Worker Protection Scenarios for General Analytical Testing Facility under Several Infection Propagation Risks: Scoping Review, Epidemiological Model and ISO 31000
Abstract
:1. Introduction
2. Materials and Methods
2.1. Identification of Risk Sources (Step 1 of Risk Management)
2.1.1. Epidemiological Triad Model and Scoping Review
2.1.2. Deduction of Environmental Risk Sources
2.2. Risk Analysis (Step 2)
2.3. Deduction of Risk Treatment Option (Step 3)
2.4. Establishment of Risk Treatment Plans (Step 4)
2.5. Scoping Review
3. Results
3.1. Environmental Risk Sources
3.2. Transmission Routes as Risk Sources
3.3. Human Reservoir as Risk Sources
3.4. Risk Analysis
3.5. Risk Treatment Option: Direction, Goal, Scenarios, and SOP
3.6. Scenarios
3.6.1. First Step of Configuration of Procedures over Time: Primary Case Occurrence
Part 3. Further Case Occurrences | |
---|---|
3.1 | Health quarantine, close observation, and isolation |
(1) | Further case occurrence indicates Type A propagation, even before the medical evaluation of primary case deduction. Close and indirect contacts should be isolated from occupation. The reason for attempting indirect contact isolation is that the risk of indirect transmission increases in the case of direct transmission. |
(2) | Medical evaluation and treatment must be performed in consideration of asymptomatic case that discharge causative agents in both close and indirect contacts. |
(3) | If someone does not correspond to close or indirect contacts, close observation is required because of a shared general domestic environment. |
3.2 | Record management |
(1) | Symptoms of further cases and medical evaluation results should be recorded and managed. |
Part 4. With Deduction of Medical Evaluation | |
4.1 | Type A |
(1) | Even if there is no further case occurrence, all close and indirect contacts must maintain isolation to block or slow down propagation and obey the procedures of (2.3) |
4.2 | Type B |
(1) | Close and indirect contacts maintain close observation because of the possibility of indirect transmission through close and indirect contact. |
(2) | Isolation should be performed whenever additional symptoms occur during close observation. Rapid propagation among close and indirect contacts can be blocked by maintaining close observation. |
4.3 | Type C |
(1) | Primary case can be released from isolation. |
(2) | Close and indirect contacts can be released from health quarantine or close observation. |
4.4 | Type D |
(1) | Primary case might be isolated until symptom extinguished. |
(2) | Close and indirect contacts might be released from health quarantine and close observation. |
Part 5. Release | |
5.1 | Confirmed case |
(1) | This is limited to Types A and B. Types C and D comply with the regulations of 4.3 or 4.4 |
(2) | Since shedding period varies by etiology and host factor, it is necessary to return to occupation after confirming that there is no discharge through medical evaluation (2.3). |
(3) | If medical evaluation is not possible due to financial conditions, the case should be excluded from occupation until the longest known period of each agent’s discharging period. |
5.2 | Health quarantine |
(1) | This is limited to Types A and B. Types C and D comply with the regulations of 4.3 or 4.4. |
(2) | Close and indirect contacts without any symptoms can return to occupation after the maximum shedding periods has elapsed from the last case isolation date, and other close observations can be released. |
3.6.2. Second Step of Configuration of Procedures over Time: Medical Evaluation and Further Case Occurrence
3.6.3. Third Step of Configuration of Procedures over Time: Categorized Scenario
3.6.4. Fourth Step of Configuration of Procedures over Time: Release
4. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Stratification of Environment | Environmental Risk Sources Potentially Causing Direct or Indirect Transmission |
---|---|
A. General daily space | Direct contact (talking, meal, coughing) |
Indirect contact (toilet or meal facility) | |
