BIO-SAFETY CABINET; A TOOL FOR INFECTION CONTROL IN HEALTH CARE FACILITIES HOTEL WATERBUCK-NAKURU,KENYA. 13-15TH NOV.2013 PRESENTED BY OMONDI GEORGE OTIENO BIO-MED AND BIO-SAFETY CABINETS CERTIFIER. KEMRI/CDC PROGRAM. Cell phone; +254 723825594.

BACKGROUND/INTRODUCTION The increasing need to work with TB and other airborne infectious agents places greater reliance upon the following containments offered by a BSC; Personnel (2). Product (3). Environment Proper risk assessment, selection, installation, service ,certification and use of BSC play a pivotal role in bio-containment programme, thus minimizes infections and contaminations in medical/research laboratory set-ups.

WHAT IS A BSC? A biological Safety cabinet is a ventilated box/enclosure which uses directional air flow and HEPA Filters to provide the following protections; BSCs serve as primary containment devices for operations involving potential splashes, spills or aerosolization of hazardous biological materials.

ELEMENTS OF CONTAINMENT A section of the lab brought down for a BSC installation in a District Hospital in Kenya. This shows no proper assessment was carried out prior to BSC purchase. Proper mix of the three elements is assessed by needs and specific hazards of any facility

A well maintained & located BSC will operate smoothly to give the required protections

BSC CERTIFICATION It involves testing for; Site installation test Certification is the testing process used to verify proper continuous functionality of BSCs using duly calibrated equipment by a qualified certifier. Below is a Kenyan certifier testing for down flow velocity in a class IIA2 BSC. It involves testing for; Site installation test Down flow velocity test Inflow velocity test HEPA Filter leak test Air flow smoke pattern test Cabinet integrity test( for class AI cabinets only)

WHEN DO WE CERTIFY BSCs? Consider the following; Equipment used must be calibrated, they include; When installed for first use Annually When relocated When major repairs are done/ change of HEPA filters Thermal anemometer/hot wire Aerosol photometer Aerosol generator Direct instrument measurement (DIM) Smoke pattern testing equipment

A SECTION OF TEST RESULTS/ REPORT   Allowable Ranges Initial measurements Final Setpoints HEPA Filter test PROGRAM / SPONSOR Cabinet # Manufacturer Model Serial # Intake Downflow Inflow Final Setpoints Supply Exhaust Smoke Test Mag. Gauge Cabinet location 01 Thermo 1376 110236-96 100-110 58-68 103 58 62 ok pass N/A  Migori DH DGHA 02 Gelaire BSB4 12250 0.4 m/s 70-80 0.39 72 81 77 Fails OK Pass 125 Blood Bank Kisumu 03 ESCO Airstream .28-.35 m/s 0.37 0.28  N/A KMTC Kisumu 04 BH 550 Class 1 75 N/A 50 Failed Nyamira D. Hospital 05 Nuve NA 02-0416 .31-.45 m/s 0.81 0.38 Kericho D.Hospital 06 1285 101681-314 105-115 65-75 113 67 115 69 Changed 0.55 NBTS 07 Faster BHEN2006 382 .4 m/s 0.25-.5 m/s 0.31 0.34 KNH 08 Nuaire 440 7844061702 .46 m/s 0.38 m/s 0.2 0.3 GFC ward KNH 09 Lab Caire SC12R SCR-197 0.52 0.22 0.65 0.36 be changed TB lab KNH 10 104830 108 70 TB lab 11 BHEN2004 S763 0.4 Virology lab kabete GDD 12 S746 0.32 13 Telstar Biostar plus 24309 0.42 0.27 manual needed Culture/isolation Kabete 14 AC2 E41 2009-42977 .51 m/s 0.28-.35 m/s CVL Kabete 15 100927 66-76 94 106 59 HIV lab 2KEMRI 16 Baker SG600UK 63252 61-71 93 63 105 VHF lab

INDICATORS AND ANALYSIS The following indicators were looked into out of 52 BSCs Analysis of the indicators BSC non- functionality =6 Poor facility design = 31 BSC never been certified =47 BSC user incompetency =47 No basic maintenance = 47 Poor containment level =48

CHALLENGES FACED In adequate funds Poor facility designs that led to breaking of walls thereby consuming much time in a facility In adequate certification equipment led to sharing hence lowering the pace of work.

RECOMMENDATIONS AND CONCLUSION To improve lab safety in our facilities and move towards accreditation, it is crucial that the Kenya ministry of Health; Have a structural local BSC maintenance and certification program. Put in place annual BSC user training. Standardize the facility designs in Kenya Allocate funds for BSC annual maintenance and certification exercise and spare parts replacement.

ANY QUESTIONS? SPECIAL ACCOLADES TO; DIVISION OF GLOBAL HIV AIDS( DGHA) GLOBAL DISEASE DETECTION (GDD) KEMRI/CDC MOH,KENYA. EAGLESON INSTITUTE. SANFORD, MAINE, USA. MY LISTENERS