PMLS 037 Medical Laboratory Science Laboratory Safety Procedures PDF

TOPIC 5: BASIC ON LABORATORY PMLS 037 | PRINCIPLES OF MEDICAL LABORATORY SCIENCE 1 | Period 2 __________________________________________________________________________________________ LABORATORY SAFETY 75 - 80 C for 2 hours 3 successive days. Not all heroes wear caps. That’s us! B. DRY HEAT - kills by oxidation Laboratory safety rules are a major aspect of every clinical a. ﬂame - to sterilize inoculating loops and needles laboratory. Each student in a clinical laboratory must follow speciﬁc b. oven - 160-180 C for 1.5 to 2 hours safety rules and procedures. Quality Control = Bacillus subtilis var. niger WHY IS LABORATORY SAFETY IMPORTANT c. incineration - most common method of treating infectious ➔ Laboratory safety rules and symbols are needed so that waste. burned ashes at 870-980 C. students and or workers do not include themselves or their classmates or workers. 2. FILTRATION 2 WIDELY USED METHODS IN THE LABORATORY Asbestos Filter Membrane Filter STERILIZATION DISINFECTION Method of choice for antibiotics solutions, toxic chemicals, radioisotopes, vaccines and carbs which are all heat Is a process where all Is a process whereby sensitive. forms of microbial life pathogenic organisms, Filtration of air is accomplished using HEPA (High including bacterial but not necessarily all Efﬁciency Particulate Air) ﬁlters designed to remove spores, are killed microorganisms or organisms larger than 0-3 nanometer from isolation may be accomplished spores are destroyed. rooms, operating rooms, and biological safety by physical or may be accomplished cabinets(BSCs). chemical means by physical and chemical methods. 3. IONIZATION RADIATION METHODS OF STERILIZATION used in plastic syringe, catheter or gloves short wavelength, high energy gamma rays, ionizing PHYSICAL METHODS OF STERILIZATION gamma radiation used for evacuated tubes 1. HEAT A. MOIST HEAT - Coagulate Proteins CHEMICAL METHODS OF STERILIZATION 1. Ethylene Oxide (ETO) Autoclave. Most common sterilant most effective method of sterilization, 121 C at 15 PSI Quality control = Bacillus subtilis (pounds per square inch/pressure of autoclave) for 15 minutes 2. Formaldehyde vapor and vapor phase hydrogen peroxide infectious medical waste is often sterilized at 132 C for 30 sterilized HEPA ﬁlters in BSCs - 69 minutes. 3. Glutaraldehyde Quality Control = Bacillus stearothermophilus sporocidal in 3-10 hours, is used in the medical equipment cold sterilization. Quality control ensures equipment operates correctly. Bacillus stearothermophilus is used to test autoclaves: if the bacterium is 4. Peracetic acid killed after 15 minutes, the autoclave is functioning properly; used in surgical equipment otherwise, there's an issue. cold sterilization Fractional. alternative heating (kills vegetative cell), METHODS OF DISINFECTION incubation (spores germinate), heating kills remaining vegetative cells. PHYSICAL METHODS OF DISINFECTION a. Tyndallization ﬂowing steam 100 C for 30 minutes for 3 successive days. 1. BOILING b. Inspissation 100 C for 15 minutes which kills vegetative e. Gloves 2. Pasteurization 2. DOFFING OF PPE - taking off the PPE a. Gloves kills milk borne pathogens b. Perform hand hygiene c. Hair cap / Bouffant cap a. Batch method = 63 C for 30 minutes d. Perform hand hygiene b. Flash method = 72 for 15 minutes e. Goggles/Eye protection f. Perform hand hygiene g. Mask 3. Non-ionizing Radiation h. Perform hand hygiene i. Lab gon long wavelength and low energy j. Perform hand hygiene do not penetrate well, direct surface exposure such as working surface of BSC (Biological Safety Cabinet) CHEMICAL METHODS OF DISINFECTION 1. Disinfectant destroys vegetative forms of on inanimate objects Phenol, QUATS, Chlorine, 2% glutaraldehyde alcohols, aldehydes, halogens, heavy metals, quaternary ammonium compounds 2. Antiseptic microbiostatic agents on living tissues alcohol, iodine tincture (alcohol), iodophor (iodine - detergent) DO’S AND DON'TS IN THE LABORATORY Common Protocols for Control of Microbial Growth 1. WEAR PROTECTIVE CLOTHING Gloves are essential Laboratory coat are required Safety goggles may be required to avoid splashes BIOLOGICAL INDICATORS ➔ Biological indicators means bacteria for quality control. 2. LABORATORY PERSONNEL SHOULD NOT WEAR SANDALS Autoclave = Bacillus stearothermophilus or Clostridium DO NOT WEAR: PA3679 Jewelry Ionizing Radiation = Bacillus pumilus Loose or Baggy clothing Dry Heat Oven = = Bacillus subtilis variation niger Wearing crocs is not recommended since it is not close. Ethylene Oxide = Bacillus subtilis variation globljii CONTINUATION OF DO’S AND DON'TS PROPER WEARING OF PPE (PERSONAL PROTECTIVE EQUIPMENT) 3. Avoid touching objects (e.g pencils, cell phones, door handles) while wearing gloves 1. DONNING OF PPE - wearing the PPE. 4. Pencils, labels, or any other materials should never be placed ↑ a. Lab gown in your mouth b. Mask 5. Caution must be taken when using gas burners. Be sure gas c. Goggles/Eye protection burners are turned off when ﬁnished. d. Hair cap / Bouffant cap 6. Long hair must be tied or covered to minimize ﬁre hazards or Fire Blanket contamination of experiments. 