Safeguards for Using Viral Vector Systems in Human Gene Therapy: A Resource for Biosafety Professionals Mitigating Risks in Health Care Settings
Introduction: Health care workers who work daily with human body fluids and hazardous drugs are among those at the highest risk of occupational exposure to these agents. The Occupational Safety and Health Administration’s (OSHA) Bloodborne Pathogens Standard (29 CFR 1910.1030) prescribes safeguards...
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Published in | Applied biosafety Vol. 25; no. 4; pp. 184 - 193 |
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Main Authors | , , , |
Format | Journal Article |
Language | English |
Published |
Los Angeles, CA
SAGE Publications
01.12.2020
Mary Ann Liebert, Inc., publishers |
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Abstract | Introduction:
Health care workers who work daily with human body fluids and hazardous drugs are among those at the highest risk of occupational exposure to these agents. The Occupational Safety and Health Administration’s (OSHA) Bloodborne Pathogens Standard (29 CFR 1910.1030) prescribes safeguards to protect workers against health hazards related to bloodborne pathogens. Similarly, the United States Pharmacopeia General Chapter 800 (USP ), a standard first published in February 2016 and implementation required by December 2019, addresses the occupational exposure risks of health care workers at organizations working with hazardous drugs. With emerging technologies in the field of gene therapy, these occupational exposure risks to health care workers now extend beyond those associated with bloodborne pathogens and hazardous drugs and now include recombinant DNA. The fifth edition of the Biosafety in Microbiological and Biomedical Laboratories (BMBL) and the National Institutes of Health Guidelines for Research Involving Recombinant or Synthetic Nucleic Acid Molecules (NIH Guidelines) mostly govern work with biohazardous agents and recombinant DNA in a laboratory research setting. When gene therapy products are utilized in a hospital environment, health care workers have very few resources to identify and reduce the risks associated with product use during and after the administration of treatments.
Methods:
At the Abigail Wexner Research Institute at Nationwide Children’s Hospital, a comprehensive gap analysis was executed between the research and health care environment to develop a program for risk mitigation. The BMBL, NIH Guidelines, World Health Organization Biosafety Manual, OSHA Bloodborne Pathogens Standard, and USP were used to develop a framework for the gap analysis process.
Results:
The standards and guidelines for working with viral vector systems in a research laboratory environment were adapted to develop a program that will mitigate the risks to health care workers involved in the preparation, transportation, and administration of gene therapies as well as subsequent patient care activities. The gap analysis identified significant differences in technical language used in daily operations, work environment, training and education, disinfection practices, and policy development between research and health care settings. These differences informed decisions and helped the organization develop a collaborative framework for risk mitigation when a gene therapy product enters the health care setting.
Discussion:
With continuing advances in the field of gene therapy, the oversight structure needs to evolve for the health care setting. To deliver the best outcomes to the patients of these therapies, researchers, Institutional Biosafety Committees, and health care workers need to collaborate on training programs to safeguard the public trust in the use of this technology both in clinical trials and as FDA-approved therapeutics. |
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AbstractList | Introduction:
Health care workers who work daily with human body fluids and hazardous drugs are among those at the highest risk of occupational exposure to these agents. The Occupational Safety and Health Administration’s (OSHA) Bloodborne Pathogens Standard (29 CFR 1910.1030) prescribes safeguards to protect workers against health hazards related to bloodborne pathogens. Similarly, the United States Pharmacopeia General Chapter 800 (USP ), a standard first published in February 2016 and implementation required by December 2019, addresses the occupational exposure risks of health care workers at organizations working with hazardous drugs. With emerging technologies in the field of gene therapy, these occupational exposure risks to health care workers now extend beyond those associated with bloodborne pathogens and hazardous drugs and now include recombinant DNA. The fifth edition of the Biosafety in Microbiological and Biomedical Laboratories (BMBL) and the National Institutes of Health Guidelines for Research Involving Recombinant or Synthetic Nucleic Acid Molecules (NIH Guidelines) mostly govern work with biohazardous agents and recombinant DNA in a laboratory research setting. When gene therapy products are utilized in a hospital environment, health care workers have very few resources to identify and reduce the risks associated with product use during and after the administration of treatments.
Methods:
At the Abigail Wexner Research Institute at Nationwide Children’s Hospital, a comprehensive gap analysis was executed between the research and health care environment to develop a program for risk mitigation. The BMBL, NIH Guidelines, World Health Organization Biosafety Manual, OSHA Bloodborne Pathogens Standard, and USP were used to develop a framework for the gap analysis process.
