GII THIU: An ton sinh hc (ATSH) phng th nghim (PTN): L thut ng c s dng m t nhng nguyn tc, k thut v thc hnh cn thit ngn nga nhng phi nhim khng mong mun hoc lm tht thot tc nhn gy bnh (TNGB) v c t. Ngi lm vic trong PTN lun phi i mt vi nguy c b ly nhim tc nhn gy bnh. Trn th gii, rt nhiu trng hp mc bnh truyn nhim lin quan n vic khng m bo an ton sinh hc trong PTN c ghi nhn .

MT S NGUYN TC CHUNG V AN TON SINH HC: Phn loi cc vi sinh vt gy bnh theo nhm nguy c : Kh nng gy bnh ca vi sinh vt. Phng thc lan truyn bnh v yu t vt ch. Cc bin php phng nga. Cc bin php iu tr. Nhm nguy c 1 (khng c hoc nguy c ly nhim c th v cng ng thp): Bacillus subtilis, Naegleria gruberi... Nhm nguy c 2 (c nguy c tng i i vi c th v nguy c thp i vi cng ng). C phng php d phng v iu tr hiu qu. Vim gan B, t, viruscm A/H1N1... Nhm nguy c 3 (c nguy c ly nhim cao i vi c th v nguy c thp i vi cng ng). C bin php iu tr v phng chng hiu qu. Vi khun than, virus cm A/H5N1, virus SARS... Nhm nguy c 4 (nguy c ly nhim cao i vi c th v cng ng). Cha c cc bin php iu tr v phng chng hiu qu. Virus Ebola, Marburg nh gi nguy c vi sinh vt Vn ct li -> nh gi nguy c ca vi sinh vt. Ngi tin hnh: hiu bit y v cc loi vi sinh vt, thit b, cng nh c s vt cht sn c.

Ngi ph trch/an ton sinh hc: m bo vic nh gi mc nguy him mt cch y v kp thi. Vic nh gi nguy c cn c tin hnh nh k v b sung khi cn thit -> xc nh c cp an ton sinh hc ph hp -> La chn trang thit b cn thit, s dng trang b bo h c nhn ng, -> Nhm bo m an ton cao nht trong cng vic

CP AN TON PTN : Theo cp an ton sinh hc: c 4 cp Cp an ton 1 (BSL-1) Cp an ton 2 (BSL-2) Cp an ton 3 (BSL-3) Cp an ton (BSL-4) Nhm nguy c cp an ton loi PTN tiu chun thc hnh PTN Thit b an ton

GMT: Phng h c nhn: bo h, gng tay, knh eo,.. Cch thc hot ng trong PTN Quy trnh m bo v sinh

YU CU V AN TON SINH HC PTN: An ton sinh hc cp 1 v 2: Tiu chun thc hnh: Tiu chun ny l danh sch cc quy trnh v tiu chun thc hnh phng th nghim cn thit nht trong k thut vi sinh vt an ton c bn. Cc khi nim quan trng nht l: 1. ng vo: Cc du hiu v biu tng cnh bo quc t v nguy him sinh hc( BIOHAZARD) phi c t ngay ca phng th nghim lm vic vi cc nhm vi sinh vt thuc nhm nguy c 2 tr ln.

2. Ch nhng ngi c trch nhim mi c php ra vo khu vc lm vic. 3. Lun ng ca phng th nghim. 4. Khng cho php tr em vo khu vc lm vic. 5. Ch c nhng ngi c trch nhim c bit mi c ra vo khu vc nui ng vt th nghim. 6. Ch a vo nhng ng vt cn cho cng vic th nghim

Khu vc lm vic ca phng th nghim:1. Phng th nghim cn phi ngm np, sch s v ch nhng g cn thit cho cng vic. 2. Vo cui mi ngy lm vic, cc mt bn, gh phi c kh nhim sau khi lm cc vt liu nguy him. 3. Tt c cc vt liu, vt phm v mi trng nui cy nhim trng phi c kh trng trc khi thi b hoc ra sch s dng lai. 4. ng gi v vn chuyn phi tun theo quy nh quc gia hoc quc t. 5. Khi m ca s cn c li chn cn trng. Thit k v trang b phng th nghim: Vic thit k phng th nghim v ch nh loi cng vic xc nh cho n cn c bit ch n nhng iu kin nh hng n vn an ton nh sau: 1. Thao tc to ra ht kh dung. 2. Lm vic vi lng ln hoc nng cao cc vi sinh vt. 3. Qu ng nhn vin v qu nhiu trang thit b. 4. ng vt gm nhm v ng vt chn t xm nhp. 5. Ngi khng c trch nhim vo phng th nghim. 6. Cc thao tc s dng mu v thuc th ring bit. An ton sinh hc cp 3: Phng th nghim kim sot an ton sinh hc cp 3 c thit k lm vic vi vi sinh vt nhm nguy c 3 v nhm nguy c 2 nhng mc tp trung vi sinh vt cao hn v c nguy c tng s nguy him khi lan to kh dung. Mc an ton sinh hc cp 3 i hi mt chng trnh thao tc v an ton cao hn so vi mc an ton sinh hc cp 1,2.

