Ethical integrity and responsible conduct in the life sciences are vital to scientific advancement. Laboratory management systems that prioritize collective accountability and leadership behavior while nurturing effective biorisk management principals play an important role in creating an international culture of safety. In laboratories where equipment and institutional mentoring are limited, staff must focus on what they can control. Out of this global need, ASM has been implementing a unique biosafety curriculum promoting behavioral and technical best practices, based on cooperative and collaborative learning. As the number of individuals requiring training on safe practices in high biocontainment laboratories increases, standardized introductory biosafety training is critical to reducing the potential for human error. While complications and challenges abound regarding global health governance, creating a culture of responsibility is a critical component to promoting worker and community safety.
 

What Is Biosafety?

Biosafety addresses the safe handling and containment of potentially infectious microorganisms and hazardous biological materials. The goal of biosafety is to reduce the risk of laboratory-acquired infections to individual workers and their environment, reducing the potential consequences for accidental introduction of a pathogen into the community. Human error is often the main cause of preventable exposures of lab workers to dangerous pathogens. Biosafety relies on both equipment and reagents, as well as the development and application of appropriate biosafety and biosecurity behavioral best practices.
 
In recent years, there has been a global expansion in laboratory-based diagnostic and research capacities driven by an increased demand for disease detection and control. However, despite the increase in infectious disease surveillance and diagnostics, sustainable capacity in biosafety and biosecurity management remains constrained by many variables, including the lack of national biological safety regulatory guidelines and biosafety curricula, as well as limited laboratory infrastructure and limited dedicated funding, particularly in lower-resource countries. Without resources for PPE, or the ability to reinforce biosafety and biosecurity practices, researchers working with infectious microorganisms, whether for clinical diagnosis or population-based surveillance, remain at risk of infection.
 

Biosafety is Accountability

ASM implements a curriculum known as the 52 Weeks of Biosafety program to address the biggest risk factor for biosafety: human behavior. Scientist participants learn critical behavioral skills for the control and accountability of biological agents, as well as the knowledge and processes to protect themselves and their communities from preventable exposure to infectious disease. Participants include public health leaders from multiple public health-related fields, as engagement of all aspects of the laboratory workforce is essential to improving biosafety and strengthening the biorisk-management practices of their hospitals, universities and laboratories.
 
The 52 Weeks program works to strengthen laboratory capacity by creating a culture of accountability, consciousness and education. This year-long mentorship program combines monthly webinars, virtual office hours and capacity-building assignments to improve biosecurity and biosafety knowledge and behavioral practices at the worker level and containment measures at the institutional level. 52 Weeks culminates in a five-day workshop, facilitated by a Biosecurity and Laboratory Behavioral Safety Specialist. The 2019 workshop was held in Cairo and convened 18 laboratory scientists who serve many of Egypt’s public health microbiological laboratories, as a cohort that included clinical microbiologists, epidemiologists and infection-control officers who handle high-consequence pathogens. The workshop focused on skill-building in donning and doffing of PPE, emergency response drills and other relevant areas. It also focused on instilling a culture of responsibility in scientific communities through positive behavioral, procedural and institutional change through the creation of standardized training, codes of conduct and reinforcing shared values of scientific integrity.
 

Biosafety Is Behavior

As a behavior-based training approach, 52 Weeks provides an overview of the four primary controls of biosafety, phases of biological risk mitigation and biosecurity strategies. This program also ensures that participants understand laboratory risks and demonstrate behaviors needed to mitigate those risks, and develop customized and innovative solutions for their institutions — thereby increasing professional resilience and sustainable behavioral competencies in biosafety. The primary focus of 52 Weeks is on the psychology of individuals as they engage in decision making, interpersonal relations, and small group activities. Instructional methods for the use of PPE as part of contamination and protocol adherence, specifically donning and doffing methods, are emphasized to participants throughout the course of the program. At the Cairo workshop, participants practiced best techniques for glove removal in a Glo-Germ exercise. In this simulation exercise, participants were asked to put on disposable lab gloves, Glo-Germ was added to gloves, then students were asked to remove their gloves as they would in the lab. Their hands were examined using ultraviolet lighting in a darkened room to see where and how the Glo-Germ had spread, simulating self-inoculation. Best-use studies and CDC guidelines around doffing methods emphasizes that standardized PPE use is one of a hierarchy of controls aimed at eliminating hazards from infectious disease exposures.
 
Through repeated skills practice, participants can experience increased confidence in demonstrating safe donning and doffing procedures, becoming experts who then return to their home labs and spread these behavioral competencies to the rest of their lab colleagues. In addition to technical skill development, complimentary behavior-based instruction is taught. Courses titled, “Behavioral Cues, Distinguishing Safety Climate and Safety Culture, and Personality” are core parts of the 52 Weeks curriculum which supports positive conditioning thereby shaping our actions through repeated exposure to environmental stimuli.
 
Global health security is a shared responsibility of the international community. While outbreak protocol, surveillance and reporting are important, it is the behavior of communities which have the ability to drive change towards success or failure. In recognition of this collective responsibility, ASM’s Global Public Health Programs promotes global health security by strengthening biosafety and biosecurity management practices through delivering behavior-based biosafety curricula for the scientists who are on the front lines of disease detection and control. By combining an integrated culture of responsibility with technical laboratory skills training, ASM strives to sustain a safe and effective generation of laboratory scientists through capacity development and accountability.
 
To become involved in ASM’s Global Public Health Programs as a consultant, volunteer or country ambassador, please visit www.asm.org/globalhealth.