Health Security最新文献

Laboratory security is a vital component of institutional laboratory operations. While hazardous biological agents and toxins are inherent to a biomedical institution, the chemicals and radiological materials used to support biomedical research goals have their own unique security requirements. The presence and use of these materials necessitates heightened security measures that must be followed to ensure adherence to federal and state regulations and the safety and health of an institution's employees and the surrounding environment. In this paper, we outline best practices, key considerations, and applicable institutional oversight measures related to laboratory security activities. The laboratory security components we describe are intended to help institutions implement, address, and mitigate the complex security risks associated with laboratory work in biomedical facilities. Leveraging these best practices can ensure a secure work environment by reducing risks of insider threats, intentional theft or misuse of laboratory materials, and release of sensitive information by restricting sensitive information and hazardous material access to only those who require or have a need for it.

Infectious disease transmission continues to be an unmet challenge. This is in part due to the air that circulates within our indoor environments, which can contain a myriad of potentially pathogenic bacteria, fungi, mold, and viruses as well as various allergens. This issue was highlighted during the COVID-19 pandemic, due to the highly infectious nature of SARS-CoV-2 and the public measures taken to limit airborne transmission of the pathogen through quarantining, social distancing, and maskwearing. The broad disruption in normal activities and interactions within these indoor environments prompted rethinking how indoor air quality can be improved to further mitigate infectious disease transmission. There is opportunity to accomplish health security and biosurveillance for protecting critical building infrastructures by incorporating existing and new measures for detection and control of microbial burden. Integrating central building controls and systems for heating, ventilation, and air conditioning with ongoing detection of environmental flora and microbes can help identify emerging pathogens and endemic biothreats such as SARS-CoV-2 and Legionella, respectively. This effort, however, will require (1) synergistic funding from 1 or more government agencies and multiple commercial entities to maintain habitable indoor environments and (2) environmental factors on infectious disease emergence and transmission to improve health outcomes and overall national security. In this commentary, we illustrate the importance of indoor air quality through case studies of infectious pathogens, their interaction with indoor environments, and measures to curtail the airborne transmission of respiratory disease.

The US Occupational Safety and Health Administration (OSHA) mandates employers provide a workplace "free from recognized hazards that are causing or are likely to cause death or serious physical harm" to employees; however, those regulations do not include workplace-acquired infectious diseases. This article examines federal and state regulations specific to workplace infectious disease exposures, highlighting their insufficiencies. The regulatory framework for occupational exposures to infectious diseases within United States workplaces is examined using specific criteria: (1) the intended scope of the federal or state standards, (2) the infectious diseases that are specifically covered, (3) the categories of workers covered, and (4) the limitations or constraints in the standard. We reviewed past attempts by OSHA to implement infectious disease standards, the impact of the COVID-19 pandemic on workplace health, and the gaps in protections for nonhealthcare workers. Healthcare workers were temporarily covered under the OSHA Emergency Temporary Standard (ETS) for COVID-19. Due to the expiration of that ETS in 2021, there are limited protections for all workers against the known hazards of various respiratory infectious diseases in the workplace. A comprehensive infectious disease standard from OSHA would address insufficiencies of the current standards protecting workers during outbreaks and with other respiratory diseases. Immediate action is required to establish a comprehensive OSHA standard that covers all industries, not just healthcare, and includes measures such as tailored worker infection control plans, enhanced ventilation, medical surveillance, infectious disease recordkeeping, and mandatory training. A unified national standard is needed to ensure public health preparedness and protect the workforce against future pandemics and endemic infectious diseases.

Ultraviolet-C (UVC) disinfection has gained considerable attention as a continuous, real-time method to mitigate the transmission of airborne pathogens within aircraft cabins. Recent investigations have demonstrated its potential to inactivate viruses such as SARS-CoV-2, influenza, and other emerging infectious agents in situ, thereby reducing both immediate infection risks and broader public health burdens. This commentary evaluates how continuous UVC disinfection-applied in tandem with established preventive measures-may effectively curtail disease transmission, reassure passengers, and inform the future direction of in-flight health and safety standards.

Artificial Intelligence (AI) has the potential to revolutionize biosecurity, health security, biodefense, and pandemic preparedness by offering groundbreaking solutions for managing biological threats. This landscape review explores recent advancements in AI across these fields, drawing from both grey literature and peer-reviewed studies published between January 2019 and February 2024. AI has demonstrated potential in predicting viral mutations, which could enable earlier detection of outbreaks, and streamlining resource allocation by analyzing diverse data sources. It could also play a crucial role in accelerating the development and deployment of medical countermeasures, such as vaccines and therapeutics. Additionally, use of AI may enhance laboratory automation, reducing human error and increasing biosafety. Despite these promising advancements, significant challenges related to the potential misuse of AI, data security, and privacy concerns necessitate careful implementation and robust governance. This article highlights the rapid progress and vast potential of AI in biosecurity and provides key recommendations for US policymakers to effectively harness AI's capabilities while ensuring safety and security. These recommendations include expanding access to advanced computing resources, fostering collaboration across sectors, and establishing clear regulatory frameworks to support the safe and ethical deployment of AI technologies.

