Week 2 Lab: Lab Safety Flashcards
OSHA
Occupational Safety and Health Administration
CLSI
Clinical and Laboratory Standards Institute (NCCLS)
CDC
Centers for Disease Control and Prevention
CAP
College of American Pathologists
TJC
The Joint Commission (formerly JCAHO)
It is within the U.S. Department of Labor to set levels of safety and health for all workers in the United States. It covers all different professions.
OSHA
A nonprofit organization that sets voluntary consensus standards for all areas of clinical laboratories. Standardizes procedure and for certification of controls.
CLSI
A Federal agency that carries out mandated public health laws and reporting requirements. It releases guidelines.
CDC
Provides accreditation and proficiency testing for laboratories.
CAP
An independent, not-for-profit organization that accredits and certifies health-care organizations and programs in the United States.
TJC
OSHC
Occupational Safety and Health Commission
Who mandates OSHC in the PH?
DOH
What does OSHC do?
Training of Safety Officers
What are the responsibilities of safety officers?
- identify different risks and hazards in the laboratory
- ensure several controls and measures are in place
People included in the Infection Control Team?
- physicians specialized in infectious diseases
- representative nurses
- representative medtechs
The Infection Control Team is involved in ensuring that the _____________________ by the DOH are met.
National Standards in Infection Control for Healthcare Facilities
It refers to the quality assurance checking of a laboratory with other laboratories.
Proficiency Testing
Who is responsible for the proficiency testing/NEQAS (National External Quality Assurance Scheme)?
NRLs/National Reference Laboratory
Which NRL is for drug and toxicology?
East Avenue Medical Center
Each professional must be ___________ at all times!
safety conscious
Source of chemical hazards?
Preservatives and reagents
Possible injuries from chemical hazards?
Exposure to toxic, carcinogenic, or caustic agents
Source of sharps?
Needles, lancets, broken glass
Possible injuries from sharps?
Cuts, punctures or blood-borne pathogen exposure
Source of electrical hazards?
Ungrounded or wet equipment; frayed cords
Possible injuries from electrical hazards?
Burns or shock
Source of fire/explosives?
Bunsen burners, organic chemicals
Possible injuries from fire/explosives?
Burns, dismemberment
Source of physical hazards?
Wet floors, heavy boxes, patients
Possible injuries from physical hazards?
Falls, sprains or strains
Source of radiation hazards?
Equipment and radioisotopes
Possible injuries from radiation hazards?
Radiation exposure
Source of biological hazards?
Infectious agents
Possible injuries from biological hazards?
(infections) bacterial, fungal, viral, or parasitic
What are the types of laboratory hazards?
- chemical
- sharps
- electrical
- fire/explosives
- physical
- radiation
- biological
Risk factors that includes pathogens on the hands of medical personnels, invasive procedures (intubation, indwelling vascular lines, urine catheterization).
Iatrogenic risk factors
Risk factors that include contaminated air-conditioning systems, contaminated water systems, staffing and physical layout of the facility.
Organizational risk factors
Risk factors that include severity of illness, underlying state of the patient and length of stay.
Patient risk factors
Potential hazards in the laboratory?
- electric shock
- toxic vapors
- compressed gases
- flammable liquids
- radioactive material
- corrosive substances
- mechanical trauma
- poisons
- inherent risks of handling biologic materials
Primary cause of accidents?
- unsafe acts
- unsafe environmental conditions
First rule of self-protection?
alertness at all times
Things to always remember while working in the laboratory?
- stay informed
- use common sense and presence of mind
- listen to any instructions
Psychology of Safety?
- Laboratory safety necessitates the effective control of all hazards that exists in the clinical laboratory at any time.
- Safety begins with the recognition of hazards and is achieved through:
- Application of common sense
- Safety-focused attitude
- Good personal behavior
- Good housekeeping in all laboratory work and storage areas
- Continual practice of good laboratory technique - Inexperience may cause some accidents; others are results of ignoring known risks, haste carelessness, fatigue or mental preoccupation.
- Preventive Measures:
• Annual safety reviews
• Safety drills
• General consciousness
• Appropriate orientation to safety rules
• Safe work environment
Which states that blood and body fluid precautions should be consistently used for all patients?
Universal Precautions (1987)
Who mandated the Universal Precautions?
CDC
Potentially infectious materials?
Body fluids (semen, vaginal secretions, amniotic fluid, saliva, tears, CSF, urine and breast milk); Unfixed tissues, organs or blood slides
Precautions for safety awareness for clinical laboratory personnel?
- Appropriate barriers (gloves, gowns or laboratory coats)
- Appropriate engineering controls
Universal practices for safety awareness for clinical laboratory personnel?
- Wearing of gloves (reusing is not allowed)
- Handwashing
- Laboratory coats (on site)
- Prohibited: eating, drinking, smoking, applying cosmetics, touching contact lenses
Inactivation methods for safety awareness for clinical laboratory personnel?