7. Do not eat food or drink water in the laboratory. Do not use laboratory glass wares as food or water containers. 8. Protect your hand safety: Wash hands before and after every laboratory experiment Handle glassware, sharp tools and heater containers carefully 9. Electrical Safety: Unplug electrical equipment after use Keep all electrical cords and wired away from water 10. Chemical Safety: Biological Safety Cabinet Never touch, taste, or smell a chemical unless instructed to do so. Never mix chemicals unless instructed to do so Keep lids on chemical containers when not in use 11. Do not take any cultures out of the laboratory All cultures should be handled as potential pathogenic Liquid cultures must always be kept in a test tube rack 12. Do not engage in practical jokes or horseplay in a laboratory 13. Keep nonessential books and clothing far away from your work area 14. Wipe the bench tops with disinfectant both before you begin your work and after you have completed your work. 15. Dispose of waste products according to instructions 16. Report all accidents no matter how minor to your supervisor SYMBOLS They alert about the possible dangers in the laboratory LABORATORY EQUIPMENT Emergency eyewash Emergency shower UNIVERSAL PRECAUTION All patients are considered to be possible carriers of blood borne pathogens. Wearing gloves when collecting and handling blood and body ﬂuids contaminated with blood. Fire Extinguisher The CDC (Centers for Disease Control and Prevention) excluded urine and body ﬂuids not visibly contaminated by blood from UP (Universal Precaution) BSI (Body Substance Isolation) guidelines are not limited to blood borne pathogens; they considered all body ﬂuids and most body substances to be potentially infectious. According to BSI guidelines, personnel should wear gloves at all times when encountering most body substances. They do not recommend hand washing after removing gloves unless visual contamination is present. 2. Single-use items are discarded properly. STANDARD PRECAUTION In 1996 the CDC (Centers for Diseases Control Preventation) ENVIRONMENTAL CONTROL and HIPAC (Health Infection Control Practices Advisory Committee) combined the major features of UP and BSI Ensure that the hospital has adequate procedures for the guidelines. routine care, cleaning, and disinfection of environmental surfaces, beds, bed rails, bedsides equipment, and other frequently touched surfaces. HAND HYGIENE includes both hand washing and the use of alcohol-based LINEN antiseptic cleaners. Handle transport, and process, linen soiled with blood, body sanitize hands immediately after; ﬂuids, secretions, and execrations in a manner that prevents 1. touching blood, body ﬂuids, secretions, and contaminating it skin and mucous membranes exposure, clothing whether or not gloves are worn. contamination, and transfer of microorganisms to other 2. gloves are removed, between patient contacts patients or environments Sanitizing hands may be necessary between tasks and procedures on the same patient to prevent cross contamination procedures on the same patient to prevent OCCUPATIONAL HEALTH AND BLOOD BORNE PATHOGENS cross contamination. Never recap needles or otherwise manipulate them using both hands or use any other equipment directing the point of GLOVES a needle toward any part of the body; rather, use self-sheathing needles or a mechanical device to conceal the Wearing gloves (clean, non sterile gloves are adequate) when needle. touching blood, body ﬂuids, secretions, and contaminated Do not; items 1. Remove used unsheathed needles from disposable syringes change gloves between task and procedures on the same by hand. patient after contacting materials with high concentration of 2. Bend, break, or otherwise manipulate used needles by hand microorganisms Placed used needles and other sharp items in remove gloves after use, before touching non-contaminated appropriate puncture-resistance containers items and environmental surfaces, and between patients, PATIENT PLACEMENT MOUTH, NOSE AND EYE PROTECTION Place patient in a private room who contaminates the Wear a mask and eye protection or face shield to protect environment or who does not (or cannot be expected to) mucous membranes of the eyes, nose, and mouth during assist in maintaining appropriate hygiene or environment procedures and patient care activities that are likely to control. generate splashes or sprays of blood, body ﬂuids, secretions, If a private room is unavailable, consult with infection control or excretions professionals regarding patient