Medical Laboratory Safety Introduction

Introduction to Medical Laboratory Safety

• Medical laboratory safety involves implementing protocols and practices to protect personnel, patients, and the environment from potential hazards.
• This encompasses proper handling of biological specimens, chemicals, equipment, and waste.

Importance of a Safe Lab Environment

• Prevents workplace injuries such as cuts, burns, and needle-stick injuries
• Avoids exposure to harmful chemicals and infectious agents
• Protects public health by preventing specimen contamination that leads to misdiagnosis
• Minimizes the risk of spreading infections to patients, visitors, and the community
• Ensures operational efficiency by reducing downtime from accidents and contamination
• Maintains a safe and organized lab to promote productivity
• Fosters ethical and responsible behavior among laboratory personnel
• Demonstrates commitment to patient care and safety

Consequences of Ignoring Safety Protocols

• Health risks, including exposure to hazardous substances, infectious agents, and radiation that lead to acute or chronic health issues
• Increases the risk of occupational diseases like laboratory-acquired infections, hepatitis and tuberculosis
• Increased liability, legal actions, or penalties due to non-compliance
• Loss of laboratory accreditation or operating license
• Compromised patient outcomes, such as contaminated samples and inaccurate results that lead to misdiagnosis
• Environmental impact from improper disposal of laboratory waste

Why Safety Matters

• Protects laboratory personnel and ensures a safe workspace free from risks
• Reduces the likelihood of accidents and occupational illnesses
• Protects the public and patients by preventing cross-contamination and ensuring sample integrity
• Decreases the risk of spreading laboratory-acquired infections to the community
• Allows for environmental protection by preventing contamination
• Promotes sustainable and ethical laboratory practices
• Regulatory compliance with OSHA, CDC, and WHO guidelines
• Improves reputation and trust with healthcare professionals, patients, and regulatory authorities
• Helps maintain accreditation and operational legitimacy

Key Safety Regulations

• Occupational Safety & Health Act (OSHA): Applies to every industrial establishment and to all owners, employers, and employees
• ISO 15190: 2022 is an international standard that specifies requirements for safe practices in the medical laboratory
• GYS 170:2021 is a safety regulation guideline
• WHO's Laboratory Biosafety Manual (4th ed.) is a global guideline presenting best practices in biosafety

General Laboratory Safety Rules

• Do not eat, drink, smoke, or chew gum in the laboratory
• Do not put pencils or pens in the mouth
• Never place food or beverages in a refrigerator used for storing reagents or specimens
• Do not apply cosmetics, handle contact lenses, or rub eyes in the laboratory
• Do not wear long chains, large or dangling earrings, or loose bracelets
• Always wear a fully buttoned lab coat during activities, and never wear lab coat to lunch or outside lab.
• Always tie back hair that is longer than shoulder length
• Always wear a face shield when performing specimen processing or any activity that generates splash/aerosol of bodily fluids
• Always wear gloves for phlebotomy procedures and specimen processing
• Keep nails short and well-manicured; avoid nail polish, artificial nails, biting nails or cuticles

Key Aspects of Safety Regulations - Personal Protective Equipment (PPE)

• PPE minimizes exposure to biological, chemical, and radiological hazards
• Without PPE, exposure leads to injuries and illnesses
• PPE protects healthcare workers from potential transmission routes with respect to biological agents
• Person-to-person contact, droplet contact, airborne transmission, and contaminated objects (fomites) are routes of potential transmission
• PPE use is part of infection control that includes hand hygiene and waste management

PPE Characteristics and Use

• PPE includes hairnets, goggles, latex gloves, lab coats, medical masks, and closed-toe shoes
• PPE should protect mucous membranes and minimize junctions
• Provide a clear range of vision
• Communication capability
• Ergonomic design for size and comfort
• PPE should be protective for the duration of work and withstand repeated disinfection
• Packaged to withstand tropical climate
• Following an easy PPE donning and doffing procedure

PPE Donning

• Wash hands
• Gown
• Mask or Respirator
• Goggles or face shield
• Gloves

PPE Doffing

• Gloves
• Gown
• Goggles or face shield
• Mask or Respirator
• Wash hands

Removing Gloves Safely

• Grasp outside of glove at the wrist
• Peel glove away from body, turning it inside-out
• Hold inside-out glove in the other hand
• Slide fingers under the wrist of the other glove; peel it away from the body, turning it inside out and leaving the first glove inside
• Dispose of gloves safely
• Wash hands

Recommendations for COVID-19 PPE

• Isolation, contact, and airborne/eye protection is recommended for those suspected as positive for COVID.
• Face masks are acceptable when respirator supply is limited
• Respirators needed for aerosol-generating procedures

Hazard Communication

• A chemical safety workplace
• OSHA's Hazard Communication Standard 29 CFR 1910.2200 (h) requires employers to provide information and training about hazardous chemicals
• Employers must maintain a written hazard communication program with requirements for labels, warning, safety data sheets, information, and training
• Components include hazard identification, labeling, safety data sheets, employee training, and program implementation