Results:
The standards and guidelines for working with viral vector systems in a research laboratory environment were adapted to develop a program that will mitigate the risks to health care workers involved in the preparation, transportation, and administration of gene therapies as well as subsequent patient care activities. The gap analysis identified significant differences in technical language used in daily operations, work environment, training and education, disinfection practices, and policy development between research and health care settings. These differences informed decisions and helped the organization develop a collaborative framework for risk mitigation when a gene therapy product enters the health care setting.
Discussion:
With continuing advances in the field of gene therapy, the oversight structure needs to evolve for the health care setting. To deliver the best outcomes to the patients of these therapies, researchers, Institutional Biosafety Committees, and health care workers need to collaborate on training programs to safeguard the public trust in the use of this technology both in clinical trials and as FDA-approved therapeutics. IntroductionHealth care workers who work daily with human body fluids and hazardous drugs are among those at the highest risk of occupational exposure to these agents. The Occupational Safety and Health Administration's (OSHA) Bloodborne Pathogens Standard (29 CFR 1910.1030) prescribes safeguards to protect workers against health hazards related to bloodborne pathogens. Similarly, the United States Pharmacopeia General Chapter 800 (USP ), a standard first published in February 2016 and implementation required by December 2019, addresses the occupational exposure risks of health care workers at organizations working with hazardous drugs. With emerging technologies in the field of gene therapy, these occupational exposure risks to health care workers now extend beyond those associated with bloodborne pathogens and hazardous drugs and now include recombinant DNA. The fifth edition of the Biosafety in Microbiological and Biomedical Laboratories (BMBL) and the National Institutes of Health Guidelines for Research Involving Recombinant or Synthetic Nucleic Acid Molecules (NIH Guidelines) mostly govern work with biohazardous agents and recombinant DNA in a laboratory research setting. When gene therapy products are utilized in a hospital environment, health care workers have very few resources to identify and reduce the risks associated with product use during and after the administration of treatments. MethodsAt the Abigail Wexner Research Institute at Nationwide Children's Hospital, a comprehensive gap analysis was executed between the research and health care environment to develop a program for risk mitigation. The BMBL, NIH Guidelines, World Health Organization Biosafety Manual, OSHA Bloodborne Pathogens Standard, and USP were used to develop a framework for the gap analysis process. ResultsThe standards and guidelines for working with viral vector systems in a research laboratory environment were adapted to develop a program that will mitigate the risks to health care workers involved in the preparation, transportation, and administration of gene therapies as well as subsequent patient care activities. The gap analysis identified significant differences in technical language used in daily operations, work environment, training and education, disinfection practices, and policy development between research and health care settings. These differences informed decisions and helped the organization develop a collaborative framework for risk mitigation when a gene therapy product enters the health care setting. DiscussionWith continuing advances in the field of gene therapy, the oversight structure needs to evolve for the health care setting. To deliver the best outcomes to the patients of these therapies, researchers, Institutional Biosafety Committees, and health care workers need to collaborate on training programs to safeguard the public trust in the use of this technology both in clinical trials and as FDA-approved therapeutics. |
Author | Campbell, Katie Brown, Alex M. Ghosh, Sumit Blind, Jill |
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Cites_doi | 10.1056/NEJMp1810628 10.1016/S0065-2660(05)54014-8 10.1093/ajhp/zxz056 10.1177/1535676019854866 10.1177/1535676019838075 10.1038/s41423-019-0207-3 10.3389/fmed.2019.00058 10.1093/toxsci/kfw220 10.1006/mthe.2001.0494 10.1177/1535676017721488 10.1310/hpj4909-811 10.1177/1535676019899502 10.1186/s12990-015-0018-1 10.1146/annurev.pharmtox.43.100901.140257 10.1002/cpmo.58 10.1358/dnp.1998.11.5.863673 10.3390/diseases6020042 10.1177/1535676019859787 |