- Heat sterilization (250C for 15 minutes)
- Ethylene Oxide (450-500 mg/L at 55-60C )
- 2% Glutaraldehyde
- 10% hydrogen peroxide
- 5.25 hypochlorite (bleach)
- 10% (v/v with tap water) of common household bleach: HBV (10 minutes), HIV (2 minutes)
Other information for safety awareness for clinical laboratory personnel?
- Vaccination against HBV (medical technologists, phlebotomists, pathologists)
- Appropriate signs to identify hazards
Safety showers, eyewash stations, fire extinguishers are _________ tested and inspected.
periodically
______________________ must be used to manipulate liquids.
Mechanical pipetting device
Safety showers deliver ______ gallons of water per minute at ______ pounds per square in. (psi) and be located in areas where corrosive liquids are stored or used.
30 - 50 gallons; 20-50 pounds per square in. (psi)
Eyewash stations must be accessible (i.e., within __________)
100 ft or 10 s travel
They are required to expel noxious and hazardous fumes from chemical reagents.
Fume Hoods
How to check airflow direction of fume hood?
tissue paper placed at the hood opening
Face Velocity of fume hood?
Velocity meter: 100 – 120 ft. per minute
What testing is done to locate no flow or turbulent areas in the working space?
Smoke Testing
This engineering control removes particles that may be harmful to the employee who is working with potentially infectious biologic specimens.
Biosafety Cabinet
What type of filter is present in a biosafety cabinet?
high efficiency particulate air (HEPA) filter
All Clinical Lab should have?
- Chemical hygiene plan
- Exposure control plan
- Copy of MSDS
Specimens should be _______ during centrifugation.
capped
Use __________ to pick-up broken glass or other sharp objects.
mechanical devices
Absorb spills with ________, ________ or ________.
paper towels, gauze pad, or tissue
Clean the spill site using a common __________________.
aqueous detergent
Disinfect the spill site using approved disinfectant or _______ using appropriate contact time.
10% bleach
Category __ Exposure: daily exposure to blood and body fluids
I
Category _ Exposure: regular exposure to blood and body fluids
II
Category _ Exposure: no exposure to blood and body fluids
III
OSHA Blood-Borne Pathogens standard requires written ______________.
Exposure Control Plan
Employers must offer ______ to all personnel
(Category I and II)
HBV/Hepatitis B Vaccine
__________________ should be installed to facilitate manipulations of infectious materials.
Biological Safety Cabinets
Hazard Communication Standard includes?
- Hazard communication program
- Chemical Hygiene Plan
- Inventory of hazardous substances
Toxic chemicals (Communication) includes?
- Labelling of containers
- Information and training
- Program of Hazard communication
Sample chemical label includes?
(1) statement of hazard
(2) hazard class
(3) safety precautions
(4) NFPA hazard code
(5) fire extinguisher type
(6) safety instructions
(7) formula weight
(8) lot number
Hazard Rating Scheme: blue means?
health
How is health (blue portion) categorized in the hazard rating scheme?
4 - severe hazard
3 - serious hazard
2 - moderate hazard
1 - slight hazard
0 - minimal hazard
Hazard Rating Scheme: red means?
flammability
How is flammability (red portion) categorized in the hazard rating scheme?
4 - flammable liquids, volatile liquids, pyrophoric materials
3 - ignites at ambient temperatures
2 - ignites when moderately heated
1 - must be preheated to burn
0 - wil not burn
Hazard Rating Scheme: yellow means?
reactivity/instability
How is reactivity/instability (yellow portion) categorized in the hazard rating scheme?
4 - Readily capable of detonation or explosion
3 - Capable of detonation or explosion
2 - Violent chemical change possible at elevated temperature and pressures
1 - Normally stable but become unstable if heated
0 - Normally stable
Hazard Rating Scheme: white means?
personal protection/special
How is personal protection/special (white portion) categorized in the hazard rating scheme?
₩ - Avoid Use of Water
OX - Oxidizer
SA - Simple Asphyxiant
HMIS
Hazardous Materials Identification System
A voluntary hazard rating scheme developed by American Coatings Association (ACA). It communicates chemical hazard information through the use of colors, numbers and letters of the alphabet.
Hazardous Materials Identification System (HMIS)
ACA
American Coatings Association
SDS contents?
Section 1: Identification
Section 2: Hazard identification
Section 3: Ingredients information
Section 4: First aid procedures
Section 5: Fire-fighting procedures
Section 6: Accidental-release measures
Section 7: Handling and storage
Section 8: Exposure controls and personal protection
Section 9: Physical and chemical properties
Section 10: Stability and reactivity
Section 11: Toxicological information
Section 12: Ecological information
Section 13: Disposal considerations
Section 14: Transport information
Section 15: Regulatory information
Section 16: Other information, including date of preparation or last revision
The temperature at which sufficient vapor is given off to form an ignitable mixture with air.
