LESSON 1 LAB SAFETY Flashcards
- Authorized to conduct on on-site inspections to
determine whether an employer is complying
with the mandatory standards (Bishop, 2013) - Organization that encompasses all workplace
area (not just laboratories) - Philippines: Department of Labor and
Employment and Department of Health - Most of their policies are being used by the
agencies here in the Philippines
OCCUPATIONAL SAFETY AND HEALTH
ADMINISTRATION (OSHA)
• Bloodborne Pathogen Standard
• Formaldehyde Standard
• Laboratory Standard
• Hazard Communication Standard
• Respiratory Protection Standard Air
• Contaminants Standard
• Personal Protective Equipment Standar
Standards that regulate safety in the laboratory:
- provides excellent general laboratory safety and
infection control guidelines - more specific in procedures
- step by step laboratory procedures
CLINICAL LABORATORY STANDARDS
INSTITUTE (CLSI)
- Standard System for the Identification of the Fire
Hazards of Materials, (NFPA 704)
NATIONAL FIRE PROTECTION
ASSOCIATION (NFPA)
Health Hazard
blue diamond
Fire hazard
red diamond
specific hazard
white diamond
reactivity
yellow diamond
- All Patients are considered possible carriers of
bloodborne pathogens (HIV and HBV) - Wearing gloves when collecting/ handling blood
and body fluids visibly contaminated with blood - Wearing face shields when in danger of splashing
blood and body fluids contaminated with blood - Doesn’t include urine and fluids not visibly
contaminated with blood - First set of guidelines on how to approach
patients and specimens
Universal Precautions (1987)
- Considers all body fluids and moist body
substances to be potentially infectious - Does not recommend handwashing after
removal of gloves
Body Substance Isolation Guidelines (1987)
- Combines aspects of Universal Precautions and
Body Substance Isolation Guidelines - Way of handling the patients
Standard Precautions (1996)
- Accreditation of Clinical Laboratories (US)
THE JOINT COMMISSION
- Development of policies regarding laboratory
safety - Accreditation of Clinical Laboratories
- International Organization for Standardization
(ISO) also inspects clinical laboratories in the
Philippines
DEPARTMENT OF HEALTH (PHILIPPINES)
Guidelines in laboratory setting
STANDARD PRECAUTIONS (CDC, 1996)
Handwashing,
gloves,
Masks, Goggles, and Face Shields
➢ Laboratory Gown
➢ Occupational Health ➢ Patient Care Equipment
➢ Environmental Control
➢ Linen
➢ Patient Placement
o Before patient contact
o When gloves are removed
o Before leaving the work area
o At any time when they have been
knowingly contaminated
o Before going to designated break areas
o Before and after using bathroom
facilities
➢ Handwashing
o worn to protect the health care worker’s
hands from contamination by patient
body substances and to protect the
patient from possible microorganisms
on the health care worker’s hands.
o NOT a substitute for hand washing
o Latex allergy in patients
Gloves
o Masks are worn to protect against
inhalation of droplets containing
microorganisms from infective patients.
o Masks and goggles are worn to protect
the mucous membranes of the mouth,
nose, and eyes from splashing of body
substances
o Face shields also protect the mucous
membranes from splashes.
➢ Masks, Goggles, and Face Shields
o worn to protect the clothing and skin of
health care workers from contamination
by patient body substances and to
prevent the transfer of microorganisms
out of patient rooms.
o tie in the back at the neck and the waist
and have tightfitting cuffs
Laboratory Gown
o Never recap used needles using both
hands
o Place used disposable syringes and
needles, scalpel blades, and other sharp
items in appropriate puncture resistant
containers
Occupational Health
- requires all employers to have a written
Bloodborne Pathogen Exposure Control Plan and
to provide necessary protection, free of charge
for employees
OSHA (Occupational Safety and Health
Administration)
Components of the OSHA Bloodborne Pathogen
Standard
o Providing sharps disposal containers and
needles with safety devices.
o Requiring discarding of needles with the
safety device activated and the holder
attached
o Labeling all biohazardous materials and
containers
Engineering Controls
Components of the OSHA Bloodborne Pathogen
Standard o Requiring all employees to practice
Standard Precautions.
o Prohibiting eating, drinking, smoking,
and applying cosmetics in the work area.
o Establishing a daily work surface
disinfection protocol.