hygiene placement or other an N95 mask must be used during patient care activities alternatives. related to suspected mycobacterium exposure RESPIRATORY HYGIENE OR COUGH ETIQUETTE GOWN Educate health-care personnel, patients, and visitors to ○ contain respiratory secretions to prevent droplet Wear a clean, nonsterile gown, gown to protect skin and to and formite transmission of respiratory pathogens prevent soiling of clothing during procedures and activities ○ Offer mask ro coughing patients, distance that are likely to generate splashes or symptomatic patients from others Sprays of blood, body ﬂuids, secretions or excretions ○ Practice good hand hygiene Select a gown that is appropriate for the activity and the amount of ﬂuid likely to be encountered Remove soiled gown as promptly as possible UNIVERSAL VS STANDARD PRECAUTION Sanitize hands to avoid transferring microorganisms to other patients or environment INFECTION CONTROL GUIDELINES USED IN HEALTHCARE SETTINGS TO MINIMIZE THE RISK OF SPREADING INFECTIOUS DISEASE PATIENT CARE EQUIPMENT UNIVERSAL PRECAUTION STANDARD PRECAUTION Handle used patient care equipment soiled with blood, body 1987 CDC PUBLISHED 1996 these safety ﬂuids, secretions, and execrations in a manner that prevents guidelines known as UP recommendations skin and mucous membranes exposure, clothing developed in response become known as contamination, and transfer of microorganisms to other to the HIV epidemic Standard Precautions patients or environments To reduce risk of HBV evolving form UP to Ensure that; transmission of include wider range 1. Reusable equipment is not used for the care of another bloodborne pathogens, of precautions for patient until it has been cleaned and reprocessed primarily HIV various infections appropriately hypersensitivity reactions often characterized by facial Main focus, treatment agents, expansions ﬂushing and breathing difﬁculties all human blood and and modiﬁcation of Replacing latex gloves with nitrile or vinyle gloves provides certain human body UP an alternative ﬂuids as infections for These precautions Fluid resistant laboratory coats with wrist cuffs are worn to bloodborne pathogens require that blood protect clothing and skin from exposure to patient’s body regardless of the and ﬂuids from every substances perceived risk patient be treated as Disposable coats are placed in containers for biohazardous Rigid and more focused potentially infectious. waste, and nondisposable coats are placed in on speciﬁc types of Designed to reduce designatedlaundry receptacles ﬂuids the risk of Shoes must be closes-toed and cover the entire foot infections controls: PPE transmissions of a A variety of protective equipment available, including masks (gloves, gowns, masks broader range of and goggles, full-face plastic shields that cover the front and and eye production) infectious agents, the sides of the face, mask with attached shield, and Plexiglas including those countertop shield transmitted by respiratory droplets or contact with contaminated surfaces. Wider range of infections control: proper hygiene, PPE, safe injection practices, respiratory hygiene, cough etiquette, safe handling potentially contaminated equipment and surfaces, and strategies to prevent OSHA Regulation transmission of (Occupational Safety and Health Administration) infectious agent in healthcare settings. ➔ Healthcare facilities provide employees with all PPE necessary to protect themselves from hazards encounter during the course of work. UNIVERSAL PRECAUTIONS WERE A FOUNDATIONAL CONCEPT THAT LAID THE GROUNDWORK FOR INFECTION CONTROL AND STANDARD PRECAUTIONS EXPANDED THESE PRACTICES TO BE DONNING OF PPE MORE COMPREHENSIVE AND ADAPTABLE TO A WIDER RANGE OF INFECTIOUS DISEASES. THE TRANSITION FROM UNIVERSAL TO 1) Perform hand hygiene STANDARD PRECAUTIONS REFLECTS A MORE HOLISTIC 2) Put on gown APPROACH TO INFECTION PREVENTION IN HEALTHCARE SETTINGS. 3) Put on surgical mask or P2 or N95 respirator 4) Put on protective eyewear or face shield 5) Put on gloves Personal Protective Equipment (PPE) Disposable gloves DOFFING OF PPE Surgical masks/respirators/N95 goggles/eye visors 1) Remove gloves Faceshields shee covers 2) Perform hand hygiene Bouffant cap/hairnet 3) Remove gown 4) Perform hand hygiene Lab gown/labsuit/isolation gown 5) Remove goggles or face shield 6) Perform hand hygiene PPE used in the laboratory includes gloves, ﬂuid-resistant 7) Remove mask or respirator gowns, eye and face shield, and plexiglas countertop shield 8) Immediately perform hand hygiene When specimens are collected, gloves must be changed between patients every patient A variety of glove types are available: ○ Sterile and nonsterile HAND HYGIENE ○ Powdered and unpowdered ○ Latex and nonlatex Hand contact is the primary method of Infection transmission, Allergy on latex is increasing among health workers Laboratory personnel must always sanitize hands before Reactions to latex include irritant contact dermatitis, which patient contact, after gloves are removed, been leaving the produces patches of dry, itchy irritation on the hands; delayed work area, at any time when hands have been knowingly hypersensitivity reactions resembling poison ivy that appeaer contaminated. 