Two months after safety breaches at federal labs first set off a public furor, top health officials are auditioning new checks on worker safety including specialized time-lapse cameras and digital worksheets to track crucial steps such as bacterium inactivation. The goal: to prevent future debacles with dangerous pathogens and protect employees from potentially lethal illness.
The extra checks will help ensure workers are following the correct steps and performing them for the precise amounts of time typically required to be effective. The specialized cameras, which debuted in a few laboratories at the U.S. Centers for Disease Control and Prevention in the past couple weeks, are affixed to heating equipment used to kill dangerous substances and to cabinets where pathogens are kept. Supervisors will quickly view footage and ensure proper procedures are followed before substances are moved out of the lab. “I’m not talking about slapping cameras all over CDC,” says Jim Pirkle, the architect behind the camera idea and director of the Division of Laboratory Sciences at CDC’s National Center for Environmental Health. Rather, the idea is to introduce a targeted check on processes that depend on just a single individual doing the right thing. “We don’t want the error from one person to be able to propagate through,” Pirkle says.
Anthrax, for example, can be inactivated via established protocols such as boiling for 10 minutes or treating it with certain chemicals, yet federal employees failed to follow any of the approved protocols to kill the deadly bacteria before sending out anthrax samples in June, potentially endangering scores of federal employees. That case was not an anomaly. In 2006 the same CDC laboratory involved in the recent anthrax troubles had transferred vials of anthrax DNA that were not properly inactivated. That same year samples sent from another CDC lab were found to contain live Clostridium botulinum (which produces the most potent toxin ever studied) due to inadequate inactivation procedures. “It’s clear we need some way to secondarily verify that an inactivation is being done. This is one way to do that,” says Darin Carroll, acting chief of the Poxvirus and Rabies Branch at CDC. The alternative, pulling another employee from his or her work to stand over a worker to watch, would be costlier.
Time-lapse footage, which creates small files that can be quickly shared across computers, allows supervisors to review an hour-long procedure film via fast-forward in just a few minutes, scanning it make sure proper protocols were followed. Only then could materials be sent out of the lab. “Bluntly, it would take care of problems we had with the anthrax and the flu,” Pirkle says. “Neither of those things would have happened if this had been in place.” The flu incident occurred in March when a sample of a relatively benign avian flu was accidentally contaminated with a deadly influenza strain at a CDC lab before being sent out.
Pirkle recently floated the camera idea to Michael Bell, the CDC official charged with strengthening lab safety following the recent mishaps, and about a dozen other internal safety working group members. Labs could not just set up standard surveillance cameras on the ceiling, they realized, because they would not be close enough to samples to capture the necessary footage. Moreover, the files would be too large to download and quickly share, leaving samples waiting too long for approval.
Three weeks after Pirkle presented his idea, a computer scientist in his lab had devised a unique setup to record any needed goings-on and then easily send the footage onto a supervisor for review. He chose a tiny, time-lapse camera and secured it inside a clear, waterproof case. The cam would then be affixed to a lab instrument, in this case a heating block. When a worker engages in a lab procedure, say boiling an anthrax sample, he or she presses a button on the camera to record everything. Once the procedure is complete the worker stops the recording and presses a different button to kick off a series of events that ultimately sends the footage to a supervisor who could green-light the shipment. “We wanted something as simple to use as an iPod,” Pirkle says. “You don’t want to cramp anything going on in the lab.” Six cameras were slated to be in CDC laboratories by the end of last week.
In addition to the camera, Bell plans to try out digital tablets with time-stamped worksheets in laboratories. The automated system, currently in the works, would ensure that employees catalogue the time spent on specific steps and help ensure that protocols are safely adhered to. “This isn’t about telling laboratory staff to be safer or being accusative or punitive,” Bell says. “The reality is that our lab staff is very committed to safety. Not a single person comes to work planning to do something unsafe.”
Carroll, of the Poxvirus and Rabies Branch, already has one of the cameras set up in one of his labs. It monitors inactivation procedures for the 11 staff members working there. Scott Smith, a microbiologist and manager for the lab, says that the laboratory team is fine with the camera. “It doesn’t make you feel like big brother, the person isn’t in the shot,” he says. Instead, just the individual’s hands and the lab equipment make an appearance.
Exactly what the CDC will do in the longer-term to bring about more changes in the “culture” of work-flows to better ensure safety remains murky. An external advisory group, formed following the incidents, is helping devise a plan. One component: “I can imagine moving toward a CDC library where protocols could be approved,” Bell says. And the video footage gathered through this pilot program could potentially be used to make training videos.
When Bell first arrived at CDC 18 years ago, he says, it was a different place altogether in terms of size and attitude. It was more like “small boutique labs doing specialized work,” he says. But since then the size of CDC—and especially the number of top level biosafety labs—has swelled. There were around 6,000 CDC employees in 1996 but more than 10,000 work there today, not counting the approximately 4,000 federal contractors. The structures and practices that were sufficient 20 years ago to maintain safety and ensure oversight apparently no longer suffice.
For more on the federal lab lapses:
Poor Oversight Catches Up with High-Security Infectious Agent and Disease Labs
CDC Botched Handling of Deadly Flu Virus
Bio-Unsafety Level 3: Could the Next Lab Accident Result in a Pandemic?