paul moyer, ms ct response coordinator minnesota department of health public health laboratory...
TRANSCRIPT
![Page 1: Paul Moyer, MS CT Response Coordinator Minnesota Department of Health Public Health Laboratory Division A Tiered Approach to All-Hazards Laboratory Testing](https://reader036.vdocument.in/reader036/viewer/2022081515/55180fae5503468c438b4720/html5/thumbnails/1.jpg)
Paul Moyer, MS
CT Response Coordinator
Minnesota Department of Health
Public Health Laboratory Division
A Tiered Approach to All-Hazards Laboratory Testing of Unknown
Environmental Samples
![Page 2: Paul Moyer, MS CT Response Coordinator Minnesota Department of Health Public Health Laboratory Division A Tiered Approach to All-Hazards Laboratory Testing](https://reader036.vdocument.in/reader036/viewer/2022081515/55180fae5503468c438b4720/html5/thumbnails/2.jpg)
2
Introduction
Why Is Unknown Sample Testing Important?– “Credible” Threats Exist– Surveillance
Why Is Testing at PHL Important?– Public Health Events– LRN Laboratories
![Page 3: Paul Moyer, MS CT Response Coordinator Minnesota Department of Health Public Health Laboratory Division A Tiered Approach to All-Hazards Laboratory Testing](https://reader036.vdocument.in/reader036/viewer/2022081515/55180fae5503468c438b4720/html5/thumbnails/3.jpg)
3
Objectives
Describe a process for applying standardized procedures to non-standard events
Illustrate the significance of notification and threat assessment pieces (“Focus Areas” working together)
Discuss the advantages of a Bio/Chem/Rad tiered step analysis
![Page 4: Paul Moyer, MS CT Response Coordinator Minnesota Department of Health Public Health Laboratory Division A Tiered Approach to All-Hazards Laboratory Testing](https://reader036.vdocument.in/reader036/viewer/2022081515/55180fae5503468c438b4720/html5/thumbnails/4.jpg)
4
Background
Anthrax 2001– Specific Protocol– Letters
Evolution to “All-Hazards” Approach– Specific Guidelines– Letters– Leaking Packages– Tainted Food/Water
![Page 5: Paul Moyer, MS CT Response Coordinator Minnesota Department of Health Public Health Laboratory Division A Tiered Approach to All-Hazards Laboratory Testing](https://reader036.vdocument.in/reader036/viewer/2022081515/55180fae5503468c438b4720/html5/thumbnails/5.jpg)
5
Background
What the MDH plan “IS”– A Starting Point – Guidance– SOPs, Checklists, & Forms– Safety First
What the MDH plan “IS NOT”– A “Rote” Protocol – Thinking IS Required– A Lab Only Effort – Partners Crucial– Rigid
![Page 6: Paul Moyer, MS CT Response Coordinator Minnesota Department of Health Public Health Laboratory Division A Tiered Approach to All-Hazards Laboratory Testing](https://reader036.vdocument.in/reader036/viewer/2022081515/55180fae5503468c438b4720/html5/thumbnails/6.jpg)
6
Safety
Lab Safety Officer – IHBSL 3 FacilityLimited QuantitiesBuddy + 1 SystemPPE
![Page 7: Paul Moyer, MS CT Response Coordinator Minnesota Department of Health Public Health Laboratory Division A Tiered Approach to All-Hazards Laboratory Testing](https://reader036.vdocument.in/reader036/viewer/2022081515/55180fae5503468c438b4720/html5/thumbnails/7.jpg)
7
Safety
Chemical Splash Resistant Coveralls with
Hood and Boots
Chemical Resistant Sleeves
Full Face APR: Dual Particualte/Organic Vapor Cartridges
Outer Gloves:Nitrile
Inner Gloves: Nitrile or Chemical Laminate
![Page 8: Paul Moyer, MS CT Response Coordinator Minnesota Department of Health Public Health Laboratory Division A Tiered Approach to All-Hazards Laboratory Testing](https://reader036.vdocument.in/reader036/viewer/2022081515/55180fae5503468c438b4720/html5/thumbnails/8.jpg)
8
What does “Tiered” Mean
Expandable SystemBegins with Field Information/“Tests”Minimum Testing – Tier 1 Can Include:
– Scenario/Submitter Directed Testing– Tier 2 Testing– Minimum Plus Testing
![Page 9: Paul Moyer, MS CT Response Coordinator Minnesota Department of Health Public Health Laboratory Division A Tiered Approach to All-Hazards Laboratory Testing](https://reader036.vdocument.in/reader036/viewer/2022081515/55180fae5503468c438b4720/html5/thumbnails/9.jpg)
9
Resource Management
Anthrax Only Testing – “Too Cold?”
All-Agent Testing – “Too Hot?”
Tiered Testing – “Just Right”?
![Page 10: Paul Moyer, MS CT Response Coordinator Minnesota Department of Health Public Health Laboratory Division A Tiered Approach to All-Hazards Laboratory Testing](https://reader036.vdocument.in/reader036/viewer/2022081515/55180fae5503468c438b4720/html5/thumbnails/10.jpg)
10
Plan Strategy
SOPs vs. SOGs
“Menu” of Tests/Procedures
Judgment – “What makes sense”
Here’s the “Road Map”
![Page 11: Paul Moyer, MS CT Response Coordinator Minnesota Department of Health Public Health Laboratory Division A Tiered Approach to All-Hazards Laboratory Testing](https://reader036.vdocument.in/reader036/viewer/2022081515/55180fae5503468c438b4720/html5/thumbnails/11.jpg)
No
No
Referenced SOP
Decision
Data / Information
Additional Resource
Process SOP
Yes
Yes
Yes
OpenSample
SOP
Receive Sample /
Over-packSOP
Notification
SOP(Phase I)
Minimum Testing + Additional Biological
Staff Resource Call-Down
Final ReportSOP
Process SOP Sections- Communications- QA / QC- Documentation- Safety - Analysis
Rad Check
Positive?
Rad Check
Positive?
Results & Observation
s
Tier 2Testing?
Radiological ScreenSOP
Alert RadiationResponse
Team
GC/MS, ICP/MS,
OtherCT Analytical
SOPS
LRNBT Analytical
SOPS
BT / CT Personnel
AcceptSample?
DocumentSample
Rejection
No
Yes
ResultsNotificatio
nSOP
(Phase II)
Prioritize Tier 1
Testing
Information
Results & Observation
s
Minimum Testing &
ProcessingSetup
No
Document
Minimum Testing + Additional Chemical
Minimum Testing + Additional Toxin
Minimum Testing+ Viral
Minimum Testing
Or
Or
Or
Or
Document
Document
![Page 12: Paul Moyer, MS CT Response Coordinator Minnesota Department of Health Public Health Laboratory Division A Tiered Approach to All-Hazards Laboratory Testing](https://reader036.vdocument.in/reader036/viewer/2022081515/55180fae5503468c438b4720/html5/thumbnails/12.jpg)
12
Plan Strategy
BT, CT & REP* TeamsOn-Call Pairs (BT, CT-Rad)Cross - Trained on:
– Threat Assessment– Sample Receiving – Chain-of-Custody– Sample Opening – Processing– Communications
*Radiological Emergency Program
![Page 13: Paul Moyer, MS CT Response Coordinator Minnesota Department of Health Public Health Laboratory Division A Tiered Approach to All-Hazards Laboratory Testing](https://reader036.vdocument.in/reader036/viewer/2022081515/55180fae5503468c438b4720/html5/thumbnails/13.jpg)
13
Screening: Chemical vs. Biological
Serial Analysis:– Rule Out Chemical Agents
• What about the Bio-Hazard?
– Rule Out Biological Agents• What about the Chemical Hazard?
Parallel Analysis:– BT and CT-Rad Working Together– Broader Perspective / Depth of Knowledge– Use the Threat Assessment/Field Information
![Page 14: Paul Moyer, MS CT Response Coordinator Minnesota Department of Health Public Health Laboratory Division A Tiered Approach to All-Hazards Laboratory Testing](https://reader036.vdocument.in/reader036/viewer/2022081515/55180fae5503468c438b4720/html5/thumbnails/14.jpg)
14
Testing: Is It Hazardous? (…and If Not, What Is It?)
