Date: Sat, 30 Jan 1999 18:15:48 -0500 (EST)

From: The Man in Black

We should all be familiar with Biohazard Levels 1-4, but what about the theoreti
cal levels of five, six and seven?
Date: Mon, 1 Feb 1999 00:21:57 +0900 (JST)
From: Jay and Mikiko
Actually, I'm not. I could guess, but if anyone knows exactly how they break dow
n, I'd love to hear it.
Date: Sun, 31 Jan 1999 11:46:07 -0500 (EST)
From: John Petherick
Actually, I'm not. I could guess, but if anyone knows exactly how
From the CDC page on Biosafety in Microbiological and Biological Laboratories at
http://www.cdc.gov/od/ohs/biosfty/bmbl/bmbl-1.htm , in Section 3 http://www.cdc
.gov/od/ohs/biosfty/bmbl/section3.htm
The definitions of L-1 to L-4 are:
BIOSAFETY LEVEL 1:
- work involving well-characterized agents not known to cause disease in healthy
adult humans, and of minimal potential hazard to laboratory personnel and the e
nvironment
- no special precautions beyond what you learned in college microbiology lab
- in other words, your college microbiology laboratory
- examples include known organisms not listed as requiring a higher BSL
BIOSAFETY LEVEL 2:
- work involving agents of moderate potential hazard to personnel and the enviro
nment.
- restricted access, training on the hazard(s) of the infectious agents, sterili
zation of waste, standard "sharps" handling, PPE required, etc.
- immunization, if available
- in other words, the standard diagnostic medical laboratory
- example organisms: infectious stages of Plasmodium sp. (malaria), most activit
ies using Chlamydia, work using Mycobacterium leprae (Hansen's Disease), Trepone
ma pallidum (syphilis), Hepatitis A, human herpesviruses, contemporary strains o
f influenza, poxviruses (including smallpox), dengue
BIOSAFETY LEVEL 3:
- clinical, diagnostic, teaching, research, or production facilities in which wo
rk is done with indigenous or exotic agents which may cause serious or potential
ly lethal disease as a result of exposure by the inhalation route
- as above, plus higher level of training and supervision, biological safety cab
inets, a two-door airlock system, immunization
- vaccine production, research labs, referral medical diagnostic laboratories
- example organisms or procedures: Histoplasma capsulatum contaminated soil (his
toplasmosis), production of Baccilus anthraci (anthrax), production of Clostridi
um botulinum (botulism), production of Yersinia pestis (plague), historical or r
ecombinant strains of influenza, production of rabies, production quantities of
HIV or SIV
BIOSAFETY LEVEL 4:
- work with dangerous and exotic agents which pose a high individual risk of aer
osol-transmitted laboratory infections and life-threatening disease. Agents with
a close or identical antigenic relationship to Biosafety Level 4 agents are han
dled at this level until sufficient data are obtained either to confirm continue
d work at this level, or to work with them at a lower level.
- the whole nine yards, like "Hot Zone"
- examples include: Ebola, Marburg, Lassa
BIOSAFETY LEVEL FIVE:
- would be engineered biowarfare agents or Binary compounds in close proximity.
BIOSAFETY LEVEL SIX:
- would be newly engineered experimental agents or unknown agents.
BIOSAFETY LEVEL SEVEN:
- would be xenobiological, extraterrestrial, or alien biological agents, whethe
r used for biowarfare or not.
Note that there are some some crossovers. For example, diagnostics work on HIV s
pecimens should be done in a BSL-2 facility using BSL-3 equipment and procedures
. For many agents, diagnostic work is BSL-2 while production is BSL-3. While all
research work involving pox viruses is BSL-2 work, the only facility known to h
ave a sample of smallpox is the CDC.
There's a companion document for animal biosafety practices (ABSL) where handlin
g and confinement for infected animals is described. I couldn't find anything ab
out clinical isolation fo human patients, but general procedures would be simila
r to those for research animals.
Date: Sun, 31 Jan 1999 12:42:35 -0500
From: Graeme Price
John bet me to the punchline when he wrote:
Biosafety Level 2: contemporary strains of influenza, poxviruses (including smal
lpox),
NO! Not including smallpox you can handle poxviruses safely at level 2, but only
if you are vaccinated. In fact, all work on Smallpox (such as it is now) is done
under very close supervison at one of the two labs (see below) that actually st
ill have it I think they may mean "smallpox vaccine" here.
Note that there are some some crossovers. For example, diagnostics work on HIV s
pecimens should be done in a BSL-2 facility using BSL-3 equipment and procedures
. For many agents, diagnostic work is BSL-2 while production is BSL-3. While all
research work involving pox viruses is BSL-2 work, the only facility known to h
ave a sample of smallpox is the CDC.
Very true. In fact, most BSL-3 agents can be (read are) handled at BSL-2 conditi
ons in diagnostic labs, provided they are in small quantities (things like small
volumes of blood from HIV patients) larger volumes require BSL-3 conditions. Als
o there are 2 facilites with Smallpox: The CDC and the VECTOR research facility
in Russia. This has all been discussed before though and should be in the archiv
es.
The words "Trexler portable isolator" leap to mind here. This is basically a pla
stic tent with built in gloves and airlock that can be erected around a conventi
onal hospital bed. Not sure how may hopsitals still have this stuff though. Cert
ainly in the 1960's there was a lot of worry about moving Lassa patients around
- some medical personnel were actually evacuated from outbreak sites to Germany
in an Apollo (or possibly Gemini, I forget) space capsule on loan from NASA. In
other words, try not to get infected with a BSL-4 agent. Thank you.
