2.5 lab safety Flashcards
Mercury spill
1) ? a posion
1) mercury
- heavy metal
- toxic ingested or absorbed via skin
- vaporise inhaled
- avoid skin contact
- attracted to gold, silver, copper
- ventilate area as vapour is rel by globules
- aspirate pipette collect drops dont use vaccum
- adhesive tape
- containment
- store underwater or glycerol
- decontaminate sulfur powder or zinc dust
Mercury
2) approach to spill (generic)
3) checking fluorescence of new lamp
flammable vs caustic
1) Evaluate
- extent/type; minor or major
- notify lab manager/safety officer
- get MSMD/spill kit
2) Evacuate/attend
- mark area/block/ open windows
- wear PPE
- emergency shower
- first aid
- send to ED for attention
3) control/contain
- stop source
- make barrier
- clean up
- - acid/base
- - biological spill
- - flammable liquids- remove ignition source
- - mercury- absorbent
- - radioactive- absorbant, radioactive waste bag
4) Report/monitor
- record incident
- RV meeting
- - root cause, prevention
- - monitor
For mercury
- aspirate mercury using pipette, cover w tamer, dispose in hazardous bin
- dont touch, use strips of adhesive tape
- use mercury absorbent compounds
3) lamp
- check alignment
- QC microscope with fluorescent beads
- check few runs previous patients/known/delta checks
Steps involved in the approach to an incident/mistake
- Investigation
- CAR/incident report
- report error
- immediate corrective/remedial action
- root cause analysis
- preventative measures - Quality manager/quality meetings
- Monitor
- If requires escalation
- consider SAC category
- reviewed by principal scientist, head pathologist, lab quality manager, head representative, chief pathologist
How are different laboratories stratified according to risk groups?
Biosafety level
-CDC/NIH calssifed infectious organisms
Based on human and animal infectious microorganisms risk groups 1-4 depending on how infectious
PC1 – low individual and community risk
PC2 – moderate individual risk but low community risk* most diagnostic labs handling human clinical diagnostic specimens*
- also labs that prep primary cells from human organs or tissues/ in class II BSC
PC3 – high individual risk but low-moderate community risk (eg TB)
PC4 – high individual and community risk (eg Ebola)
PC1 - NO blood or body fluids, open bench, usu student or undergrad teaching
PC2 - Clinical specimens, if aerosols should handle in a safety cabinet I / II , use PPE- hiv, human blood, not open bench
PC3 - High risk of aerosols and airborne infections, separate room, safety cabinet III, PPE
PC4 - Viruses (WHO maximum containment), separate building, controlled access, safety cabinet III, PPE, neg pressure, airlocks clothing-change and shower room
Define a PC2 laboratory and discuss 10 requirements that PC2 labs must follow
GMO?
documents for NATA
risk group organisms
immunology tests /risk groups
PC2 lab mostly works with risk group 2 organisms
- good technique work may be on open bench
- if transmissible by respiratory route then BSC
- limit access to lab
- construction, ventilation, work practices, PPE
- gloves when BSC, handling human blood/body fluids, liquids w potential risk group2 microorganisms
- direct handing of glassware porhibited
2243.3-2010
Name 3 classes of biohazard cabinets
1) Class I – Personal and environment safety
- NOT suitable for sterile work, non sterile air taken inward away from operator
- laminar flow
- Air from the work area filtered through HEPA filter and returned the laboratory
2) Class II – Personal, product and environment safety
- Inflow of air from work opening, then deliver recirculated filtered laminar flow air downwards through work zone by HEPA filtration
3) Class III – Extreme personal, product and environment safety
- For class 4 microorganisms
- Completely enclosed, maintained at negative pressure
- Working through sealed gloves
- two series of HEPA filters, air recirculated or vented to outside
What is a fume cupboard?
Fume Cupboard - Personal safety - limit exposure to toxic fumes, vapor and dust
Partially enclosed
Takes in air from the front (laminar flow)
Expels through an exhaust to outside the building
How are pipettes calibrated?
NATA standard pipettes
Gravimetric scale 6 decimals Calibration software Same temp/humidity/ standard pipette tip pure distilled water Min 2 volumes (top volume/10% volume) x 10 replicates at each volume tested Check precision/cv
6 monthly service (CSLI says 3-6 monthly but depends on use, single vs multi channel)
if fails calibration then service/open- decontaminate
one point calibration for pipette- tweak only one
check precision/cv
NATA accredited pipette calibration technician/can do in house
What is a MSDS?
