C L1 NCHEM
LAB
Lab safety and regulation 1
Clinchem lab #1 “Laboratory safety and regulation”
● each professional must be "safety conscious” at all times
● safety begins with common sense
Occupational safety and Health act (OSHA)
● Public law (91 - 596)
● enacted by US congress in 1970
● The goal was to provide all employees with a safe work environment
● OSHA is authorized to conduct on-site inspections to determine whether an employer is
complying with the mandatory standard
Bloodborne pathogen (29 CFR 1910. 1030)
● applies to all exposure o to blood or other potentially infectious materials in any
occupation setting
● universal precautions and personal protective equipment are foremost among these
infection control measures
● "all human blood, tissue and most uids are treated as if known to be infections for hv
hepatitis B, and other blood borne pathogens."
Hazard Communication (29 CFR 1910.1200)
● Ensures that the hazards of all chemicals in the workplace have been evaluated and that
this hazard information is successfully transmitted to employers and their employees who
use the substances.
● Primary means of communication are through proper labeling, the development and use
of material safety data sheets (MSDSs), and employee education.
Standard precautions are intended to supplement rather than replace handwashing
Selection and use of gloves - vinyl or latex,Laboratory coats or gowns as barrier
protection
Facial barrier pro facial tection and occlusive bandages
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Occupational Exposure to Hazardous
Chemicals in the Laboratory (29 CFR
1910.1450)
● Address the shortcomings of the hazard communication standard regarding its application peculiar to the handling of hazardous
chemicals in laboratories.
● The Lab Standard requires the appointment of a chemical hygiene of cer and the development of a chemical hygiene plan to reduce
or eliminate occupational exposure to hazardous chemicals.
Other Regulations and Guidelines
● Clean Water Act
● Resource Conservation and Recovery Act
● Toxic Substances Control Act
● Clinical Laboratory Standards Institute (CLSI)
● The Joint Commission (TJC) - publishes a yearly accreditation manual for hospitals.
● College of American Pathologists (CAP) - publishes an extensive inspection checklist as part of their laboratory accreditation program.
SAFETY AWARENESS FOR CLINICAL
LABORATORY PERSONNEL
Safety Responsibility
● The employer and the employee share safety responsibility.
● The employer has the ultimate responsibility for safety and delegates authority for safe operations to supervisors.
● Safety management in the laboratory should start with a written safety policy.
Employer's Responsibilities
1. Establish laboratory work methods and safety policies
2. Provide supervision and guidance to employees
3. Provide safety information, training, personal protective equipment, and medical surveillance to employees.
4. Provide and maintain equipment and laboratory facilities that are adequate for the tasks required.
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Employee's Responsibilities
1. Know and comply with the established laboratory work safety methods.
2. Have a positive attitude towards supervisors, coworkers, facilities, and safety training.
3. Give prompt noti cation of unsafe conditions or practices to the immediate supervisor and ensure that unsafe conditions and practices
are corrected.
4. Engage in the conduct of safe work practices and use of personal protective equipment.
Signage and Labeling
• Appropriate signs to identify hazards are critical, not only to alert laboratory personnel to potential hazards, but also to identify speci c
hazards that arise because of emergencies such as re or explosion
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SAFETY EQUIPMENT
● Safety equipment has been developed speci cally for use in the clinical laboratory.
● The employer is required by law to have designated safety equipment available.
● All laboratories are required to have safety showers, eyewash stations, and re extinguishers and to periodically test and inspect the
equipment for proper operation.
● It is recommended to that safety showers deliver 30 to 50 gallons of water per minute at 20 to 50 psi.
● Other items that must be available for personnel to include re blankets, spill kits, and rst aid supplies
Biosafety Cabinets
● Biohazard hoods remove particles that may be harmful to the employee who is working with infective biologic specimens.
● The Center for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH) have described four levels of
biosafety which consists of combinations of laboratory practices and techniques, safety equipment, and laboratory facilities.
● Most contain HEPA (High-Ef ciency Particular Air) lters.
Chemical Storage Equipment
● Safety equipment is available for the storage and handling of chemicals and compressed gases.
● Safety carriers should always be used to transport 500 mL bottles of acids, alkalis, or other solvents, and approved satety cans should
be used for storing, dispensing, or disposing of ammables in volumes greater than 1 quart.
● Safety cabinets are required for the storage of ammable liquids and only specially designed, explosion-proof refrigerators should be
used to store ammable materials.
