Laboratory-Acquired Infections (LAI)

Contained Use of GMOs and pathogens
Laboratory-acquired Infections: Introduction
(Author: P. Herman) (Last revised: April 26, 2013 )

Laboratory-acquired infections (LAIs) also called occupational illness or laboratory-associated infections are not new phenomena in microbiological laboratories. LAIs can arise in clinical laboratories as well as in animal facilities, R&D, production installations. It is sometimes difficult to determine if a discovered infectious worker's disease is caused by a micro-organism that is present in the laboratory only or also in the community. LAIs are also of public health concern as an infected worker may present a risk of transmission to his colleagues, relatives, family members or other citizens.

Some biological agents responsible of LAIs are presented in Table1 and a study from Pike in 1976 giving the percentage of LAI per laboratory category is showed on Table 2.

Exhaustive reports on LAIs are scanty and are based on voluntary reporting by laboratories (case reports) or by more elaborated and detailed inquiries. The underreporting of such infections is widely acknowledged due to fear of reprisal and the stigma associated with such events (Sewell, 1995). Some comprehensive publications referencing a large number of LAIs were published in the past decade (see references).

The link between LAIs and Biosafety is obvious. These concerns are also to be considered as one of the underlying reasons for the elaboration of containment measures and application of safe work practices.

LAIs are defined as all infection acquired through laboratory or laboratory-related activities regardless whether they are symptomatic or asymptomatic in nature.

LAIs are resulting from occupational exposure to infectious agents. The most common route of exposure and accidental inoculation are the following:

Inhalation (see aerosols)
Percutaneous inoculation (needle and syringe, cuts or abrasions from contaminated items and animal bites)
Contact between mucous membranes and contaminated material (hands or surfaces)
Ingestion (aspiration through a pipette, smoking or eating)

Important factors to consider when assessing the risks for staff working in R&D, production or microbiology laboratory are the following:

Mode of transmission
Infectious doses for human (see Table 3)

Another useful information is the persistence or viability of infectious agents in the environment (Table 4 under revision)

Link to a webpage dedicated to literature references (LAI case reports) with Reviews, the most frequent laboratory-acquired infections, other infectious agents and non infectious agents.

Link to a webpage gathering reported LAIs from year 2000 to the most recent references.

On request of the Flemish Agency for Care and Health, Public Health Surveillance, the Biosafety and Biotechnology Unit (SBB), which belongs to the Scientific Institute of Public Health, developed a survey in the interest of mapping and evaluating the risk for “laboratory-acquired infections” (LAIs) related to bio-incidents with pathogenic organisms (genetically modified or not) in Flanders over the last 5 years (2007-2012).

The aim of this survey was to gather information on bio-incidents and LAIs in biological laboratories in the Flemish region and to gain insight into the possible underlying causes in order to provide biosafety officers, prevention officers and occupational health practitioners with tools that can enhance biological safety in the laboratory.

The survey was available in Dutch and English. In total ~50 questions and sub questions were addressed to each respondent, consisting of single-answer questions and multi-answer questions, most of the questions were mandatory. The survey documents are availbale here: