Technical Safety Office Infectious Waste Manual Chapter 5

Infectious Waste Policies and Procedures Manual
Idaho State University (HTML version) 2002 Edition

Chapter 5 - CDC Guidelines for Pathogenic Organisms

Compliance suggestions proposed by the Centers for Disease Control (CDC) as they pertain to Idaho State University are outlined in this section. These CDC suggestions specifically address the safety and security recommendations for particular pathogenic organisms, but are not federal, state, or local code.

5.1 Bio-safety Levels
The following table is a classification system proposed by CDC (Centers for Disease Control) for levels of precautionary measures and security levels for pathologic agents; BSL refers to Bio-safety Level. This table is from in CDC’s Bio-safety in Microbiological and Bio-medical Laboratories (BMBL) 4th edition (section III).

BSL	Agents	Practices	Safety Equipment Primary Barriers	Facilities (Secondary Barriers)
1	Not known to consistently cause disease in healthy human adults.	Standard animal care and management practices, including appropriate medical surveillance programs.	As required for normal care of each species.	Standard animal facility No recirculation of exhaust air Directional air flow recommended Handwashing sink recommended
2	Associated with human disease. Hazard: percutaneous exposure, ingestion, mucous membrane exposure.	ABSL-1 practices plus: Limited access Biohazard warning signs Sharps precautions Biosafety manual Decontamination of all infectious wastes and of animal cases prior to washing	ABSL-1 equipment plus primary barriers: containment equipment appropriate for animal species; PPE: laboratory coats, gloves, face and respiratory protection as needed.	ABSL-1 facility plus: Autoclave available Handwashing sink available in the animal room Mechanical cage washer used
3	Indigenous or exotic agents with potential for aerosol transmission; disease may have serious health effects.	ABSL-2 practices plus: Controlled access Decontamination of clothing before laundering Cages decontaminated before bedding removed Disinfectant foot bath as needed	ABSL-2 equipment plus: Containment equipment for housing animals and cage dumping activities Class I or II BSCs available for manipulative procedures (inoculation, necropsy) that may create infectious aerosols. PPE: appropriate respiratory protection	ABSL-2 facility plus: Physiccal seperation from access corridors Self-closing, double-door access Sealed penetrations Sealed windows Autoclave available in facility
4	Dangerous/exotic agents that pose high risk of life threatening disease; aerosol transmission, or related agents with unknown risk of transmission.	ABSL-3 practices plus: Entrance through change room where personal clothing is removed and laboratory clothing is put on; shower on exiting All wastes are decontaminated before removal from the facility	ABSL-3 equipment plus: Maximum containment equipment (i.e. Class III BSC or partial containment equipments in combination with full body, air-supplied positive pressure personnel suit) used for all procedures and activities	ABSL-3 facility plus: Seperate building or isolated zone Dedicated suplly and exhaust, vacuum and decontamination systems Other requirments outlined in the text

5.2 Pathogenic Bacterial Agents
The following is a categorization of pathogenic bacterial organisms by their recommended bio-safety level. With exceptions, all of the following are bio-safety level 2 for activities using clinical materials and diagnostic quantities of the organism.

Name of Bacterial Organism	Exception
Bacillus anthracis	BSL – 3 for production quantities or concentrations of cultures, and for activities with a high potential for aerosol production.
Bordetella pertussis	BSL – 3 for large-scale production operations.
Brucella abortus, B. canis, B. melitensis, B. suis	BSL –3 for all manipulations of cultures.
Burkholderia pseudomallei	BSL – 3 for production quantities or concentrations, or activities with a high potential for aerosol production.
Campylobacter jejuni, C. coli, C. fetus	N/A
Chlamydia psittaci, C. pneumoniae, C. trachomatis	BSL – 3 for production quantities or concentrations, or activities with a high potential for aerosol production.
Clostridium botulinum	BSL – 3 for production quantities of toxin, or activities with a high potential for aerosol production.
Clostridium tetani	N/A
Corynebacterium diphtheria	N/A
Escherichia coli	N/A
Francisella tularensis	BSL –3 for all manipulations of cultures and experimental animal studies.
Helicobacter pylori	N/A
Leptospira interrogans	N/A
Listeria monocytogenes	N/A
Legionella pneumophila	BSL – 3 for production quantities of toxin, or activities with a high potential for aerosol production.
Mycobacterium leprae	N/A
Mycobacterium spp. except M. leprae, tuberculosis, and bovis	N/A
Mycobacterium tuberculosis, M. bovis	BSL – 3 for propagation and manipulation of cultures
Neisseria gonorrhoeae	BSL –3 for production quantities or concentrations, or activities with a high potential for aerosol production.
Neisseria meningitides	BSL – 3 for production quantities or concentrations, or activities with a high potential for aerosol production.
Salmonella spp. except S. typhi	N/A
Salmonella typhi	BSL – 3 for production quantities or concentrations, or activities with a high potential for aerosol production.
Shigella spp.	N/A
Treponema pallidum	N/A
Vibrio cholera, V. para-haemolyticus	N/A
Yersinia pestis	BSL – 3 for production quantities or concentrations, or activities with a high potential for aerosol production.

5.3 Pathogenic Fungal Agents
The following table is a categorization of pathogenic fungal organisms by their recommended bio-safety level. With exceptions, all of the following are bio-safety level 2 for activities using clinical materials and diagnostic quantities of the organism.

Name of Fungal Organism	Exceptions
Blastomyces dermatitidis	N/A
Coccidioides immitis	BSL – 3 for propagating and manipulating sporulating cultures, or processing environmental materials (soil) suspected to contain the fungi.
Cryptococcus neoformans	N/A
Histoplasma capsulatum	BSL – 3 for propagating and manipulating cultures, or processing environmental materials (soil) suspected to contain the fungi.
Sporothrix schenckii	N/A
Pathogenic members of the genera: Epidermophyton, Microsporum, Trichophyton	N/A
Misc. molds: Penicillium marneffei, Exophiala dermatitidis, Fonsecaea pedrosoi, Ochroconis gallopavum, Claduphialopora bantians, Ramichlorisium machenzieim	N/A

5.4 Pathogenic Viral Agents
The viral agents mentioned by the Centers for Disease Control are not relevant for the minimal viral use at I.S.U. Further information about CDC regulations pertaining to pathogenic viral agents can be found in CDC’s Bio-safety in Microbiological and Biomedical Laboratories (BMBL) 4th edition at: http://www.cdc.gov/od/ohs/biosfty/bmbl4/bmbl4s7f.htm

Technical Safety Office
Idaho State University
Campus Box 8106
785 S. 8th St. PS Rm 101
Pocatello, ID 83209
Phone: (208) 282-2310 or 282-2311
Fax: (208) 282-4649