Laboratory Safety Chapter 2

Facilities and Safety Overview

• A laboratory safety program aims to safeguard employees, patients, equipment, and the environment.
• Neglecting laboratory safety can lead to significant losses, including reputation, customers, and increased legal and insurance costs.
• Quality and safety management are crucial responsibilities of laboratory managers.
• Laboratory directors must be actively involved in designing safe environments and assessing risks.
• Quality managers need to ensure training in safety rules and perform risk assessments regularly.
• All laboratory personnel share the responsibility for maintaining quality and safety protocols.

Laboratory Design

• Ensure segregation of pathways for patients and biological samples to minimize contamination risks.
• Circulation paths should restrict access to hazardous areas to authorized personnel only.
• Laboratory layout should facilitate efficient movement while reducing contamination risks during sample processing.
• Post-examination results must be accurately recorded and promptly delivered to the appropriate recipients.
• Communication systems should align with laboratory complexity to ensure effective messaging.

Geographic or Spatial Organization

• Different access controls should separate areas handling patients from those processing samples.
• Service rooms (autoclaves, sinks) should be centrally located to improve flow and reduce travel distances.
• Specialized areas must be designated for activities like molecular biology and fluorescence microscopy to ensure safety.
• Equipment design should consider access for delivery, maintenance, and safe handling of liquid waste.

Physical Aspects of Premises and Rooms

• Laboratories require proper ventilation and space to accommodate personnel and equipment movement.
• High ceilings, washable surfaces, and durable materials should be used for walls, floors, and benches.
• Work areas need to be organized by analysis type to prevent cross-contamination effectively.
• Daily cleaning protocols should be established for surfaces, equipment, and floors to maintain hygiene.

Safety Management Program

• A dedicated safety officer typically oversees the safety program in laboratories, particularly for compliance and training.
• A comprehensive safety manual should outline written procedures and training for all potential hazards.
• Regular risk assessments and safety audits help identify areas for improvement.
• Standard practices include hygiene protocols, restricted access, and mandatory personal protective equipment (PPE) usage.
• Monthly fire drills and laboratory evacuation procedures reinforce staff preparedness for emergencies.

Identification of Risks

• Comprehensive risk assessments are essential to identify and mitigate hazards within laboratory operations.
• A record of staff exposures to hazardous materials is necessary for ongoing safety improvement.
• Training on handling equipment (e.g., autoclaves, centrifuges) is crucial to prevent injuries.
• Proper disposal methods for sharps and contaminated glassware are vital for ensuring safety.
• Exposure to toxic chemicals primarily occurs through inhalation, skin absorption, and ingestion; proper labeling and storage are critical.

Material Safety Data Sheets (MSDS)

• MSDS provide essential information on chemical hazards, safe handling, storage, and emergency measures.
• Laboratories must ensure MSDS are accessible near the hazardous materials in use.
• Up-to-date MSDS facilitate safe operations and compliance with legal requirements.

Laboratory-Acquired Infections

• Diagnostic laboratories face contamination risks primarily from aerosols; maintaining cleanliness and safety protocols is imperative to minimize infection spread.
• Special precautions must be taken when handling radiochemicals, including appropriate storage and waste disposal methods.### Containment Systems in Laboratories
• Major focus on blocking aerosol diffusion in laboratory spaces.
• Level 2 diagnostic labs dealing with moderate-risk pathogens require adequate ventilation.
• Higher containment labs mandate continuous inward airflow and absolute air filtration to prevent aerosol release.

Personal Protective Equipment (PPE)

• Key routes for lab staff infections include inhalation of aerosols, percutaneous inoculation, contact with mucous membranes, and accidental ingestion.
• Access to PPE and training on its proper use are critical for reducing infection risk.
• Types of PPE include goggles, masks, gloves, and protective clothing.

