PMLS 2

• Laboratory Safety and Hazards
• Safety begins with the recognition of hazards and is achieved through the following:
• Ways to achieve laboratory safety


  • Application of common sense
  • Listen to the instructions
  • A safety-focused attitude
  • Good personal behaviour
  • Good housekeeping in all laboratory work and storage areas
  • Continual practice of good laboratory technique
• Two Primary Causes of Accidents


  • Unsafe activities
  • Unsafe environmental conditions
• Safety Equipment


  • Safety showers & eye wash station
  • Fire extinguisher
  • Fume hood
  • Biosafety cabinets
  • Personal Protective Equipment

  
• Biological Hazard


  Biological substances that pose a threat to the health of living organisms, primarily that of humans
• These microorganisms are frequently present in the specimens received in the clinical laboratory
• Infection control


  Healthcare facilities developed procedures to control and monitor infections occurring within the facilities
• CDC →Universal Precautions (1985) - Blood and body fluid precautions should be consistently used for all patients
• Biological Hazard


  • Infectious agents - consist of bacteria, fungi, parasites, and viruses
  • Reservoir - is the location of potentially harmful microorganisms, such as a contaminated clinical specimen or an infected patient
  • Fomites – these are equipment and other soiled inanimate objects will serve as reservoirs, particularly if they contain blood, urine, or other body fluids
  • Portal of Exit - Infectious agent must have a way to exit the reservoir to continue the chain of infection
  • Means of transmission – direct contact, airborne, droplet, vehicle, vector
• Portal of entry


  • Mucous membranes of the nose, mouth, and eyes, breaks in the skin, and open wounds
• Susceptible host


  Another patient during invasive procedures, visitors, and healthcare personnel when exposed to infectious specimens or needlestick injuries
• Proper hand hygiene, correct disposal of contaminated materials, and wearing personal protective equipment (PPE) are of major importance in the laboratory

  
• Categories of Exposure


  • Category I – daily exposure to blood and body fluids
  • Category II – regular exposure to blood and body fluids
  • Category III – no exposure to blood and body fluids
• Employers must offer HBV vaccine to all personnel (Category I and II)
• Specimens should be "capped" during centrifugation
• Any blood, body fluid, or other potentially infectious material spill must be cleaned up using: Spill cleanup kit, Common aqueous detergent, 10% bleach using appropriate contact time
• Chemical Hazard


  When skin contact occurs, the best first aid is to flush the area with large amounts of water for at least 15 minutes and then seek medical attention
• Chemicals should never be mixed together unless specific instructions are followed, and they must be added in the order specified
• Chemical Hygiene Plan


  OSHA requires all facilities that use hazardous chemicals to have a written chemical hygiene plan (CHP) available to employees. The purpose of the plan is to detail appropriate work practices, Standard operation procedures, PPE, Engineering controls, such as fume hoods and flammable safety cabinets, Employee training equipment's and Medical consultation guidelines
• Types of Chemicals


  • Flammable/Combustible Chemicals
  • Corrosive Chemicals
  • Reactive Chemicals
• Hazardous chemicals should be labeled with a description of their particular hazard, such as poisonous, corrosive, flammable, explosive, teratogenic, or carcinogenic
• Contents of Material Safety Data Sheets (MSDS)


  • Physical and chemical characteristics
  • Fire and explosion potential
  • Reactivity potential
  • Health hazards and emergency first aid procedures
  • Methods for safe handling and disposal
  • Primary routes of entry
  • Exposure limits and carcinogenic potential

  
• The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) requires that all health-care institutions post evacuation routes and detailed plans to follow in the event of a fire
• Actions to take when a fire is discovered


  • Rescue
  • Alarm
  • Contain
  • Extinguish/Evacuate

  
• The National Fire Protection Association (NFPA) has developed the Standard System for providing codes and standard information about the chemicals/solutions
• All areas where radioactive materials are used or stored must be posted with caution signs, and traffic in these areas should be restricted to essential personnel only
• Exposure to radiation during pregnancy presents a danger to the fetus, and personnel who are or who think they may be pregnant should avoid areas with this symbol
• Equipment should not be operated with wet hands
• Equipment that has become wet should be unplugged and allowed to dry completely before reusing. Equipment also should be unplugged before cleaning
• All electrical equipment must be grounded with three-pronged plugs
• All sharp objects must be disposed in puncture-resistant, leak-proof container with the biohazard symbol
• General precautions to consider for physical hazards


  • Avoid running in rooms and hallways
  • Watch for wet floors
  • Bend the knees when lifting heavy objects
  • Keep long hair pulled back
  • Avoid dangling jewelry
  • Maintain a clean, organized work area
  • Wear closed-toed shoes that provide maximum support
• Centrifuges must be balanced to distribute the load equally. Never open the lid until the rotor has come to a complete stop
• Disposal of Biological/Biohazardous Waste


  • All biological waste (EXCEPT URINE) should be placed in appropriate containers labeled with biohazard symbol
  • URINE: may be discarded by pouring it into the lab sink. The sink should be flashed also with water after the urine has been discarded. Decontaminate the sink by 1:5 or 1:10 dilution of sodium hypochlorite (bleach solution). Disinfection of the sink should be performed daily. Empty urine containers can be discarded as nonbiologically hazardous waste
  • Incineration, inactivation, burial, chemical disinfection, encapsulation in a solid matrix
• Disposal of Chemical Waste


  • Flush water-soluble substances down the drain with large quantities of water
  • Strong acids and bases should be neutralized before disposal
  • Foul smelling chemicals should never be disposed down the drain
  • Flammable solvents → collected in approved containers
  • Flammable material → specially designed incinerators
  • Solid chemicals → landfill
• Waste Disposal Technique


  • Incineration
  • Recycling
  • Landfill burial
  • Flushing down the drain
• Phlebotomy is "an incision into a vein"
• Bloodletting is now called "therapeutic phlebotomy"
• Techniques for bloodletting (earlier times)


  • Suction cup devices with lancets that pulled blood from the incision
  • The application of blood-sucking worms called "leeches" to an incision
  • Barber surgery – blood from an incision produced by the barber's razor was collected in a bleeding bowl