B. General office space | Direct contact (meeting, hand-shaking, talking, coughing) |
Indirect contact (joint phone, handle, meeting room and door) | |
C. Space unique to analytical and testing facility | Direct contact (co-working, collaboration) |
Indirect contact (joint space, facility, equipment, tools) |
Transmission Route | Risk Source | |
---|---|---|
Direct transmission (1) | Collaboration | Sampling (4 days, 9 people) |
Pretreatment of experimental sample (3 days, 10 people) | ||
Co-working | Use of communal experimental room at the same time (12 days, 11 people) | |
Use of experimental desks at the same time (10 days, 11 people) | ||
Use of clean bench or home hood at the same time (11 days, 5 people) | ||
Fomite or surface transmission (2) | Joint space | Communal experimental room (11 count/day) |
Joint facility | Clean bench or home hood (6.5 count/day) | |
Chair (8.8 count/day) | ||
Deionizer (9 count/day) | ||
Gas chromatograph (1.5 count/day) | ||
Inductively coupled plasma (0 count/day) | ||
Liquid chromatograph (1.5 count/day) | ||
Experimental desk (11.5 count/day) | ||
Joint equipment, utensils | Pipette (6.5 count/day) | |
Syringe (2.8 count/day) | ||
Types of handles (8.5 count/day) | ||
Sprayer (8.8 count/day) | ||
Sterilizer (3.3 count/day) |
Categorization Type | Risk Sources |
---|---|
Type A. Direct, fomite- and surface-mediated transmission | Enterohemorrhagic Escherichia coli [29,30,31] |
Vibrio cholerae [32,33] | |
Salmonella typhi [34]; S. enteritidis [35]; S. typhimurium [36,37,38] | |
Shigella sp. [39,40,41] | |
Rotavirus [42,43,44,45] | |
Astrovirus [46] | |
Norovirus [44,47,48,49,50,51,52,53] | |
Hepatitis A virus [44,54,55,56,57] | |
Giardia intestinalis [7,58] | |
Type B. Fomites or surface transmission | Entamoeba histolytica, coli [59,60,61] |
Type C. Water or foodborne | Vibro vulnificus, V. parahemolyticus [33] |
Campylobacter sp. [62] | |
Entero-invasive, -aggresive, -pathogenic, and -toxigenic E. coli [63] | |
Coxienella burnetii [64] | |
Brucella sp. [65] | |
Type D. Intoxication or atypical carrier | Clostridium perfringens [66] |
Bacillus cereus [67] | |
Staphylococcus aureus [68,69] |
Part 1. Potential Reservoirs | ||
---|---|---|
1.1 | Primary case | First symptomatic workers with visible symptoms |
1.2 | Further case | Additional case under similar symptoms as the primary case |
1.3 | Confirmed case | Cases in which an intestinal infection or causative agent was identified in a medical evaluation |
1.4 | Close contacts | In cases of sharing both time and space through co-work (collaboration) with cases, e.g., sampling, pretreatment procedures, using a shared laboratory room, facility, utensils at the same time |
1.5 | Indirect contacts | In cases involving sharing of space and property with a time difference (if joint facilities, equipment, and utensil are shared) |
Part 2. Measures for Potential Reservoirs | ||
2.1 | Isolation | Exclusion from occupation of all cases or contact, according to a response procedure scenario |
2.2 | Close observation | All close or indirect contacts should be observed by manager with the onset of symptoms in mind, to slow down or block propagation |
2.3 | Health quarantine | Even if there are no symptoms, isolation is performed if there is a risk of infection after exposure to the primary or confirmed cases, to slow down or block propagation |
2.4 | Release | Return to occupation from isolation, close observation, health quarantine |
2.5 | Medical evaluation | Clinical estimation diagnosis or laboratory diagnosis by medical staff to estimate or determine the cause of symptoms. |
Internal Factor | |||
---|---|---|---|
Strengths | Weakness | ||
S1 | Proceduralization and standardization of work | W1 | Increased possibility of close contact |
S2 | Acceptability of regulations and procedures to workers | W2 | Increased possibility of indirect contact |
S3 | Acceptability of documentation to workers | ||
S4 | Familiarity with documentation | ||
External Factor | |||
Opportunities | Threats | ||