PPE Guidelines

• Goggles: Essential for eye protection against droplet exposure during sample handling; should be worn behind protective screens if necessary.
• Masks: Serve as a barrier against splashes and should be worn for all sample handling and hazardous material manipulation.
• Lab Coats: Required in Level 2 labs; designed to protect skin and clothing, should cover the upper body and be comfortably fitted.
• Gloves: Must be worn at all times in the lab; never reused or decontaminated; must be disposed of properly after use.

Types of Gloves

• Latex Gloves: Protection against biological hazards; can cause allergic reactions; not suitable for chemical exposure.
• Nitrile Gloves: Common in clinical settings; resistant to punctures and a range of hazardous chemicals; should not be reused.
• Insulated Gloves: Protect against thermal hazards during high-temperature tasks.
• Chemical-Resistant Gloves: Selected based on specific chemical hazards, using manufacturer compatibility guides.

Respiratory Protection

• Respirators are vital in the presence of infectious aerosols; must fit tightly for effectiveness.
• Types include N95, KN95, P100, and PAPRs; N95 is most commonly used.
• Each respirator class has distinct resistance characteristics and efficiency ratings; must meet NIOSH standards.
• A respiratory protection program must involve hazard evaluation, medical clearance, and training.

Footwear and Other PPE

• Laboratory footwear should be closed-toed, avoiding sandals and other permeable materials; disposable shoe covers may be required in high containment areas.
• Sleeve guards can provide additional wrist and arm protection, particularly in certain lab settings.
• Laboratory dress code policies are often tailored to minimize contamination risks, including long pants, natural fiber clothing, and secured long hair.

Selection of Appropriate PPE

• Selection is based on the specific hazards present, nature of tasks, and type of materials used.
• Compliance with guidelines from CDC and NIOSH on the hierarchy of controls is essential for creating a safe laboratory environment.
• Continuous assessment and adaptation of PPE usage are necessary according to task requirements and evolving risks.### PPE Program Implementation
• Establish a PPE program including hazard identification, risk mitigation, and ongoing monitoring.
• Provide PPE free of charge to all employees.
• Include training on PPE use, maintenance, and limitations for all staff.
• Conduct regular evaluations to ensure PPE efficacy and necessary updates.

Considerations for PPE Selection

• Ensure PPE meets national and state-specific safety standards.
• Capability for use in various lab combinations or different workplaces.
• Provide diverse size options to accommodate all staff.
• PPE must prevent hazardous material transfer to clothing and skin.
• Assess whether PPE serves as a primary barrier against infectious substances or chemicals.
• Perform risk assessments for laboratory processes to select suitable PPE.

Laboratory Specific Guidelines

• Evaluate handling types of specimens, facility capabilities, and staff qualifications when selecting PPE.
• Laboratory safety plans should document tasks, hazards, and required PPE.
• Employers must carry out hazard assessments to guide PPE selection based on risks.

Employee Responsibilities and Training

• Train workers on when and what type of PPE is necessary, including proper donning, doffing, and maintenance.
• Require staff to demonstrate competence in PPE use before working in potentially hazardous environments.
• Retraining must occur if work conditions change or if staff inadequately use PPE.

Ongoing PPE Management

• Employers are obligated to create a PPE maintenance program, including replacement of worn/damaged gear and regular suitability reassessment.
• Employees must properly wear, utilize, and dispose of PPE and report any needs for additional PPE.

PPE for Hazardous Material Exposure

• Appropriate PPE is required for potential exposure to hazardous chemicals and biohazardous materials.
• Proper laboratory attire is critical for minimizing skin exposure to hazardous agents.
• Laboratories should develop specific PPE policies based on conducted risk assessments.

Biological Safety Levels

• Most clinical labs operate at Biological Safety Level 2 (BSL-2) for standard clinical work.
• Follow CDC standard precautions and BSL-2 safety practices for sample handling.

Typical BSL-2 PPE Items

• Lab coats and/or gowns as needed.
• Nitrile gloves to protect against chemicals.
• Safety glasses and face shields for eye protection, used as required.
• Respiratory protection based on risk assessment requirements.