Work Practice Controls
Components of the OSHA Bloodborne Pathogen
Standard o Providing laboratory coats, gowns, face
shields, and gloves to employees and
laundry facilities for non-disposable
protective clothing
Personal Protective Equipment
Components of the OSHA Bloodborne Pathogen
Standard
o Providing immunization for the hepatitis
B virus free of charge.
o Providing medical follow-up to
employees who have been accidentally
exposed to bloodborne pathogens.
Medical
Components of the OSHA Bloodborne Pathogen
Standard
o Documenting annual training of
employees in safety standards.
o Documenting evaluations and
implementation of safer needle devices.
o Involving employees in the selection and
evaluation of new devices and
maintaining a list of those employees
and the evaluations.
o Maintaining a sharps injury log including
the type and brand of safety device,
location, and description of the incident,
and confidential employee follow-up.
Documentation
- Any accidental exposure to blood through
needlestick, mucous membranes, or nonintact
skin must be reported to a supervisor and a
confidential medical examination must be
started immediately - Evaluation of the incident must begin
immediately to ensure appropriate
postexposure prophylaxis (PEP) is initiated
within 24 hours.
Postexposure Prophylaxis
Color Coding of Waste Containers (from DOH)
Non-infectious dry waste
black
Color Coding of Waste Containers (from DOH) Non-infectious wet waste (kitchen, dietary, etc.)
Green
Color Coding of Waste Containers (from DOH) Infectious and pathological waste
Yellow
Color Coding of Waste Containers (from DOH)
Chemical waste including those with heavy metals
Yellow with
black band
Color Coding of Waste Containers (from DOH) Radioactive waste
Orange
Color Coding of Waste Containers (from DOH)
Sharps (needles and glasswares) and pressurized
containers
Red
- describes hazards, safe handling, storage, and
disposal of hazardous chemicals.
Safety Data Sheet (SDS)
Source- Infectious agents
POSSIBLE INJURY- Bacterial, fungal, viral, or
parasitic infections
biological
Needles, lancets, and
broken glass
Cuts, punctures, or
bloodborne pathogen
exposure
Sharp
Preservatives and reagents
Exposure to poisonous, caustic, or carcinogenic agents
chemical
Equipment and radioisotopes
Damage to a fetus or generalized overexposure to
radiation
Radioactive
Ungrounded or wet equipment and frayed cords
Burns or shock
Electrical
Open flames and organic chemicals
Burns or dismemberment
Fire/Explosive
Wet floors, heavy boxes, and patients
Falls, sprains, or strains
Physical
- refers to biological substances that pose a threat
to the health of living organisms, primarily that
of humans. - contain any of the four microorganism - virus,
bacteria, fungi, parasite - laboratory specimens
BIOHAZARDS
o Consist of bacteria, fungi, parasites, and
viruses.
Infectious Agent
▪ Early detection and treatment of
infectious agents.
Breaking the Chain:
o A place where the infectious agent can live and possibly multiply.
o Ideal ______: Humans and Animals (they do not exhibit symptoms)
o Equipment and other soiled objects (fomites)
Reservoir
▪ Disinfecting the work area kills the infectious agent and eliminates the reservoir.
Breaking the Chain
o A way to exit the reservoir to continue the chain of infection
o Nose, mouth, and mucous membranes and in blood or other body fluids
Portal of Exit
▪ Disposing of needles and lancets
in sealed sharps containers
▪ Disposing of contaminated
materials in biohazard
containers
▪ Keeping tubes and sample
containers sealed.
Breaking the Chain:
unprotected host touches or is touched by the reservoir
Direct contact
the host inhales material from the reservoir such as aerosol droplets from an infected person (too large to
remain suspended in the air
Droplet
inhalation of dried aerosol nuclei circulating on air currents or attached to dust particle (usually for
viruses; too small to remain suspended in the air)
Airborne
ingestion of contaminated food or water
Vehicle
parasites such as malaria transmitted by a mosquito bite (transportation of microorganism)
Vector
the means of transmission can be an accidental
needlestick.
phlebotomist
▪ Hand washing
▪ Standard Precautions
▪ Transmission-based precautions
Breaking the Chain:
o Means to enter the reservoir
o Nose, mouth, mucous membranes, and open wounds.
Portal of Entry
▪ Disinfection and sterilization
▪ Strict adherence to Standard precautions and transmission-based precautions
Breaking the Chain
o Can be another patient or the health health-care provider.
o Ideal ________: Patients (they are immunocompromised)
Susceptible Host
▪ Observation of special precautions when working in the nursery and in isolation rooms designated for protection of susceptible patients.
