A Risk Assessment-based Approach to Defining Minimum Biosafety Precautions for Tuberculosis Laboratories in Resource-limited Settings

In developing minimum biosafety precautions for laboratories that conduct diagnostic testing for tuberculosis (TB), a risk assessment-based approach was used to define minimum precautions for individual procedures and processes. A consensus-building approach involving three expert committees was necessary because risk assessment is a subjective process with judgments based sometimes on incomplete information. This article describes the process behind the development of recommendations for minimum biosafety precautions for TB laboratories in high-burden and low-resource settings. The recommendations of the expert committees are being used by the World Health Organization (WHO) to produce a safety manual for TB laboratories that is tentatively scheduled for publication in mid-2012. The intended audience for these recommendations is directors and managers of laboratories and programs that conduct testing for TB in resource-limited and high-burden settings. However, the process used here and the recommendations developed are suitable for consideration by all laboratories that conduct testing for TB.