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References | Boulaiz, Marchal, Prados, Melguizo, Aránega 2005; 51 Collins, Gottlieb 2018; 379 Lunshof, Birnbaum 2017; 22 Dangi, Yu, Luo 2019; 16 Bubela, Boch, Viswanathan 2019; 6 Blind, McLeod, Campbell 2019; 76 David, Doherty 2017; 155 Petrich, Marchese, Jenkins, Storey, Blind Eisenman 2019; 24 Hansen, Gram 2002; 164 Chen, Keiser, Davidson 2018; 8 Favre, Provost, Blouin 2001; 4 Strayer 1998; 11 Millett, Binz, Evans 2019; 24 2003 Ghosh, Brown, Jenkins, Campbell 2020; 25 Hutchinson 1998; 1 Guedon, Wu, Zheng 2015; 11 Gabay 2014; 49 Kootstra, Verma 2003; 43 Ghosh, Voigt, Wynne, Nelson 2019; 24 Lundstrom 2018; 6 Shah, Losordo 2005; 54 bibr14-1535676020934917 bibr19-1535676020934917 bibr27-1535676020934917 bibr22-1535676020934917 Department of Health and Human Services (bibr20-1535676020934917) bibr23-1535676020934917 Hansen JE (bibr15-1535676020934917) 2002; 164 bibr10-1535676020934917 Petrich J (bibr17-1535676020934917) bibr2-1535676020934917 bibr6-1535676020934917 bibr24-1535676020934917 bibr11-1535676020934917 bibr25-1535676020934917 bibr29-1535676020934917 bibr12-1535676020934917 Boulaiz H (bibr1-1535676020934917) 2005; 51 bibr7-1535676020934917 bibr16-1535676020934917 bibr4-1535676020934917 World Health Organization (bibr18-1535676020934917) 2004 bibr21-1535676020934917 Hutchinson E (bibr9-1535676020934917) 1998; 1 bibr13-1535676020934917 Occupational Safety and Health Administration (bibr26-1535676020934917) 2003 bibr8-1535676020934917 |
References_xml | – volume: 11 start-page: 27 year: 2015 article-title: Current gene therapy using viral vectors for chronic pain publication-title: Mol Pai contributor: fullname: Zheng – volume: 54 start-page: 339 year: 2005 end-page: 361 article-title: Non-viral vectors for gene therapy: clinical trials in cardiovascular disease publication-title: Adv Genet contributor: fullname: Losordo – volume: 16 start-page: 334 issue: 4 year: 2019 end-page: 342 article-title: Emerging approaches and technologies in transplantation: the potential game changers publication-title: Cell Mol Immunol contributor: fullname: Luo – volume: 4 start-page: 559 issue: 6 year: 2001 end-page: 566 article-title: Immediate and long-term safety of recombinant adeno-associated virus injection into the nonhuman primate muscle publication-title: Mol Ther contributor: fullname: Blouin – volume: 6 start-page: 58 year: 2019 article-title: Recommendations for regulating the environmental risk of shedding for gene therapy and oncolytic viruses in Canada publication-title: Front Med (Lausanne) contributor: fullname: Viswanathan – volume: 24 start-page: 64 issue: 2 year: 2019 end-page: 71 article-title: Developing a comprehensive, adaptive, and international biosafety and biosecurity program for advanced biotechnology: the iGEM experience publication-title: Appl Biosaf contributor: fullname: Evans – volume: 43 start-page: 413 year: 2003 end-page: 439 article-title: Gene therapy with viral vectors publication-title: Annu Rev Pharmacol Toxicol contributor: fullname: Verma – volume: 8 start-page: 58 issue: 4 year: 2018 article-title: Viral vectors for gene transfer publication-title: Curr Protoc Mouse Biol contributor: fullname: Davidson – volume: 76 start-page: 795 issue: 11 year: 2019 end-page: 802 article-title: Viral-mediated gene therapy and genetically modified therapeutics: a primer on biosafety handling for the health-system pharmacist publication-title: Am J Health Syst Pharm contributor: fullname: Campbell – volume: 51 start-page: 3 issue: 1 year: 2005 end-page: 22 article-title: Non-viral and viral vectors for gene therapy publication-title: Cell Mol Biol (Noisy-le-grand) contributor: fullname: Aránega – volume: 164 start-page: 4272 issue: 37 year: 2002 end-page: 4276 article-title: Viral vectors for clinical gene therapy publication-title: Ugeskr Laeger contributor: fullname: Gram – volume: 379 start-page: 1393 issue: 15 year: 2018 end-page: 1395 article-title: The next phase of human gene-therapy oversight publication-title: N Engl J Med contributor: fullname: Gottlieb – volume: 1 start-page: 265 issue: 3 year: 1998 end-page: 267 article-title: American society of gene therapy - First Annual Meeting Education session. The ABCs of non-viral vectors for gene therapy publication-title: IDrugs contributor: fullname: Hutchinson – volume: 22 start-page: 97 issue: 3 year: 2017 end-page: 103 article-title: Adaptive risk management of gene drive experiments: biosafety, biosecurity, and ethics publication-title: Appl Biosaf contributor: fullname: Birnbaum – article-title: National Institutes of Health publication-title: Biosafety in Microbiological and Biomedical Laboratories – volume: 49 start-page: 811 issue: 9 year: 2014 end-page: 822 article-title: USP <800>: handling hazardous drugs publication-title: Hosp Pharm contributor: fullname: Gabay – publication-title: The National Institutes of Health (NIH) Guidelines for Research Involving Recombinant or Synthetic Nucleic Acid Molecules (NIH guidelines) – start-page: 1 year: 2003 end-page: 29 publication-title: Model Plans and Programs for the OSHA Bloodborne Pathogens and Hazard Communications Standards – volume: 24 start-page: 153 issue: 3 year: 2019 end-page: 160 article-title: The United States’ Regulatory Environment is evolving to accommodate a coming boom in gene therapy research publication-title: Appl Biosaf contributor: fullname: Eisenman – volume: 6 start-page: 1 issue: 2 year: 2018 end-page: 20 article-title: Viral vectors in gene therapy publication-title: Diseases contributor: fullname: Lundstrom – volume: 155 start-page: 315 issue: 2 year: 2017 end-page: 325 article-title: Viral vectors: the road to reducing genotoxicity publication-title: Toxicol Sci contributor: fullname: Doherty – volume: 25 start-page: 7 issue: 1 year: 2020 end-page: 18 article-title: Viral vector systems for gene therapy: a comprehensive literature review of progress and biosafety challenges publication-title: Appl Biosaf contributor: fullname: Campbell – volume: 11 start-page: 277 issue: 5 year: 1998 end-page: 286 article-title: Viral vectors for gene therapy: past, present and future publication-title: Drug News Perspect contributor: fullname: Strayer – volume: 24 start-page: 153 issue: 3 year: 2019 end-page: 160 article-title: Developing an in-house biological safety cabinet certification program at the University of North Dakota publication-title: Appl Biosaf contributor: fullname: Nelson – article-title: Gene replacement therapy: a primer for the health-system pharmacist publication-title: J Pharm Pract contributor: fullname: Blind – ident: bibr7-1535676020934917 doi: 10.1056/NEJMp1810628 – ident: bibr20-1535676020934917 publication-title: The National Institutes of Health (NIH) Guidelines for Research Involving Recombinant or Synthetic Nucleic Acid Molecules (NIH guidelines) contributor: fullname: Department of Health and Human Services – ident: bibr10-1535676020934917 doi: 10.1016/S0065-2660(05)54014-8 – volume: 164 start-page: 4272 issue: 37 year: 2002 ident: bibr15-1535676020934917 publication-title: Ugeskr Laeger contributor: fullname: Hansen JE – ident: bibr25-1535676020934917 doi: 10.1093/ajhp/zxz056 – ident: bibr4-1535676020934917 doi: 10.1177/1535676019854866 – ident: bibr22-1535676020934917 doi: 10.1177/1535676019838075 – volume: 51 start-page: 3 issue: 1 year: 2005 ident: bibr1-1535676020934917 publication-title: Cell Mol Biol (Noisy-le-grand) contributor: fullname: Boulaiz H – ident: bibr12-1535676020934917 doi: 10.1038/s41423-019-0207-3 – ident: bibr27-1535676020934917 doi: 10.3389/fmed.2019.00058 – ident: bibr19-1535676020934917 – ident: bibr16-1535676020934917 doi: 10.1093/toxsci/kfw220 – ident: bibr21-1535676020934917 doi: 10.1006/mthe.2001.0494 – ident: bibr23-1535676020934917 doi: 10.1177/1535676017721488 – ident: bibr29-1535676020934917 doi: 10.1310/hpj4909-811 – ident: bibr6-1535676020934917 doi: 10.1177/1535676019899502 – ident: bibr17-1535676020934917 publication-title: J Pharm Pract contributor: fullname: Petrich J – ident: bibr14-1535676020934917 doi: 10.1186/s12990-015-0018-1 – ident: bibr11-1535676020934917 doi: 10.1146/annurev.pharmtox.43.100901.140257 – ident: bibr8-1535676020934917 doi: 10.1002/cpmo.58 – volume-title: Laboratory Biosafety Manual year: 2004 ident: bibr18-1535676020934917 contributor: fullname: World Health Organization – start-page: 1 year: 2003 ident: bibr26-1535676020934917 publication-title: Model Plans and Programs for the OSHA Bloodborne Pathogens and Hazard Communications Standards contributor: fullname: Occupational Safety and Health Administration – ident: bibr13-1535676020934917 doi: 10.1358/dnp.1998.11.5.863673 – volume: 1 start-page: 265 issue: 3 year: 1998 ident: bibr9-1535676020934917 publication-title: IDrugs contributor: fullname: Hutchinson E – ident: bibr2-1535676020934917 doi: 10.3390/diseases6020042 – ident: bibr24-1535676020934917 doi: 10.1177/1535676019859787 |
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Snippet | Introduction:
Health care workers who work daily with human body fluids and hazardous drugs are among those at the highest risk of occupational exposure to... IntroductionHealth care workers who work daily with human body fluids and hazardous drugs are among those at the highest risk of occupational exposure to these... |
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Title | Safeguards for Using Viral Vector Systems in Human Gene Therapy: A Resource for Biosafety Professionals Mitigating Risks in Health Care Settings |
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