Material safety data sheet
- describes chemical and physical properties
- uses of a material
- safely handle, transport, store and dispose
- first aid/in a spill
- health hazard information
- fire fighting measure
- exposure control/PPE
- toxicology information
- contact details manufacturer, importer
- date, revision set
safety standards 2243.1
- inventory readily accessible and understandable
uncontrolled document
- review 5 yearly or when there is change to the substance or new health/safety information
What are safe lab practices around radioactive materials?
ionising- dna damaging b/g most important 3T and I125
- Reduce exposure
- preplan to minimise time
- distance keep far, remote
- shielding lead g perspex b
- PPE fume hood
- cover wounds - Storage
- shielding , label w isotope details/date - Documentation
- MSDS access, inventory - Designated work area
- spill trays absorbent material
- warnings, - Protocol for emergency response plan
- incident - Staff training
- handling - Periodic checks/radiation monitoring
- audits/gieger counter for g, surface swabs and b reader for b radiation
- monitor staff exposure with tags - Correct waste disposal
- ?radiation license/radiation safety officer
A pregnant employee does not want to perform radioimmunoassay- what is your approach to this request?
International comission on radiological protection
radiation dose limit is 1mSv per annum (general population)
20mSv occupational averaged over 5 years
- meeting open disclosure
- discussion
- RIA kits- badge not necessary as very small radiation
- likelihood of other excessive exposure
- if possible other duties/ carry on
What are safety standards?
Groups of written guidelines/standards
By Joint technical committee, safety in laboratories, council of standards australia and NZ
Outlines everything PHYSICAL - laboratory structure/building - sunlight exposure, ventilation, amenities for hand washing/breaks, electrical installation - storage of chemicals - fire safety/alarms/spill kits - fume/biohazard cabinets
SYSTEMS lab safety management
- risk assessment
- training and induction
- safet operation
- emergency preparedness
- safety equipment
- information management and review
General
- safety conduct
- PPE use
- substance containment
- general practices
How do you dispose radioactive materials?
- dispose radiation bags, sealed, stored, acc radioactive waste disposal guiddlines
- note half life (time taken to reach BG radiation level) need to calculate this
- depending on levels of radioactive waste need to be stored locally or restricted areas until radioactive levels decline
- low level waste (blotting paper, paper towels) need to be stored in red radioactive bags until levels reach BG
What steps constitute a corrective action?
- Define the problem
- Investigate the problem
- root cause analysis - Rectify immediate harm
- quarantine area/equipment
- ensure safety affected, witness, public - Propose solution
- learning points - Document actions taken
- disseminate, discuss, awareness - Assess effectiveness
- audit/monitor - Close issue
What steps are involved in root cause analysis?
- Identify sequence of events leading to non conformance/incident
- Identify contributing factors
- pre analytical
- analytical
- post analytical
- training/competence
- workflow/equipement/resrouces
- quality
- communication
What are some of the OH&S categories that need to be considered for lab employees?
- Specific hazards
a) Biological hazards
- blood born
- infectious
- exposure
b) chemical
- storage/handling/disposal
- flammable/corrosive
- labelling
- MSDS
- spill kit - Ergonomic
- posture, RSI, back, computer use - Pre existing medical issues
- Other safe work practice
- footware, PPE, nil eating/drinking, BSC, training on safety
Explain the concept of risk management in the laboratory
Manage potential risks which may lead to harm in the laboratory
- Identify hazards
- equipment, substance, task or action
- register/audit/inspection
- physical/chemical/radiation/biological/
ergonomic/psychological - Risk assessment
- potential outcome of hazard
- injury, damage or loss
- MSDS/health environment check/discussion / audit
Implement
- Risk control
- eliminate , substitute, engineer, behaviour/administration, PPE
- minimize risk
- PPE, staff training/education
- modify change substitute work process - Evaluate
- monitoring of process and changes for further improvement
- objectives and performance measures
- collect information
- review and improve- can re audit/
- management meeting/hospital safety committee/OHS??
How is biological waste disposed of from medical laboratory?
Needlestick injury
Concept: all biological material should be rendered harmless (incapable of transmitting genetic material) before leaving the lab
- infectious material in yellow biohazard bags
- bins/34 full sterilised
- autoclaving before transport of dead material to disposal facility
- autoclave waste then treat like domestic waste (no longer need biohazard symbol)
- final disposal by incineration or burial in landfill
Dept of Health
EPA? requirements
OHS regulations
containment
segregation
burial
incineration
List sources of hazard in the diagnostic immunopathology lab
- biological
- chemical
- physical
- ?radiation if doing radioactive assays
- ergonomic
Polyacrylamide gels containing ethidium bromide - what kind of waste are they?
