PMLS 6: LABORATORY SAFETY Signage and Labeling

LAB SAFETY • Appropriate signs to identify hazards are critical

• Lab safety is considered a legal responsibility of • Manufacturer's provide precautionary labeling
the employer as well as moral obligation to the information for users:
employee. - Statement of the hazard
• Achieved through the application of common - Precautionary measures
sense, a safety-focused attitude, good personal - Specific hazard class
behavior, good housekeeping in all laboratory - First aid instructions for internal/external
work and storage areas, and above all, the contact
continual practice of good laboratory technique - Storage code
• Begins with RECOGNITION OF HAZARDS: - Safety code
- Electric shock - Personal protective gear and equipment
- Toxic vapors needed
- Compressed gases • In-house prepared reagents and solutions should be
- Flammable liquids labeled in a standard manner with the chemical
- Radioactive materials Corrosive substances identity, concentration, hazard warning, special
Mechanical trauma handling, storage conditions, date prepared,
- Poisons expiration date (if application), and preparer's
- Biological materials initials
• In handling such reagents and solution one should
SAFETY AWARENESS FOR CLINICAL LABORATORY wear protective gear and equipment’s such as: hand
PERSONNEL gloves and eye goggles

Safety Responsibilities: THE LAW AND SCIENCE OF LABORATORY SAFETY

EMPLOYER’S ▪ Establish laboratory work methods Occupational Safety and Health Administration
RESPONSIBILITES and safety policies. (OSHA)
▪ Provide supervision and guidance to • Implemented the "Occupational Safety and Health
employees.
Act of 1970"
▪ Provide safety information, training,
seminars, personal protective - the act governs safety in all types of workplaces
equipment, and medical surveillance including laboratories
to employees • OSHA requirements with the greatest day-to-day
▪ Provide and maintain equipment and impact for laboratories are the following:
laboratory facilities that are ✓ Recording and reporting workplace accidents,
adequate for the tasks required.
injuries, or illnesses
EMPLOYEE’S ▪ Know and comply with the
✓ Hazard Communication Standard
RESPONSIBILITY established laboratory work safety
methods specifying how workers must be made aware of
▪ Have a positive attitude toward hazardous materials in the workplace
supervisors, coworkers, facilities, ✓ Standards for chemical hygiene, including
and safety training occupational exposure to hazardous chemicals in
▪ Give prompt notification of unsafe the laboratories
conditions or practices to the
✓ Bloodborne Pathogens standard
immediate supervisor and ensure
that unsafe conditions and practices intended to minimize the risk of exposure to
are corrected bloodborne pathogens
▪ Engage in the conduct of safe work
practices and use of the personal.
protective equipment
 Environmental Protection Agency (EPA) White Corrosive • May harm skin, eyes,
• Enforces regulations under the Clean Air Act, the or mucous
Resource Conservation and Recovery Act, and other membranes.
environmental statutes • Store away from red,
blue, and yellow-
e.g. ventilation, air contamination, disposal of
coded reagents.
hazardous waste Gray Presents no • For general chemical
more than storage
Department of Transportation (DOT) moderate
• Enforces regulations it issues about transporting hazard in any of
all types of hazardous materials the categories
Exception Reagent • Store separately
e.g. transport of laboratory specimens
incompatible
Food and Drug Administration (FDA)
with other
• Approves new medicines and medical devices for
reagents of
safe after use
same color bar
e.g. toxicology, transfusion medicine, apheresis
Hazard code (4) Following the NFPA usage, each
Safety Officer
diamond shows:
• As for Velez College, all safety related concerns
1. RED segment (flammability),
(such as needle stick injury) should be reported to
2. BLUE segment (health; ie, toxicity),
the safety officer
3. YELLOW (reactivity).
• Who is our current safety officer?
(Print over each color-coded segment is a black number
showing the degree of hazard involved.)
Color of the diamond in the NFPA label indicates 4. The fourth segment, as stipulated by the NFPA,
hazard: is left blank.
• It is reserved for special warnings, such as
radioactivity.
• The numeric ratings indicate degree of hazard:
4 = extreme;
3 = severe;
2 = moderate;
1 = slight;
0 = none according to present data.