● Only the amount of chemical needed for that day should be available at the bench. Gas-cylinder supports or clamps must be used at
all times, and large tanks should be transported using handcarts.
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BIOLOGIC SAFETY
● All blood samples and other body uids should be collected, transported, handled, and processed using strict precautions.
● Gloves, gowns, and face protection must be used if splashing or splattering is likely to occur.
● Consistent and thorough hand washing is an essential component of infection control.
● Centrifugation of biologic specimens produces nely dispersed aerosols that are a high-risk source of infection.
Spills
● Any blood, body uid, or other potentially infectious material spill must be cleaned up, and the area or equipment must be disinfected
immediately
● Wear appropriate protective equipment
● Use mechanical devices to pick up broken glass or other sharp objects
● Absorb the spill with paper towels, gauze pads, or tissue
● Clean the spill site using a common aqueous detergent
● Disinfect the spill site using 10% bleach using appropriate contact time.
● Rinse and spill with water
● Dispose of all materials in appropriate biohazard containers
Bloodborne Pathogens
● In 1991, OSHA issued the nal rule for occupational exposure to bloodborne pathogens.
● The employer must have a written exposure control plan.
● Adopt a STANDARD PRECAUTIONS policy which considers blood and other body uids from all patients as potentially infectious.
Airborne Pathogens
● OSHA issued a statement in 1993 that the agency would enforce the CDC Guidelines for Preventing the Transmission of Tuberculosis
in Health Care Facilities.
● The purpose of the guidelines is to encourage early detection, isolation, and treatment of active cases. A TB exposure control program
must be established, and risks to laboratory workers must be assessed.
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CHEMICAL SAFETY
HAZARD COMMUNICATION STANDARD
● Also known as the Right to Know Law.
● Developed for employees who may be exposed to hazardous chemicals.
● Employees must be informed of the health risks associated with those chemicals.
To comply with the regulation, clinical laboratories must.
● Plan and implement a written hazard communication program.
● Obtain SDSs for each hazardous compound present in the workplace and
● have the SDSs readily accessible to employees.
● Educate all employees annually on how to interpret chemical labels,
SDSS,
● and health hazards of the chemicals and how to work safely with the
● chemicals.
● Maintain hazard warning labels on containers received or lled on-site.
● In 2012, OSHA adopted signi cant changes to the Hazard Communication Standard to
facilitate a standardization of international hazard communication programs.
● This new initiative was titled the Globally Harmonized System of Classi cation and
Labelling of Chemicals, or GHS.
● The primary improvements to the program involved more speci c criteria for classi cation
of chemicals; a uniform system of chemical labeling, including intuitive pictographs; and,
replacing the existing Material Safety Data Sheet (MSDS) program with the new SDS
format. These changes were phased in over a 3-year period, with the nal requirements
effective in June of 2016.
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Safety Data Sheet
● The SDS is a major source of safety information for employees who may use hazardous materials in their occupations.
● Employers are responsible for obtaining the SDS from the chemical manufacturer or developing an SDS for each hazardous agent
used in the workplace.
The information contained in the SDS must follow a speci c format, addressing each of the following 16 items:
● Section 1: Identi cation
● Section 2: Hazard identi cation
● Section 3: Ingredients information
● Section 4: First aid procedures
● Section 5: Fire- ghting 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
Safety Data Sheet
• The SDS must provide the speci c compound identity, together with all common names.
All information sections must be completed, and the date that the
SDS was printed must be indicated. Copies of the SDS must be readily accessible to employees during all shifts.
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OSHA Laboratory Standard
● Occupational Exposure to Hazardous Chemicals in Laboratories (29 CFR 1910.1450), also known as the laboratory standard, was
enacted in May 1990 to provide laboratories with speci c guidelines for handling hazardous chemicals.
● This OSHA standard requires each laboratory that uses hazardous chemicals to have a written chemical hygiene plan. This plan
provides procedures and work practices for regulating and reducing exposure of laboratory personnel to hazardous chemicals.
Toxic Effects from Hazardous Substances
• In the clinical laboratory, personnel should be particularly aware of toxic vapors from chemical solvents, such as acetone, chloroform,
methanol, or carbon tetrachloride, that do not give explicit sensory-irritation warnings. (x2mc+)
Storage and Handling
● Arrangements for the storage of chemicals will depend on the quantities of chemicals
needed and the nature or type of chemicals.
