Lecture 1 - Lab Safety.pdf
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LAB- SAFETY & HAZARDS...
LAB- SAFETY & HAZARDS Special Diagnostic Procedures: Lecture 1 Rich King T. Valdez, RMT Illustration by Smart-Servier Medical Art Illustration by Smart-Servier Medical Art Learning Objectives: Special Diagnostic Procedures: Lecture 1 1. Discuss the different Agencies/Departments responsible for Laboratory Safety 2. List down the Employees and Employers responsibilities 3. Classify the different Laboratory hazards 4. Discuss the Safety Measure for each Laboratory Hazards Special Diagnostic Procedures: Lecture 1 Why do we need to learn about Safety and Hazards? Illustration by Smart-Servier Medical Art Illustration by Smart-Servier Medical Art Laboratory Safety Special Diagnostic Procedures: Lecture 1 Containment principles, technologies and practices that are implemented to prevent unintentional exposure to biological agents or their inadvertent release What are the Different Agencies/ Departments responsible for Special Diagnostic Procedures: Lecture 1 Laboratory Safety? 1. Occupational Safety and Health Administration (OSHA) Enacted in 1970 – PL 91-596 The goal of this federal regulation body is to provide all employees with safe work environment. Provides written manuals that define specific safety policies and procedures for all potential hazards required in laboratories. Provide guidelines for developing these written policies and procedures are provided in several Clinical and Laboratory Standards Institute (CLSI) documents PRIMARY STANDARDS: Special Diagnostic Procedures: Lecture 1 i. Bloodborne Pathogens - Applies to all exposure to blood or other POTENTIALLY infectious materials. - Mandates development of Control Plan. - Proper decontamination and safe handling. - *HBV vaccine ii. Hazard Communication Standard - Intended to ensure that hazards of all chemicals used in the workplace have evaluated. - Development of SDS – Safety Data Sheet. PRIMARY STANDARDS: Special Diagnostic Procedures: Lecture 1 iii. Occupational Exposure to Hazardous Chemicals in Laboratories - OSHA Lab Standard - Appointment of Chemical Hygiene Officer. - Development of Chemical Hygiene Plan. OTHER PRIMARY STANDARDS: iv. Formaldehyde Standard v. Respiratory Protection Standard vi. Air Contaminants Standard vii. Protective Equipment Standard What are the Different Agencies/ Departments responsible for Special Diagnostic Procedures: Lecture 1 Laboratory Safety? 2. The Clinical and Laboratory Standards Institute (CLSI) formerly National Committee for Clinical Laboratory Standards a non-profit educational organization that sets voluntary consensus standards for all areas of clinical laboratories provides excellent general laboratory safety and infection control guidelines What are the Different Agencies/ Departments responsible Special Diagnostic Procedures: Lecture 1 for Laboratory Safety? 3. Center for Disease Control and Prevention (CDC) a federal agency that carries out mandated public health laws and reporting requirements 4. The Joint Commission (JC) Ensure quality healthcare for patients, prevent harm, and improve Advocacy. What is Standard Precaution and Universal Precaution? Special Diagnostic Procedures: Lecture 1 Universal Precaution - All patients are considered to be possible carriers of blood borne pathogens. Wearing of Personal Protective Equipment when handling/collecting blood and bodily fluids contaminated with blood. Body Substance Isolation Guidelines – Consider all body fluids and moist body substances to be infectious“ Standard Precaution - combines major features of Universal Precautions and BSI Guidelines What are the Employer’s and Employee’s Responsibilities? Special Diagnostic Procedures: Lecture 1 Employer’s Employee’s Establish laboratory work Know and comply with the methods and safety policies established laboratory safe work Provide supervision and guidance practices to employees Have a positive attitude toward Provide safety information, supervisors, coworkers, facilities, training, PPE, and Medical and safety training surveillance to employees. Be Alert and give prompt Provide and maintain equipment notification of unsafe conditions and facilities that are free of and practices are corrected. recognized hazards and adequate Engage in the conduct of safe work for the task required. practices and use of PPE. WHAT ARE THE DIFFERENT TYPES OF HAZARD? Special Diagnostic Procedures: Lecture 1 I. Biological II. Sharps V. Electrical III. Chemical VI. Radiation IV. Fire: NFPA VII. Ergonomics I. BIOLOGIC HAZARD Special Diagnostic Procedures: Lecture 1 ▪ What is Biological hazard? ▪ What are the Nosocomial Infection? ▪ What is Chain of Infection? ▪ What is a BSC? ▪ In case of Spill what should