Lab safety

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  • Laboratory safety is a legal responsibility of the employer as well as a moral responsibility to the employee.As medtechs, we should have an awareness and understanding of safe work practices so that will find the laboratory to be a safe environment in which to work.To maintain a safe environment, all levels of laboratory personnel should be educated in safe work practices and emergency preparedness…
  • As medical technologists, by the nature of our work, we are exposed to a variety of real or potential hazards: ENNUMERATELaboratory safety necessitates the effective control of all hazards that exist in the clinical laboratory at any time.
  • Common senseA safety-focused attitudeGood personal behavior/habitsWear proper attire and protective clothingTie back long hairDo not eat, drink, or smoke in the work areaNever mouth pipetWash hands frequentlyGood housekeepingKeep work areas free of chemicals, dirty glassware, etc.Store chemicals properlyLabel reagents and solutionsPost warning singsContinual practice of good laboratory technique.Don’t operate new or unfamiliar equipment until you have received instruction and authorizationRead all labels and instructions carefullyUse the PPE that is providedFor the safe handling, uses, and disposal of chemicals, learn their properties and hazards.Learn emergency procedures and become familiar with the location of fire exits, fire extinguishers, blankets, etc.Be careful when transferring chemicals from container to container and always add acid to water slowly.
  • In most cases, accidents can be traced directly to two primary causes:Personal – unsafe actsImproper laboratory attireLack of skills or knowledgeSpecific physical or mental conditionsAttitude Environmental – unsafe conditionsInadequate safeguardsUse of improper or defective equipmentHazards associated with the locomotionPoor housekeeping
  • Several strategies exist to contain hazards:Engineering controls are safety features built into the overall design of a productCircuit breakersProtective sheath on phlebotomy needlePuncture resistant containers for disposal and transport of needles and sharpsBiohazard bagsSplash guardsVolatile liquid containersCentrifuge safety bucketsBiological safety cabinets and fume hoodsMechanical pipetting devicesSensor/foot controlled sinks and faucetsPersonal protective equipment and barriers like gloves and face shields physically separate the user from a hazard.(let the students enumerate some of the PPE)Work practice controls include general procedures and preventive measures that reduce or eliminate exposure to hazardsSegregating biological wastesHand washingCleaning surfaces with disinfectantsAvoiding unnecessary use of needles and sharps and not recappingRed bag waste disposalImmunization for hepatitisJob rotation to minimize repetitive tasksOrientation, training, and continuing educationNo eating, drinking, or smokingWarning signageThe most effective safety programs use all three strategies.
  • Other government and private agencies that provide guidance by adopting safety standards, codes, and guidelines that are voluntary but are often adopted by regulatory agencies and become mandatory:
  • Voluntary accrediting agencies that adopt standards for inspection and accreditation based on both mandatory regulations and standards adopted by the aforementioned voluntary organizations:1. Commission on Laboratory Accreditation of the College of American Pathologists2. Joint Commission for Accreditation of Healthcare Organizations
  • These laws are related to occupational safety and care for the environment…OSH eliminate or reduce work-related injuries, illnesses & deaths, implement effectively occupational safety and health & safety programs that will promote health, efficiency, & general well-being of Filipino workers.
  • Again, laboratory safety is a legal responsibility of the employer as well as a moral responsibility to the employee.
  • 1. Smoking, eating, and application of cosmetics are prohibited to prevent the spread of hand to mouth infectious agents or toxic chemicals.2. To prevent contact with or spread of infectious agents, a protective garment must be worn over clothing. These same garments should not be worn outside the laboratory.3. Shoes should be made of nonporous material with closed toes and heels.4. Contact lenses should be discouraged because of fumes and splashes that might occur. Contact lenses inhibit tearing and allow substances to remain on the cornea longer.5. Goggles or face shields are recommended if contact lenses are worn, especially if there is a high risk of fumes, aerosols, or splashes.6. Dangling jewelry, long hair, and beards may pose a safety hazard by coming contact with specimens or other surfaces or by becoming entangled or caught in moving instruments such as rotators or centrifuges.7. Sampling specimens, reagents, water, or any substance through a pipette by mouth should be strictly prohibited.
  • Labels and Signage1. All chemical containers should be clearly labelled with the name of the chemical and any precautions for handling.2. Appropriate signs to identify hazards are critical, not only to alert laboratory personnel to potential hazards, but also identify specific hazards that arise because of emergencies such as fire or explosion.3. Areas where flammables, hazardous or toxic chemicals, and carcinogens are stored or being used must be clearly marked.4. Areas where blood and body fluids are being stored or analyzed should be clearly marked with a biohazard mark.
  • Labels and Signage1. All chemical containers should be clearly labelled with the name of the chemical and any precautions for handling.2. Appropriate signs to identify hazards are critical, not only to alert laboratory personnel to potential hazards, but also identify specific hazards that arise because of emergencies such as fire or explosion.3. Areas where flammables, hazardous or toxic chemicals, and carcinogens are stored or being used must be clearly marked.4. Areas where blood and body fluids are being stored or analyzed should be clearly marked with a biohazard mark.
  • Each quadrant shows the magnitude of severity, graded from a low of 0 to a high of 4, of the hazards within the posted area.The white quadrant is used to alarm the laboratory personnel of other special information about that certain chemical.flashpoint – the lowest temperature that produces sufficient vapor to form an ignitable mixture at the surface of the liquid.
  • BLUE1 – slightly hazardousRED 4 – flashpoint below 73oF… material will rapidly or completely vaporize at atmospheric pressure and normal ambient temperature and will burn readily.YELLOW 0 – that material is normally stable, even under fire exposure conditions, and is not reactive to water…
  • Class I Cabinets allow room (unsterilized) air to pass into the cabinet and around the area and material within, sterilizing only the air to be exhausted.
  • BSC II –These cabinets sterilize air that flows over the infectious material, as well as air to be exhausted. The air flows in “sheets” which serve as barriers to particles from outside the cabinet, and direct the flow of contaminated air into the filters. Also called LAMINAR FLOW.. Commonly used in microbiology laboratories.
