Biomedical Engineering Reference
In-Depth Information
Anesthesia, Surgery, Dentistry, and
Technical Procedures
Surgical and dental procedures conducted on nonhuman
primates present significant biosafety concerns. A prean-
esthetic regimen may have a chemical restraint component,
and precautions listed in the section “Veterinary care,
animal health, and husbandry practices/Physical and
chemical restraint” are applicable here. Anesthetic agents
should be used with caution. Anesthetic machines should
have scavenging devices for safely exhausting waste gases.
The use of volatile, explosive agents, such as ether, is
greatly discouraged and these agents have no place in
modern veterinary practice.
Particular care and caution must be exercised when
using suture needles and various surgical instruments such
as scalpels, scissors, towel clamps, and forceps, which have
sharp edges or pointed/serrated tips that may puncture, cut,
or abrade (even through surgical gloves) the fingers, hands,
or other body parts of the surgeon. The potential trans-
mission of herpes B from macaques to humans via these
routes must be minimized and avoided. This hazard
remains until potentially contaminated surgical instru-
ments, needles, and scalpels have been appropriately dis-
infected or disposed of.
The surgeon and others handling tissues of potentially
infected nonhuman primates, whether naturally or experi-
mentally infected, should wear orthopedic gloves or two
pairs of latex surgical gloves. The failure rate of some
surgical gloves is very high and the loss of dexterity when
using two pairs of gloves is minimal when compared to the
risk to the surgeon.
To lessen the chance of human error, it is advisable for
the surgeon or individual performing intricate surgical and
dental procedures on nonhuman primates, particularly
macaques, to do so only when well-rested and relaxed.
In the performance of dental procedures on nonhuman
primates, especially macaques potentially infected with
herpes B, extreme caution must be used to avoid punctures,
cuts, or abrasions to humans with contaminated instru-
ments. In addition, to minimize the risk of pathogens
gaining access to mucous membranes, wearing face masks
and face shields or goggles is recommended for close
contact work, especially if aerosols are created. Powered air
purifying respirator (PAPR) devices should be considered
for any dental procedures that utilize ultrasonic equipment,
high-speed drills, or saws.
Technical procedures, in particular those involving
hypodermic needles and other sharps, must be conducted
with the utmost of care to prevent one's exposure to
a hazardous agent. Needles should not be recapped but
rather discarded in appropriate sharps containers, as for
other disposable sharps. Syringes should be of the Luer-
Lok type to prevent the detachment of needles during
injection and the subsequent spraying of aerosols from
solutions of medications, fluids, etc., particularly after
blood has been aspirated into the syringe.
ZOONOSES, BIOHAZARDS, AND
OTHER HEALTH RISKS
INTRODUCTION
Zoonoses are infections and diseases shared in nature by
humans and other vertebrate animals; more than 150 zoo-
notic diseases have been recognized and described (
Schultz,
1983
). Biohazards include not only etiological agents of
zoonotic diseases but also those of experimentally induced
infectious diseases that can be transmitted from animals to
people in a research setting (
Muchmore, 1987
). Because of
their close phylogenetic relationship, nonhuman primates
and people share susceptibility to many species-specific
pathogens that do not infect other animals. While this makes
them invaluable models for studying human infectious
diseases, it also gives them the greatest potential for disease
transmission to humans when compared with other labora-
tory animals. Animals carrying endogenous latent viruses
(
Hsiung, 1970; Heberling and Kalter, 1978; Wells et al.,
1989; Many et al., 1991
) may show no clinical disease and
thereby present a hidden hazard to laboratory personnel, as
do cell cultures made from their tissues (
Hsiung and Swack,
1973
). In addition, the risk from bites, scratches, and acci-
dental injury, common to all laboratory animal work, is
particularly great with nonhuman primates (
Muchmore,
1976; Gerone, 1983
).
Articles about emerging zoonoses (
Schultz, 1983;
Murphy, 1998
) and emerging viruses (
Morse and Schlue-
derberg, 1990
) emphasize the need for vigilance. As yet
unknown agents with human disease potential may exist
even in stable colony animals; thus, all nonhuman primates
should be regarded as biohazards.
Biosafety Level 2 and Animal Biosafety Level 2 prac-
tices, containment equipment, and facilities, as recom-
mended by the Centers for Disease Control (
Centers for
Disease Control/National Institutes of Health, 2009
),
should be observed in the care and use of nonhuman
primates. In this section, specific recommendations and
emphasis for preventing and controlling the spread of
certain etiological agents are given in addition to those
prescribed in the Biosafety Level 2 and 3 standards.
The greatest risk for exposure to many of the zoonotic
agents listed below are from imported animals where the
colonies are not as well characterized as established
colonies present in the USA. The limited number of
sources of animals and the use of dedicated breeding
facilities in foreign countries has reduced the morbidity
