[Current problems arising from not having biosafety level 4 laboratories in Japan--qualitative study of infectious disease experts].
OBJECTIVE
No public consensus exists yet on handling Biosafety Level 4 agents and no laboratory is operational at BSL4 in Japan. A discussion that includes neighboring residents and experts should be initiated to communicate risks. In this article, we present the current situation and prioritize problems we presently face.


METHODS
A three-stage Delphi survey was conducted. The subjects were twenty-two persons with extensive experience and knowledge of infectious diseases. Seven projections and issues were made with regard to the problems arising from the lack of an operational BSL4 laboratory. These were tabulated by the KJ method. The top seven projections were scored, such that the top received 7 points and the last received 1 point.


RESULTS
A total of 51 projections were obtained for the first part of the survey, 39 for the second, and 29 for the last. The projection with the highest score was that it is impossible to cope with newly emerging infectious diseases. The second was that complete diagnoses are impossible without a BSL4 laboratory. All projections and issues were divided into the following four main groups: issues for researchers and laboratory staff, clinical practice and research on BSL4 agents, domestic and global security, and Japan's international position.


CONCLUSIONS
We clarified possible problem arising from not having BSL4 laboratories in Japan. The identification of projections by the Delphi survey in this study should be considered as one of many attempts to develop effective risk communication strategies.
Yamamoto
Yuko
Y
Juntendo University School of Medicine, Department of Public Health, Bunkyo-ku, Tokyo, Japan. yukoyam@med.juntendo.ac.jp
Horiguchi
Itsuko
I
Marui
Eiji
E
D003264:Containment of Biohazards / Q000592:standards*; D003697:Delphi Technique; D006801:Humans; D055552:Infectious Disease Medicine; D007564:Japan; D007753:Laboratories / Q000592:standards*