24-28 hours after exposure; and true, immediate Hand Hygiene includes both hand washing and using alcohol-based antiseptic cleaners. Alcohol-based cleaners can be used when hands are not MURPHY’S LAW: APPLICATION TO DISASTER MANAGEMENT visibly soiled; hand washing when hands are visibly soiled. Hand washing is the best way to break the CHAIN OF “Anything that can go wrong will go wrong” INFECTION. (Murphy) HISTORY OF MURPHY’S LAW The author of the law, Edward Murphy, was an engineer in the US air force He was involved in a project called Gee whiz where they would assess on what will happen to a person when decelerated rapidly in a certain g-force The project used a chimpanzee as a tribute for better results after multiples trials with a humanoid Everything was ready until one of his assistant accidentally switched the instruments and installed the wrong way resulting to no data collected Murphy stated that “if there are two ways to do things and one of those ways result in a disaster then he will do it that way” Hence, if anything can go wrong, will go wrong…at the worst possible moment MURPHY’S LAWS 1st Law: ○ Nothing is as easy as it looks. 2nd Law: ○ Everything takes longer than you think. 4th Law: ○ If there is a possibility of several things going wrong, the one that will cause the most damage will be the one to go wrong. 5th Law: ○ If anything just cannot go wrong, it will anyway. 6th Law: ○ If you perceive that there are four possible ways in CHAIN OF INFECTION which a procedure can go wrong and circumvent these, then a ﬁfth way, unprepared for, will promptly develop. POSTULATES OF MURPHY’S LAW Anything that can go wrong, will go wrong You will always ﬁnd something in the last place you look No matter how long or hard you shop for an item, after you’ve bought it, it will be on sale somewhere cheaper The other line moves faster If it jams, force it. If it breaks, it needs replacing anyway Build a system that even a fool can use, and only a fool will use it MURPHY’S LAW AND DISASTER MANAGEMENT After the tragedy of the Gee Whiz, Col. Stapp, told his subordinates to prepare every project with Murphy’s law in mind, because anything can go wrong Entire months of practices were destroyed in a few minutes of testing and they cannot do anything about it but pivot by doing the project and recover all materials that they can use again Bad things do happen, even to good people Preparation for disaster is the key. As the saying goes, “an ounce of prevention is worth a pound of cure.” Murphy’s 1st law reminds us of the importance of risk assessment and the value of investment of risk prevention However, hard organizations try and however, much they ○ Wide enough to accommodate the number of invest inr isk prevention, they never completely identify and evacuating personnel eliminate all risk ○ Clear and unobstructed at all times The rules of mathematics are clear; regardless of how small ○ Unlikely to expose evacuating personnel to the probability of risk occurence, given enough time it is additional hazards certain to happen Have evacuation routes evaluated by someone not in your Murphy’s law aware is that always install the fail-safes organization Fail-safes are referred to as “idiot-proofs”. Murphy’s law still has the tendency to strike even the care ASSEMBLY AREAS & ACCOUNTABILITY (idiot-proof) has been taken against the failure So this leads us to compare murphy’s law with one more law Accurately accounting for personnel after a site evacuation called “Grave’s Law”. Which states that: requires planning and practice. “If you make something idiot-proof, the world will create a 1. Designate assembly areas where personnel should better idiot.” gather after evacuating 2. Take a head count after the evacuation - determining the names and last known locaitons of SYSTEMIC AND DEPLOYABLE EVACUATION PLAN personnel not accounted for. List to be given to Emergency Operations Center 3. Establish a method for accounting for EMERGENCY EVACUATION PLAN non-employees such as suppliers and customers Protecting the lives of everyone within your facility is the ﬁrst 4. Establish procedures for further evacuation in case priority in the event of an emergency the incident expands. This may involve sending One common means of protection is evacuation emplotees home by normal means or providing In the case of ﬁre, an immediate evcacuation to a them with transportation to an off-site location predetermined area away from your facility may be necessary TRAIN YOUR EMPLOYEES IN EVACUATION STEPS TO