Addressing indoor air quality (IAQ) is essential for reducing respiratory disease risks. In this commentary, we highlight the need for increased connections between typically siloed engineering and health disciplines to tackle remaining IAQ knowledge gaps that, if closed, would enhance IAQ applications and health. We provide actionable insights for policymakers, building designers, and funding agencies, recommending multidisciplinary research to support (1) increasing understanding of the complex and multifactorial variables in human infection, (2) using physical and mathematical models to understand disease transmission, and (3) determining the effectiveness of layered interventions in different environments. Addressing these knowledge gaps will help in the delivery of cost-effective IAQ solutions that reduce infectious disease risks in workplaces, schools, homes, and other indoor environments.

Following a bioterrorism event, an incident or unified command is established, the impacted area characterized, and response work zones set up based on the extent of indoor/outdoor contamination. The personnel decontamination line, established in the contamination reduction zone, is essential for ensuring potentially biohazardous contamination on worker personal protective equipment (PPE) does not migrate outside of this zone. During personnel decontamination, conventional backpack or portable garden-type sprayers are often used to distribute liquid decontaminant onto PPE surfaces to physically remove and/or inactivate the contaminant. This process can lead to migration of biological contaminants and produces large volumes of liquid waste. A comparison of the performance of electrostatic sprayers and conventional backpack sprayers in personnel biological decontamination revealed that the electrostatic sprayer generated substantially less liquid runoff (∼75X), which would minimize waste generation and disposal costs following an event. Pilot-scale tests using manikins with PPE showed decontamination efficacy greater than 6 log₁₀ reduction (liquid and aerosol inoculation of spores) for the conventional backpack sprayer while decontamination was effective but incomplete with the electrostatic sprayer (<6 log₁₀ reduction) with residual spores detected at "hard-to-reach" areas. Decontamination efficacy of the electrostatic sprayer was improved by increasing the spray time, as greater than 6 log₁₀ reduction was then observed (liquid and aerosol inoculation). Spore reaerosolization was higher during decontamination with the conventional backpack sprayer. The electrostatic sprayer as used in our study presents a viable decontamination option for a personnel decontamination line following biological agent contamination incidents.

Far ultraviolet-C (UVC) is an emerging, flexible technology for indoor air disinfection with the potential to reduce airborne transmission of pathogens while maintaining safety for human tissues. Despite its high efficacy to neutralize a wide range of pathogens and safety for human tissues, implementation of far UVC is hampered by regulatory gaps, consumer uncertainty, and unanswered research questions surrounding the formation and interaction of generated ozone and volatile oxidative byproducts. This commentary describes targeted recommendations for both epidemic-where rapid far-UVC deployment and ability to counter a wide variety of pathogens in balanced with potential environmental impacts on the indoor environment-and long term implementation scenarios, highlighting the need for human health risk studies, regulatory guidance for fa- UVC devices, and real-world cost benefit analyses, which consider the tradeoffs long term of far UVC and germicidal ultraviolet implementation. Far-UVC technologies demonstrate an exciting opportunity to promote the benefits of germicidal UV disinfection to more indoor spaces. More research is needed, however, to ensure its safe and equitable use and development. This work was in part informed by a workshop held by the Johns Hopkins Center for Health Security, which convened experts from academia, government, and industry to evaluate the scientific and policy considerations for far UVC, comparing the new technology to traditional germicidal ultraviolet.

The United States has significant opportunities to ensure buildings have clean indoor air. Federal and state governments can promote health-based indoor air quality (IAQ) targets, provide guidance and technical assistance, fund ventilation improvements, incentivize or require IAQ standards in public buildings, and work alongside industry and state and local partners to promote best IAQ practices. Despite the demonstrated health, economic, and national security benefits of improved IAQ, there has been limited progress in advancing clean indoor air across buildings in the United States. There is no comprehensive roadmap for federal and state policy actions. In this commentary, we offer a suite of policy options to improve IAQ that focus on establishing health-based IAQ targets, supporting state and local actions to adopt IAQ standards and policies, implementing sector-specific guidelines, and expanding IAQ research and development. This paper presents a spectrum of policy approaches, recognizing that different jurisdictions and sectors will have unique needs and constraints.

Military healthcare workers (HCWs) face similar clinical challenges in providing care during the pandemic as the civilian workforce. The most common respirator used in healthcare is the N95 filtering facepiece respirator (FFR). Video scoring has been successful in describing the challenges HCWs face with transmission-based precautions in healthcare. This case study explores the critical safety behavioral outcomes of 2 training interventions for respiratory protective equipment use by military HCWs during a Center for Sustainment of Trauma and Readiness Skills course on biocontainment care in Omaha, Nebraska, at the University of Nebraska Medical Center. The study included a knowledge quiz and computer-based educational materials. Behavioral assessment was done by video recording and scoring skills performance during 3 donning and doffing N95 respirator opportunities in the training course. The main finding of the knowledge quiz was the gap in recognition that hand hygiene is warranted after the personal touching required when donning a respirator. The expert scoring of respirator use showed poor performance of critical safety behaviors such as performing the user seal check for the respirator. Training opportunities can be used for data collection related to respirator safety behavior change, but our investigators would recommend isolating the behavioral interest more than this case study was able to do. There were limitations in this project by the nature of combining this assessment with the training course and its dense curriculum. This investigation into respiratory protection equipment behavior interventions during a pandemic may provide for improvement in future educational and behavioral assessment activities.