Clinical research Continued »
to achieve good decontamination practice are outlined in the HPS LDU guidelinesı7. Although the BSE epidemic is
substantially over, there are still considerable uncertainties over the number of cases of vCJD that may appear in the future. Moreover, there are a number of prion diseases still present in animals. Chronic Wasting disease has been found in both farmed and wild deer populations in the USA and increased surveillance in Europe has detected a number of newly identified diseases in cattle, sheep and goats. The ability of these diseases to
transmit to humans is not known. It therefore remains important to retain both animal and human surveillance for prion diseases. Additionally, it is important to ensure safe practices are maintained to prevent such disease entering the animal or human food chain to ensure another prion disease does not impact on human health.
RISK CATEGORISATION
Risk categorisation for surgical instruments in contact with different tissues Categorisation of risk High
Clinical procedures
All procedures that involve piercing the dura, or contact with the trigeminal and dorsal root ganglia, or the pineal and pituitary glands. Procedures involving the optic nerve and retina.
Medium
Other procedures involving the eye, including conjunctiva, cornea, sclera and iris.
Procedures that involve contact with lymphoreticular system (LRS).
Anaesthetic procedures that involve contact with LRS during tonsil surgery (for example, laryngeal masks). Procedures in which biopsy forceps come into contact with LRS tissue.
Procedures that involve contact with olfactory epithelium. Low
All other invasive procedures including other anaesthetic procedures and procedures involving contact with cerebrospinal fluid. Dental tissues.
Table 3
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