1 Safety in Clinical Laboratory

• Biohazards are defined as any biological or chemical substance that is dangerous to humans, animals, or the environment, including body fluids, human tissue and blood, and recombinant DNA.
• Transmission occurs when the agent leaves its reservoir or host through a portal of exit, is conveyed by some mode of transmission, and enters through an appropriate portal of entry to infect a susceptible host, sometimes referred to as the chain of infection.
• Procedures describing how to protect employees against teratogens, carcinogens, and other toxic chemicals must be described in the chemical hygiene plan.
• A Material Safety Data Sheet (MSDS) is a document that contains information on the potential hazards (health, fire, reactivity and environmental) and how to work safely with the chemical product, and is an essential starting point for the development of a complete health and safety program.
• The Occupational Safety and Health Administration is a large regulatory agency of the United States Department of Labor that originally had federal visitorial powers to inspect and examine workplaces.
• Personal protective equipment is protective clothing, helmets, goggles, or other garments or equipment designed to protect the wearer's body from injury or infection, addressing hazards such as physical, electrical, heat, chemicals, biohazards, and airborne particulate matter.
• Post-exposure prophylaxis, also known as post-exposure prevention, is any preventive medical treatment started after exposure to a pathogen in order to prevent the infection from occurring.
• The drafting of guidelines and regulations by the Centers for Disease Control and Prevention (CDC) and the Occupational Safety and Health Administration (OSHA) resulted in the implementation of Universal Precaution (UP) to prevent exposure to blood-borne pathogens.
• All specimens are considered hazardous and blood-borne pathogens according to BSI guidelines.
• The modification of Universal Precaution for body substance isolation (BSI) helped to alleviate this concern.
• A major disadvantage of BSI guidelines is that they do not recommend handwashing following removal of gloves unless visual contamination is present.
• Wearing of personal protective equipment (PPE) including gloves, eye and face shield, mask, and laboratory gown is recommended according to standard precaution.
• Disposal of biological wastes should be done through incineration, as per standard precaution.
• BSI guidelines are not limited to blood-borne pathogens; they consider all body fluids and moist body substances to be potentially infectious.
• Personnel should wear gloves at all times when encountering moist body substances according to BSI guidelines.
• CDC excluded urine and body fluids not visibly contaminated by blood from Universal Precaution, although many specimens can contain a considerable amount of blood before it becomes visible.
• Disinfection protocol using Sodium Hypochlorite (1:10) is a standard precaution.
• Radioisotopes are radioactive isotopes of an element, atoms that contain an unstable combination of neutrons and protons, or excess energy in their nucleus.
• Standard Precautions are the minimum infection prevention practices that apply to all patient care, regardless of suspected or confirmed infection status of the patient, in any setting where health care is delivered.
• Chemicals should never be mixed without instruction.
• The six o’clock position on the symbol represents special hazards and has a white background; it is not always filled.
• Urine can be discarded in the sink.
• Pick-up by a certified hazardous waste company is recommended for autoclaved items.
• Hazard severity is indicated by a numerical rating that ranges from zero (0) indicating a minimal hazard, to four (4) indicating a severe hazard.
• Incineration is not advisable due to environmental concerns, as parts of the body or specimens collected from the patient are given to the patient after the procedure if they wish to take them home or see them (e.g., amputated leg, gallstones, fetus).
• NFPA has developed Standard System (NFPA 704) for chemical hazard identification.
• The chemical container should be in a manageable size.
• Sharp hazards such as needles, lancets, and broken glassware must be disposed in a puncture-resistant container, located near the workplace.
• The NFPA 704 hazard identification system is characterized by a diamond which is more precisely defined as a “square-on-point” shape.
• In case of a chemical spill accident in the laboratory, flush the infected area of the skin with large amount of water for at least 15 minutes.
• The hazards are arranged spatially such that health hazards are indicated in the nine o’clock position, flammability at the twelve o’clock position, and instability at the three o’clock position.
• Acid should always be added to water.
• Mouth pipetting is not allowed in the laboratory.
• Autoclaving involves high pressure and high temperature, exposing each item to direct steam contact at the required temperature and pressure for the specified time.
• Radioactivity is encountered in the clinical laboratory when procedures using radioisotopes are performed.
• Equipment that has become wet should be unplugged and allowed to dry completely before reusing.
• Physical hazards are not unique to the laboratory.
• Equipment should not be operated with wet hands.
• When a fire is discovered, all employees are expected to follow the acronym RACE: Rescue, Alarm, Contain, Extinguish/Exit.
• It is important to be able to operate the fire extinguishers.