Date: Sun, 31 Jan 1999 12:28:28 -0500
From: Graeme Price
Jay wrote:
Actually, I'm not. I could guess, but if anyone knows exactly how they break dow
n, I'd love to hear it.
One for me, I fear. The laboratory (and production facility/animal room) biohaza
rd classifications (in the US known as BSL 1-4 [BSL for Biological Safety Level]
, in the UK as P 1-4 [P for pathogen] or sometimes as category 1-4) run somethin
g like this (I've used one of my safety manuals to get the fine points).
Level 0: No risk whatsoever. No micro organisms handled or stored here. Effectiv
ely "clean". No protective apparatus or procedures required. This would be somet
hing like the coffee room, or an office.
Level 1: Most laboratories fit into this band. Minimal risk of infection to heal
thy individuals. Organisms handled here would be non-pathogenic for humans (thin
gs like lab strains of E.coli or yeast which have been crippled for genetic engi
neering purposes). Laboratory coats required, no eating and drinking, no applica
tion of cosmetics (yes, really), good laboratory practices to be followed.
Level 2: This would be most clinical labs, and most microbiology labs. Organisms
handled here may cause human disease and may be a hazard to laboratory workers,
but are unlikely to spread in the community. Lab exposure rarely produces infec
tion and effective prophylaxix (vaccination) or treatment is usually available.
This would include things like influenza virus, Salmonella, Streptococci etc. Al
l Level 1 precautions must be followed, plus hand washing facilities must be pro
vided (in the US - this is mandatory for Level 1 in the UK), access to the labor
atory must be restricted to authorised personnel, room must be under negative pr
essure if air-conditioned, all waste materials must be sterilised by autoclaving
prior to final disposal. I routinely work under Level 2 conditions. It's pretty
straightforward, actually.
Level 3: Starting to get more nasty here. This is what would routinely be called
a "containment lab". Level 3 organisms may cause severe human disease and prese
nt a serious hazard to laboratory workers. They may present a risk of spread in
the community but there is usually effective prophylaxis or treatment available.
This includes things like Mycobacterium tuberculosis, HIV, Hepatitis B, Yellow
Fever and CJD (the latter due to the uncertain risk involved in handling it). Al
l Level 1 and 2 precautions apply, plus gloves may be required at all times (dep
ending on what you are using), splash-proof overgowns may be worn over lab coats
, safety cabinets must be used at all times when handling organisms, there shoul
d be an autoclave en suite, all materials should be decontaminated before remova
l, the room is maintained under negative pressure at all times with air vented t
o the outside via a HEPA (high efficiency particulate air) filter and door must
be kept close whilst work is in progress. I have worked under these conditions.
It's less fun and more awkward generally.
Level 4: EEEK! This is the really dodgy stuff. Level 4 organisms cause severe hu
man disease and are a serious hazard to laboratory workers. They may present a h
igh risk of spread in the community and there is usually no effective prophylaxi
s or treatment. This is things like Ebola, Marburg, Hanta virus, the Argentine a
nd Bolivian haemorrhagic fever viruses etc. All Level 1, 2 and 3 conditions appl
y, plus. shower on the way and out, rooms under negative pressure, lab must be in
a seperate part of the building (preferably in a seperate building) restricted
to authorised personnel and there must be a key procedure to restrict entry at a
ll times. Entry is though an airlock, with the clean side of the airlock operate
d from the restricted side by changing and showering facilities and preferably b
y interlocking doors. The outer door must be labelled with a "work in progress"
sign. Then there are about another 3 pages of regulations which concern airflow
and emergency procedures (nothing very exciting though). In the US there is a te
ndency to require fully enclosed "space suits" working from an external air supp
ly in Level 4 labs. In the UK, this is regarded as a bit extreme and all work is
done inside glove boxes (also sometimes called "Porton Cabinets" for obvious re
asons) which are sealed from the environment. The Russians seem to take this to
extremes and use gloveboxes whilst wearing full suits. Perhaps they know somethi
ng we don't.
Anyway, I hear rumours (currently unconfimed. and they came from our Biosafety of
ficer, who isn't 100% reliable) that there is a "Level 5" containment classifica
tion. Personally I think she is talking rubbish, unless Level 4 has been split u
p, with use of gloveboxes now at Level 4 and the use of suits at Level 5. I will
try and look this up. Note that most large animal work (particularly with infec
ted monkeys) using Level 4 organisms will require the use of suits, although you
could probably use mice in a Porton Cabinet.
Anyway, this ought to explain things a bit better.
Date: Mon, 1 Feb 1999 09:17:02 -0800 (PST)
From: Doug Iannelli
I'm brand new to this forum, so excuse any lack of decorum. First, a little back
ground:
Regarding the Biohazard Levels, as far as I was aware, Levels 1-4 were the only
ones in use by USAMRIID at the time of my service. This however, is obviously su
bject to change. I will be attending a school on Weapons of Mass Destruction (WM
D) for AFD in the near future and will let you know if I find out otherwise. Thi
s course should cover the area as it deals with nuclear, biological and chemical
threats. Although I have to admit, I don't see the use in training municipal fi
refighters in dealing with these types of incidents. Even in a HazMat incident i
nvolving federal, military, or terrorist materials, the feds have jurisdiction a
nd we are to assume a "stand clear" policy and allow them to mop it up.