General Chemical Safety Rules

• Always wear protective clothing, safety goggles, gloves, lab coat, and apron
• Always use chemical cleanup materials to clean up the spills
• Never store chemicals above eye level
• Never add water to acid
• Never indiscriminately mix chemicals
• Never store chemicals in unlabeled containers
• Never pour chemicals into dirty containers, especially used to store others
• Never use chemicals in ways that are unintended

Hazard Identification

• Create a hazardous material inventory of chemicals
• Take chemical inventories to create a written record
• Ensure that SDS is on file for each chemical
• Get a new copy from supply source if SDS is missing

Labeling

• Hazardous materials need to be clearly labeled, with contents identified along with appropriate hazard warnings
• Chemical manufacturers and distributors ensure labeled chemical containers, but employers must ensure correct labeling as well
• Any time chemicals are transferred into a new container the employers are responsible for labeling

Safety Data Sheets (SDS)

• Provides the details of hazardous materials with physical characteristics
• Describes how to work more safely and protect themselves from potential risks

Information and Training

• All employees are properly trained to work with dangerous chemicals
• Safety training includes OSHA's HCS requirements, locations, and other documentation
• Employees will learn how to be mindful of workplace hazards, read SDS before working, and how to act in the emergence of dangerous chemicals

Hazard Communication Program Implementation

• Provides employees with accurate up-to-date info on any potential safety hazards at workplace and how to protect themselves

Types of Hazards in the Medical Laboratory: Biological Hazards

• Biological Hazards includes disease-causing agents (pathogens) that can be transmitted to individuals through various exposure routes (modes of transmission) - Exposure to biological agents that result in acute or chronic health conditions
• Biosafety is a term on the safe handling of biological substances that pose risk to health
• Biohazards are identified by a symbol

Exposure Routes of Biological Hazards

• Healthcare workers exposed to biohazards have many routes
• Many routes include parenteral
• Microorganism present in blood / other body fluids
• Other routes include:
• Airborne transmission, inhalation of aerosols or fumes, via non-intact skin, percutaneous, per mucosal
• BBPs include HIV, HBV, HCV, CMV, the mo’s that cause syphilis, malaria, the prion CJD and West Nile virus

BBP Exposure Routes

• Exposure included a puncture form contaminated needle or sharp objects
• A splash of blood/body fluids into mouth
• Blood / body fluids into contact with skin and wounds
• OSHA regulations mandate the implementation of engineering controls and PPE usage
• Availability of PPE, training, and medical surveillance

Biological Hazards Injury Treatments.

• Seek immediate attention
• Wash with 30 seconds of soap and water
• Antiseptic is not recommended
• Flush the site (eyes, nose, mouth) for 10 minutes with sterile saline or water
• Remove lenses
• Re- disinfect them if you plan to re-use

Chemical and physical health hazards

• Must follow a certain set a electrical safety rules as well as the handling
• Must wear ppe when exposed to biological hazards
• Keep sharp tools away from person

Physical hazards due to equipment:

• Electrical shocks should be shut off
• Should be removed with non- conductivity material
• Call for medical support and keep patient warm

Emergency preparedness

• Prepared for design to enhance response in the event that an event occurs. The plans structured includes
• Alarm activation
• Re-entry and evaluation procedure
• Coordination with Emergency Responders
• Communication plan

Emergency management phases:

• There are major phases to managing an emergency, the process includes:
• Mitigation
• Preparedness
• Response
• Recovery

Four Components of Fire- Tetrahedron

• Fuel, oxygen, heat source, chemical Reaction

Procedures for Breaking of Fire

• Make sure all the doors and windows is closed tight.
• Smother the person or equipment
• Crawl the area
• Run without panic

Spill procedures and contents

• Ppe gear
• Absorbent material
• Disinfectants
• Clean agents
• Instructions on how to remove stain

Infection Controls

• The condition that results after a microbial body has in effect taken over the body
• Microbes is now known as bacteria such as fungi protozoa and/ or viruses
• In most cases the cause the death from certain infections

Body Bacteria:

• Bacteria will be at the upper part of the respiratory which including Staph
• GI infection
• Strep

Contagious infections

• The most pathogenic germs are called communicable diseases.
• The CDC is mainly charged with investigation and control

Types of contagious infections:

• HIV
• INFLUENZA
• MEASLES
• MUMPS
• SARS -VRE

Breaking the Chain of Infection

• Hand washing
• Nutrition
• Rodent Control

Policy infection control

• Hand hygiene
• Use ppe such as gloves
• Wearing masks
• Standard procedure is to assume the sample is intact

Chemical and eye first aid

• Chemical splashes affected area with water
• Remove clothing
• Wounds should be cleaned