Dr Ali A. Mohammadi President Global Health and Security Consultants. 18/3/2013 Global Health & Security Consultants



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Dr Ali A. Mohammadi President Global Health and Security Consultants 18/3/2013 Global Health & Security Consultants

Contents of presentation Definition Biosafety & Biosecurity considerations and principles Biosafety levels and Risk Groups Elements of Biosafety program GMP and Biosafety, Synergies and conflicts Biosecurity program and issues. Conclusion

Available guidelines and guidance documents EN FR SP PO CH RU IT PE Laboratory biosafety (working safely) describes containment principles, technologies and practices implemented to prevent unintentional exposure to pathogens and toxins, or their accidental release. (Laboratory biosafety manual, 3 rd edition, 2004) http://www.who.int/csr/resources/publications/biosafety/wh O_CDS_CSR_LYO_2004_11/en/ Laboratory biosecurity as a complement to laboratory biosafety Laboratory biosecurity (keeping the work safe) describes the protection, control and accountability for valuable biological materials (VBM) within laboratories, in order to prevent their unauthorized access, loss, theft, misuse, diversion or intentional release. (Biorisk management: laboratory biosecurity guidance, 2006) http://www.who.int/csr/resources/publications/biosafety/who_cds_epr_2006_ 6/en/index.html Global Health & Security Consultants

Laboratory biosecurity as a complementto laboratory biosafety Laboratory biosafety and biosecurity mitigate different risks, but they share a commongoal: keeping valuable biological materialssafely and securely inside the areas where they are used and stored. Good laboratory biosafety and biosecurity practices reinforce and strengthen GLP and GMP

Why biosafety practicein the Facility Protection of: - Personnel - products - co-workers - lab support personnel - environment

When is it Relevant to Consider the Issues of Biosafety? Manufacturers Vaccine production (in combination with GMP) GMO (Genetically Modified Organisms) Hospitals/patient care facilities Isolation rooms with or without airlocks Research, diagnostic and control laboratories Vaccine production Hospitals/patient care facilities Biodefense

Biosafety levels BSL1 -agents not known to cause disease(no or low individual and community risk). BSL2 -agents that cause human or animal diseaseswith moderate individual or low community risk (e.g. blood borne diseases). BSL3 -indigenous/exotic agents associatedwith human disease and with potential foraerosol transmission-high individual risk (respiratory) low community risk) BSL4 - dangerous/exotic agents of life threatening nature serious diseases readily transmitted.

Relation of risk groups to biosafety levels, practices and equipment Risk grou p Biosafety level (BSL) Laboratory type Lab. practice Safety equipment 1 Basic BSL- 1 Basic teaching and research Good microbiological techniques (GMT) None, open bench work 2 Basic BSL- 2 Production/ Diagnostic services and research GMT + protective clothing biohazard sign Open bench plus bio safety cabinet (BSC) for potential aerosols, PPE 3 Containment BSL- 3 Special production/ diagnostic services and research As BSL-2 plus special clothing controlled access directional airflow Biosafety cabinet and/or other primary devices for all activities, Special PPE 4 Maximum Containment BSL- 4 Dangerous pathogen units As BSL-3 plus airlock entry, shower exit and special waist disposal Class-3 BSC or positive pressure suites in conjunction with class-2 BSCs, double ended autoclave trough the wall and filtered air, highly specialized PPE

Summary of biosafety level requirements BIOSAFETY LEVEL 1 2 3 4 Isolation of laboratory No No Yes Yes Room sealable for decontamination No No Yes Yes Ventilation: inward airflow No Desirable Yes Yes controlled ventilating system No Desirable Yes Yes HEPA-filtered air exhaust No No Yes/Nob Yes Double-door entry No No Yes Yes Airlock No No No Yes Airlock with shower No No No Yes Anteroom No No Yes Anteroom with shower No No Yes/Noc No Effluent treatment No No Yes/Noc Yes Autoclave: on site No Desirable Yes Yes in laboratory room No No Desirable Yes double-ended No No Desirable Yes Biological safety cabinets No Desirable Yes Yes Personnel safety monitoring capability No No Desirable Yes

Essential Building Principles Primary containmentbarrier is the first barrier between agent and man(ppes such as gloves, gowns, masks, biosafety cabinets,respiratory protection etc.) Secondary containmentbarrieris the barrier between agents and environment (airtight rooms, air handling and filtration, air locks,showers, laundry, sewage treatment, waste disposal, sterilisers, redundantservices as well as equipment and material niches. Tertiary containmentbarrier represents an additional organisational barrier with the physical operation with items such as walls, fences, security,quarantine and animal exclusion zones.