DEVELOP AN EVACUATION POLICY & PROCEDURE CONDUCT sessions at least annually or when: Determine the conditions under which an evacuation would ○ New employees are hired be necessary ○ Evacuation wardens, shelter managers, and othe Establish a clear chain of command with special assignments are designated Establish speciﬁc evacuation procedures ○ New equipment, materials or processes are Establish a system for accounting for personnel - consider introduced employees’ transportation needs for community-wide ○ Procedures are revised evacuations ○ Exercise show that employee performance must be Establish procedures for assissting personnel with disabilities improved and those who do not speak English. Post evacuation PROVIDE emergency information such as checklists and procedures evacuation maps Designate personnel to continue or shut down critical POST evacuation maps in strategic locations operations while an evacuation is underway. They must be CONSIDER the information needs of customers and others capable of recognizing when to abandon the operation and who visit your facility evacuate themselves Coordinate plans with your local emergency management FIRE EXTINGUISHER ofﬁce EVACUATION ROUTES & EXITS HOW TO USE A FIRE EXTINGUISHER Designate primary and secondary evacuation routes and exits ○ Make sure routes and exits are clearly marked and well lit ○ Post signs ○ Install emergency lightning in case a power outage occurs during an evacuation. Ensure evacuation routes and emergency exits are: FIRE EXTINGUISHER TYPES HAZARDOUS MATERIALS CLASSIFICATION TOPIC 6: TYPES OF HAZARDS IN THE LABORATORY PMLS 037 | PRINCIPLES OF MEDICAL LABORATORY SCIENCE __________________________________________________________________________________________ LABORATORY SAFETY BIOLOGIC HAZARD ➔ Is a concern for all personnel Consist of pathogens (disease producing agents) that can be ➔ Vital part of any total quality control program transmitted through various routes of exposure. ➔ Involves injuries that affect the morale and threatens the The chain of infection requires a continuous link between an emotional and physical health of individuals infectious agent, a reservoir, a portal of exit, a means of transmission, a portal of entry and a susceptible host. WHY IS LABORATORY SAFETY IMPORTANT? CHAIN OF INFECTION To prevent Exposure: ○ Adverse health effects from exposure ○ Exposure to organisms, diseases, etc. in laboratories Laboratory equipment hazards if not maintained properly. HAZARDS OF THE WORKPLACE: A MATTER OF ATTITUDE We must be constantly aware of the safety elements that surround us. Take the steps that are conducive to a safe working environment. Ensure that the measures necessary to protect ourselves from any threats to our well-being are in place. The role of the employee: The individual must ultimately assume responsibility for his or 1. INFECTIOUS AGENTS her health and safety. Infectious agents consist of bacteria, fungi, parasites, and The role of the employer: viruses. Obligated both morally and legally to see that employees have the training, support, equipment, workload, resources, environment and oversight necessary to perform in a safe and 2. RESERVOIR (live) secure manner. The reservoir is the location of potentially harmful microorganisms, such as a contaminated clinical specimen or LABORATORY SAFETY MUST BE TAUGHT TO: an infected patient. It is a place where the infectious agent can live and possibly ★ All employees, including service groups multiply. ★ Undergraduate students Human and animals are excellent reservoirs ★ Graduate students ★ Professors ★ Visitors FOMITES equipment and other soiled inanimate objects GENERAL PROCEDURES OR RULES Will serve as reservoirs, particularly if they contain blood, urine, or other body ﬂuids Do not eat or drink in the laboratory Some microorganisms form spores or become inactive when No mouth pipetting conditions are not ideal and wait until a suitable reservoir in Wear required equipment available. No smoking in the laboratory Maintain good housekeeping habits 3. PORTAL OF EXIT TYPES OF HAZARDS The infectious agent must have a way to exit the reservoir to continue the chain of infection. This can be through the mucous membranes of the nose, mouth, and eyes, and in blood or other body ﬂuids. 