Tiu chun thc hnh:

p dng nguyn tc phng th nghim cp 1,2 v mt s im sau: 1. Tn hiu cnh bo nguy him sinh hc t ca ra vo phng th nghim phi ghi r mc an ton sinh hc ca phng th nghim, tn ngi gim st c quyn kim sot vic ra vo phng th nghim cng nh iu kin c bit khi vo phng th nghim, v d nh to min dch. 2. Qun o bo h phng th nghim phi l nhng loi qun o c bit: loi kn pha trc, o di c bao ph hon ton, qun o c th c ra, c che u, khi cn thit c th c giy kn mi hoc loi giy ring bit. khng nn s dng qun o ci khuy pha trc v tay o khng ph ht cnh tay. Khng mc qun o th nghim ra khi phng th nghim v qun o ny phi c kh nhim trc khi em i sy. thay thng phc bng qun o chuyn dng cho phng th nghim khi lm vic vi mt s tc nhn ( v d tc nhn trong nng nghip hay ng vt gy bnh). 3. Thao tc m bt c loi vt liu c kh nng gy ly nhim no cng phi c tin hnh trong t an ton sinh hc hoc thit b ngn chn khc. Mt s thao tc trong phng th nghim hoc lm vic vi ng vt nhim mt s no c th cn nhng thit b.

Thit k v tin nghi phng th nghim:

p dng thit k v trang b nh i vi cc phng th nghim c bn an ton sinh hc cp 1,2 v mt s thay i sau: 1. Phi tch ring phng th nghim ra khi khu vc c nhiu ngi qua li trong to nh. C th t phng th nghim cui hnh lang hoc xy mt vch ngn v ca hoc i qua phng ch vo phng th nghim. 2. Ca phng ch c th ng t ng hoc kho lin ng trong mt thi im ch mt ca m. c th c mt tm panel d p v khi thot him. 3. B mt tng, sn nh, trn nh phi chng thm nc v d lau chi. 4. Phng th nghim phi c th bt kn kh nhim. Cc h thng ng kh phi c lp t cho php vic ngn chn bng kh. 5. Cc ca s phi c ng cht, c th bt kn v kh v. 6. B tr ca ra vo cc bn ra t ng.

7. Phi c h thng thng gi c kim sot duy tr hng lung kh vo phng th nghm. 8. Tt c b lc HEPA phi c lp t c th kh nhim v kim tra kh. 9. T an ton sinh hc phi c t trnh li i li, ca v h thng thng hi. 10. Cc quy trnh thit k c s h tng v vn hnh phng th nghim an ton sinh hc cp 3 phi c th hin bng vn bn.

An ton sinh hc cp 4:

Tiu chun thc hnh: p dng tiu chun thc hnh cho mc an ton sinh hc cp 3 v mt s im c b sung di y: 1. Cn p dng quy tc 2 ngi, do khng c nhn no lm vic mt mnh. y l quy tc c bit quan trng. 2. Phi thay ton b qun o v giy dp trc khi ra vo phng th nghim. 3. Nhn vin phi c o to v quy trnh cp cu c bn trong trng hp c ngi b thng hoc au m. 4. Mt phng php thng tin lin lc thng thng v trong trng hp khn cp phi c thit lp gia nhn vin lm vic trong phng th nghim v nhn vin h tr bn ngoi phng th nghim.

Thit k v trang thit b ca phng th nghim:

Phng th nghim kim sot ti a an ton sinh hc cp 4 c cc c im ging vi phng th nghim kim sot - an ton sinh hc cp 3 v c thm mt s c im di y: 1. Kim sot c bn: phi c mt h thng kim sot c bn hiu qu, bao gm mt hay nhiu th sau: Phng th nghim vi t an ton sinh hc cp 3/phng thi nghim cabin 3. Phng th nghim yu cu mc bo h.