● Proper storage is essential to prevent and control laboratory res and accidents. Ideally,
the storeroom should be organized so that each class of chemicals is isolated in an area
that is not used for routine work.
● An up-to-date inventory should be kept that indicates location of chemicals, minimum/
maximum quantities required, shelf life, and so on. Some chemicals deteriorate over time
and become hazardous (e.g., ether forms explosive peroxides).
● Storage should not be based solely on alphabetical order because incompatible
chemicals may be stored next to each other and react chemically.
Different Chemicals
● FLAMMABLE/COMBUSTIBLE CHEMICALS
They are classi ed according to ash point, which is the temperature at which suf cient vapor is given off to form an ignitable mixture with
air.
A ammable liquid has a ash point below 37.8°C (100°F) and combustible liquids, by de nition, have a ash point at or above 37.8°C
(100°F).
Some commonly used ammable and combustible solvents are acetone, benzene, ethanol, heptane, isopropanol, methanol, toluene, and
xylene. It is important to remember that ammable chemicals also include certain gases, such as hydrogen, and solids, such as paraf n.
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● CORROSIVE CHEMICALS
These are injurious to the skin or eyes by direct contact or to the tissue of the respiratory and gastrointestinal tracts if inhaled or ingested.
Typical examples include acids and bases.
● REACTIVE CHEMICALS
Reactive chemicals are substances that, under certain conditions, can spontaneously explode or ignite or that evolve heat or ammable
explosive gases.
● CARCINOGENIC CHEMICALS
Carcinogens are substances that have been determined to be cancer-causing agents. OSHA has issued lists of con rmed and suspected
carcinogens and detailed standards for the handling of these substances. Benzidine is a common example of a known carcinogen. If
possible, a substitute chemical or different procedure should be used to avoid exposure to carcinogenic agents.
● CHEMICAL SPILLS
Strict attention to good laboratory technique can help prevent chemical spills. However, emergency procedures should be established to
handle any accidents. If a spill occurs, the rst step should be to assist/evacuate personnel, and then con nement and cleanup of the spill
can begin.
RADIATION SAFETY
● ENVIRONMENTAL PROTECTION
A radiation safety policy should include environmental and personnel protection.
All areas where radioactive materials are used or stored must be posted with caution signs, and traf c in these areas should be restricted to
essential personnel only.
● PERSONAL PROTECTION
It is essential that only properly trained personnel work with radioisotopes and that users are monitored to ensure that the maximal
permissible dose of radiation is not exceeded.
● NONIONIZING RADIATION
Non-ionizing forms of radiation are also a concern in the clinical laboratory. Equipment often emits a variety of wavelengths of
electromagnetic radiation that must be protected against through engineered shielding or use of PPE.
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FIRE SAFETY
Fire Chemistry
Fire is basically a chemical reaction that involves rapid oxidation of a combustible material or fuel, with the subsequent liberation of heat and
light.
The basic elements essential for re to begin are fuel, heat, ignition source, and oxygen. A fourth factor has been added which has been
thiso
classi ed as a reaction chain in which burning continues and even accelerates.
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OTHER HAZARDS
ELECTRICAL HAZARD
● Use only explosion-proof equipment in hazardous atmospheres.
● Be particularly careful when operating high-voltage equipment, such as electrophoresis
apparatus.
● Use only properly grounded equipment (three-prong plug).
● Check for frayed electrical cords.
● Promptly report any malfunctions or equipment producing a "tingle" for repair.
● Do not work on "live" electrical equipment.
● Never operate electrical equipment with wet hands.
● Know the exact location of the electrical control panel for the electricity of your work area.
● Use only approved extension cords and do not overload circuits.
● Have ground checks and other periodic preventive maintenance performed on
equipment.
COMPRESSED GASES HAZARDS
● Know the gas that you will use.
● Store tanks in a vertical position.
● Keep cylinders secured at all times.
● Never store ammable liquids and compressed gases in the same area.
● Use the proper regulator for the type of gas in use.
● Do not attempt to control or shut off gas ow with the pressure relief regulator.
● Keep removable protection caps in place until the cylinder is in use.
● Make certain that acetylene tanks are properly piped (the gas is incompatible with copper tubing).
● Do not force a "frozen" or stuck cylinder valve.
● Use a hand truck to transport large tanks.
● Always check tanks on receipt and then periodically for any problems such as leaks.
