Op-Ed — The Proper Balance of Science, Safety, and Security… It’s Only Achievable Through Sustainable, Competency-Based Training That is Consistent Around the World

Murray L. Cohen, Ph.D., M.P.H., C.I.H, President and Chairman of the Frontline Healthcare Workers Safety Foundation, Ltd.

As recently as 10 years ago, you could count the number of BSL-4 labs throughout the world on your hands, and the private sector was decommissioning BSL-3 labs for lack of work. Since then, the number and size of these facilities have been increasing due to global awareness and preparedness for bioterror threats, and recognition of pandemic-possible emerging infections. The rapid expansion of life sciences laboratories creates an increasing demand for well trained professionals from many fields in order to operate, protect and conduct research in these facilities. Proper and ongoing biosafety and biocontainment training for all staff of these facilities can significantly reduce the chance that a laboratory incident or accident will become a threat to the community and surrounding environment. All workers in these facilities must be properly trained in the specific techniques and with the specific equipment that they will be using in the laboratory. Support personnel to operate, maintain, and secure the equipment and facilities, conduct inspections, and care for laboratory animals also require specialized training.1

Unfortunately, training is often the first casualty of budget wars. Not only does training become expendable, but the standards for acceptable training may be watered down based on the price of training programs, or even the appropriateness of the training programs to the work and mission of the laboratory institution. We should learn from the experiences of other highly complex, technical industries.

In 1958, the US government created The National Aeronautics and Space Administration (NASA), to plan, direct and conduct national non-military space activities. The founding of NASA created thousands of jobs requiring uniquely trained personnel, with a primary focus on safe operations. The budgets provided ensured that training was developed and conducted commensurate with the mission requirements and demands.2 Another important lesson comes from the military sector, where the training of soldiers is meticulously planned, innovative, and challenging in its approach. Training is designed to accomplish mission-essential tasks. It is performance-oriented, requiring demonstration of proficiencies learned, and an effectiveness evaluation plan. Military commanders have learned that troops will react instinctively in combat as they were trained in peacetime; in other words they will fight the way they are trained.3

Similarly, the biodefense industry requires a new type of workforce with special and advanced skills in order to work safely with dangerous pathogens in increasingly complex facilities and research situations. Training for all workers in high (BSL-3) and maximum (BSL-4) containment laboratories must include hands-on as well as didactic training. It must be specific to the facility, procedures, and equipment that the workers will encounter when working in containment. Specialized training must be given to all workers who will have access to any kind to containment areas. Training programs must be innovatively designed to confer, drill, and confirm that competencies and proficiencies have been mastered by the trainees. Continuing education must be provided to keep workers’ skills sharp, to iron out any poor practices that may have developed, introduce new techniques, and afford opportunities for continuous quality improvement.

Since microbes have no respect for geo-political boundaries, such training also must be consistent throughout the world. The best way to achieve fungibility of training programs is to participate in internationally accredited training conducted by credentialed instructors. Subject matter expertise is simply not enough; the trainers and the curriculum must be matched, adult learning principles adhered to, and curriculum validation accomplished through honest evaluation.

Three years ago, a congressional commission recommended the establishment of a workforce adequate to these tasks: “Despite recent initiatives, the national security agencies, including the national laboratories, still lack the flexibility and workforce culture they need to attract, train, and retain individuals with the skills necessary to effectively respond to globalized, networked threats… The United States must build a … workforce for the 21st century.”4 Three years later we are still waiting for adequate funding and coordinated programs to create the workforce that is required to ensure the safety and security of the life sciences’ research effort.

Initial and continuing education for biosafety and biocontainment professionals is also critical. The urgency required in responding to an incident or accident when prevention has failed dictates the necessity to train first responders and emergency personnel who will be the frontline defense in the event of a biological attack or accidental release of a dangerous pathogen or toxin. Building and maintaining a properly trained laboratory workforce and emergency response capability has proved challenging in this time of budget shortfalls and recession.

Alan Leshner of the American Association for the Advancement of Science has eloquently noted that “… science has permeated every aspect of humanity, but food safety issues, pandemic preparedness, breaches in lab safety and other issues widely reported in the media are eroding society’s relationship with science;” and that “… never has the science-security relationship been more fragile.”5

The erosion of society’s trust in our scientists and researchers can not continue; that relationship needs to be rebuilt and fortified. Training, certification programs, and sustainable competency-based continuing education programs aimed at preventing and reducing laboratory acquired infections and accidents must lead the way to regain and maintain public trust. Only then can the proper balance of science, safety, and security be achieved.

Murray L. Cohen, Ph.D., M.P.H., C.I.H is President and Chairman of the Frontline Healthcare Workers Safety Foundation, Ltd., a 501(c)(3) non-governmental organization headquartered in Atlanta, GA, USA. Frontline Foundation is dedicated to building national and international biological security and cooperative threat reduction through training, education, and ongoing research that allows communities and nations to best respond to natural and contrived biological incidents, emergencies, pandemics, and mass casualty management. Dr. Cohen serves as the Executive Director of the National Biosafety & Biocontainment Training Program of the U.S. National Institutes of Health, is a voting member of the National Science Advisory Board for Biosecurity, and consults with several U.S. and foreign government agencies.

1. LeDuc, JW et al. Framework for Leadership and Training of Biosafety Level 4 Laboratory Workers, EID, 14:11, pp 1685-8. Nov 2008.
2. NASA Historical Data Book 1958-1968, Vol. 1: NASA Resources. Available at http://history.nasa.gov/SP-4012v1.pdf.
3. McKnight, D. (2006). Command Philosophy. Retrieved Jan. 2, 2009, from http://www.dannymcknight.com/CommandPhilosophy.pdf.
4. Graham, B, J Talent, A Graham, R Cleveland, S Rademaker, T Roemer, W Sherman, H Sokolski and R Verma. 2008. World At Risk: The Report of the Commission on the Prevention of WMD Proliferation and Terrorism, p. 110. New York: Vintage Books.
5. Leshner, Alan, Sustaining Progress in the Life Sciences: Strategies for Managing Dual Use Research, Nov. 5, 2008.