ID and ConfirmRule Out Hazardous:
– Radioactivity– Chemicals– Biological Agents
What’s Left? Back to the “Map”
![Page 15: Paul Moyer, MS CT Response Coordinator Minnesota Department of Health Public Health Laboratory Division A Tiered Approach to All-Hazards Laboratory Testing](https://reader036.vdocument.in/reader036/viewer/2022081515/55180fae5503468c438b4720/html5/thumbnails/15.jpg)
No
No
Referenced SOP
Decision
Data / Information
Additional Resource
Process SOP
Yes
Yes
Yes
OpenSample
SOP
Receive Sample /
Over-packSOP
Notification
SOP(Phase I)
Minimum Testing + Additional Biological
Staff Resource Call-Down
Final ReportSOP
Process SOP Sections- Communications- QA / QC- Documentation- Safety - Analysis
Rad Check
Positive?
Rad Check
Positive?
Results & Observation
s
Tier 2Testing?
Radiological ScreenSOP
Alert RadiationResponse
Team
GC/MS, ICP/MS,
OtherCT Analytical
SOPS
LRNBT Analytical
SOPS
BT / CT Personnel
AcceptSample?
DocumentSample
Rejection
No
Yes
ResultsNotificatio
nSOP
(Phase II)
Prioritize Tier 1
Testing
Information
Results & Observation
s
Minimum Testing &
ProcessingSetup
No
Document
Minimum Testing + Additional Chemical
Minimum Testing + Additional Toxin
Minimum Testing+ Viral
Minimum Testing
Or
Or
Or
Or
Document
Document
![Page 16: Paul Moyer, MS CT Response Coordinator Minnesota Department of Health Public Health Laboratory Division A Tiered Approach to All-Hazards Laboratory Testing](https://reader036.vdocument.in/reader036/viewer/2022081515/55180fae5503468c438b4720/html5/thumbnails/16.jpg)
16
Key Pieces
NotificationThreat/Hazard AssessmentAction Plan – Scenario SpecificMinimum Testing – Tier 1
– Radiological– Chemical– Biological
Advanced/LRN Testing – Tier 2
![Page 17: Paul Moyer, MS CT Response Coordinator Minnesota Department of Health Public Health Laboratory Division A Tiered Approach to All-Hazards Laboratory Testing](https://reader036.vdocument.in/reader036/viewer/2022081515/55180fae5503468c438b4720/html5/thumbnails/17.jpg)
17
Notification
Incoming Request for Lab Analysis Internal Notification(s)
– Hazard Assessment• Response Coordinators (Focus Areas C & D)• Unit Leaders
– Management FYI• Director• Section Managers
![Page 18: Paul Moyer, MS CT Response Coordinator Minnesota Department of Health Public Health Laboratory Division A Tiered Approach to All-Hazards Laboratory Testing](https://reader036.vdocument.in/reader036/viewer/2022081515/55180fae5503468c438b4720/html5/thumbnails/18.jpg)
18
Notification
External Notification(s)– Hazard Assessment
• MDH Epidemiology (Focus Area B)• MDH Environmental Health Rep (Focus Area A)• FBI WMD Coordinator• CST
– Management FYI• MDH Health Protection Division Directors (All Focus
Areas)
Decision to Accept/Reject Sample
![Page 19: Paul Moyer, MS CT Response Coordinator Minnesota Department of Health Public Health Laboratory Division A Tiered Approach to All-Hazards Laboratory Testing](https://reader036.vdocument.in/reader036/viewer/2022081515/55180fae5503468c438b4720/html5/thumbnails/19.jpg)
19
Threat/Hazard Assessment
Credible Threat?
Excessive Hazard?– Fatalities– Explosives
Suitable Request?– Public Health Threat?– Forensics?