O1 | Traceability of infection through working procedures | T1 | Increasing infectious disease risk and likelihood |
O2 | Accumulation of prior study cases via infectious disease epidemiology | T2 | Depend on group capabilities for infectious disease management |
Decision Making Strategies | |||
Active response | Step-by-step implementation | ||
SO1 | Standardizing scenario | WO1 | Continual revision of scenarios |
SO2 | Stipulation of scenario | ||
SO3 | On-site application of stipulated scenario | ||
Defensive response | Differentiation strategy | ||
WT1 | Minimize close/indirect contact through scenario | ||
WT2 | Ensuring continuity of industrial roles of institution through scenario |
Part 1. General Requirement for Prevention of Infection and Transmission | |
---|---|
1.1 | Monitoring and record management |
(1) | Employees’ health status should always be monitored, and visible symptoms should be recorded and managed. |
(2) | The issue of infectious diseases outside the organization is always monitored and considered. |
1.2 | Risk source management |
(1) | Since the laboratory facilities have relatively high chance of indirect transmission, cross-contamination behavior and opportunities in workplaces should be avoided as much as possible. |
(2) | Sufficient experimental utensils, tools, or equipment should be prepared as much as possible to control the possibility of fomite- or surface-mediated transmission. |
1.3 | Exposure traceability |
(1) | To determine whether employees have direct or indirect contact with the primary case, procedures for reviewing an analytical testing manual, experiment or working diary, access record, etc. should be organized. |
(2) | Infrastructure should be established to enable the implementation of the procedures proposed in this scenario. |
Part 2. Primary Case Occurrence | |
2.1 | Health quarantine, close observation, isolation |
(1) | In the case of primary case occurrence, it should be isolated in the workplace, assuming type of direct transmission (Type A), even before medical evaluation. |
(2) | Close and indirect contacts should be closely observed until medical evaluation and (2.3) deduction. Since the discharge of agent takes place after the onset of symptoms, analyzing test activities is possible only if there are no similar symptoms. |
2.2 | Record management |
(1) | If the primary case occurs, record symptoms and signs for further case occurrence situation. Propagation can be determined through record comparison even before the medical evaluation of primary case deduction. |
(2) | Record management includes all symptoms of the body (fever, pain, vomit, food consumed, travel history) and backgrounds that can cause it. |
2.3 | Medical evaluation and treatment |
(1) | The type of disease must be specified through medical evaluation and isolated from work until the results of the medical examination are derived. |
(2) | Primary case should receive appropriate medical treatment. |
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Park, J.-M.; Cho, J.-H.; Jun, N.-S.; Bang, K.-I.; Hong, J.-W. Worker Protection Scenarios for General Analytical Testing Facility under Several Infection Propagation Risks: Scoping Review, Epidemiological Model and ISO 31000. Int. J. Environ. Res. Public Health 2022, 19, 12001. https://doi.org/10.3390/ijerph191912001
Park J-M, Cho J-H, Jun N-S, Bang K-I, Hong J-W. Worker Protection Scenarios for General Analytical Testing Facility under Several Infection Propagation Risks: Scoping Review, Epidemiological Model and ISO 31000. International Journal of Environmental Research and Public Health. 2022; 19(19):12001. https://doi.org/10.3390/ijerph191912001
Chicago/Turabian StylePark, Jong-Myong, Joong-Hee Cho, Nam-Soo Jun, Ki-In Bang, and Ji-Won Hong. 2022. "Worker Protection Scenarios for General Analytical Testing Facility under Several Infection Propagation Risks: Scoping Review, Epidemiological Model and ISO 31000" International Journal of Environmental Research and Public Health 19, no. 19: 12001. https://doi.org/10.3390/ijerph191912001