  • Because they are completely enclosed, with negative pressure, class III cabinets afford the most protection to the worker. Air coming into and going out of the filter is sterilized, and the infectious material within is handled with rubber gloves that are attached and sealed to the cabinet.
  • Sing HAPPY BIRTHDAY twice
  • PHYSICAL METHODS:1.Incineration – most common method of treating infectious wastes. The hazardous material is literally burned to ashes at temperatures of 870o to 980oC. Major disadvantages of incineration are toxic air emissions and the presence of heavy metals in ashes.2. Moist heat (steam under pressure) – is used to sterilize biohazardous trash and heat-stable objects; an autoclave is used for this purpose. An autoclave is essentially a large pressure cooker. Moist heat in the form of saturated steam under 1 atmosphere (15 pounds per square inch or psi) of pressure causes the irreversible denaturation of enzymes and structural proteins.Two common sterilization temperatures: 1 – items such as media, liquids, and instruments are usually autoclaved for 15 minutes at 121oC.2 – infectious medical wastes, on the otherhand, are often sterilized at 132oC for 30-60 minutes. PURPOSE: to allow penetration of the steam throughout the waste and the displacement of air trapped inside the autoclave bag.3. Dry heat– requires longer exposure times (1.5 to 3 hours) and higher temperatures than moist heat (160o to 180oC). Dry heat ovens are used to sterilize items such as glassware, oil, petrolatum, or powders.4. Filtration - is the method of choice for antibiotic solutions, toxic chemicals, radioisotopes, vaccines, and carbohydrates – which are all HEAT-SENSITIVE.Liquids: accomplished by pulling the solution through a cellulose acetate or cellulose nitrate membrane with a vacuum.Air: makes use of HEPA filters, which are designed to remove organisms larger than 0.3 um from isolation rooms, operating rooms, and BSCs.5. Ionizing radiation – is used in microwaves, and radiograph machines and are short wavelength and high-energy gamma rays ionizing radiation is used for sterilizing disposables such as plastic syringes, catheters, or gloves before use.
  • CHEMICAL METHODS:Ethylene oxide gas – most common sterilizing agent, which is used in the gaseous form, used for sterilizing heat-sensitive objects.Formaldehyde vapor and vapor-phase H2O2 – used to sterilize HEPA filters in BSCsGlutaraldehyde – which is sporicidal…it kills spores in 3 to 10 hours…used to sterilize medical equipment such as bronchoscopes because it does not corrode lenses, metal, or rubber.Peracetic acid – is effective in the presence if organic matter…used to sterilize surgical instrumentsThe use of glutaraldehyde orperacetic acid is called COLD STERILIZATION.
  • Disinfection is the process whereby pathogenic organisms, but not necessarily all microorganisms or spores, are destroyed. As with sterilization, disinfection may be accomplished by physical or chemical methods…
  • When chemicals are used to destroy all life, they are called chemical sterilants, or biocides; Disinfectants used on a living tissue (skin) are called antiseptics.A 1:100 dilution of household bleach inactivates:HBV in 10 minHIV in 2 min
  • If employees are adequately trained, they already know what to do and they can prevent accidents from occurring in the future.
  • Laboratory personnel should be responsible for maintaining a clean sanitary work area even if there is an institutional janitorial service.
  • This regulation basically directs laboratory employers to comply with existing OSHA exposure limits and right to know requirements (Hazard Communication Standard) and to provide medical surveillance programs.
  • The hazard categories of chemicals are:
  • Studies in humans and animals form the basis for guidelines that set limits for exposure to toxic chemicals in the workplace. These limits are called threshold limit values (TLV).
  • Threshold limit values (TLV) – indicate the amount an individual can have exposure to without any adverse effect. There are three different TLVs:
  • The MSDS identifies chemicals that have been shown to be mutagenic or teratogenic.Pregnant laboratory workers should be aware of the chemicals with which they are working.
  • This table lists the typical oxidizers which include chemicals with the oxygen-containing groups…
  • Oxidizers may be grouped into 4 classes based on their ability to affect the burning rate of combustible materials or undergo self-sustained decomposition.This classification system was established by the National Fire Protection Association (NFPA) as a means to provide information on safe storage of oxidizing materials.
  • These materials are generally corrosiveand present a fire and explosion hazard when in contact with organic or combustible materials. All contact with organic or combustible material must be avoided.
  • Remember!DNADC
  • flashpoint – the lowest temperature that produces sufficient vapor to form an ignitable mixture at the surface of the liquid.
  • Fire is basically a chemical reaction that involves the rapid oxidation of a combustible material or fuel, with a subsequent liberation of heat and light. The traditional “fire triangle” has been modified into a three-dimensional triangular pyramid known as the “fire tetrahedron”.A fire will extinguish if any of the three basic elements (heat, air, or fuel) are removed.
  • Fires have been divided into classes based on the nature of the combustible material and requirements for extinguishment.
  • Just as fires have been divided into classes, fire extinguishers are divided into classes that correspond to the type of fire to be extinguished.Be certain to use the RIGHT type – using the wrong type of extinguisher may be dangerous.
  • Never attempt to fix broken machines / equipment by yourself…Promptly report any malfunctions or equipment producing a “tingle” for repair by a qualified engineer.HAZARDS:BurnsShockElectrocution Ignition Explosion
  • Biological effect of all types of ionizing radiation is damage to DNA in the cell nucleus. This damage can lead to mutation, cancer, or cell death.