be done? ▪ What is Sterilization and Disinfection? ▪ What is the proper disposal of Biological Waste? I. BIOLOGIC HAZARD Special Diagnostic Procedures: Lecture 1 What is a Biological hazard? - any patient specimen or body substance is considered infectious What are the different kinds of Nosocomial Infection? BACTERIA VIRUS FUNGI Acinetobacter Hepatits A,B,C Candida auris Burkholderia cepacia HIV/AIDS Clostridioides difficile Influenza Clostridioides Sordellii Norovirus Enterobacterales (CR) ESBL- Enterobacterales MRSA, VRSA, VISA, Nontuberculous Mycobacteria TB VRE I. BIOLOGIC HAZARD Special Diagnostic Procedures: Lecture 1 What is a Chain of Infection? a continuous link in the transmission of harmful microorganisms between a source and a susceptible host Key components of a Chain of Infection Infectious Agent: Bacteria, Viruses Reservoir: Patient Portal of Exit: Aerosols Mode of Transmission: Inhalation Portal of Entry: Respiratory Tract Susceptible Host: HCW Special Diagnostic Procedures: Lecture 1 I. BIOLOGIC HAZARD Special Diagnostic Procedures: Lecture 1 How to break a Chain of Infection? Disinfection Hand Hygiene - Handwashing Sealed specimen container PPE Standard Precaution I. BIOLOGIC HAZARD Special Diagnostic Procedures: Lecture 1 What is a BSC? - Biosafety Cabinet (BSC) is a specialized containment device designed to provide a safe working environment for laboratory personnel and to protect the external environment from exposure to potentially hazardous materials Key features - Containment - Airflow Control - HEPA Filtration - Work Area Classes of BSC Special Diagnostic Procedures: Lecture 1 Aspect Class I BSC Class II BSC (A1, A2, B1, B2) Class III BSC Complex pattern: Recirculation Totally enclosed; All air Airflow Direction From lab towards operator and exhaust exhausted Operator and environment; Operator, environment, and Highest level for operator, Protection Limited product product environment, and product Handling of low to moderate-risk Handling of low to high-risk Handling of highly hazardous Common Use agents agents agents Open front; Partial barrier to Partial enclosure; Barrier to Totally enclosed; No direct Enclosure product product access to cabinet interior Part recirculated, part All air exhausted through HEPA Exhaust Depends to the Type exhausted outside filters Common Cell culture, microbiology, Handling of highly infectious Sample weighing, chemicals Applications virology agents Classes of BSC Class II Special Diagnostic Procedures: Lecture 1 BSC CLASS II TYPE A1 TYPE A2 TYPE B1 TYPE B2 Inflow Velocity 75 100 100 100 Exhaust air % 30% 30% 50% 100% Re-circulation air % 70% 70% 50% 0 Exhaust air Internal environment Internal environment External environment External environment Destination I. BIOLOGIC HAZARD Special Diagnostic Procedures: Lecture 1 Sterilization Disinfection - Process of eliminating or destroying all forms of microbial life, including - involves the reduction of the number bacteria, viruses, fungi, and spores. of pathogenic microorganisms on surfaces, instruments, or in the - The goal of sterilization is to render environment to a level that is an object or surface completely free considered safe for public health of viable microorganisms that could cause infection or contamination. I. BIOLOGIC HAZARD Special Diagnostic Procedures: Lecture 1 ▪ What to do in case of Blood or Body Fluid Spill? Alert others in area of the spill. Use mechanical devices to pick up broken glass Absorb the spill with paper towels, gauze pads, or tissue. Clean the spill site using a common aqueous detergent. Disinfect the spill site using approved disinfectant or 10% bleach, using appropriate contact time. Rinse the spill site with water. Dispose of all materials in appropriate biohazard containers These wastes must be placed in a yellow colored bag. I. BIOLOGIC HAZARD Special Diagnostic Procedures: Lecture 1 What is the Proper waste Disposal of Biological Hazard? All biologic waste, except urine, must be placed in appropriate containers labeled with the biohazard symbol The waste is then decontaminated following institutional policy: incineration, autoclaving, pickup by a certified hazardous waste company. Urine: directly down a sink or toilet, with caution taken to avoid splashing. rinse the sink well with water after discarding specimens and at least daily with a 0.5% bleach (sodium hypochlorite) solution Noninfectious glass such as empty reagent bottles and non-hazardous waste such as emptied urine containers are considered normal waste and require no special precautions for disposal. II. SHARPS HAZARD Special Diagnostic Procedures: Lecture 1 A. What is Sharp Hazard? B. What are the things to consider with Biohazard Sharp Container? C. In case of Accidental Prick -What