Biosafety Principles Substitution (replace hazardous material) IIV vs LAIV Technical safety measures (engineering controls) Facility design Directional airflow, ventilation Isolators for animals... Organisational measures SOP Practices, procedures Training Access control... Personal Protective Equipment Does not necessarily eliminates the hazard!! 11

Personal Protective Equipment (PPE)

Production Work flow considerations During the programming phase it is essential to define how various elements are processed, including production material (working seeds, culture media, chemicals) animals (clean and dirty), people, wastes (carcasses, solid, other), laundry, samples from animals, feed and bedding (if used).

Elements of Biosafety Program Risk assessment Accident and spills control and prevention and reporting Decontamination/ Disinfection Waste management Animal handling and safety Personal Protective Equipment (PPE) Medical check and records Biosafety committee (BC) and Biosafety officer (BO) Packaging and transport Training Managers, Experts, Co-workers is the MUST Biosecurity Global Health & Security Consultants

GMP and Biosafety Where do we find synergies? Where do the guidelines contradict each other? And what to do about it?

GMP & Biosafety The definition of Biosafety and GMP Synergies and clashes Strategies for sorting out clashes Risk assessments Examples General layout Ventilation systems Cleaning flows

Definition GMP -Good Manufacturing Practice The Good Manufacturing Practices (GMP) are the part of the quality assurance that ensures that pharmaceutical products are produced consistently and controlled in accordance with the appropriate quality standards. These standards depend on the intended use of the product and the requirements issued by the health authorities (WHO, MOH) or the product specification GMP applies to both production and quality control laboratory Purpose To ensure that the product is safe and effective for the end user

Biosafety GMP: Synergies Restricted access Segregation of production areas Facility designed for easy cleaning Minimize contamination Validate processes, systems, equipment, and facilities Job certification and mandatory training Mandatory personal protective equipment (PPE) Written policies and procedures, SOPs Documentation, double signatures, etc.

Why do Biosafety and GMP Clash? GMP (Keep Out) Protect the product Minimize cross contamination Production flow: dirty to clean (raw materials to purified product) Biosafety (Keep In) Protect the employees Prevent escape of materials Work flow: clean to dirty (non-infectious to infectious)

GMP and Biosafety Design Clashes Risk assessment HVAC design Room pressure Doors Cleaning rooms

Biosafety -Risk Assessment Evaluate Type of Hazard(s) Reservoir Volume Concentration Possible ways of escape Route of transmission Infectious dose Susceptible hosts Incubation period Decontamination principles Along with all other aspects of product safety

Production -Risk Assessment In different situations During production Planned start up/shut down Unplanned start up/shut down Fire/power failure CIP/SIP For different aspects of the production Temperature (high, low) Pressure (high, low) Flow (fast, slow, reverse) Volume/level (high, low) Mixing/surface tension/bubbles ph, Redox/density Leakage/breakage Tanks/pumps/pipes/valves Computer/alarms/communication

Large Scale Production Risk Assessment Due to GMP we already have Closed systems a process requirement Double filters & steam traps on tanks etc. to keep all contaminating elements out Thereby keeping the infectious agents within the tanks Sterile tube welders for inoculation and sampling Adequate monitoring and alarms Automatic shut down in response to critical alarms cgmp procedures Batch records, GMP trained employees, SOPs, log books, etc.

