Safety and Hazards in Clinical Laboratory PDF

Module 06 UNIT 1: z HARZARDS IN THE CLINICAL LABORATORY  z OBJECTIVES  Define the difference between a hazard and a risk;  Describe the Occupational Safety Health Administration (OSHA) and other bodies addressing occupational hazards;  Define...

Module 06 UNIT 1: z HARZARDS IN THE CLINICAL LABORATORY  z OBJECTIVES  Define the difference between a hazard and a risk;  Describe the Occupational Safety Health Administration (OSHA) and other bodies addressing occupational hazards;  Define biohazards and describe the chain of infection;  Define biosafety and biosecurity;  Describe the classification of microorganisms according to risk groups;  Discuss the Universal Precautions (UP), Body Substance Isolation (BSI), and Standard Precautions (SP);  Discuss the essentials of Standard Precautions; and  Discuss the Biosafety Levels.  z RISK = HAZARD X EXPOSURE  z SAFETY FIRST  z Occupational Safety and Health Act To provide for the health and safety of persons at work and for the health and safety of persons in connection with the activities of persons at work To establish an advisory council for occupational health and safety z z z Note: z OSHA Categories of Exposure Category 1: exposed to blood and body fluids on a daily basis Category 2: regularly exposed to blood and body fluids Category 3: never exposed to blood and body fluids  z Undertake continuing studies and researches on occupational safety and health Plan, develop and implement occupational safety and health training programs  z Serve as clearing house for occupational safety and health information, methods, techniques, and approaches and, institute an information dissemination mechanism Monitor work environment and conduct medical examinations of workers  z Serve as duly recognized agency for testing and setting standard specifications of PPE and other safety devices  z Assist other GO’s in policy and standards formulation on occupational safety and health matters issue technical guidelines for prevention of occupational disease and accidents  z Enlist assistance of GO’s and NGO’s in achieving the objectives of the Center Perform such other acts appropriate for attainment of the above functions and enforcement of the provisions of E O No 307  BioRisk Association of the Philippines (BRAP) z I nternational F ederation of B iosafety A ssociations Cooperates and collaborates with other associations throughout the Philippines and globally in the promotion of biosafety, biosecurity, and biorisk management as scientific disciplines  z Principles of Biohazard and Biosafety Typeszof Safety Hazards Biological Hazard or Biohazard Symbol Chain of Infection and Safety Practices related to the Biohazard Symbol The Chain of Infection Note: Transmission Contact Direct Indirect Droplet Airborne Common vehicle (soil,water, food) Vector borne Mechanical Biological z Risk Group Classification and Biosafety Level Biosafety versus Biosecurity Biosafety Biosecurity Risk Group Classification of Biological Agents Biosafety Level (BSL) Set of biocontainment controls based on risk Has specific controls based on: Infectivity and severity of disease Source of the agent Route of invasion Biosafety Level (BSL) Has important role on: Laboratory safety practices Safety environment Designing the facility Biosafety Level 1 Basic Safety Basic Safety Practices: Handwashing Mechanical pipetting Wearing PPE Cleaning and Limited access to decontamination of area people Warning signs Biosafety Level 2 Basic Safety Basic Safety Practices: BSL 1 standard practices Using biosafety Vaccination for the cabinets workers, if applicable Trained personnel Availability of eye wash station Biosafety Level 3 Basic Safety Note: HEPA (high efficiency particulate air) filter Biosafety Level 3 Basic Safety Note: HEPA (high efficiency particulate air) filter HEPA (high efficiency particulate air) filter  Recirculation of air thru HEPA filter Additional Laboratory Practices: Periodic medical testing for workers Full body garment with respiratory protection Restricted access at all times Biosafety Level 4 Basic Safety Dedicated supply air Additional Laboratory Practices: Decontamination of materials before exiting Full body garment Taking shower after leaving the facility Biosafety Level (BSL) Risk Groups and Biosafety Level Risk Groups and Biosafety Level z Occupational Exposure Occupational Exposure Specific requirements of this standard of the Occupational Safety and Health Administration (OSHA) include the following: 1. Requiring all employees to practice Universal/Standard Precautions Universal Precautions (UP) All blood and bodily fluids should be treated as if they are infectious, regardless of whether the source is known to be infected Designed to reduce the risk of blood borne transmission Body Substance Isolation (BSI) Designed to reduce the transmission of pathogen from moist body substances Standard Precautions (SP) Designated for the care of all staff and patient, regardless of diagnosis or presumed infectious status Transmission based precautions Additional controls for contact, droplet, and airborne transmissible diseases.  