  • Because it is important to determine why and how an accident occurred, an accident investigation should be conducted.In most cases, accidents can be traced directly to two primary causes:Personal – unsafe actsImproper laboratory attireLack of skills or knowledgeSpecific physical or mental conditionsAttitude Environmental – unsafe conditionsInadequate safeguardsUse of improper or defective equipmentHazards associated with the locomotionPoor housekeeping
  • Because it is important to determine why and how an accident occurred, an accident investigation should be conducted.In most cases, accidents can be traced directly to two primary causes:Personal – unsafe actsImproper laboratory attireLack of skills or knowledgeSpecific physical or mental conditionsAttitude Environmental – unsafe conditionsInadequate safeguardsUse of improper or defective equipmentHazards associated with the locomotionPoor housekeeping
  • Lab safety

    1. 1. OBJECTIVESAt the end of the discussion, the students must be able to:• Discuss safety awareness for clinical laboratory personnel.• List the responsibilities of employer and employee in providing a safe workplace.• Identify hazards related to handling chemicals, biologic specimens, and radiologic materials.• Choose appropriate personal protective equipment when working in the clinical laboratory.• Identify the classes of fires and the type of fire extinguishers to use for each.• Describe steps used as precautionary measures when working with electrical equipment, cryogenic materials, and compressed gases and avoiding mechanical hazards associated with laboratory equipment.• Select correct means for disposal of waste generated in the clinical laboratory.• Outline the steps required in documentation of an accident in the workplace.
    2. 2. POTENTIAL HAZARDS1. Electric shock2. Toxic vapors & irritants3. Compressed gases4. Flammable liquids5. Radioactive material6. Corrosive substances7. Mechanical trauma8. Poisons9. Biologic materials10.Cryogenic materials
    3. 3. LABORATORY SAFETYSafety begins with recognition of hazards and isachieved through the application of: Common sense. A safety-focused attitude. Good personal behavior/habits. Good housekeeping. Continual practice of good laboratory technique.
    4. 4. LABORATORY SAFETYIn most cases, accidents can be traced directlyto two primary causes:1. Unsafe acts (PERSONAL)2. Unsafe conditions (ENVIRONMENTAL)
    5. 5. LABORATORY SAFETY3 Strategies to contain hazards:1. Engineering Controls2. Personal Protective Equipment3. Work Practice Controls
    6. 6. REGULATIONSOccupational Safety and Health Act• Public Law 91-596, enacted on 1970.• Goal: to provide all employees (clinical laboratory personnel included) with a safe work environment.• Under this legislation, the Occupational Safety and Health Administration (OSHA) is authorized to conduct on-site inspections to determine whether an employer is complying with the mandatory standards and assess fines if it finds noncompliance with the regulations.
    7. 7. REGULATIONSOccupational Safety and Health Act• The National Institute of Occupational Safety and Health (NIOSH) serves as OSHA’s research and advisory arm.• The regulations most specific to clinical laboratories :1. Occupational Exposure to Formaldehyde Standard2. Hazard Communication Standard3. Occupational Exposure to Blood-borne Pathogens4. Occupational Exposure to Hazardous Chemicals in Laboratories
    8. 8. REGULATIONSAgencies other than OSHA also have regulationsthat affect laboratories:• Research Conservation and Recovery Act (RSRA)• Department of Transportation (DOT)• Medical Waste Tracking Act• Nuclear Regulatory Commission (NRC)
    9. 9. REGULATIONSOther government and private agencies:• National Fire Protection Association (NPFA)• National Committee on Clinical Laboratory Standards (NCCLS)• Centers for Disease Control and Prevention (CDC)• National Institute of Occupational Safety and Health (NIOSH)• National Institute of Health (NIH)• American Conference of Governmental Industrial Hygienists (ACGIH)
    10. 10. REGULATIONSVoluntary accrediting agencies:• Commission on Laboratory Accreditation of the College of American Pathologists• Joint Commission for Accreditation of Healthcare Organizations (JCAHO)
    11. 11. REGULATIONSIn the Philippines:• Republic Act 9003 – “Ecological Solid Waste Management of 2000”• Republic Act 6969 – “Toxic Substances and Hazardous and Nuclear Wastes Control Act of 1990”• Republic Act 8749 – “Phil. Clean Air Act of 1999”• Republic Act 9275 – “Phil. Clean Water Act of 2004”• Occupational Safety and Health Center (OSHC) of the Department of Labor and Employment (DOLE)
    12. 12. SAFETY AWARENESS FOR CLINICAL LABORATORY PERSONNELSafety Responsibility• The employer and the employee share safety responsibility.• The employer has the ultimate responsibility for safety and delegates authority for safe operations to supervisors.• Safety management in the laboratory should start with a written safety policy.
    13. 13. SAFETY AWARENESS FOR CLINICAL LABORATORY PERSONNELEMPLOYER’S RESPONSIBILITIES1. Establish laboratory work methods and safety policies.2. Provide supervision and guidance to employees.3. Provide safety information, training, personal protective equipment, and medical surveillance to employees.4. Provide and maintain equipment and laboratory facilities that are adequate for the tasks required.
    14. 14. SAFETY AWARENESS FOR CLINICAL LABORATORY PERSONNELEMPLOYEE’S RESPONSIBILITIES1. Know and comply with the established laboratory work and safety methods.2. Have a positive attitude toward supervisors, co- workers, facilities, and safety training.3. Give prompt notification of unsafe conditions or practices to the immediate supervisor and ensure that unsafe conditions and practices are corrected.4. Engage in the conduct of safe work practices and use of personal protective equipment (PPE).
    15. 15. SAFETY PRACTICESGeneral Practices:1. Smoking, eating, and application of cosmetics are prohibited.2. Protective garment must be worn over clothing.3. Shoes should be made of nonporous material with closed toes and heels.4. Contact lenses should be discouraged.5. Goggles or face shields are recommended if contact lenses are worn.6. Dangling jewelry, long hair, and beards are not allowed.7. Mouth pipetting should be strictly prohibited.
    16. 16. SAFETY PRACTICESLabels and Signage:• All chemical containers should be clearly labelled.• Appropriate signs to identify hazards are critical.• Areas where flammables, hazardous or toxic chemicals, and carcinogens are stored or being used must be clearly marked.• Areas where blood and body fluids are being stored or analyzed should be clearly marked with a biohazard mark.