![Page 20: Paul Moyer, MS CT Response Coordinator Minnesota Department of Health Public Health Laboratory Division A Tiered Approach to All-Hazards Laboratory Testing](https://reader036.vdocument.in/reader036/viewer/2022081515/55180fae5503468c438b4720/html5/thumbnails/20.jpg)
20
Event Action Plan – Scenario Specific
Decisions By:– One Person– On-Call Pair– Group
Decide To:– Test or Not Test– Test At What Level – “Order Off the Menu”– Assign Duties and Responsibilities
![Page 21: Paul Moyer, MS CT Response Coordinator Minnesota Department of Health Public Health Laboratory Division A Tiered Approach to All-Hazards Laboratory Testing](https://reader036.vdocument.in/reader036/viewer/2022081515/55180fae5503468c438b4720/html5/thumbnails/21.jpg)
21
Minimum Testing – Tier 1
Radiological Screen
Chemical Characterization
Biological Testing
![Page 22: Paul Moyer, MS CT Response Coordinator Minnesota Department of Health Public Health Laboratory Division A Tiered Approach to All-Hazards Laboratory Testing](https://reader036.vdocument.in/reader036/viewer/2022081515/55180fae5503468c438b4720/html5/thumbnails/22.jpg)
22
Minimum Testing – Tier 1
Radiological Screen– Inner Package / Sample– Geiger-Muller Counter (CPM)
• Alpha• Beta• Gamma
Over-pack Previously Screened at Loading Dock
![Page 23: Paul Moyer, MS CT Response Coordinator Minnesota Department of Health Public Health Laboratory Division A Tiered Approach to All-Hazards Laboratory Testing](https://reader036.vdocument.in/reader036/viewer/2022081515/55180fae5503468c438b4720/html5/thumbnails/23.jpg)
23
Minimum Testing – Tier 1
Chemical Characterization– Papers: pH, M8, Oxidizer– Solubility: Water, Methylene Chloride– FTIR: HazmatID– Head Space Vial Aliquot (GC/MS)
![Page 24: Paul Moyer, MS CT Response Coordinator Minnesota Department of Health Public Health Laboratory Division A Tiered Approach to All-Hazards Laboratory Testing](https://reader036.vdocument.in/reader036/viewer/2022081515/55180fae5503468c438b4720/html5/thumbnails/24.jpg)
24
Minimum Testing – Tier 1
Biological Testing– Slides: Wet Mount, Gram Stain– RT-PCR– TRF– Cultures: BAP, Chocolate, Thio Broth
![Page 25: Paul Moyer, MS CT Response Coordinator Minnesota Department of Health Public Health Laboratory Division A Tiered Approach to All-Hazards Laboratory Testing](https://reader036.vdocument.in/reader036/viewer/2022081515/55180fae5503468c438b4720/html5/thumbnails/25.jpg)
25
Advanced/LRN Testing – Tier 2
Chemical– GC/MS – SVOC– ICP/MS – Metals – General/Bench Chemistry – Inorganic
Biological– LRN Level B/C Agent Specific Protocols
![Page 26: Paul Moyer, MS CT Response Coordinator Minnesota Department of Health Public Health Laboratory Division A Tiered Approach to All-Hazards Laboratory Testing](https://reader036.vdocument.in/reader036/viewer/2022081515/55180fae5503468c438b4720/html5/thumbnails/26.jpg)
26
References
Guidance on Initial Responses to a Suspicious Letter / Container With a Potential Biological Threat, FBI – DHS – HHS/CDC, 2004
Assessment of Methods for Handling Mixed-Threat Environmental Samples, NCEH – Battelle, 2004
Assessment of Protocols Involving Unknown Samples, NCEH – Battelle, 2004
Proposed Draft DHS Screening Protocol, 2005 (to augment/standardize existing assessments and field screening techniques)
![Page 27: Paul Moyer, MS CT Response Coordinator Minnesota Department of Health Public Health Laboratory Division A Tiered Approach to All-Hazards Laboratory Testing](https://reader036.vdocument.in/reader036/viewer/2022081515/55180fae5503468c438b4720/html5/thumbnails/27.jpg)
27
Contact Information
Paul Moyer, MS Chemical Terrorism Response Coordinator
612-676-5245
![Page 28: Paul Moyer, MS CT Response Coordinator Minnesota Department of Health Public Health Laboratory Division A Tiered Approach to All-Hazards Laboratory Testing](https://reader036.vdocument.in/reader036/viewer/2022081515/55180fae5503468c438b4720/html5/thumbnails/28.jpg)
28
Questions
? ? ? ? ? ? ? ? ?
? ? ? ? ? ?
? ? ? ? ? ? ? ?
? ? ? ?
? ? ? ? ? ?
? ? ? ? ? ?? ? ?
? ? ? ?