N 95 mask “N” for non oil “95” for 95% efficiency 0.3 microns of particulates  Occupational Exposure Occupational Exposure Specific requirements of this standard of the Occupational Safety and Health Administration (OSHA) include the following: 1. Requiring all employees to practice Universal/Standard Precautions 2. Providing laboratory coats, gowns, face and respiratory protection, and gloves to employees and laundry facilities for non disposable protective clothing  Occupational Exposure 3. Providing sharps disposal containers and prohibiting recapping of needles 4. Prohibiting eating, drinking, smoking, and applying cosmetics, lip balm, and contact lens in the work area 5. Labeling all biohazardous material and containers 7. Providing free immunization for HBV 6. Establishing a daily disinfection protocol for work surfaces; an appropriate disinfectant for blood borne pathogens is 5.25% hypochlorite (1:10) HBV for 10 minutes HIV for 2 minutes 8. Providing medical follow up for employees who have been accidentally exposed to blood borne pathogens 9. Documenting regular training in safety standards for employees Post exposure prophylaxis  Module 06 UNIT 2: z Other Hazards in the Clinical Laboratory Types of Safety Hazards z Laboratory Hazard Prevention Strategy Laboratory Hazard Prevention Strategy 1. Work practice controls General procedures/ policies that mandate measures to reduce or eliminate exposure to hazard Hand Hygiene  Handwashing Technique Wetting hands Lathering hands and creating friction  Handwashing Technique Cleaning Rinsing hands between fingers  Handwashing Technique Drying hands Turning off water  Laboratory Hazard Prevention Strategy 1. Work practice controls 2. Engineering controls Safety features built into the overall design of a product Fume Hood vs Laminar Air Flow vs Biosafety Cabinet Biosafety Cabinet Class I Blower HEPA filter Biosafety Cabinet Class II Biosafety Cabinet Class II Types of Biosafety Cabinet Class II Biosafety Cabinet Class III Biosafety Cabinet Work Zone Setup  Laboratory Hazard Prevention Strategy 1. Work practice controls 2. Engineering controls 3. Personal Protective Equipments Barriers that physically separate the user from a hazard Occupational Exposure Donning PPE Removing PPE Occupational Exposure Hierarchy of Controls Example: Needlestick injury z Safety Practices in the Laboratory Occupational Exposure Chemical Spills C ontain the spill L eave the area E mergency; eyewash shower and medical care A ccess Material Safety Data Sheet (MSDS) N otify supervisor Never store chemicals above head height Ergonomic Hazard FIRE HAZARD Types of Fire and Fire Extinguishers FIRE SAFETY R escue injured A larm C ontain fire / close doors E mergency number / extinguish only if small Never use water on flammable liquids or electrical fires Use of Fire Extinguisher P ull the pin A im at the base of the fire S queeze the handles S weep nozzle side to side Use of Fire Extinguisher Most safety signs and symbols fall into one of four categories: Prohibition Mandatory Warning Emergency Globally Harmonized System (GHS) of Classification and Labeling of Chemicals Hazard Communication Standard Pictogram National Fire Protection Association (NEFA) Label z Waste Disposal Disposal of Biological Waste All biological waste, except urine, must be placed in appropriate containers labeled with the biohazard symbol Disposal of Biological Waste Wastes must be decontaminated following institutional policy Color coding Scheme for Containers (from DOH Health Care Waste Management Manual) Color Coding for Wastes Basic Steps in Healthcare Waste Handling (from DOH Health Care Waste Management Manual) Ergonomic Hazard Module 06 Unit 02 - Other Hazards in the Clinical Laboratory Objectives: Describe the other hazards found in clinical laboratory; Describe measures that can be used to manage clinical laboratory hazard; and Describe general guidelines for management of health care wastes. Module 06: Hazards in the Clinical Laboratory Describe the principles of biohazard and biosecurity; Identify hazards found inside the clinical laboratory; Enumerate and describe the strategies utilized for management of laboratory hazards; and Enumerate the prescribed strategies, policies, and practices in management of health care wastes.