    17. 17. SAFETY PRACTICESFlammable Harmful / Corrosive IrritantPoison / Explosion BiohazardToxicOxidizer Environmental Radioactive Hazard
    18. 18. SAFETY PRACTICESLabels and Signage:• All chemical containers should be clearly labelled.• Appropriate signs to identify hazards are critical.• Areas where flammables, hazardous or toxic chemicals, and carcinogens are stored or being used must be clearly marked.• Areas where blood and body fluids are being stored or analyzed should be clearly marked with a biohazard mark.
    19. 19. SAFETY PRACTICESLabels and Signage:• The National Fire Protection Association (NFPA) developed a standard hazards- identification system (diamond-shape, color- coded symbol), which has been adopted by many clinical laboratories.
    20. 20. SAFETY PRACTICES
    21. 21. SAFETY PRACTICES
    22. 22. SAFETY EQUIPMENT1. Hoods  Fume Hoods  Biological Hoods2. Chemical storage equipment3. Personal protective equipment (PPE)
    23. 23. SAFETY EQUIPMENTHOODSFume Hoods• Fume hoods are used when chemical reagents may produce a hazardous fume.• The sash or window should be lowered when working in the hood.• Air flow should be checked to assure proper ventilation.• Controls such as power, gas, and vacuum should be located externally to prevent a spark that may cause a fire when using volatiles.
    24. 24. SAFETY EQUIPMENTHOODSBiosafety / Biological Hoods• Biological safety cabinets (BSCs)• Biological hoods remove particles that may infect the person working with the biologically infected specimen.• These hoods contain a HEPA (high-efficiency particulate air) filter and are used typically in a microbiology laboratory.
    25. 25. SAFETY EQUIPMENT CLASSIFICATION OF BIOLOGIC AGENTS BASED ON HAZARDBIOSAFETY LEVEL AGENTS Bacillus subtilis Agents include those that have no known 1 Mycobacterium gordonae potential for infecting healthy people. HIV, HBV Agents associated with human disease; routes 2 Bacillus anthracis Yersinia pestis of transmission include percutaneous injury, ingestion, and mucous membrane exposure. Mycobacterium tuberculosis Indigenous/exotic agents that may cause Mold stages of systemic fungi 3 Francisella tularensis serious or potentially lethal disease through the inhalation route of exposure. Brucella spp. Dangerous/exotic agents which post high Arbovirus individual risk of aerosol-transmitted Arenavirus 4 Filovirus laboratory infections that are frequently fatal, for which there are no vaccines or treatments Smallpox virus available.
    26. 26. SAFETY EQUIPMENTCLASS I Biological Safety Cabinet
    27. 27. SAFETY EQUIPMENTCLASS II Biological Safety Cabinet
    28. 28. SAFETY EQUIPMENTCLASS III Biological Safety Cabinet
    29. 29. SAFETY EQUIPMENTCHEMICAL STORAGE EQUIPMENT• Safety equipment is available for the storage and handling of chemicals and compressed gases.• Safety carriers should always be used to transport 500-mL bottles of acids, alkalis, or other solvents, and approved safety cans should be used for storing, dispensing, or disposing of flammables in volumes greater than 1 qt.
    30. 30. SAFETY EQUIPMENTCHEMICAL STORAGE EQUIPMENT• Safety cabinets are required for the storage of flammable liquids, and only specially designed, explosion-proof refrigerators should be used to store flammable materials.• Only the amount of chemical needed for the day should be available at the bench.• Gas cylinder supports or clamps must be used at all times, and large tanks should be transported using handcarts.
    31. 31. SAFETY EQUIPMENTPERSONAL PROTECTIVE EQUIPMENT (PPE)• The parts of the body most frequently subject to injury in the clinical laboratory are the eyes, skin, and respiratory and digestive tracts. Hence, the use of personal protective equipment is very important.• All contaminated PPE must be removed and properly disposed of before leaving the laboratory.
    32. 32. BIOLOGICAL SAFETY
    33. 33. BIOLOGICAL SAFETYGeneral Considerations:• All blood samples and other body fluids should be collected, transported, handled, and processed using strict precautions.• Gloves, gowns, and face protection must be used if splashing or splattering is likely to occur.• Consistent and thorough hand washing is an essential component of infection control.• Centrifugation of biologic specimens produce finely dispersed aerosols that are a high-risk source of infection.• Ideally, specimens should remain capped during centrifugation.
    34. 34. BIOLOGICAL SAFETYHand Washing:• Hand washing is one of the major ways of preventing the spread of infectious agents.• Even if gloves are worn, hand washing is necessary because of microscopic holes in gloves that may occur.• When dealing with patients, hand washing should be done between each patient even if gloves are worn.
    35. 35. BIOLOGICAL SAFETYSTERILIZATION & DISINFECTIONSterilization – is a process whereby all forms of microbiallife, including bacterial spores, are killed. Sterilization maybe accomplished by physical or chemical means.PHYSICAL METHODS: 1. Incineration – most common method 2. Moist heat – simplest and fastest method 3. Dry heat 4. Filtration 5. Ionizing radiation
    36. 36. BIOLOGICAL SAFETYSTERILIZATION & DISINFECTIONSterilization – is a process whereby all forms of microbiallife, including bacterial spores, are killed. Sterilization maybe accomplished by physical or chemical means.CHEMICAL METHODS: 1. Ethylene oxide gas – most common sterilant 2. Formaldehyde vapor and vapor-phase H2O2 3. Glutaraldehyde 4. Peracetic acid
    37. 37. BIOLOGICAL SAFETYSTERILIZATION & DISINFECTIONDisinfection- - it is the process destroying pathogenicmicroorganisms EXCEPT spores. Disinfection may beaccomplished by physical or chemical means.PHYSICAL METHODS: 1. Boiling at 100oC for 15 minutes 2. Pasteurizing at 63oC for 30 minutes or 72oC for 15 seconds 3. Non-ionizing radiation such as UV light – long wavelength and low energy
    38. 38. BIOLOGICAL SAFETYSTERILIZATION & DISINFECTIONDisinfection- - it is the process destroying pathogenicmicroorganisms EXCEPT spores. Disinfection may beaccomplished by physical or chemical means.CHEMICAL METHODS: 1. Alcohols – 70% ethanol 2. Aldehydes – 2% glutaraldehyde 3. Halogens – bleach, iodophor 4. Heavy metals – 1% silver nitrate 5. Quaternary ammonium compounds 6. Phenolics – carbolic acid derivatives
    39. 39. BIOLOGICAL SAFETYSpills:• Any blood, body fluid, or any other potentially infectious material spill must be cleaned up and the area or equipment disinfected immediately.
