Papacchini Maddalena, Mansi Antonella, Marta Isabella
Istituto Superiore per la Prevenzione e la Sicurezza del Lavoro, Dipartimento di Insediamenti Produttivi ed Interazione con l'Ambiente, Centro Ricerche di Monteporzio Catone, Via di Fontana Candida 1, 00040 Monteporzio Catone, Roma.
Med Lav. 2003 May-Jun;94(3):271-84.
Transmissible Spongiform Encephalopathies (TSEs) are infectious, progressive, lethal neurodegenerative diseases which affect both human and other mammalian species. The knowledge on the agent responsible for the infection and its pathogenetic mechanism is still limited. Specific diagnostic tests are currently not available; diagnosis is based on clinical symptoms and confirmed by a post-mortem examination which can reveal the typical brain lesions. There is some evidence on the relationship between the agent responsible for Bovine Spongiform Encephalopathy (BSE) and the new human variant of the Creutzfeldt-Jakob disease (nvCJD). The TSEs agents have some peculiarities: they overcome the interspecies barriers and are resistant to the normal disinfections and sterilization procedures.
On the basis of current scientific evidence, the aim of this article was: to make an excursus on the efficacy of inactivation methods and to give an overview of what has been issued by International and Italian Regulatory Agencies for the prevention of such diseases in hospital and occupational environments.
We examined current scientific literature on inactivation of TSEs by physical or chemical methods or combinations thereof. We also reviewed the most relevant guidelines on exposure risk, containment and occupational exposure to TSEs agents.
Due to the peculiarity of the prion protein and its transmission, it is very important to have effective methods to inactivate the TSE agents and to prevent them spreading. At present, no certain data are available on TSE development in occupational environments, while sources of exposure risk are known for several occupational categories, such as health-care personnel, pathologists, technicians in diagnostic and research laboratories, farmers, veterinary surgeons, slaughter house operators. For these workplaces, after an accurate risk assessment, it is necessary to implement certain precautionary measures, based on containment procedures and on the adoption of specific inactivation protocols.
传染性海绵状脑病（TSEs）是一类传染性、进行性、致死性神经退行性疾病，可影响人类和其他哺乳动物。关于引发感染的病原体及其致病机制的知识仍然有限。目前尚无特异性诊断检测方法；诊断基于临床症状，并通过尸检予以证实，尸检可揭示典型的脑部病变。有证据表明牛海绵状脑病（BSE）病原体与新型克雅氏病（nvCJD）之间存在关联。TSEs病原体具有一些特性：它们可跨越种间屏障，且对常规消毒和灭菌程序具有抗性。
基于当前科学证据，本文旨在：探讨灭活方法的有效性，并概述国际和意大利监管机构针对在医院和职业环境中预防此类疾病所发布的内容。
我们查阅了关于通过物理或化学方法或二者结合来灭活TSEs的当前科学文献。我们还回顾了关于TSEs病原体暴露风险、控制和职业暴露的最相关指南。
由于朊病毒蛋白及其传播的特性，拥有有效的方法来灭活TSEs病原体并防止其传播非常重要。目前，关于职业环境中TSEs发展情况尚无确切数据，而一些职业类别的暴露风险源是已知的，如医护人员、病理学家、诊断和研究实验室技术人员、农民、兽医、屠宰场操作人员。对于这些工作场所，在进行准确的风险评估后，有必要基于控制程序并采用特定的灭活方案实施某些预防措施。
