into account, containment measures, different types of required information.
Official Journal of the European Communities - Journal officiel des Communautés européennes, 8 May 1990, Vol.33, No.L.117, p.1-14.

CIS 93-1074 Council Directive 90/220/EEC of 23 April 1990 on the deliberate release into the environment of genetically modified organisms [CEC]
Directive 90/220/CEE du Conseil, du 23 avril 1990, relative à la dissémination volontaire d'organismes génétiquement modifiés dans l'environnement [CCE] [en francés]
The objective of this Directive is to approximate the laws, regulations and administrative provisions of the member States and to protect human health and the environment when carrying out the deliberate release of genetically modified organisms (GMOs) into the environment and placing on the market products containing GMOs. Definitions, obligation of notification and detailed information about the content of the notification, role of competent authorities in the evaluation of the notification and written consent to proceed to the release or to the placing on the market of products containing GMOs by the competent authority. Setting up by the Commission of a system of exchange of the information contained in the notifications. Annexes: techniques of genetic modification referred to in the directive, information required in the notification.
Official Journal of the European Communities - Journal officiel des Communautés européennes, 8 May 1990, Vol.33, No.L.117, p.15-27.

CIS 92-1370 Altmeyer N., Abadia G., Schmitt S., Leprince A.
Microbiological risks and work in waste water purification plants
Risques microbiologiques et travail dans les stations d'épuration des eaux usées [en francés]
The risk of infection with work in water purification plants (biological treatment) is the subject of numerous investigations. While the theoretical risk may be disturbing, the actual risk may be less clear, as shown by this literature survey, based on observations made by a group of industrial physicians. The principles of waste water treatment are first explained, followed by a description of the microbiological risks in biological-treatment purification plants: theoretical risks, routes of contamination, actual risks (digestive, respiratory and skin diseases, leptospirosis, sewer workers' syndrome). A summary of the data collected is presented, along with preventive measures concerning all types of risks found in purification plants. An annex shows a medical follow-up sheet.
Documents pour le médecin du travail, 4th Quarter 1990, No.44, p.373-388. Illus. 100 ref.

CIS 91-1364 Breo D.L.
The 'slippery slope': handling HIV-infected health workers
This paper discusses the issues concerning the possible restriction of invasive procedures performed by HIV-infected health workers, notably surgeons and dentists. Although the number of HIV-infected health workers is small and the potential risk to patients is remote, the subject is an emotive one. A case report involving a patient who claimed to have contracted AIDS following an invasive dental procedure highlights the problem. A meeting of AIDS consultants convened by the US Centers for Disease Control (CDC) concluded that there was a need to define and identify high-risk invasive medical procedures and to develop CDC guidelines for the management of HIV-infected health workers.
Journal of the American Medical Association, 19 Sep. 1990, Vol.264, No.11, p.1464-1466.

CIS 91-1363 Occupational infection among anaesthetists
Short review of the risks for anaesthetists of exposure to blood and body fluids carrying infectious organisms, in particular hepatitis B virus (HBV) and human immunodeficiency virus (HIV). The fact that anaesthetists have more HBV markers than the general population suggests that occupational infection does occur. Immunisation against hepatitis B gives a high level of protection. Although there have been no fully documented cases of accidental HIV infection among anaesthetists, such incidents have been reported in other health care workers. There is no protective vaccine against HIV and the wearing of gloves is advised as a minimum protective measure.
Lancet, 3 Nov. 1990, Vol.336, No.8723, p.1103. 17 ref.

CIS 91-1020
Health and Safety Executive
Vaccination of laboratory workers handling vaccinia and related poxviruses infectious for humans
This guidance note presents the statement on vaccination policy given by the Advisory Committees on Dangerous Pathogens and on Genetic Modification: it is recommended that the smallpox vaccine should not generally be given to those who work with vaccinia virus or related poxviruses except in certain circumstances (details of which are given). Brief guidance is given on counselling before vaccination and after exposure, teaching and use of poxviruses, and training of workers handling poxviruses. Appendices provide detailed information on: risk assessment; contra-indications and complications of vaccination; vaccination procedures; hygiene precautions following vaccination; accidental personal contamination with wild-type or recombinant virus; containment of work with vaccinia and other poxviruses; poxviruses infectious for humans.
HMSO Books, P.O. Box 276, London SW8 5DT, United Kingdom, 1990. 16p. Illus. Price: GBP 5.50.

CIS 91-1019
Advisory Committee on Dangerous Pathogens
Categorisation of pathogens according to hazard and categories of containment
Contents of this guide: introductory comments on assessing the dangers of pathogenic organisms, a review of categorisation, physical containment of work and implementation of preventive measures; categories of pathogens (allocation of pathogens to hazard groups; definition of hazard groups; matching hazard group with containment level; modification to containment; categorisation lists; vaccination; vaccinia immunisation; sources of vaccines and other immunological products); categories of containment (model rules; local adjustments to levels of containment; laboratory and animal room containment levels). Appendices include: recommendations for certain types of virus, the use of Class II microbiological safety cabinets, respiratory protective equipment and training of laboratory personnel.
HMSO Books, P.O. Box 276, London SW8 5DT, United Kingdom, 2nd ed., 1990. 68p. 17 ref. Price: 6.00.