    40. 40. BIOLOGICAL SAFETYSpills:Recommended clean-up includes the following: 1. Wear appropriate protective equipment. 2. Use mechanical devices to pick up broken glass or other sharp objects. 3. Absorb the spill with paper towels, gauze pads, or tissue. 4. Clean the spill using a common aqueous detergent. 5. Disinfect the spill site using approved disinfectant or 10% bleach, using appropriate contact time. 6. Rinse the spill site with water. 7. Dispose of all materials in appropriate biohazard containers.
    41. 41. BIOLOGICAL SAFETYBlood-borne Pathogen Exposure Control Plan• To minimize employee exposure, each employer must have a written exposure control plan.• The plan must be available to all employees whose reasonable anticipated duties may result in occupational exposure to blood or other potentially infectious materials.• The exposure control plan must be discussed with all employees and be available to them while they are working.• The employee must be provided with adequate training of all techniques described in the exposure control plan at initial work assignment and annually thereafter.
    42. 42. BIOLOGICAL SAFETYBlood-borne Pathogen Exposure Control Plan• All necessary equipment and supplies must be readily available and inspected on a regular basis.• Special precautions must be taken when handling all specimens because of the continual increase of infectious samples received in the laboratory.• Adopting a Standard Precautions- policy, which considers blood and other body fluids from all patients as potentially infective, is required.
    43. 43. BIOLOGICAL SAFETYAirborne Pathogens• A tuberculosis (TB) exposure control program must be established and risks to laboratory workers must be assessed.• Those workers in high-risk areas may be required to wear a respirator for protection.• All health workers considered to be at risk must be screened for TB infection.
    44. 44. BIOLOGICAL SAFETYShipping of Specimens• There are two types of specimen classifications: 1. Known or suspect infectious specimens – are labelled “infectious substances” if the pathogen can be readily transmitted to humans or animals and there is no effective treatment available. 2. Diagnostic specimens – are those tested as routine screening or for initial diagnosis.• Each type of specimen has rules and packaging requirements.
    45. 45. BIOLOGICAL SAFETYShipping of Specimens
    46. 46. BIOLOGICAL SAFETYHousekeeping• Work surfaces should be frequently cleaned with a disinfectant and at the beginning and end of each shift.• Trash, infectious waste, and dirty glassware should not be allowed to accumulate in large quantities in the laboratory.• Containers of discarded specimens and causative agents should be covered when not in use.• The disinfectant should be a 10% bleach solution, which is made fresh every 24 hours.
    47. 47. BIOLOGICAL SAFETYNeedles and Sharps• Needles, blades, broken glass, and other sharp objects pose a physical hazard and a potential infectious hazard to the laboratory and support personnel.• All disposable needles and other sharps should be discarded into puncture-resistant and leak-proof containers marked with the biohazard symbol.• These containers should be discarded according to institutional policy when they are one-half to three- fourths full.
    48. 48. BIOLOGICAL SAFETYNeedles and Sharps• Most institutions incinerate sharp containers.• Needles should not be recapped unless a recapping device is used.• Needles should never be cut because cutting may splatter blood or other fluids into the environment.
    49. 49. BIOLOGICAL SAFETYEmployee Training• Each new laboratory employee should be instructed in safe work practices before exposure to hazardous substances or situations.• Annual training in chemical safety and in exposure control is required by OSHA and must be documented.• The laboratory should appoint a person to be responsible for laboratory safety training.
    50. 50. CHEMICAL SAFETYHazard Communication• Employees must be informed of the health risks associated with those chemicals.• This ensures that health hazards are evaluated for all chemicals that are produced and that this information is relayed to employees.
    51. 51. CHEMICAL SAFETYTo comply with the new Hazard CommunicationStandard, clinical laboratories must:  Plan and implement a written hazard communication program.  Obtain material safety data sheets (MSDS) for each hazardous compound present in the workplace and have the MSDS readily accessible to employees.  Educate all employees annually on how to interpret chemical labels, MSDS, and health hazards of the chemicals and how to work safely with the chemicals.  Maintain hazard warning labels on containers received or filled on site.
    52. 52. CHEMICAL SAFETYChemical Hygiene Plan (CHP)The written CHP must include the following:1. Criteria for and methods of monitoring chemical exposure2. Standard operating procedures for handling hazardous chemicals3. Criteria for implementing engineering controls (fume hoods)4. Use of personal protective equipment and other hygiene practices5. Special precautions for extremely hazardous chemicals
    53. 53. CHEMICAL SAFETYChemical Hygiene Plan (CHP)The written CHP must include the following:6. Specific measures to ensure that fume hoods and other equipment are working properly7. Provision for employee information and training8. Provision for medical consultation and examination9. Designation of a chemical hygiene officer responsible for implementation of the CHP.
    54. 54. CHEMICAL SAFETYMaterial Safety Data Sheet• The MSDS is a major source of safety information for employees who may use hazardous materials in their occupations.• Employers are responsible for obtaining from the chemical manufacturer or developing an MSDS for each hazardous agent used in the workplace.• A standardized format is not mandatory, but all requirements listed in the law must be addressed.