4. MEANS OF TRANSMISSION ➔ Once the infectious agent has left the reservoir, it must have a way to reach a susceptible host. Urine may be discarded by pouring it into a laboratory sink Means of transmission include: under a Plexiglas countertop shield. Avoid splashing, and the sink should be ﬂushed with water Direct contact the unprotected host touches the after specimens are discarded patient, specimen, or a Disinfect sink using 1:5 or 1:10 dilution of sodium contaminated object (reservoir) hypochlorite and should be performed daily. Empty urine containers can be discarded as non biologically Airborne inhalation of dried aerosol hazardous waste. particles circulating on air currents or attached to dust DISPOSAL particles Must be placed in an appropriate container with a biohazard Droplet the host inhales material from symbol, then decontaminated the reservoir (e.g., aerosol Decontamination depends per institution: droplets from a patient or an uncapped centrifuge tube, or INCINERATION AUTOCLAVING when specimens are aliquoted or spilled). burning into ashes steam sterilization Vehicle ingestion of a contaminated (non-living) substance (e.g., food, water, SHARP HAZARD specimen) Includes needles, lancets, and broken glasswares Most dangerous because it can cause injury and infection Vector from an animal or insect bite All sharp objects must be disposed in puncture-resistant, (living) leak proof container with biohazard symbol. Biohazard sharp containers should not be overﬁlled and must always be replaced when the safe capacity mark is reached. ROUTES OF TRANSMISSION CHEMICAL HAZARD DIRECT INDIRECT Can be solid, liquid or gas which can harm the person touching airborne exposed to it biting/kissing vector-borne sexual intercourse vehicle-borne CHEMICAL SPILLS vertical transmission needlestick injury Ex. Fomites, Dust When comes in contact with the skin, best ﬁrst aid is to ﬂush droplets the area with large amount of water for at least 15 seconds, then seek medical attention. ➔ All laboratory personnel should know the location and proper 5. PORTAL OF ENTRY use of emergency shower and eye wash stations ➔ After infectious agent has been transmitted to a new reservoir ➔ The portal of entry can be the same as the portal of exit, CHEMICAL HANDLING which includes Acid should always be added to water to avoid the ◆ the mucous membranes of the nose, mouth, and possibility of sudden splashing caused by the rapid eye generation of heat in some chemical reactions. ◆ breaks in the skin Wearing goggles and preparing reagents under fume hoods ◆ open wounds. are recommended. Pipetting by mouth is unacceptable 6. SUSCEPTIBLE HOST ➔ The susceptible host can be another patient during invasive CHEMICAL LABELLING procedures, visitors, and healthcare personnel when exposed Hazardous chemicals should be labeled with a description of to infectious specimens or needle stick injuries. their particular hazard such as ➔ Once the chain of infection is completed, the infected host ○ poisonous, corrosive, ﬂammable, explosive, then becomes another source able to transmit the teratogenic, or carcinogenic microorganisms RADIOACTIVE HAZARD BIOLOGICAL WASTE DISPOSAL Radioactivity may be encountered in the clinical laboratory All biological waste, except urine, must be placed in when procedures using radioisotopes are performed. appropriate containers labeled with biohazard symbol, It can cause cancer and kill cells including both specimens and the materials with which the The amount of radioactivity present in the clinical laboratory specimens come in contact. is very small and represents little danger The waste is then decontaminated following institutional The effects of radiation are cumulative related to the amount policy: incineration, autoclaving, or pickup by a certiﬁed of exposure. waste company The amount of radiation exposure is related to a combination capsizing extinguisher. The acronym PASS can be used to of time, distance, and shielding. remember the steps in the operation: The symbol must be displayed on the doors of all areas where radioactive material is present Exposure to radiation during pregnancy presents danger to P.A.S.S. the fetus; personnel who are pregnant or think they may be should avoid areas with this symbol. ELECTRICAL HAZARD Laboratory settings contains a large amount of electrical equipment with which workers have frequent contact. May cause electric shock and burns, and ﬁre Equipment should not be operated with wet hands. All electrical equipment must be grounded with three-pronged plugs. When an accident involving electrical shock occurs, the following must be done: Turning off the circuit breaker Unplugging the current Moving the equipment using a nonconductive glass or wood object FIRE/EXPLOSIVE HAZARD Pull the pin Any actions, materials, or conditions that might increase the Aim at the base of the ﬁre size or severity of a ﬁre or that might cause a ﬁre to start are Squeeze handles ﬁre hazards Sweep nozzle side to side When a ﬁre is discovered, all employees are expected to take the actions in the acronym TYPES OF FIRE EXTINGUISHER RACE RESCUE rescue anyone in immediate danger ALARM activate the institutional ﬁre alarm system CONTAIN close all doors to potentially affected areas EXTINGUISH tempt to extinguish the ﬁre, if possible or evacuate, closing the door Flammable chemicals should be stored. Fire blankets may be present in the laboratory. Persons with burning clothes should be wrapped in the blanket