SAFETY EQUIPMENT
Personal Protective Equipment (PPE)
COLOR INDICATES • Is any equipment worn to minimize exposure to
Red Flammable • Store in an area for hazards that cause serious workplace injuries and
flammable reagents illnesses.
Blue Health hazard • Toxic if inhaled, • These injuries and illnesses may result from
ingested, or absorbed
contact from either chemical, radiological,
through the skin.
physical, electrical, mechanical, or other
• Store in a secure area.
Yellow Reactive and • May react violently workplace hazards
oxidizing with air, water, or • Personal protective equipment may include items
reagents other substances. such as gloves, safety glasses and shoes, earplugs
• Store away from or muffs, hard hats, respirators, or coveralls, vests
flammable and and full body suits.
combustible materials
 Safety showers Decontamination of spills
• Green-and-white sign above the safety shower & • Regardless of what type of spill, PPE must be used:
eyewash locations is helpful in locating them in an fluid-resistant cover gown & facial protection
Emergency • Heavyweight, puncture-resistant utility gloves are
• Must be within 100 ft. and within a 10-second recommended
walk of caustic and corrosive chemicals • Rubber boots or waterproof shoe covers if the spill
• Water should be moderately warm or lukewarm is large
for the full 15-minute cycle • If the spill contains broken glass, these should be
removed first with tongs and forceps or brush and
dustpan
• If the spill contains culture media, site should be
covered completely with absorbent materials.
After 10 minutes, cleanup procedures can be
started
• Generally, bleach is used to soak and disinfect
Eyewash stations
spills
• Must be within 100 ft, and within a 10-second
walk of caustic and corrosive chemicals
• Flush the eye from the inside corner of the eye
outward (inside to outside)
• Stations must be capable of providing a minimum
of 15 minutes of hands-free flushing capacity
• Water pressure should be gentle First aid supplies
• Water from eyewash station should be cultured • All employees must be trained in first aid & at a
every 6 months minimum, must know:
a. the location of the first aid kit
b. how to stop bleeding by direct pressure
with a gauze over the wound
c. emergency numbers.
d. cardiopulmonary resuscitation (CPR)
In addition, first aid kit must be available within the
Fire extinguishers laboratory, in a clearly marked box or cabinet
• used to help identify the location of a single or • Should contain the following:
multiple fire extinguishers. 1. Adhesive plastic bandages (large fingertip fabric
• They are generally mounted 2 meters above floor bandages, knuckle fabric bandages, triangular sling
level for visibility or adjacent to the fire with safety pins, gauze dressing pads, first aid tape
extinguisher. roll)
Fire blankets 2. Hot & cold gel packs
3. Sterile sponge dressings
4. Gauze roll bandages
5. Adhesive tape
6. Sterile eye pad
7. Eyewash
8. Alcohol prep pads
9. Antiseptic towelettes
10. Triple antibiotic ointment pack
11. Scissors Mask
12. Tweezers • Used when performing laboratory procedures
13. Burn spray with potential of splashes or sprays of infectious
14. Ibuprofen tablets materials and aerosol potential
15. Antacid tablets • Very little info is available about the effectiveness
16. Non-aspirin pain tablets of facemasks in controlling spread of flu
Mechanical pipetting devices • Flu virus is transmitted thru direct contact
Hoods • What is not known is the extent to which tiny
• Fume hoods aerosol particles are implicated in transmission.
- Required to expel noxious and hazardous Mask What It Filters When to Use
fumes from chemical reagents Type
- Biosafety hoods Surgical Bacteria When directly
remove particles that may be harmful to the employee mask working with a patient
who may be
who is working with infective biologic specimens
Immunocompromised
Chemical storage equipment N-95 Particles as Interaction with
- Safety carriers small as 0.1u patient known or
- Safety cabinets such as TB suspected of having
- Explosion proof refrigerators active TB: Culturing TB
specimen
Cartridge Organic When ppm of a
PERSONAL PROTECTIVE EQUIPMENT
purifying vapors such as hazardous chemical is
Laboratory Gowns xylene or above the action level
• Primary protection to prevent skin exposure from formaldehyde for that chemical
chemical or specimen (blood and other body
Gloves
fluids) splash or spill
• Disposable, single-use gloves when they have the
• Must be a bit loose, available as reusable or
potential for direct skin contact with infectious
disposable depending on laboratory application
materials and contaminated items or surfaces
• Aprons are not substitutes for lab gowns but
• Different types for different protection from
provide extra protection when fluid
infectious materials, chemicals, radioactive
contamination is likely (i.e. during autopsy)
contamination, cold and heat, sterile procedures,
• SHOULD NOT BE WORN OUTSIDE THE LAB!
and sharp edges
Use and Storage When to Change or
Replace • most commonly used material: vinyl, nitrile, and
Worn at all times while Changed when soiled latex
in lab work areas - Train employees in the proper use of gloves
"In-use" gowns hung on Replaced when - Select the right glove for each task
designated hooks in damaged - Inspect each glove for holes or tears & discard
work area if damage is found
Clean lab gowns stored
- Replace gloves that are torn, damaged, or
in cabinets or closets
soiled (when using)
- Wear gloves that completely cover the hands
and wrists
- Remove gloves aseptically (turning inside out)
- Never reuse gloves and NEVER WEAR GLOVES
IN NONBIOHAZARD AREAS
 Footwear • Prevent Nosocomial Infections.
• Comfortable • Know the Five Moments for Hand Hygiene
• Non-slip soles
• Must cover the entire foot CHEMICAL SAFETY
• Must be made of material that will not allow Hazards
blood, body fluids, or chemicals to soak o Toxic and poisonous
through o Flammable and combustible.
• You may be required to change footwears in o Corrosive
sterile areas such as OR, DR, or Nursery o Reactive
Safety Goggles o Carcinogenic
• Used to protect the eye against particles, Preventive measures
chemicals, water, glare and from thing o Know the nature of the chemical used.
striking the eyes o Mechanical pipetting aids must always
Work shield o Observe basic rule of pipetting "acid to water"
• Provide barrier protection to the facial area o Chemical spills containment.
and related mucous membranes (eyes, nose, o Use safety cans, fume hood, and cabinets.
lips) o Wear proper attire.
• Also considered an alternative to goggles o Observe proper storage and disposal.