    55. 55. CHEMICAL SAFETYMaterial Safety Data SheetInformation contained on a material safety data sheet includes the following: – Product name and identification – Hazardous ingredients – Permissible Exposure Limit (PEL) – Physical and chemical data – Health hazard data and carcinogenic potential – Primary routes of entry – Fire and exposure hazards – Reactivity data – Spill and disposal procedures – Personal protective equipment recommendations – Handling – Emergency and first aid procedures – Storage and transportation precautions – Chemical manufacturer’s name, address, and phone number – Special information section
    56. 56. CHEMICAL SAFETYCategories of Chemicals:• Since the laboratory deals with a wide variety of chemicals, clinical laboratory scientists must understand the potential hazards involved in their use.• Chemicals may have health hazards or physical hazards.
    57. 57. CHEMICAL SAFETY
    58. 58. CHEMICAL SAFETYCORROSIVE CHEMICALS• Corrosive chemicals are injurious to the skin or eyes by direct contact or to the tissue of the respiratory and gastrointestinal tracts if inhaled or ingested.• Commonly used corrosives in the laboratory:  Concentrated acids – such as hydrochloric, nitric, sulfuric, and acetic  Concentrated alkalis – sodium hydroxide, potassium hydroxide, and ammonium hydroxide.
    59. 59. CHEMICAL SAFETYTOXIC SUBSTANCES• Toxic substances include poisons, irritants, and asphyxiants.• They do not act directly with human tissue but interfere with the metabolic processes of the body.• They may enter the body by: 1. Ingestion 2. Inhalation 3. Skin absorption
    60. 60. CHEMICAL SAFETYTOXIC SUBSTANCES• There are three different TLVs: 1. Time-weighted average (TLV-TWA) – represents the maximum allowable exposure over an 8-hour work day. 2. Short-term exposure limit (TLV-STEL) – represents the maximum amount of allowable exposure for a short period such as 15 minutes. (can’t be repeated more than 4 times per day) 3. Ceiling value form (TLV-C) – represents the concentration of an agent that must never be exceeded.
    61. 61. CHEMICAL SAFETYCARCINOGENS• Carcinogens are chemicals that have been shown to cause cancer in animals or humans.• Chemicals labeled or noted on the MSDS as being carcinogenic, cancer-causing, potential carcinogen, or cancer suspect should be clearly labeled.
    62. 62. CHEMICAL SAFETYCARCINOGENSOSHA regulated carcinogenic chemicals include:  Chloromethyl methyl ether – vinyl chloride  N-Nitrosodimethylamine  N-2-Fluorenylacetamide (2-AAF)  Benz[a]pyrene  4-Aminobiphenyl  Benzidine  1-Naphthylamine  2-Naphthylamine  4-Nitrobiphenyl  Benzene  Ethylenimine  p-Dimethylaminoazobenzene  β-Propiolactone  bis-Chloromethyl ether
    63. 63. CHEMICAL SAFETYMUTAGENS & TERATOGENS Teratogen – anything capable of disrupting normal fetal growth and producing malformation, e.g., drugs, poisons, radiation, physical agents such as electroconvulsive shock, infections. Mutagen – a physical or chemical agent that is capable of causing a heritable alteration in the DNA, which induces a genetic mutation, e.g., drugs, UV light, ionizing radiation.
    64. 64. CHEMICAL SAFETYREACTIVE CHEMICALS• Reactive compounds have molecular structures of high reactivity.• EXPLOSIVES – An explosive chemical is one that rapidly decomposes and produces energy that creates an explosion. – Example: picric acid, in its crystalline form, is known to be explosive upon impact. – The MSDS for each chemical received by the laboratory should be consulted for potential hazards.• OXIDIZERS – Oxidizers are compounds which are capable of reacting with and oxidizing (i.e., giving off oxygen) other materials. – The primary hazard associated with this class of compounds lies in their ability to act as an oxygen source, and thus to stimulate the combustion of organic materials.
    65. 65. CHEMICAL SAFETY COMMON OXIDIZING GROUPSCHEMICAL GROUP CHEMICAL FORMULAPeroxide O2-2Nitrate NO3-Nitrite NO2-Perchlorate ClO4-Chlorate ClO3-Chlorite ClO2-Hypochlorite ClO-Dichromate Cr2O7-2Permanganate MnO4-Persulfate S2O2-2
    66. 66. CHEMICAL SAFETY CLASSIFICATION SYSTEM FOR OXIDIZERS CLASS HAZARD DESCRIPTIONRATING An oxidizing material whose primary hazard is that it may increase the burning rate of combustible material with which it comes in contact. Examples: 1  Potassium dichromate  Silver nitrate  Hydrogen peroxide (8 – 27.5%)  Nitric acid (<70% conc.) An oxidizing material that will moderately increase the burning rate of which may cause spontaneous ignition of combustible material with which it comes in contact. Examples: 2  Potassium permanganate  Calcium hypochlorite (<50% wt.)  Hydrogen peroxide (27.5 – 52% conc.)  Nitric acid (>70% conc.)
    67. 67. CHEMICAL SAFETY CLASSIFICATION SYSTEM FOR OXIDIZERS CLASS HAZARD DESCRIPTIONRATING An oxidizing material that will cause a severe increase in the burning rate of combustible material with which it comes contact or which will undergo vigorous self- sustained decomposition when catalyzed or exposed to heat. Examples: 3  Potassium chlorate  Hydrogen peroxide (52 – 91% conc.)  Calcium hypochlorite (>50% wt.)  Perchloric acid (60 – 72.5% conc.) An oxidizing material that can undergo an explosive reaction when catalyzed or exposed to heat, shock, or friction. Examples: 4  Ammonium perchlorate  Guanidine nitrate  Hydrogen peroxide (>91% conc.)  Perchloric acid (>72.5%)
    68. 68. CHEMICAL SAFETYREMEMBER these things about oxidizers:• The primary hazard is the ability to act as an oxygen source, especially hazardous during fire situation.• These materials present a fire and explosion hazard when in contact with organic or combustible materials. All contact with organic or combustible material must be avoided.• They are generally corrosive.• The hazards associated with the use of perchloric acid are particularly severe.