▪ Immunizations
▪ Maintenance of a healthy lifestyle is very important for the health -care worker.
Breaking the Chain
- an infection acquired by a patient during a hospital stay.
- Reasons: Unsanitary conditions and immunocompromised patients
Nosocomial/Healthcare Acquired Infections
- refers to an infection acquired by a patient as the
result of a health care procedure that may or
may not require a hospital stay.
Health care acquired infection (HAI)
- Including needles, lancets, and broken glassware
- Serious biological hazard for possible exposure
to bloodborne pathogens caused by accidental
puncture - When handling needles, NEVER manually recap
one-handed - Needle safety devices must be activated before
disposing of the entire blood collection
assembly.
SHARPS HAZARDS
- Puncture-resistant, leak-proof containers
labeled with the biohazard symbol. - Containers should be located in close proximity
to the phlebotomist’s work area.
Disposal of Sharps
- When skin or eye contact occurs, the best first
aid is to:
o Flush the area immediately with water
for at least 15 minutes and then seek medical attention
o Know the location of and how to use the
emergency shower and eyewash station
in the laboratory
o Safety Showers
CHEMICAL HAZARDS
30-50 gal/minute at 20-50 psi
Safety Showers
Disinfect the spill site using approved
disinfectant
10% bleach,
o Works like an exhaust fan
o For chemical reagents only
Chemical Fume Hoods
o For opening specimens
o Any airborne contaminants will be pushed down to filter out microorganism
Biosafety Cabinets
- Encountered in the clinical laboratory when
procedures using radioisotopes, such as
radioimmunoassay, are performed. - Exposure to radiation during pregnancy presents
a danger to the fetus, and personnel who are or
who think they may be pregnant should avoid
areas with this symbol.
RADIOACTIVE HAZARDS
- Electrical cords should be checked regularly for
fraying and replaced - All sockets should be checked for electrical
grounding and leakage at least annually. - No extension cords should be used in the
laboratory
ELECTRICAL HAZARDS
FIRE TYPE: _____
COMPOSITION OF FIRE: Wood, paper, or clothing
TYPE OF FIRE EXTINGUISHER: _______
EXTINGUISHING MATERIAL: Water
Class A
FIRE TYPE:_______
COMPOSITION OF FIRE: Flammable organic chemicals
TYPE OF FIRE EXTINGUISHER: _______
EXTINGUISHING MATERIAL: Dry chemicals, carbon
dioxide, foam, or Halon
Class B
FIRE TYPE:_______
COMPOSITION OF FIRE: Electrical
TYPE OF FIRE EXTINGUISHER: ______
EXTINGUISHING MATERIAL: Dry chemicals, carbon
dioxide, or Halon
Class C
FIRE TYPE:______
COMPOSITION OF FIRE: Combustible metals
TYPE OF FIRE EXTINGUISHER: _______
EXTINGUISHING MATERIAL: Sand or dry powder
Dry chemicals
Class D
None Class ABC
FIRE TYPE: ______
COMPOSITION OF FIRE: Grease, oils, fats
TYPE OF FIRE EXTINGUISHER: _______
EXTINGUISHING MATERIAL: Liquid designed to
prevent splashing and cool the fire
Class K
PASS
Pull, Aim, Squeeze, sweep
RACE
Rescue, Alarm, Contain, extinguish/evacuate
• Avoid running in rooms and hallways.
• Be alert for wet floors.
• Bend the knees when lifting heavy objects or
patients.
• Keep long hair tied back and remove dangling
jewelry to avoid contact with equipment and
patients.
• Wear comfortable, closed toe shoes with
nonskid soles that provide maximum su
PHYSICAL HAZARDS
Cleaning Reagents
1:10 dilution of chlorine bleach
70% Ethanol solution
• 5% Phenolic Solution (Lysol)
- Safety carriers should always be used to
transport glass bottles of acids, alkalis, or organic
solvents in volumes larger than 500 mL, - Approved safety cans should be used for storing,
dispensing, or disposing of flammables in
volumes greater than 1 quart - Steel safety cabinets with self-closing doors or
explosion proof refrigerators
Chemical Storage
- Manufacturers of laboratory chemicals
- All in-house prepared reagents and solutions
should be labeled in a standard manner and
include the
o chemical identity
o concentration
o hazard warning
o special handling
o storage conditions
o date prepared
o expiration date (if applicable)
o preparer’s initials.
Signage and Labelling