to smoother the ﬂames. Degree of Hazards: It is important to be able to operate the ﬁre in a safety 0 - No or Minimal Hazard cabinets and explosion-proof refrigerators, and cylinders of 1 - Slight Hazards compressed gas should be located away from heat and 2 - Moderate Hazard securely fastened to a stationary device to prevent accidental 3 - Serious Hazard 4 - Extreme or Severe Hazard ERGONOMIC HAZARD ERGONOMIC HAZARD This is a collective group of injuries involving the musculoskeletal and or nervous system in response to long term repetitive twisting, bending, lifting, or assuming static postures for an extended period of time These injuries may evolve from environmental factors such as constant or excessive repetitive actions, mechanical pressure, vibrations, or compressive forces on the arms, hands, wrists, FORMATIVE ACTIVITY necks, or back. Human error may also be a causative factor when individuals push themselves beyond their limits or when productivity SCENARIO TYPE OF SAFETY HAZARD limits are set too high. Spilling a chemical reagent on Chemical Hazard the skin. GENERAL PRECAUTIONS ARE TO CONSIDER Avoid running in rooms and hallways Improper disposal of Biological Hazard biohazardous waste Watch for wet ﬂoors Bend knees when lifting heavy objects Working in a poorly ventilated Chemical Hazard Keep long hair pulled back area with fumes Avoid dangling jewelry Maintain clean, organized work area Using electrical equipment with Electrical Hazard frayed cords Closed-toe shoes that provide maximum support are essential for safety and comfort. SYMBOLS FOR THE DIFFERENT TYPES OF HAZARD BIOHAZARD SHARP HAZARD CHEMICAL HAZARD RADIOACTIVE HAZARD ELECTRICAL HAZARD FIRE/EXPLOSIVE HAZARD TOPIC 7 : CHEMICAL SAFETY PROCEDURES PMLS 037 | PRINCIPLES OF MEDICAL LABORATORY SCIENCE 1 | Period 2  Acid should always be added to water to avoid the PHLEBOTOMIST AND MEDICAL TECHNOLOGIST possibility of sudden splashing - may come in contact with hazardous chemicals when using Chemicals should never be mixed together unless specific cleaning reagents, adding preservatives to 24-hour urine instructions are followed, and they must be added in the order containers, or delivering specimens to the laboratory. Many of specified. these preservatives can be hazardous when they are not Wearing goggles and preparing reagents under a fume hood properly handled. are recommended safety precautions. - Inappropriate use of chemicals can have dangerous Chemicals should be used from containers that are easily consequences. manageable size. State and federal regulations are in place for the disposal of chemicals and should be consulted. THE OCCUPATIONAL SAFETY Pipetting by mouth is unacceptable in the laboratory. AND HEALTH ADMINISTRATION (OSHA) CLASSIFIES CHEMICAL HAZARDS INTO TWO GROUPS: AAA RULE PHYSICAL HAZARDS  ALWAYS  ADD  Compressed gas  ACID  Explosives  Flammable: aerosol, gas, liquid or solid CHEMICAL LABELING  Organic Peroxide  Oxidizer  Pyrophoric (i.e., capable of spontaneous ignition when - Hazardous chemicals should be labeled with a description of exposed to air) their particular hazard such as poisonous, corrosive,  Reactive/unstable flammable, explosive, teratogenic, or carcinogenic.  Water-reactive - National Fire Protection Association developed the Standard System for Identification of the Fire Hazard of Materials, NFPA 704. HEALTH HAZARDS - The diamond-shaped, color – coded symbol contains information relating to health, flammability, reactivity, and  Toxic and highly personal protection/special precautions.  Toxic agents - Each category is graded on a scale of 0 – 4, based on the  Reproductive skin extent of concern  Carcinogen - These symbols are placed on doors, cabinets, and containers.  Irritant  Tissue corrosive  Sensitizer  Liver, Kidney and CNS toxins  Agents that act on or damage other body systems CHEMICAL HANDLING GENERAL RULES FOR CHEMICAL SAFETY:  Always wear proper protective clothing when working with chemicals, including lab coat, apron, gloves, and safety OTHER CHEMICAL HAZARD SYMBOLS goggles.  Always use proper chemical cleanup materials when cleaning up chemical spills PHYSICAL HAZARDS NAMES OF SYMBOLS  Never store chemicals above eye level. EXPLOSIVES  Never add water to acid.  