    69. 69. CHEMICAL SAFETYREMEMBER these things about oxidizers:• Perchloric acid may NOT be used in any hood except those specially designed for perchloric acid use.• Strong oxidizing agents, such as chromic acid, should be stored and used in glass or other inert, and preferably unbreakable, containers.• Corks or rubber stoppers must NEVER be used.• Reaction vessels containing appreciable amounts of oxidizing materials should never be heated in oil baths, but rather on a heating mantle or sand baths.
    70. 70. CHEMICAL SAFETYOther reactive chemicals  Compounds with redox groups (hydrazine, hydroxylamine)  Compounds that react violently with water or air (anhydrous metal oxides)  Pyrophoric compounds that spontaneously react with air  Compounds that form peroxides over time and become explosive – such as diethyl ether.
    71. 71. CHEMICAL SAFETYStorage of Chemicals• Chemicals should be stored in an uncluttered area that is properly ventilated and away from a heat source.• They should not be stored above eye level.• It is not a good idea to store chemicals alphabetically.• Inorganic compounds should be stored separately from organics. – Inorganic acids should be stored together with the exception of nitric acid. – Nitric acid should be isolated from other acids. – Acetic acid can be stored with inorganic acids.
    72. 72. CHEMICAL SAFETYStorage of Chemicals• Water-reactive chemicals such as sodium, potassium, and metal hydrides should be segregated from other chemicals and stored in a dry environment.• These areas should NOT be equipped with sprinkler systems. W
    73. 73. CHEMICAL SAFETYCONCENTRATED ACID / BASE SPILLS:• Dilute first with water before clean-up is attempted.• The spill should then be covered with a neutralizer: Boric acid – for bases Sodium bicarbonate – for acids• The spill should then be absorbed with an absorbent material.
    74. 74. CHEMICAL SAFETYCONCENTRATED ACID / BASE SPILLS:• Dispose according to the institutional policy on chemical waste disposal.• The surface should then be cleansed with soap and water after the chemical is cleaned up.
    75. 75. CHEMICAL SAFETYSOLVENT SPILLS:• If a solvent is spilled, no water or diluent should be added and the solvent should not be allowed to flow down a drain.• Since solvents may present a fume problem, respiratory protective equipment needs to be available.• After absorption with absorbent material, the material should be placed in a closed container to prevent fumes from escaping.• All containers should be labeled with the chemical name and any hazard and disposed as chemical waste.
    76. 76. FIRE SAFETYFLAMMABLE & COMBUSTIBLE CHEMICALS• Flammable and combustible liquids, which are used in numerous routine procedures, are among the most hazardous materials in the clinical chemistry laboratory because of possible fire or explosion.• They are classified according to flashpoint 1. Flammable liquids have a flashpoint below 100 or 140oF. 2. Combustible liquids have a flashpoint at or above 100 or 140oF.
    77. 77. FIRE SAFETYFLAMMABLE & COMBUSTIBLE CHEMICALS HEAT FUEL OXYGEN FIRE TRIANGLE
    78. 78. FIRE SAFETYFLAMMABLE & COMBUSTIBLE CHEMICALS Fuel Uninhibited reaction Oxygen Heat
    79. 79. FIRE SAFETY GEOMETRIC PICTOGRAM / PICTUREFIRE CLASS INTEDED USE SYMBOL SYMBOL Garbage can Ordinary solid A and wood pile burning combustibles Fuel container Flammable liquids and B and burning puddle gases Electric plug Energized electrical C and burning outlet equipment D - Combustible metals K Pan burning Cooking oils and fats
    80. 80. FIRE SAFETY TYPE SUITABLE FOR USE ON FIRE CLASSES WATER FOAM DRY CHEMICAL (POWDER)CARBON DIOXIDECLASS D POWDER
    81. 81. FIRE SAFETYTo operate a fire extinguisher:P ULLA IMS QUEEZES WEEP
    82. 82. ELECTRICAL SAFETY• Laboratories have a great deal of electrical equipment in proximity to sinks, liquids or other grounded surfaces.• HAZARDS: 1. Burns 2. Shock 3. Electrocution 4. Ignition 5. Explosion• Fire and explosion hazards are avoided by preventing the occurrence of high temperatures.• Circuit breakers, fuses, and ground fault interrupters (GFI) are designed to detect overloaded circuits that could cause ignition and explosion.
    83. 83. ELECTRICAL SAFETYPrecautionary Measures• Use only explosion-proof equipment in hazardous atmospheres.• Be particularly careful when operating high-voltage equipment, such as electrophoresis apparatus.• Use only properly grounded equipment (three-prong plug).• Check for frayed electrical cords.• Promptly report any malfunctions or equipment producing a “tingle” for repair.
    84. 84. ELECTRICAL SAFETYPrecautionary Measures• Do not work on “live” electrical equipment.• Never operate electrical equipment with wet hands.• Know the exact location of electrical control panel for the electricity to your work area.• The use of extension cords is NOT ALLOWED. In emergency situations, use only approved extension cords (properly grounded, heavy-duty) and do not overload circuits.• Have ground checks and periodic preventive maintenance performed on equipment.
    85. 85. COMPRESSED GASES• Compressed gas cylinders of varying sizes can be found in laboratories and especially in research laboratories.• Since the cylinders are pressurized, they can become “torpedoes” that can even penetrate block walls if the main valve stem is sheared by falling over.• A good working practice when using a flammable gas is to allow only one cylinder of gas to be in use at a time and to use the smallest size possible.
    86. 86. COMPRESSED GASES• Gas cylinders, both flammable and non-flammable, should never be stored in fire safety cabinets with flammable and combustible liquids.• They should be grouped by type and stored in a ventilated room reserved exclusively for cylinder storage. The room should have a fire resistance rating of at least 2 hours.
    87. 87. COMPRESSED GASES • Cylinders should always be secured by a chain or other device to prevent them from falling over and shearing the valve stem. • When cylinders are transported, valve protective caps should be used. • When cylinders are not in use, the valves should be tightly closed.