Flash point
Flammable/combustible chemicals are classified according to ____________.
flash point
Injurious to the skin or eyes by direct contact or to the tissue of the respiratory and gastrointestinal tracts if inhaled or ingested.
Corrosive Chemicals
Spontaneously explode or ignite or that evolve heat or flammable or explosive gases.
Reactive Chemicals
Non-conductive materials include__________________.
paper, glass, rubber, procelain, ceramic, plastic, wood
___________________ malfunctioning electrical or mechanical equipment until serviced.
Lock-out or tag
Records for radioactive materials must be maintained for _______________________________.
the length of employment plus 30 years
Radiation monitoring utilizes _________________.
film badge or survey meter
Maximum permissible dose for radiation monitoring using film badge or survey meter is ________________.
5000 mrem/year whole body
The __________________ involves wiping laboratory surfaces with moistened absorbent material and the radiation contained in each wipe is counted.
wipe test (leak test)
Compressed Gases Hazards?
- Danger of fire
- Explosion
- Asphyxiation
- Mechanical injuries
Store tanks in a _______ position.
vertical
PASS acronym stands for?
P - pull pin
A - aim nozzle
S - squeeze trigger
S - sweep nozzle
Class A fires involve?
common combustibles such as:
- wood
- paper
- cloth
- rubber
- trash
- plastics
Class A fire symbol shape and color?
green triangle
Class B fires involve?
- flammable liquids
- solvents
- oil
- gasoline
- paint
- lacquers
- other oil-based products
Class B fire symbol shape and color?
red square
Class C fires involve?
- energized electrical equipment
- wiring
- controls
- motors
- machinery
- appliances
Class C fire symbol shape and color?
blue circle
Class D fires involve?
combustible metals (ex: magnesium, lithium, titanium)
Class D fire symbol shape and color?
yellow star
Class D fire extinguisher agent?
dry powder
Class K fires involve?
combustible cooking media such as oils and grease
Class K fire symbol shape and color?
black hexagon
Class K fire extinguisher agent?
wet chemical
JCAHO
Joint Commission on Accreditation of Healthcare Organizations
The _____________________ requires that all health-care institutions post evacuation routes and detailed plans to follow in the event of a fire.
Joint Commission on Accreditation of Healthcare Organizations (JCAHO)
RACE acronym stands for?
Rescue - rescue anyone in immediate danger
Alarm - activate the institutional fire alarm system
Contain - close all doors to potentially affected areas
Extinguish- attempt to extinguish the fire, if possible; exit the area
_________ is the most widely used cryogenic fluids (liquefied gases) in the laboratory
Liquid nitrogen
Liquid nitrogen or any cryogenic material may cause?
- fire or explosion
- asphyxiation
- pressure buildup
- embrittlement of materials
- tissue damage similar to that of thermal burns
____________ help eliminate bumping/boilover when liquids are heated.
Glass beads
5 Hierarchy of Controls?
- Elimination - blue, most effective
- Substitution - green
- Engineering Controls - yellow
- Administrative Controls - orange
- PPE - red, least effective
Hierarchy of Control: Completely remove the hazard from the workplace or the process, thus eliminating the risk entirely.
Elimination
Hierarchy of Control: Replace the hazardous material, process, or equipment with a safer alternative.
Substitution
Hierarchy of Control: Implement physical modifications to the workplace or equipment to isolate workers from the hazard or reduce exposure.
Engineering Controls
Hierarchy of Control: Develop and implement safety policies, procedures, and training to reduce the likelihood of exposure to hazards.
Administrative Controls
Hierarchy of Control: Provide workers with appropriate PPE, such as gloves, respirators, or protective clothing, to protect against the identified hazard.
Personal Protective Equipment (PPE)
4 Basic Waste Disposal Technique?
- Flushing down the drain
- Incineration
- Landfill burial
- Recycling
Strong acids and bases should be ___________ before disposal.
neutralized
Flammable solvents are collected in _________.
approved containers
Flammable material waste are put in ___________.
specially designed incinerators
Solid waste chemicals are brought to the ______.
landfill
Radioactive wastes are disposed depending on:
- type of waste (soluble/nonsoluble)
- level of radioactivity
- radiotoxicity
- half-life of isotopes involved
___________ are special waste from health care facilities. They are solid waste that, if improperly treated or handled, may transmit infectious diseases.
Medical waste
Medical wastes may be disposed in one of the following ways?
- steam sterilization
- incineration
- thermal inactivation
- burial
- chemical disinfection
- encapsulation in a solid matrix
Class E fires involve?
detonation fire and arsenal fire
What is the maximum amount of flammable liquid that can be stored?
5 gallons
A manufactured carcinogenic chemical used in clinical laboratories for detecting blood as a rubber-compounding agent.
Benzidine
Temperature for flammables?
lower than 37.8 degrees Celsius
Temperature for combustibles?
greater than 37.8 degrees Celsius
