Laboratory-acquired vaccinia virus infection in a recently immunized person--Massachusetts, 2013.

On November 26, 2013, the CDC poxvirus laboratory was notified by the Boston Public Health Commission (BPHC) of an inadvertent inoculation of a recently vaccinated (ACAM2000 smallpox vaccine) laboratory worker with wild type vaccinia virus (VACV) Western Reserve. A joint investigation by CDC and BPHC confirmed orthopoxvirus infection in the worker, who had reported a needle stick in his thumb while inoculating a mouse with VACV. He experienced a non-tender, red rash on his arm, diagnosed at a local emergency department as cellulitis. He subsequently developed a necrotic lesion on his thumb, diagnosed as VACV infection. Three weeks after the injury, the thumb lesion was surgically debrided and at 2 months post-injury, the skin lesion had resolved. The investigation confirmed that the infection was the first reported VACV infection in the United States in a laboratory worker vaccinated according to the Advisory Committee on Immunization Practices (ACIP) recommendations. The incident prompted the academic institution to outline biosafety measures for working with biologic agents, such as biosafety training of laboratory personnel, vaccination (if appropriate), and steps in incident reporting. Though vaccination has been shown to be an effective measure in protecting personnel in the laboratory setting, this case report underscores the importance of proper safety measures and incident reporting.

Comparison of indoor air quality in smoke-permitted and smoke-free multiunit housing: findings from the Boston Housing Authority.

INTRODUCTION: Secondhand smoke remains a health concern for individuals living in multiunit housing, where smoke has been shown to easily transfer between units. Building-wide smoke-free policies are a logical step for minimizing smoke exposure in these settings. This evaluation sought to determine whether buildings with smoke-free policies have less secondhand smoke than similar buildings without such policies. Furthermore, this study assessed potential secondhand smoke transfer between apartments with and without resident smokers. METHODS: Fine particulate matter (PM2.5), airborne nicotine, and self-reported smoking activity were recorded in 15 households with resident smokers and 17 households where no one smoked in 5 Boston Housing Authority developments. Of these, 4 apartment pairs were adjacent apartments with and without resident smokers. Halls between apartments and outdoor air were also monitored to capture potential smoke transfer and to provide background PM2.5 concentrations. RESULTS: Households within buildings with smoke-free policies showed lower PM2.5 concentrations compared to buildings without these policies (median: 4.8 vs 8.1 µg/m(3)). Although the greatest difference in PM2.5 between smoking-permitted and smoke-free buildings was observed in households with resident smokers (14.3 vs 7.0 µg/m(3)), households without resident smokers also showed a significant difference (5.1 vs 4.0 µg/m(3)). Secondhand smoke transfer to smoke-free apartments was demonstrable with directly adjacent households. CONCLUSION: This evaluation documented instances of secondhand smoke transfer between households as well as lower PM2.5 measurements in buildings with smoke-free policies. Building-wide smoke-free policies can limit secondhand smoke exposure for everyone living in multiunit housing.

The Boston Safe Shops Project--preliminary findings of a case study in applying the 10 essential services of public health to building environmental health capacity.

Boston's more than 500 automotive shops, located primarily in low-income communities of color, are a source both of well-paying jobs and of potential hazardous exposures to employees and residents. The Safe Shops Project works to reduce occupational and environmental health hazards without having to close these businesses. Combining inspections, in-shop trainings, outreach, and technical/financial assistance, it brings shops into compliance with laws and promotes use of safer practices and alternative products. After 18 months, 254 workers at 61 of 124 participating shops had received training. Surveys showed improved worker knowledge: Pre-training, 24.2 percent of the worker survey respondents stated that they knew what an MSDS was, and post-training, 75 percent stated that they knew. The surveys also found improvement in work practices: Pre-training, 48 percent of workers indicated that they used safety goggles in their work, while post-training, 70 percent indicated proper use of safety goggles. The results also showed shops investing in capital improvements such as replacement of PCE-based brake cleaners with aqueous cleaners. The Safe Shops Project has a successfully modeled application of the 10-essential-services framework to the building of public health capacity and community collaboration, and this model can be adapted to other locations and industries.