CIS 91-29 Council Directive of 26 Nov. 1990 on the protection of workers from risks related to exposure to biological agents at work (7th individual Directive within the meaning of Article 16(1) of Directive 89/391/EEC) [CEC]
Directive du Conseil, du 26 nov. 1990, concernant la protection des travailleurs contre les risques liés à l'exposition à des agents biologiques au travail (7e directive particulière au sens de l'article 16, paragraphe 1, de la directive 89/391/CEE) [CCE] [en francés]
This directive lays down particular minimum requirements in this area. Objectives, definitions and scope are given in the general provisions. Employers' obligations include items such as: replacement of the dangerous biological agent, reduction of risks, information of the competent authority and of workers, hygiene and individual protection, keeping of a list of exposed workers, notification of the competent authority. Miscellaneous provisions; an indicative list of activities, a biohazard sign and practical recommendations are given in the Appendices. For Directive 89/391/EEC, see CIS 89-1401.
Official Journal of the European Communities - Journal officiel des Communautés européennes, 31 Dec. 1990, Vol.33, No.L.374, p.1-12.

CIS 91-90 Lehmann M., Bösch R., Jost M., Auf der Maur A.
Humidification of the air
Luftbefeuchtung [en alemán]
Umidificazione dell'aria [en italiano]
Humidification de l'air [en francés]
Although humidification improves the quality of indoor air, humidifiers can contaminate the air with bacteria and fungi. This guide covers: hazards and symptoms of infection; principles of operation; requirements for safe and healthful operation; appropriate measures; use of disinfectants; use of ultraviolet light; ease of cleaning; planned maintenance; relevant safety regulations.
Caisse nationale suisse d'assurance en cas d'accidents, Case postale, 6002 Lucerne, Switzerland, Sep. 1990. 8p. Illus.

CIS 91-324 Baxter J.A.
Hepatitis B - A summary of the occupational health concern
L'hépatite B - Résumé des risques sur le plan professionnel [en francés]
Hepatitis B is a serious occupational concern for workers who may be exposed to blood or certain body fluids. Topics covered in this document: description of the disease and its effects; transmission of the virus via blood, saliva and other body fluids; occupational groups at risk; recognition and treatment of the disease; prevention of the spread of Hepatitis B in the workplace by infection control and immunisation measures..
Canadian Centre for Occupational Health and Safety, 250 Main Street East, Hamilton, Ontario L8N 1H6, Canada, 2nd ed., Mar. 1990. 8p. 11 ref.

CIS 91-160 Baxter J.A.
Needlestick injuries - A summary of the occupational health concern
Blessures par piqûre d'aiguille - Résumé des risques sur le plan professionnel [en francés]
Accidental punctures by contaminated needles can cause injection of hazardous substances, in particular, blood-borne viruses such as hepatitis and AIDS. Needlestick injuries are an occupational hazard for nursing and laboratory staff and for domestic staff encountering needles in waste. Recommended preventive measures include effective training programmes, safe handling and recapping procedures and effective waste disposal systems for used needles.
Canadian Centre for Occupational Health and Safety, 250 Main Street East, Hamilton, Ontario L8N 1H6, Canada, Feb. 1990. 11p. 16 ref.

CIS 91-322 Collins C.H., Grange J.M.
The microbiological hazards of occupations
Topics covered in this book: descriptions of various types of microorganisms and methods of identification; host defence mechanisms, allergies, vaccination and immunisation; sources and routes of occupational infections and descriptions of job-associated diseases; respiratory allergies associated with microorganisms; safe working practices; sterilisation and disinfection of microbiological waste; microbiological monitoring; microbiological hazards of air conditioning, plumbing and humidifying systems; food-borne illnesses; working in controlled or sterile environments; use of microorganisms in industry; hazards and benefits of genetic engineering; personal protection; legal aspects.
Science Reviews Ltd. and H & H Scientific Consultants Ltd., P.O. Box MT27, Leeds LS17 8QP, United Kingdom, 1990. 134p. Illus. 38 ref.

CIS 90-1585 Cordier S.
Risk of cancer among laboratory workers
A number of rare cancers among workers below 50yrs of age at the Institut Pasteur (Paris, France) prompted an investigation of deaths due to cancer among research laboratory workers of the Institute. The cohort consisted of the 3765 people who had worked at least 6 months in the Institute between 1971 and 1986 (follow-up until end of 1987). Among workers in the cohort, total mortality, deaths from all cancers and from cardiovascular disease were all less than expected, while from cancers of the breast and the ovary, and from leukaemia and lymphoma were close to expected. However, significant excess deaths were found for bone cancer in men, and for pancreatic cancer and brain tumours in women (all in people whose work had been mostly in bacteriology laboratories) - the absolute numbers being in all cases low. More research is being pursued.
Lancet, 5 May 1990, Vol.535, No.8697, p.1097. 1 ref.

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