Protection of neuropathology core workers and tissue users
Health risks to individuals exposed to human tissue are minimized by the use of a number of precautionary measures. The process begins with screening of medical records at the time of enrollment and repeated screens with each clinical visit and at the time of death. Those individuals with a medical history of a serious infectious pathogen are excluded from enrollment or autopsy. This includes individuals with active or carrier status for hepatitis B, hepatitis C, HIV, syphilis, tuberculosis, Creutzfeldt-Jakob disease (CJD) and acute or chronic active CNS infections of any type. As SHRI is a private research organization, not a diagnostic autopsy service, it is our option to refuse to perform an autopsy. In the 10-years since this telephone protocol was developed, only four subjects have been rejected for the presence of a hazardous infectious disease at the time of death, reflecting the low rate of these infectious diseases in our study population. Three of these rejections were for high risk of CJD, and one of the three was later confirmed as CJD by the National Prion Disease Surveillance Laboratory at Case Reserve University in Cleveland. The fourth rejection was for sepsis with methicillin-resistant Staphylococcus aureus.
Staff involved in brain removal and tissue processing are encouraged to have hepatitis A and B vaccination; during procedures involving exposure to fresh or frozen human tissue, staff wear protective clothing including hoods or caps, eye protection, masks, gowns, gloves and boots. Postmortem blood serum from each autopsied patient is sent for diagnostic serology for the detection of hepatitis B and C, syphilis and HIV. If any of these are indicative of the presence of these pathogens, all fresh or frozen tissue is discarded. If potentially infectious contamination of an individual occurs, such as splashing of fresh tissue fluids into the eyes or into a wound, the individual receives appropriate first aid measures at the scene and then is taken to a nearby Emergency Room. All Institute staff receive, upon first hiring, a full day of training in laboratory safety, including biohazard safety precautions.