LABORATORY SAFETY IN THE CLINICAL MICROSCOPY SECTION

 To work safely in this environment, laboratory personnel must learn what hazards exist, the basic safety
precautions associated with them, and how to apply the basic rules of common sense required for everyday safety
for patients, co-workers, and themselves.
 Safety procedure manuals must be readily available in the laboratory that describe the safety policies mandated by
the Centers for Disease Control and Prevention (CDC) and the Occupational Safety and Health Administration
(OSHA). The Clinical and Laboratory Standards Institute (CLSI) provides the guidelines for writing these
procedures and policies.
 The manual must be updated and reviewed annually by the laboratory director.
PERSONAL SAFETY

 Use fume hoods whenever possible when dispensing or pipetting dangerous chemicals.
 Safety goggles/glasses with side shields should be worn at all times in the laboratory.
 Fluid-resistant laboratory coats (buttoned up) will be worn at all times in the laboratory and removed when
leaving the laboratory.
 Gloves will be worn when contact with blood and body fluids is expected in the laboratory and removed when
leaving the laboratory.
 Do not mouth pipet.
 Avoid having long hair, loose sleeves/cuffs, rings, bracelets, etc. dangling in front of your eyes or outside of your
laboratory coat.
 Do not apply cosmetics in the laboratory.
 Eating and drinking is not allowed in the laboratory.

TYPES OF SAFETY HAZARD

TYPE SOURCE POSSIBLE INJURY
Biologic Infectious agents Bacterial, fungal, viral, or parasitic infections
Sharps Needles, lancets, and Cuts, punctures, or blood-borne pathogen exposure
broken glass
Chemical Preservatives and reagents Exposure to toxic, carcinogenic, or caustic agents
Radioactive Equipment and Radiation exposure
radioisotopes
Electrical Ungrounded or wet Burns or shock
equipment; frayed cords
Fire/explosive Open flames, organic Burns or dismemberment
chemicals
Physical Wet floors, heavy boxes, Falls, sprains, or strains
patients

BIOLOGIC HAZARDS

 Harmful microorganisms are frequently present in the specimens received in the clinical laboratory.
 Infection control refers to procedures health-care facilities have developed to control and monitor infections
occurring within their facilities.
 Universal Precautions (UP) – All patients are considered to be possible carriers of blood-borne pathogens;
recommends wearing gloves when collecting or handling blood and body fluids contaminated with blood and
wearing face shields when there is danger of blood splashing and when disposing needles and sharp objects.
Excluded urine and body fluids not visibly contaminated by blood.

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 Body Substance Isolation (BSI) – modified UP; considers all body fluids and moist body substances to be
potentially infectious; personnel should wear gloves at all times when encountering moist body substances. They
do not recommend handwashing after removing gloves unless visual contamination is present.
 Standard Precautions – In 1996, the Centers for Disease Control and Prevention (CDC) and the Healthcare
Infection Control Practices Advisory Committee (HICPAC) combined the major features of UP and BSI
guidelines and called the new guidelines Standard Precautions.

CHAIN OF INFECTION
INFECTIOUS RESERVOIR PORTAL OF MEANS OF PORTAL OF SUSCEPTIBLE
AGENT EXIT TRANSMISSI ENTRY HOST
ON
Bacteria Humans Nose Droplet Nose Patients
Fungi Animals Mouth Airbone Mouth Elderly
Parasites Insects Mucous Contact Mucous Newborns
membrane membranes
viruses Fomites Specimen Vector (from an Skin Immunocompromised
(inanimate collection animal or insect
objects) bite)
Blood/body Vehicle Unsterile Health care workers
fluids equipment
 CHAIN OF INFECTION
o The chain of infection requires a continuous link between an infectious agent, reservoir (where an agent
lives and possibly multiply), a portal of exit, a means of transmission, a portal of entry, and a susceptible
host.
o Preventing completion of the chain of infection is a primary objective of biologic safety.
o BREAK THE LINK:
 Reservoir: disinfection; hand hygiene
 Portal of exit: sealed biohazardous waste containers;
sealed specimen containers; hand hygiene; standard
precautions
 Means of transmission: hand hygiene; standard
precautions; PPE; patient isolation
 Portal of entry: hand hygiene; standard precautions;
PPE: sterile equipment
 Susceptible host: immunizations; patient isolation;
nursery precautions; healthy lifestyle
 PERSONAL PROTECTIVE EQUIPMENT – includes gloves,
fluid-resistant gowns, eye and face shields, and Plexiglas countertop
shields.
o Gloves can either be sterile or nonsterile, powdered or
unpowdered, and latex or nonlatex.
o Fluid-resistant gowns with wrist cuffs are worn to protect clothing and skin from exposure to patients’
body substances. Must be completely buttoned and gloves should be pulled over the cuffs.
o Shoes must be closed-toed and cover the entire foot.