2. Kim sot li ra vo: phi c b tr mt to nh ring bit hoc mt khu vc c m t r rng trong mt to nh an ton. Nhn vin v trang thit b ra vo phi qua mt phng kho kh hoc h thng ring bit. khi vo nhn vin phi thay ton b qun o v trc khi ra phi tm ra sch s v thay qun o bnh thng. 3. Kim sot h thng kh 4. Kh nhim cht thi lng. 5. V khun cht thi v vt liu. 6. Mu vt, vt liu v ng vt phi vo qua cng kho kh. 7. Phi c ng dy in chuyn dng v ngung in ring. 8. H thng cng rnh ngn chn phi c lp t.

CP 1:

C s vt cht : Khng gian cn rng thc hin cc cng vic. Vt liu d lau chi, chu c ho cht v cht dit khun nh sng cho cc hot ng. T qun o, dng c nhn, ch n ung b tr bn ngoi PTN. Bn ra tay c vi nc gn ca ra vo. Ca ra vo nn c knh trong sut, chu nhit v t ng. C phng tin cu ho, x l s c in. Hp thuc v dng c s cu c trang b thch hp v sn sng cho s dng. C h thng cp nc sch. C h thng in n nh v y , tip t ton b h thng. An ton chy n v an ninh.

Thit b

c thit k v lp t gim thiu ti a s tip xc gia ngi lm vi cc bnh phm. Cc thit b ph hp vi k thut v loi vi sinh vt Cc thit b phi c kim tra, hiu chun nh k Cc trang b bo h c nhn ph hp

CP 2:

C s vt cht C bin bo nguy him sinh hc vi biu tng quc t trn tt c cc ca ra vo ca PTN. Nn lp t h thng n chiu sng khn cp trong trng hp c s c nh mt in. Nn c phng tm c vi hoa sen trong khu vc PTN s dng trong trng hp khn cp

Thit b T ATSH cp 2. Ni hp t (autoclave) hoc cc thit b tit trng thch hp khc trong khu vc th nghim. Trang b cc loi ti, thng ng cht thi ph hp theo quy nh ca B Y t

CP 3:

C s vt cht Cch ly vi khu vc c nhiu ngi qua li. C phng m (anteroom) trc khi vo PTN: ch m c mt ca trong mt thi im. C ca thot him trong trng hp khn cp. H thng b lc khng kh (b lc HEPA), ng dn kh tit trng, khng x trc tip khng kh t PTN ra ngoi.

C h thng kim sot nhit , thng kh v iu ho nhit (HVAC) duy tr p lc m ph hp trong PTN. Nc thi ly nhim phi c tit trng trc khi thi ra ngoi. Cc quy trnh thit k c s h tng v vn hnh phng xt nghim an ton sinh hc cp 3 phi c th hin bng vn bn Thit b T an ton sinh hc cp 3, lp t trnh li i li, ca ra vo v cc ca cp, thi kh. Ni hp tit trng di ng (autoclave) trong phng xt nghim. Cn quan tm n tnh an ton ca thit b,..

CP 4:

Thit k da trn BSL-3. Nghin cu tc nhn nguy c cp 4. Hai trang thit b cn thit ca phng th nghim cp 4, tch tuyt i ca ngi nhn vin i vi cc tc nhn ly nhim: Trang phc bo h chuyn dng PTN T an ton sinh hc Phng kn, m bo khng c khng kh lu thng ra vo PTN khi cha x l Nhn vin lm vic trong PTN phi c trnh chuyn mn cao, c thi quen an ton v k lut, c tinh thn trch nhim i vi cng ng. Gim st vin phi c kh nng trong vic x l cc tc nhn v yu cu ngn chn cc tc nhn trong nhm nguy c 4. Mi hot ng PTN phi c kim sot v gim st bi hi ng hay ngi chuyn trch theo quy nh ca cc chnh sch th ch v an ton quc gia v quc t.