Never indiscriminately mix chemicals together. Description: Bursting ball  Never store chemicals in unlabeled containers CORROSIVE TO METALS  Never pour chemicals into dirty containers, especially containers previously used to store other chemicals. Description: Test tube over  Never use chemicals in ways other than their intended use. metal/hand  An important chemical safety rule to remember when OXIDIZING LIQUIDS dealing with acids and other liquids is never add water or other liquids to an acid, as it can cause an explosive Description: Circle with flame type reaction. If a mixture containing both is to be made, always add the acid to the other liquid PHYSICAL HAZARDS NAMES OF SYMBOLS COMPRESSED GAS MATERIAL SAFETY DATA SHEET - 9 SECTION Description: Cylinder SECTION 1 - PRODUCT INFORMATION FLAMMABLE LIQUID Product Name WHMIS Classification (Optional) Product Use Manufacturer's Name Supplier’s Name Physical and Mailing Address Physical and Mailing Address Emergency Contact Phone Number Emergency Contact Phone Number Description: Flame SECTION 2 - HAZARDOUS INGREDIENTS Hazardous Ingredients (very specific) OSHA HAZARD COMMUNICATION STANDARDS SECTION 3 - PHYSICAL DATA Physical State (What does it look like? Is it a liquid, gas, or solid?) - OSHA developed the Hazard Communication What happens to it under a variety of circumstances? (i.e. heat, freezing, dropping, etc.) Flammability and how to extinguish, Includes a wide variety of details concerning how easily this product: (HazCom) Standard to protect. employees who may be exposed to hazardous chemicals. According to the SECTION 4 - FIRE AND EXPLOSION DATA law, all chemicals must be evaluated for health hazards, will ignite / explode and how to deal with it. How stabile is this product? and all chemicals found to be hazardous must be labeled How it reacts under various conditions. as such and the information communicated to employees. - is known as “The Right to Know Law” because of the SECTION 5 - REACTIVITY DATA Incompatibility with other substances labeling requirement. Hazardous Decomposition Products Information about how the product affects and enters the body, Immediate affect. Long term toxic affect. - requires manufacturers to supply material safety data sheets (MSDSs) for their products. SECTION 6 - TOXICOLOGICAL PROPERTIES Exposure limits. In summary, immediate and long term affects to the human body. HazCom Labeling Requirements SECTION 7 - PREVENTIVE MEASURES Personal Protective Gear; ventilation, etc.; leak and spill info; waste disposal; handling and storage; special shipping instructions - Although labeling format may vary by company, all chemical manufacturers must comply with labeling requirements set by SECTION 8 - FIRST AID MEASURES the Manufacturers Chemical Association. Labels for Information for immediate first aid treatment. Usually always ends with "Contact a Doctor" hazardous chemicals must contain:  A statement of warning such as “danger” or “poison” SECTION 9 - PREPARATION INFORMATION Who prepared this and contact info  A statement of the hazard (e.g., toxic, flammable, combustible)  Precautions to eliminate risk  First aid measures in the event of a spill or other exposure CHEMICAL HYGIENE PLAN MATERIAL SAFETY DATA SHEET - OSHA also requires facilities that use hazardous chemicals to have a written Chemical Hygiene Plan(CHP) available to employees. - Summary of the hazardous nature of chemicals used in the The purpose of the plan is to detail the following: workplace. 1) Appropriate work practices - Must be maintained and updated 2) Standard operating procedures - All Chemical Hazard information is provided in the form MSDS 3) PPE on the file in the workplace. 4) Engineering controls, such as fume hoods and flammable - contains general information as well as precautionary and safety cabinets emergency information for the product. Every product with a 5) Employee training requirements hazardous warning on the label requires an MSDS to help 6) Medical consultation guidelines ensure that it will be used safely and as intended. - Employers are required to obtain an MSDS for every Each facility must appoint a chemical hygiene hazardous chemical present in the workplace and to make officer, who is responsible for implementing and all MSDS readily accessible to employees. documenting compliance with the plan. Information contained in an MSDS includes the CHEMICAL SPILLS AND EXPOSURE following: - Do not neutralize chemicals that come in contact with the skin. 1) Physical and Chemical characteristics - Contaminated clothing should be removed as soon as 2) Fire and Explosion potential possible. 3) Reactivity potential - Chemical spill kits contain protective apparel, nonreactive 4) Health hazards and emergency first aid procedures absorbent material, and bags for disposing of contaminated 5) Methods for safe handling and disposal materials should be available for cleaning up spills. 6) Primary routes of entry 7) Exposure limits and carcinogenic potential. Safety Showers and Eyewash Stations - The phlebotomist should know the location of and be instructed in the use of safety showers and eyewash stations in the event of a chemical spill or splash to the eyes or other body parts. What to do in cases of chemical spills? - The affected parts should be flushed with water for a minimum of 15 minutes, followed by a visit to the emergency room for evaluation.

PMLS 037 Medical Laboratory Science Laboratory Safety Procedures PDF

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