By: Gurdaver Singh, PE, C. Eng, LEED AP,
Guttmann & Blaevoet and Russell McElroy, AIA,
NCARB, Senior Principal, McClaren, Wilson &
The San Francisco Office of the Chief Medical Examiner (OCME) is an essential forensic medical complex with autopsy
suite and field investigation facilities required
to operate after an earthquake event.
There are four levels of biosafety, from BSL-
1, which work with well-characterized agents
causing disease in healthy humans and rarely
a potential hazard to lab personnel and or the
environment, to BSL- 4, involving work with
dangerous and exotic agents which can cause
fatal aerosol-transmitted lab infections and
diseases. Further classifications are prescribed
by the Center for Disease Control (CDC) for
each of the four BSLs (ABSL-1 to 4) when
dealing with animals.
The OCME facility contains a BSL- 3 suite,
which is normally suited for clinical, diagnostic, teaching, research or production facilities
working with indigenous or exotic agents that
may cause serious or potentially lethal diseases
as a result of exposure by inhalation.
Medical examiners perform unique and
intriguing science. Their labs must perform in
a unique manner, protecting both the working
staff and the evidence examined in the form
of the human body. Adding further complications to the lab designs and performance are
the cases which enter the facilities contaminated with BSL- 3 pathogens, such as tuberculosis
and meningitis. These level-three pathogens
are more common and may cause death, but
are curable if treated.
Currently, there are no formal written
BSL- 3 guidelines for designing higher-con-tainment autopsy labs. Challenges posed
to medical examiners when performing
high-containment cases begin with the sheer
size of the decedent to be autopsied. The
human body doesn’t fit inside the typical first
line of primary containment, the biological
safety cabinet (BSC). In human or public
health BSL- 3 work, the BSC is the primary
containment environment with its built-in
HEPA filtration with inward directional airflow. Other design features that assist the doctors and their staff in conducting BSL- 3 work
are as follows:
• Separate biovestibules for decedents and
staff with high concentrations of decontamination materials possible within the
decedent vestibule and shower out sequence
• Ports for introducing decontamination
materials into each possible contaminated
• Method for decontamination of all liquids
leaving the suite.
• Method for decontamination of solid materials leaving the suite.
• Method of passing decontaminated containers from the BSL- 3 out for additional testing
• A BSC within the suite to review small speci-
mens under added ventilation protection.
• Materials within the suite that can tolerate
chemical decontamination and cleaning.
• Visual observation safely from outside the suite
Guidelines (BSL- 3 Aut) have been prepared
for this type of facility, which are expected to be
published in the American Society for Microbiology
3rd Edition. The guidelines provide a solid under-
standing and resolution of the challenges posed to
medical examiners when performing high-con-
tainment cases and how their labs assist them in
LEED Gold BSL- 3 forensics pathology autopsy lab
Chilled water and heating hot water produced concurrently using a unique heat pump chiller. Image: Gurdaver
Singh, PE, LEED AP, Guttmann & Blaevoet Consulting Engineers.
First verified BSL- 3 autopsy lab in the U.S. Image: McClaren, Wilson & Lawrie Inc.