- treated as biological hazard waste
- Ethidium bromide can bind with DNA, it is highly toxic as a mutagen. may potentially cause carcinogenic or teratogenic effects
- Exposure routes of ethidium bromide are inhalation, ingestion, and skin absorption.
What is the correct way to dispose of chemical waste in the lab?
- MSDS for chemical must be checked to ensure compatibility if there is a combined chemical residue container
- ## no down the drain
Managing a biological spill/chemical spill - name the steps you would take
- Evaluate
Determine the extent and type of spill
Mark the area / block for major spills
Inform the OH&S officer for major - Evacuate
Notify staff and remove from the area
Allow aerosols to settle – 30 min - Decontaminate
Wear PPE, use handling equipment (tongs / forceps / brooms)
Use a biological / chemical spill kit
Biological - Put absorbent paper on the spill, soak with 2.5% Na hyperchlorite, wait for 10 min
Start from the edge and work inward
Clean the with absorbent papers
Repeat steps if necessary
Wipe with 70% ethanol and rinse with water
Put waste into a yellow clinical waste bin
Place sharps in a sharps containerChemical - Contain the spill with absorbent paper / barriers
Use chemical absorbent granules, leave it for a while and collect them
Put waste into a chemical waste container for proper disposal
Repeat steps if necessary - Report and monitor
Report incident to OH & S officer
Check all personnel involved in the clean up for contamination - decontaminate clothing if necessary
Major spills should be cleaned under the supervision of the OH & S officer
What is the hierarchy of controls with respect to workplace hazards?
- multiple levels of safety controls aimed at reducing hazards
eliminate, substitute, engineer, behaviour.administration, PPE
Name some of the universal precautions as it applies to the diagnostic lab (general)
Universal Precautions- treat all human blood/body fluids as if they were known to be infectious
Use barrier protection at all times.
Use gloves for protection when working with or around blood and body fluids.
Change glove between patients.
Use glasses, goggles, masks, shields, and waterproof gowns/aprons to protect face from splashes.
Wash hands if contaminated and after removing gloves.
Use puncture-resistant sharps disposal containers (at point of use).
Do not recap, bend or break needles and handle all sharps carefully.
Use resuscitation equipment and devices for mouth-to-mouth resuscitation.
Minimize spills and spatters; use leak-proof containers; appropriate biological safety cabinet.
Decontaminate all surfaces and devices after use.
Observe prudent laboratory practices.
Use proper waste management/housekeeping.
Promptly seek medical attention and counseling if exposed to contaminated materials (see below).
Who is responsible for safety in the lab?
Everyone is responsible but
head of dept pathologist and head /chief scietnsit needs to ensure lab meets safety standards
- designated safety officers eg fire warden, radiation safety officer
Name a toxic substance used in the laboratory
- Sodium azide as preservative
- PCR reagent toxic/ RNA extractions phenol chemical toxicity
What are the considerations when introducing a radioimmunoassay into the lab?
Consider in general
- kit material vs in house
- storage
- -handling
- transport in double containers
- -staff education/expertise
- -waste disposal
- cabinet */fume hood
- PPE
- most do not need monitoring but to consider/ pregnant staff
Performing assay
- batching/ TAT
- supply of radioactive isotope
- pipetting/special equipment
- analysis; reader/counter
- roster/vulnerable test
What are the potential health effects/principles of 3H thymidine ?
Thymidine is radioisotope that incoporates into DNA and hence once lymphocytes proliferated for 2-3days according to mitogen/antigens, pulsed with thymidine and counts per minute incoporated is measure of blastogenesis
compared to background and healthy control
In the amount used, low toxicity, non lethal mutagenic effects, reduces fertility, teratogenic, lung function if high dust concentration
in general, beta particles can penetrate skin and beta burns, most harmful when internal hazard- swallowed, inahlerd, absorbed wound or injected
How is fire safety applied in your lab?
• There is a hierarchy of HR/people involved
o Fire warden on each floor of department
o Area warden- area searches
o House warden- coordinate whole building
• Policies/procedures
o Fire safety/evacuation policy
Hierarchy
Building security
Emergency and evacuation procedures
o Regular checks of hazards
o Alarm testing monthly
o Fire safety induction with staff orientation/lab managers
Capability e learning
Orientation around lab- fire hydrant, spill kit etc.
