1988 Agent Summary Statement for Human Immunodeficiency Virus and Report on Laboratory-Acquired Infection with Human Immunodeficiency Virus [MMWR, Vol 37 No.S-4]

Vol. 37 / No. S-4

MMWR

21

exposures occur and how they can be prevented. Although on-the-job training
is an acceptable approach for learning techniques and practices, it is imperative
that proficiency be obtained BEFORE virus is actually handled.
B. Assure that workers are proficient in virus-handling techniques
Selection criteria for employees who will work in production operations or
with concentrated preparations of HIV should require experience in the handling of human pathogens or tissue cultures. If an employee has not had such
experience, s/he should participate in carefully structured, well-supervised
on-the-job training programs.
The director or person in charge of the laboratory or production facility must
ensure that personnel are appropriately trained and are proficient in practices
and techniques necessary for self-protection. Initial work activities should not
include the handling of virus. A progression of work activities should be
assigned as techniques are learned and proficiency is developed. Virus should
only be introduced into the work activities after the supervisor is confident it can
be handled safely.
C. Monitor work practices
Periodically, the biosafety officer or a person with expertise in biosafety
should closely observe practices and techniques used in handling HIV. This can
be helpful in identifying activities or behavior that may increase the potential for
contact with contaminated material or for inapparent parenteral exposures. If
deficiencies are noticed, corrective measures should be specified and
implemented.
D. Continuously reinforce safe practices
Practices that reduce the potential for direct contact and inapparent parenteral exposure should be continuously reinforced:
* Gloves should always be worn when concentrated preparations of HIV are
handled and when contact with a contaminated surface or material may be
unavoidable. If a gloved hand accidentally touches a contaminated surface or
material, the glove should be removed immediately and the hands washed.
* Work surfaces should be decontaminated at the end of each day and any time
contamination is recognized.
* Workers must develop the habit of keeping hands away from the eyes, nose,
and mouth in order to avoid potential exposure of mucous membranes.
Wearing filter masks and eye goggles or face shields may assist in accomplishing this objective.
* Needles and sharp implements must not be used when HIV is handled unless
no acceptable alternative is available. When possible, unbreakable containers
should be substituted for glassware, in order to avoid accidental cuts from
broken pieces.
* In the absence of advice and consent of an occupational physician or nurse,
no worker should handle any virus-containing material when s/he has cuts or
skin abrasions on the hands or wrists.
E. Establish a medical surveillance serology program
Each medical facility should have a medical-surveillance serology program.
Serum samples should be obtained at least once a year and analyzed for