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Gary Evans writes Hospital Infection Control & Prevention (HIC), Hospital Employee Health (HEH) and contributes to IRB Advisor (IRB). As senior writer at AHC, Evans has written numerous articles on infectious disease threats to both patients and health care workers, including pandemic influenza, MERS and Ebola. He has been honored for excellence in analytical reporting five times by the National Press Club in Washington, DC.
After a series of laboratory mishaps and possible exposures to deadly pathogens last year, the CDC appointed an External Laboratory Safety Workgroup (ELSW) to provide advice, recommendations, and guidance to CDC on establishing an operative and sustainable culture with regards to laboratory safety and quality at the agency. There was no mention of being taken to the woodshed.
The ELSW report, which was apparently recently posted on a CDC website – though it is dated Jan. 13 -- described a dysfunctional laboratory safety culture with inadequate training and an abiding fear of reporting incidents.
Among the ELSW findings were: Laboratory safety training is inadequate. The organizational complexity of the CDC has contributed to a fragmented, inconsistent approach to laboratory safety training. The majority of training is now conducted on-line. Training is no longer under the domain of the Environment, Safety, and Health Compliance Office (ESHCO) The CDC does not have its own hands-on directly observed centralized safety training program. Lab-specific training and competency observations are conducted at program level and therefore, the quality is not consistent. Observational competence occurs at the local lab level; however, except for clinical labs, competency skills mapping and refresher training is not consistent.
ELSW recommendations to address these issues were for the CDC ensure that responsibilities and facilities for lab safety training were done in-house and establish the following:
• A standardized lab safety training curriculum across CDC.
• Standardized methods for competency skills mapping and refresher training
. • A fellowship/internship program to train scientists to serve as laboratory safety professionals who serve as liaisons between the labs and ESHCO or other central lab safety entity.
The ELSW further reported that:
A significant percentage of CDC staff have concerns about experiencing negative repercussions, either personally or more generally to the Agency, as a result of reporting incidents involving exposures to pathogenic organisms or other hazardous materials. Some staff members working in Select Agent laboratories fear regulatory or other negative repercussions as a result of incident reporting. One example of this was the case report of the CDC accident involving highly pathogenic H5N1 that became public in June. Interviewed scientists all along the chain in that incident were concerned that there were violations of the Select Agent rule. But there were no mentions of people being similarly concerned with biosafety. Other interviews with CDC staff also seemed to show a higher level of concern regarding SA violations than biosafety violations. This finding suggests that at least in some laboratories, biosecurity requirements are being given priority over biosafety.
ELSW said “Efforts to establish a culture of responsible science and accountability are of critical importance. This culture of responsible science will require prompt and accurate reporting of incidents or breaches in standard protocol without fear of reprimand or punishment. (Not reporting should be considered a breach of responsibility.) Reporting is important for facilitating the analysis of incidents and the establishment of corrective actions to mitigate repeat occurrences.
In a statement posted on the same website the agency said: “CDC concurs with these recommendations, has made progress towards implementing them, and will soon report on that progress. CDC's aim is to improve the culture of laboratory safety across the agency and minimize the risks associated with laboratory work.”