    88. 88. COMPRESSED GASESPrecautionary Measures• Know the gas that you will use.• Store tanks in a vertical position.• Keep cylinders secured at all times.• Never store flammable liquids and compressed gases in the same area.• Use the proper regulator for the type of gas in use.• Do not attempt to control or shut off gas flow with the pressure relief regulator.• Keep removable protection caps in place until the cylinder is in use.
    89. 89. COMPRESSED GASESPrecautionary Measures• Make certain that acetylene tanks are properly piped (the gas is incompatible with copper tubing).• Do not force a “frozen” or stuck cylinder valve.• Use a hand truck to transport large tanks.• Always check tanks on receipt and then periodically for any problems such as leaks.
    90. 90. COMPRESSED GASESPrecautionaryMeasures• Make certain that the cylinder is properly labeled to identify the contents.• Empty tanks should be marked “EMPTY”.
    91. 91. CRYOGENIC MATERIALS• Liquid nitrogen – probably one of the most widely used cryogenic fluids (liquefied gases) in the laboratory.• Hazards of cryogenic material: – Fire or explosion – Asphyxiation – Pressure build-up – Embrittlement of materials – Tissue damage (similar to that of thermal burns)
    92. 92. CRYOGENIC MATERIALSPrecautionary Measures• Only containers constructed of materials designed to withstand ultralow temperatures should be used for cryogenic work.• The use of eye/face protection, hand protection to guard against the hazards of touching super- cooled surfaces is recommended.• The gloves, of impermeable material, should fit loosely so that they can be taken off quickly if liquid spills on or into them.
    93. 93. CRYOGENIC MATERIALSPrecautionary Measures• To minimize violent boiling/frothing and splashing, specimens to be frozen should always be inserted into the coolant very slowly.• Cryogenic fluids should be stored in well- insulated but loosely stoppered containers that minimize loss of fluid resulting from evaporation by boil-off and that prevent plugging and pressure build-up.
    94. 94. RADIATION SAFETYThere are four types of ionizing radiation hazards:1. Alpha particles – plutonium2. Beta particles – 3H, 14C, 32P3. Electromagnetic radiation – not composed of atomic particles  Gamma rays – 125I and 131I  X-rays4. Neutrons – arise from spontaneous fission of some isotopes and are produced by atomic reactors and accelerators.
    95. 95. MECHANICAL HAZARDS• Centrifuges – must be balanced to distribute the load equally• Autoclaves – steam under pressure• Homogenizers• Laboratory glassware – be careful in handling breakable and sharp objects• Sharp instruments – dispose in puncture-resistant containers
    96. 96. ERGONOMIC HAZARDSRepetitive strain disorders:1. Tenosynovitis2. Bursitis3. Ganglion cysts4. Acute musculoskeletal injury• Primary contributing factors associated with repetitive strain disorders: – Position / posture – Applied force – Frequency of repetition
    97. 97. CHEMICAL WASTES• In some cases, it is permissible to flush water-soluble substances down the drain with copious quantities of water.• Strong acids and bases should be neutralized before disposal.• Foul-smelling chemicals should never be flushed down the drain.• Other liquid wastes, including flammable solvents, must be collected in approved containers and segregated into compatible classes.
    98. 98. CHEMICAL WASTES• Flammable material can also be burned in specially designed incinerators with afterburners and scrubbers to remove toxic products of combustion.• Before disposal, hazardous substances that are explosive, such as carcinogens and peroxides, should be transformed into less hazardous forms whenever feasible.• Solid chemical wastes that are unsuitable for incineration must be buried in a landfill. This practice, however, has created an environmental problem, and there is now a shortage of safe sites.
    99. 99. RADIOACTIVE WASTES• A general license by the Nuclear Regulatory Commission is required for use of radioimmunoassay (RIA) kits in the clinical laboratory even when exempt material is used.• Under these guidelines, effluents from RIA in-vitro tests may be flushed into the sanitary sewer and diluted with large amounts of water.• When disposing of radioisotopes into the sanitary sewer, designate one sink for this purpose. This sink should be clearly labeled and routinely monitored with a wipe test for residual radioactivity.
    100. 100. RADIOACTIVE WASTES• Other material such as disposable tubes and pipets that have been in contact with the radioisotopes may be safely discarded in the routine trash after all the radioactive labels are removed.• If the waste also contains biohazardous material, it may be autoclaved before disposal into routine trash.• The radiation safety officer should always be consulted about policies dealing with radioactive waste disposal.
    101. 101. BIOHAZARDOUS WASTES• All biomedical waste should be placed into a leak- proof container that is puncture-resistant and equipped with a solid, tight-fitting lid. All containers must be clearly marked with the word “biohazard” or its symbol.• All sharp instruments, such as needles, blades, and glass objects, should be placed into puncture- resistant containers before placing them inside the bag and container.• Needles should not be transported, recapped, bent, or broken by hand.
    102. 102. BIOHAZARDOUS WASTES• Potentially biohazardous material, such as blood or blood products and contaminated laboratory waste, cannot be directly discarded.• Contaminated combustible waste can be incinerated.• Contaminated non-combustible waste, such as glassware, should be autoclaved before being discarded.• Special attention should be given to the discarding of syringes, needles, and broken glass that could also inflict accidental cuts or punctures.
    103. 103. ACCIDENT DOCUMENTATION AND INVESTIGATION• Any accidents involving personal injuries, even minor ones, should be reported immediately to a supervisor.• It is particularly important that the appropriate authority be notified immediately if any individual sustains a needle puncture during blood collection or a cut during subsequent specimen processing and handling.
    104. 104. ACCIDENT DOCUMENTATION AND INVESTIGATIONThe investigation report should include:1. Information on the injured person2. Description of what happened3. Cause of the accident (environmental or personal);4. Other contributing factors5. Witnesses6. Nature of the injury7. Actions to be taken to prevent recurrence.

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