should we do? II. SHARPS HAZARD Special Diagnostic Procedures: Lecture 1 What is Sharp Hazard? - includes: needles, lancets, and broken glassware What are the things to consider with Biohazard Sharp Container? - must be disposed of in a puncture-resistant, leakproof container with the biohazard symbol. Special Diagnostic Procedures: Lecture 1 II. SHARPS HAZARD Special Diagnostic Procedures: Lecture 1 In case of Accidental Prick - What should we do? - Communicate with your supervisor. - PEP and PrEP. III. CHEMICAL HAZARD Special Diagnostic Procedures: Lecture 1 A. What is Chemical Hazard? B. What are the Routes of Chemical Exposure? C. What are the different types of Chemical hazard? D. What is CHP? E. What must be included with the Chemical Labeling F. How to Handle Chemical Hazard? G. Safety Tips III. CHEMICAL HAZARD Special Diagnostic Procedures: Lecture 1 What is Chemical Hazard? Refers to the potential danger or risk posed by a chemical substance that may cause harm to individuals, the environment, or property. Chemical hazards can arise from exposure to various types of chemicals, including solids, liquids, gases, and vapors, in different settings such as workplaces, homes, laboratories, and industrial facilities. III. CHEMICAL HAZARD Special Diagnostic Procedures: Lecture 1 What are the Routes of Chemical Exposure? Route of Exposure Description Examples Entry through the respiratory system Gases, vapors, dust, Inhalation by breathing in airborne substances. aerosols. Entry through the digestive system by Contaminated food, water, or Ingestion swallowing substances. objects. Absorption through the skin, the outer Direct contact with liquids, Dermal layer of the body. powders, solutions. Absorption through the skin or Contact with skin, eyes, nose, Percutaneous mucous membranes (includes dermal mouth. exposure). III. CHEMICAL HAZARD Special Diagnostic Procedures: Lecture 1 What are the different types of Chemical hazard? - i. Corrosive Hazards - Irreversible injuries to the skin or eyes by direct contact or to the tissue of the respiratory and GI tracts if inhaled or ingested - ii. Reactive Hazards – Substances under certain conditions can spontaneously explode or ignite or that can evolve heat or flammable or explosive gases III. CHEMICAL HAZARD Special Diagnostic Procedures: Lecture 1 What are the different types of Chemical hazard? - iii. Carcinogenic Hazards – Substances that have been determined to be cancer causing agents. - iv. Irritants - Chemicals that can cause allergic reactions or sensitization in individuals upon exposure. III. CHEMICAL HAZARD Special Diagnostic Procedures: Lecture 1 v. Flammable Chemicals - Causes fire or explosion. They are classified according to flash point, which is the temperature at which sufficient vapor is given off to form an ignitable mixture with air. III. CHEMICAL HAZARD Special Diagnostic Procedures: Lecture 1 v. Flammable Chemicals – TWO TYPES Characteristic Flammable Materials Combustible Materials Ignite easily and have a low ignition temperature. – FP Require higher temperatures to ignite. Ignition Temperature 37.8°C (100°F) FP at or above 37.8°C (100°F). Flash Point Have a low flash point (below room temperature). Have a higher flash point (above room temperature). Vapor and Gas Can easily form flammable vapors and gases. Tend to release vapors and gases less easily. Examples Gasoline, ethanol, propane. wood, paper. Require special precautions due to their high Handling Precautions Still pose fire hazards but with somewhat lower risk. flammability. III. CHEMICAL HAZARD Special Diagnostic Procedures: Lecture 1 CHEMICAL SAFETY MSDS - Spill and disposal procedures. - Product name and - PPE recommendations. - identification. - Handling. - Hazardous ingredients. - Permissible exposure limit - Emergency and first aid - Physical and chemical data procedures. - Health hazard data and - Storage and transportation carcinogenic potential. precautions. - Primary routes of entry - Chemical manufacturer’s name, - Fire and explosion hazards. address, and telephone number - Reactivity data - Special information section Special Diagnostic Procedures: Lecture 1 III. CHEMICAL HAZARD Special Diagnostic Procedures: Lecture 1 What is CHP? - Chemical Hygiene Plan - Safety policies and procedures for all hazardous chemicals used in the laboratory - employee “right to know” requires chemical manufacturers, importers, and distributors to provide safety datasheets (SDS) Special Diagnostic Procedures: Lecture 1 Special Diagnostic Procedures: Lecture 1 III. CHEMICAL HAZARD Special Diagnostic Procedures: Lecture 1 How to handle Chemical Hazard? - prohibiting pipetting by mouth or the sniffing of chemicals - appropriate use of PPE (gloves, gowns & goggles) - a fume hood