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Design and Construction of a Biosafety Level 3 Autopsy Laboratory.
Nolte, Kurt B; Muller, Timothy B; Denmark, Adam M; Burstein, Ron; Villalobos, Yvonne A.
  • Nolte KB; From the Office of the Medical Investigator and Departments of Pathology and Radiology (Nolte [0000-0003-0257-6284]), University of New Mexico Health Science Center, Albuquerque.
  • Muller TB; The Office of Research (Muller), University of New Mexico Health Science Center, Albuquerque.
  • Denmark AM; The Department of Science and Technology, SmithGroup, Phoenix, Arizona (Denmark).
  • Burstein R; Studio Southwest Architects, Inc, Albuquerque, New Mexico (Burstein).
  • Villalobos YA; The Office of the Medical Investigator (Villalobos), University of New Mexico Health Science Center, Albuquerque.
Arch Pathol Lab Med ; 145(4): 407-414, 2021 04 01.
Article in English | MEDLINE | ID: covidwho-1194781
ABSTRACT
CONTEXT.­ Autopsy pathologists, including medical examiners, provide valuable public health support for infectious disease deaths through surveillance for deaths of public health concern including emerging infections, identifying causative organisms for unexplained deaths, and providing insights into the pathology and pathogenesis of novel or unusual infections. However, autopsy poses biosafety risks to workers within and outside the laboratory. The highest rates of laboratory-acquired infections occur in autopsy workers. OBJECTIVE.­ To design and construct an appropriately biosafe autopsy laboratory. DESIGN.­ We conducted a biosafety risk assessment for autopsy workers using the process developed by the US Centers for Disease Control and Prevention and National Institutes of Health and applied these findings as the basis of laboratory design and construction. RESULTS.­ Autopsy workers are unpredictably exposed to a variety of infectious organisms, including hepatitis C virus, HIV, and Mycobacterium tuberculosis. Hazardous autopsy procedures include using and encountering sharp objects and the generation of aerosols from dissection, fluid aspiration, rinsing tissues, and dividing bone with an oscillating saw. CONCLUSIONS.­ Exposure to blood-borne and airborne pathogens from procedures that can cause cutaneous inoculation and inhalation of aerosols indicates that human autopsies should be performed at biosafety level 3. We designed a large, entirely biosafety level 3 medical examiner autopsy laboratory using design principles and characteristics that can be scaled to accommodate smaller academic or other hospital-based autopsy spaces. Containment was achieved through a concentric ring design, with access control at interface zones. As new autopsy laboratories are planned, we strongly recommend that they be designed to function uniformly at biosafety level 3.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Autopsy / Communicable Diseases / Occupational Exposure / Infection Control / Infectious Disease Transmission, Patient-to-Professional / Containment of Biohazards / Facility Design and Construction / Laboratories Type of study: Prognostic study Limits: Humans Language: English Journal: Arch Pathol Lab Med Year: 2021 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Autopsy / Communicable Diseases / Occupational Exposure / Infection Control / Infectious Disease Transmission, Patient-to-Professional / Containment of Biohazards / Facility Design and Construction / Laboratories Type of study: Prognostic study Limits: Humans Language: English Journal: Arch Pathol Lab Med Year: 2021 Document Type: Article