WHO Technical Report Series No 941, 2007 Annex 5 WHO biosafety risk assessment and guidelines for the production and quality control of human influenza pandemic vaccines This document provides guidance to national regulatory authorities and vaccine manufacturers on the safe production and quality control of human influenza vaccines produced in response to a threatened pandemic. The document details international biosafety expectations for both pilot-scale and large-scale vaccine production and control and is thus relevant to both development and production activities. It should be read in conjunction with the WHO Laboratory Biosafety Manual (1) and replaces the earlier WHO guidance Production of pilot lots of inactivated influenza vaccines from reassortants derived from avian influenza viruses: Interim biosafety risk assessment (2). Tests required to evaluate the safety of candidate influenza vaccine reference viruses by WHO Reference Laboratories prior to release to vaccine manufacturers are also specified in this document. Global Health & Security Consultants

BIOSECURITY: Public Health and security activities have traditionally had minimal overlap Public Health Issues: Virus, Masks, Hospital Global Health & Security Consultants Security issues: Guards, guns, Gates (3 Gs)

Challenges to health and security Intentional misuse of biological agent Public Health Ebola Zaire Security Global Health & Security Consultants

Deliberate Use of Biological Agents represents a challenge to both Public Health and Security Security Public Health Different roles and responsibilities, different mandates Same objectives Global Health & Security Consultants

Combined Strength of Biosecurity and Biosafety Laboratory biosecurity and biosafety work together to keep dangerous biological materials safe and secure in the laboratory Biosafety is the foundation for biosecurity Biosafety is sufficient for certain risks Biosafety needs to be augmented for unique higher biosecurity risks Laboratory Biosafety Laboratory Biosecurity Overlap Global Health & Security Consultants

Laboratory biosecurity Biosecurity measures apply to: laboratories during transportation in field investigations in manufacturing facilities in health-care facilities Laboratory biosecurity guidelines Laboratory biosecurity Refers to institutional and personal security measures designed to prevent the loss, theft, misuse, diversion or intentional release of valuable biological materials (VBM) including pathogens and toxins. (keeping the work safe) Global Health & Security Consultants

valuable biological materials (VBM) Biological materials that require (according to their owners, users, custodians, caretakers or regulators) administrative oversight, control, accountability, and specific protective and monitoring measures in laboratories to protect their public health, economic and historical (archival) value, and/or the population from their potential to cause harm or death. These may include: Vaccine strains, culture collections, dangerous pathogens, probiotics, research strains, industrial strains, etc.

Components of Institutional Biosecurity Program Risk Assessment Physical security system Personnel Management Material Control and Accountability (MCA) Information security Transport and teransfer Security Managing the Biosecurity Program Global Health & Security Consultants

Physical Security Components of a physical security system Graded protection Access control Intrusion detection Response capability Training Performance testing Global Health & Security Consultants

Personnel Management Employee screening proportional to the roles and responsibilities of the individual Correlate with access authorization Visitor control Casual visitors should be escorted in restricted areas Working visitors should be processed in the same manner as regular employees Badges Identification badges should be worn in institutions that have higher risk pathogens and toxins Badges should be returned upon termination of access Global Health & Security Consultants

Material Control and Accountability (MCA) Identify what materials to control Identify pathogens and toxins of concern Identify how will materials be controlled Containment Procedures such as inventory and location of use Identify who is accountable for the materials All material should have an accountable person Identify where is MCA applicable In laboratories In Culture Collection Centers During transportation Global Health & Security Consultants

Managing the Biosecurity Program Role of management to ensure biosecurity program is: Appropriate to need (based on facility risk assessment) Resourced and cost-efficient for risk Graded in protection activities Coordinated with biosafety, good lab practices, security community, etc Define roles and responsibilities in written plan Provide regular training Provide routine system assessments Biosecurity plan is corrected/modified as needed Global Health & Security Consultants

Conclusion Biosafety and biosecurity are essential practices to all biological facilities Complementary to GLP and GMP There are synergies and conflicts Should find the way to enhance synergies and reduce (or Resolve) conflicts Training of managers, experts and other personnel is an important task. 9/7-10/2011 Global Health & Security Consultants

Wishing You All a Healthy, Safe and Secure World Thank you mohammadi@global-consultant.org Global Health & Security Consultants