● Make certain that the cylinder is properly labeled to identify the contents.
● Empty tanks should be marked "empty."
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MECHANICAL HAZARDS
• In addition to physical hazards such as re and electric shock, laboratoy personnel should be aware of the mechanical hazards of
equipment such as centrifuges, autoclaves, and homogenizers.
ERGONOMIC HAZARDS
• The primary contributing factors associated with repetitive strain disorders are position/posture, applied force, and frequency of repetition.
Remember to consider the design of hand tools (e.g., ergonomic pipets), adherence to ergonomically correct technique, and equipment
positioning when engaging in any repetitive task.
DISPOSAL OF HAZARDS
● The safe handling and disposal of chemicals and other materials require a thorough knowledge of their properties and hazards.
● Generators of hazardous wastes have a moral and legal responsibility, as de ned in applicable local, state, and federal regulations, to
protect both the individual and the environment when disposing of waste.
There are four basic waste-disposal techniques:
1. Flushing down the drain to the sewer system
2. Incineration
3. Land ll burial
4. Recycling
Chemical Waste
● It is permissible to ush water-soluble substances down the drain with copious quantities of water.
● However, strong acids or bases should be neutralized before disposal.
● Foul-smelling chemicals should never be disposed of down the drain.
Other liquid wastes, including ammable solvents, must be collected in approved containers and segregated into compatible classes. If
practical, solvents such as xylene and acetone may be ltered or redistilled for reuse. If recycling is not feasible, disposal arrangements
should be made by speci cally trained personnel.
Flammable material also can be burned in specially designed incinerators with afterburners and scrubbers to remove toxic products of
combustion.
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Radioactive Waste
The radiation safety of cer should always be consulted about policies dealing with radioactive waste disposal. Many clinical laboratories
transfer radioactive materials to a licensed receiver for disposal
Biohazardous Waste
● Medical waste is de ned as special waste from healthcare facilities and is further de ned
as solid waste that, if improperly treated or handled, "may transmit infectious diseases."
● It comprises animal waste, bulk blood and blood products, microbiologic waste,
pathologic waste, and sharps.
● The approved methods for treatment and disposition of medical waste are incineration,
steam sterilization, burial, thermal inactivation, chemical disinfection, or
encapsulation in a solid matrix.
● Employers of health care workers must establish and implement an infectious waste
program.
● All biomedical waste should be placed into a bag marked with the biohazard symbol and
then placed into a leakproof container that is puncture resistant and equipped with a solid,
tight- tting lid.
● All containers must be clearly marked with the word biohazard or ts symbol.
● All sharp instruments, such as needles, blades, and glass objects, should be placed into
special puncture-resistant containers before placing them inside the bag and container.
● Needles should not be transported, recapped, bent, or broken by hand.
● All biomedical waste must then be disposed of according to one of the recommended
procedures.
● Potentially biohazardous material, such as blood or blood products and contaminated
laboratory waste, cannot be directly discarded. Contaminated combustible waste can be
incinerated.
● Contaminated noncombustible waste, such as glassware, should be autoclaved before
being discarded. Special attention should be given to the discarding of syringes, needles,
and broken glass that also could in ict accidental cuts or punctures.
● Appropriate containers should be used for discarding these sharp objects
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ACCIDENT DOCUMENTATION AND
INVESTIGATION
● Any accidents involving personal injuries, even minor ones, should be reported
immediately to a supervisor.
● The rst report of injury is used to notify the insurance company and the human
resources or employee relations department that a workplace injury has occurred.
● The investigation report should include information on the injured person, a description of
what happened, the cause of the accident (environmental or personal), other contributing
factors, witnesses, the nature of the injury, and actions to be taken to prevent a
recurrence. This report should be signed and dated by the person who conducted the
investigation.
● Because it is important to determine why and how an accident occurred, an accident
investigation should be conducted.
● Most accidents can be traced to one of two underlying causes: environmental (unsafe
conditions) or personal (unsafe acts).
● Environmental factors include inadequate safeguards, use of improper or defective
equipment, hazards associated with the location, or poor housekeeping.
● Personal factors include improper laboratory attire, lack of skills or knowledge, speci c
physical or mental conditions, and attitude.
● The employee's positive motivation is important in all aspects
● It is particularly important that the appropriate authority be noti ed immediately if any
individual sustains a needle puncture during blood collection or a cut during subsequent
specimen processing or handling.
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