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  HAND HYGIENE
1. Wet hands with warm water. Do not allow parts of body to touch the sink.
2. Apply soap, preferably antimicrobial.
3. Rub to form a lather, create friction, and loosen debris. Thoroughly clean between the fingers and under
the fingernails for at least 20 seconds; include thumbs and wrists in the cleaning.
4. Rinse hands in a downward position to prevent recontamination of hands and wrists.
5. Obtain paper towel from the dispenser.
6. Dry hands with paper towel.
7. Turn off faucets with a clean paper towel to prevent contamination.
 WASTE COLLECTION
1. Dispose of biohazardous substances in biohazard bags.
2. Dispose of swab wrappings, band aid wrappings, used paper towels, kit boxes,
and any other non-biohazardous waste in regular trash bags.
3. Dispose of all used needles, pipettes, broken glass, and slides in plastic
biohazardous sharps containers.
4. Dispose of all used tubes in red biohazard bags.
5. Dispose of all bacterial and fungal culture plates in red biohazard bags.
6. Do not throw non-biohazardous waste into red biohazard bags.
 Biologic waste disposal: All biologic waste, except urine, must be placed in appropriate containers labeled with
biohazard symbol. The waste is then decontaminated following institutional policy (incineration, autoclaving, or
pickup by a certified hazardous waste company).
SHARP HAZARDS

 All sharp objects must be disposed in puncture-resistant, leak-proof containers

with the biohazard symbol.
 Puncture-resistant containers should be conveniently located within the work area.
CHEMICAL HAZARDS

 When skin contact occurs, the best first aid is to flush the area with large amounts
of water for at least 15 minutes, then seek medical attention.
 Safety showers provide an effective means of treatment in the event that chemicals
are spilled or splashed into skin or clothing.
 Acid should always be added to water to avoid the possibility of sudden splashing caused by the rapid generation
of heat in some chemical reactions.
 FLAMMABILITY
o It is a measure of how easily a gas, liquid, or solid will ignite and how quickly the flame, once started,
will spread.
o Flammable liquids themselves are not flammable; rather, the vapor from the liquids are combustible.
o Two physical properties of a material that indicate its flammability: flash point and volatility (boiling
point).
 Flash point – is the temperature at which a liquid (or volatile solid) gives off vapor in quantities
significant enough to form an ignitable mixture.
 Volatility – is an indication of how easily the liquid or solid will pass into the vapor stage.

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  Occupational Safety and Health Administration (OSHA) requires all facilities that use hazardous chemicals to
have a written chemical hygiene plan (CHP) available to employees.
The purpose of the plan is to detail the following:
o Appropriate work practices Hazardous Materials Classification

o Standard operating procedures

o PPE
o Engineering controls, such as fume hoods and flammables
safety cabinets
o Employee training requirements
o Medical consultation guidelines
 The National Fire Protection Association (NFPA) has developed
the Standard System for the Identification of the Fire Hazards of
Materials. The diamond-shaped, color-coded symbol contains
information relating to health, flammability, reactivity, and personal
protection/special precautions.
RADIOACTIVE HAZARDS

 The amount of radiation exposure is related to a combination of time, distance, and shielding.
 Exposure to radiation during pregnancy presents a danger to the fetus; personnel who are
pregnant should avoid areas with this symbol.

ELECTRICAL HAZARDS

 All electrical equipment must be grounded with three-pronged plugs.

FIRE/EXPLOSIVE HAZARDS

 Alarms are designed so that endangered personnel are alerted. All individuals should become familiar with the
exact location of the fire alarm stations nearest to the laboratory.
 FIRE PREVENTION
o Be aware of ignition sources in the laboratory area (heat sources or electrical equipment).
o Do not store flammable liquids in standard refrigerators. Explosion-proof refrigerators are needed for
storage of flammable liquids.
o Store flammable liquids in appropriate safety cabinets/safety cans.
o Make sure that all electrical cords are in good condition.
 When a fire discovered, all employees are expected to take the actions in the acronym RACE:
o RESCUE – rescue anyone in immediate danger
o ALARM – activate the institutional fire alarm system
o CONTAIN – close all doors to potentially affected areas
o EXTINGUISH/EVACUATE – attempt to extinguish the fire or evacuate
 When operating a fire extinguisher, remember the acronym PASS:
o Pull the pin
o Aim at the base of the fire
o Squeeze handles
o Sweep nozzle from side to side
 Type E fire is arsenal fire.

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 TYPES OF FIRES AND FIRE EXTINGUISHERS
FIRE TYPE EXTINGUISHING TYPE/COMPOSITION OF EXTINGUISHER
MATERIAL FIRE
Class A Wood, paper, clothing Class A Water
Class B Flammable organic Class B Dry chemicals, carbon
“B for Basa (wet) = chemicals or flammable dioxide, foam or halon
chemicals” liquids
Class C Electrical Class C Dry chemicals, carbon
“C for Curente = dioxide, or halon
Electrical”
Class D Combustible metals None Sand or dry powder
Class ABC Dry chemicals
Class K Grease, oils, fats or kitchen Class K Liquid designed to prevent
“K for Kaon/Kain = wastes splashing and cool the fire
Kitchen”

 Types of Health Hazards

o Biohazards
- Anything that can cause disease in humans, regardless of its source.
o Irritants
- Chemicals that cause reversible inflammatory effects at the site of contact with living tissue
(eyes, skin, and respiratory passages)
o Corrosive chemicals
- Causes destruction or irreversible alterations when exposed to living tissue or destroy
inanimate objects
o Allergens or sensitizer
- Causes allergic reaction in a substantial proportion of exposed subjects, not just with
hypersensitive individuals.
o Carcinogens
- Substances that induce tumors and present a high risk to humans
o Toxic materials
- Capable of causing death by ingestion, skin contact or inhalation at certain concentrations

BLOOD-BORNE PATHOGENS

 These includes, but not limited to, HIV, HBV, and HCV are transmitted through contact with infected blood and
body fluids including:
o Semen
o Vaginal secretions
o Cerebrospinal fluid (CSF)
o Synovial fluid
o Pleural fluid
o Peritoneal fluid
o Amniotic fluid
o Saliva (in dental procedures)
o Any body fluid visibly contaminated with blood

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 Blood-borne diseases are most commonly transmitted by sexual contact, sharing of hypodermic needles,
puncture from contaminated needles, glass or sharps, contact between broken or damaged skin and infected body
fluids, and contact between mucous membranes and infected body fluids.