TRANG THIT B PHNG TH NGHIM

T an ton sinh hc:

T an ton sinh hc(BSC): c thit k bo v ngi vn hnh, mi trng phng th nghim cng nh nguyn vt liu lm vic khi b phi nhim vi kh dung v ht nhim trng c to ra khi thao tc cc vt liu cha cc tc nhn d ly nhim nh nui cy s b, lu gi v chun on cc mu xt nghim. cc ht kh dung c to ra bi cc thao tc vi dung dch lng hoc hi c nh lc, rt, khuy, nh git dung dch ln trn mt mc phng, hoc vo trong mt dung dch khc cng c th to ra kh dung nhim trng nh nui cy trn thch, tim vo cc bnh nui cy t bo bng pipet, s dng loi pipet a knh pha ch huyn ph cc tc nhn nhim trng vo cc a nui cy, qu trnh khuy trn v ng nht cc vt liu nhim trng, ly tm cc dung dch nhim trng hoc lm vic vi cc ng vt. cc ht kh dung c ng kn nh hn 5m v git nh c ng knh

5 100 m khng th nhn thy bng mt thng. Nhn vin phng th nghim thng khng thc c rng cc thnh phn c to ra v c th b ht phi hoc c th gy nhim khun cho cc vt liu trn b mt lm vic . Khi s dng thch hp, t an ton sinh hc chng t hiu qu cao trong vic lm gim nhim trng mc phi ti phng th nghim v nhim trng cho khi nui cy v b phi nhim kiu kh dung. T an ton sinh hc cn bo v mi trng.Qua nhiu nm, mu thit k c bn ca t an ton sinh hc tri qua mt s thay i. Mt thay i ln l thm b lc khng kh hiu qu cao (HEPA) vo trong h thng thi kh. B lc gi li 99,97% cc phn t c ng knh 0,3m v 99.99%

cc phn t c ng knh nh hn hoc to hn. iu ny cho php b lc HEPA gi li mt cch hiu qu tt c tc nhn nhim trng bit v m bo rng ch c kh thi khng cn vi trng mi c thi ra ngoi t. Thay i th hai trong mu thit k l b lc HEPA t trc tip trn b mt lm vic, cho php bo v cc vt liu trn b mt khi s nhim bn. Nt c trng ny c coi chnh l bo v sn phm nhng khi nim thit k c bn ny dn ti s pht trin tng bc ca ba cp t an ton sinh hc.

T an ton sinh hc cp I:

A:khe h pha trc. B: khung knh trt. C: b lc kh thi HEPA. D: li thot gi.

PHN LOI CC T AN TON SINH HC DA TRN KIU BO V:

Kiu bo v

Loi BSC

Bo v ngi i vi vi sinh vt thuc cc nhm nguy c 1-3. Bo v ngi i vi vi sinh vt nhm nguy c 4. Phng th nghim c hp gng tay. Bo v ngi i vi vi sinh vt nhm nguy c 4. Mc phng h phng th nghim. Bo v sn phm. Bo v khi cht ho hc/ phng x d bin i theo thng pht. Bo v khi cht ho hc/ phng x d bin i.

Loi I, II, III. Loi III. Loi I, Loi II. Loi II, Loi III ch dnh cho t cy c thi kh. Loi IIB1, IIA1 thot kh ra ngoi. Loi I, IIB2, Loi III.

T an ton sinh hc cp IIA1:

A: khe h pha trc. B:khung knh trt. C: b lc kh thi HEPA. D: li thot gi. E: b lc cp khi HEPA. F: my thi gi.

T an ton sinh hc cp IIA2:

A: khe h pha trc. B:khung knh trt. C: b lc kh thi HEPA. D: li thot gi. E: b lc cp khi HEPA. F: my thi gi. G: b lc HEPA cung cp kh. Yu cu ni ng thi kh t t n h thng thi kh ca to nh.

T an ton sinh hc cp III:

A: cng gng tay cho cc gy tay di n cnh tay. B: khung knh trt. C: b lc kh thi HEPA kp. D: ni hp hai y hoc hp hai np. F: bnh cha ho cht. Yu cu ni kh thi t t n h thng thi kh ring ca to nh.

TM CCH LY BNG MNG MM P SUT M:

L mt thit b ngn chn c bn t bo v ti a khi cc vt liu sinh hc nguy him. p sut nn trong ca tm cch ly c duy tr thp hn p sut kh quyn. Thit b cch ly ny c th lp lng hp, knh hin vi v cc thit b phng th nghim khc nh ly tm, t sy bng nhit c s sng khi thao tc vi cc sinh vt c nguy c cao (nhm nguy c 3,4) nhnng ni khng th hoc khng thch hp lp t hoc duy tr cc t an ton sinh hc thng thng.