or safety cabinet Chemical Safety tips - never grasp a reagent bottle by the neck or top - always add acid to water - safety equipment: eyewash and shower IV. FIRE HAZARD Special Diagnostic Procedures: Lecture 1 A. What is Fire Hazard? NFPA? B. What are the types of Fire and How to extinguish it? C. In case of Fire, how will you handle it? IV. FIRE HAZARD Special Diagnostic Procedures: Lecture 1 What is Fire Hazard? - Substances that can catch fire or explode under certain conditions. - What are those condition? IV. FIRE HAZARD Special Diagnostic Procedures: Lecture 1 What is NFPA - National Fire Protection Association (NFPA) - a bright, color-coded labels are divided into quadrants: health (blue) flammability (red) reactivity (yellow) any special considerations (white) Special Diagnostic Procedures: Lecture 1 What are the CLASSES of Fire and How to extinguish it? Special Diagnostic Procedures: Lecture 1 Special Diagnostic Procedures: Lecture 1 V. ELECTRICAL HAZARD Special Diagnostic Procedures: Lecture 1 A. What is electrical hazard? B. Things to consider to avoid this hazard. C. In case of Electrical Accident, what to do? V. ELECTRICAL HAZARD Special Diagnostic Procedures: Lecture 1 What is electrical hazard? - refers to a potential danger or risk associated with the presence, use, or handling of electricity. Things to consider to avoid this hazard. - Use only explosion-rated equipment in hazardous atmosphere - Never operate electrical equipment with wet hands. - Promptly report any malfunction or tingle in equipment - Have ground, polarity, and leakage checks and other periodic preventive maintenance - Know the exact location of the electrical control panel V. ELECTRICAL HAZARD Special Diagnostic Procedures: Lecture 1 In case of Electrical Accident, what to do? 1. Ensure Safety 2. Call for Emergency Help 3. Do Not Touch the Victim 4. Check for Responsiveness 5. Administer CPR VI. RADIATION HAZARD Special Diagnostic Procedures: Lecture 1 1. What is Radiation hazard? 2. Things to consider to avoid this hazard. 3. Radiation Safety Tips. VI. RADIATION HAZARD Special Diagnostic Procedures: Lecture 1 What is Radiation hazard? - potential danger posed by the emission of ionizing or non-ionizing radiation. - procedures using radioisotopes How does Radiation Affect the body? VI. RADIATION HAZARD Special Diagnostic Procedures: Lecture 1 Type of Frequency Approximate Wavelength Source of Equipment Protective Measures Thermal protective clothing, Ultraviolet (UV) 4 nm - 400 nm UV lamps barriers Eye protection Thermal protective clothing, Visible Spectrum 400 nm - 750 nm Artificial lighting barriers Eye protection Heat lamps, electronic Thermal protective clothing, Infrared (IR) 750 nm - 1 mm devices barriers Eye protection Microwave ovens, Safe distance, avoid direct Microwaves 3 mm - 3 m communication devices exposure Safe distance, shielding, minimize prolonged Radiofrequency (RF) > 1 cm wireless communication exposure VI. RADIATION HAZARD Special Diagnostic Procedures: Lecture 1 Radiation Safety Tips- the protection of individuals and the environment from the harmful effects of ionizing radiation. - ALARA PRINCIPLE - Time, Distance, Shielding - PPE – Lead Aprons, Thyroid Shield - Radiation Signs and Labels - Radiation Monitoring Devices – - Radiation Safety Officer VI. RADIATION HAZARD Special Diagnostic Procedures: Lecture 1 How to Dispose Radioactive Material - Identify and Classify the Radioactive waste - Contact Regulatory Authorities - Ship Waste According to Regulations VII. ERGONOMIC HAZARD Special Diagnostic Procedures: Lecture 1 A. What is Physical hazard? B. Things to consider to avoid this hazard. C. Safety Tips VII. ERGONOMIC HAZARD Special Diagnostic Procedures: Lecture 1 What is Physical hazard? - refers to a type of danger or risk in the environment that can cause harm to individuals, property, or the surrounding area due to its physical characteristics. Things to take note: avoid running in rooms and hallways watch for wet floors bend the knees when lifting heavy objects maintain a clean, organized work area closed-toed shoes REFERENCES: Special Diagnostic Procedures: Lecture 1 Clinical and Laboratory Standards Institute (CLSI): guideline, ed 3, CLSI Document GP16-A3, CLSI, Wayne, PA, 2009. National Fire Protection Association: Hazardous chemical data, Boston, 1975, National Fire Protection Association, No. 49. Clinical Chemistry Principles, Techniques, and Correlations. Bishop. 2019 Strasinger, S. M, Urinalysis and Body Fluids (6th Edition). Publisher. Occupational exposure to hazardous chemicals in laboratories, final rule, Federal Register 55:3327–3335, 1990. Biosafety in Microbiological and Biomedical Laboratories, 2019 WHO, CDC, AMA, Red-Cross DOH & San Lazaro Hospital Guidelines