BIOLOGICAL SAFETY ELECTRICAL SAFETY

• Biological Hazards/Biohazard are biological • Electrical Hazards is a dangerous condition where
substances that can pose as a human threat to health personnel can make electrical contact with an
when they are inhaled, eaten or come into contact energized equipment or conductor
with the skin • e.g., electric shock or burns or fault wirings of
• They can cause illnesses such as food poisoning, machines and equipment
tetanus, respiratory infections, or parasite infections Hazards
as well o Physical harm from shock or burns.
• Biological Health Hazards can include bacteria, o Danger from fire due to heat and sparks produced.
viruses, parasites, mold and fungi Preventive measures
• Blood spill, needle prick, immunization, and proper o Use only explosion proof equipment in hazardous
disposal of medical wastes are considered as a atmospheres. (ex. Explosion proof refrigerators)
biological hazard o Be particularly careful when operating high-voltage
Hazards equipment, such as electrophoresis apparatus.
• Observe universal precaution. Treat every o Use only properly grounded equipment (3-prong
patient specimen as potentially infectious. plug).
• All blood samples of patient with high risk o Check for "frayed" electrical cords.
should be processed with strict precaution. o Report any malfunctioning or equipment producing
• Specimen container should remain "capped" a "triangle" for prompt
during centrifugation. o Do not work on "live" electrical equipment.
o Never operate electrical equipment with wet hands.
• Any blood spills must be cleaned up and
o Know the exact location of the electrical control
disinfected immediately.
panel for the electricity to your work area.
• Individuals with any wounds or abrasions
o Use only approved extension cords and do not
wear finger cots/gloves handling blood
overload circuits.
specimens.
o Have a periodic preventive maintenance performed
• Immunization
on equipment.
 Ergonomic Hazards
FIRE SAFETY • Consider the design of hand tools, adherence to
• Fire Hazards is a type of occupation hazard that ergonomically correct technique, and equipment
either involves the presence of a flame, increased positioning when engaging in any respective task.
probability that uncontrolled fire will occur or
increase the severity of a fire should one occur CARDINAL SAFETY RULES OF THE CLINICAL
• Can include flames, sparks, hot objects, flammable LABORATORY
chemicals, and chemical accelerants that increases a
fires rate of spread Good personal behavior/habits
Hazards • Wear proper attire and protective clothing
o Flammable/combustible chemicals or materials • Tie back long hair
o Electric hazard • Do not eat, drink, or smoke in the work
Preventive measures • Never mouth pipette.
o Keep flammable substances in separate rooms. • Wash hands frequently.
o Use fire-resistant building products.
o Use explosion proof refrigerators. Good housekeeping
o Perform procedures that result in highly combustible • Keep work areas free of chemicals, dirty
reactions under water or in a vacuum chamber. glassware, and so on.
• Store chemicals properly
OTHER LABORATORY HAZARDS • Label reagents and solutions.
Radioactive materials • Post warning signs.
• Post caution signs to areas with radioactive
materials. Good laboratory technique
• Only trained personnel area allowed in the areas. • Do not operate new or unfamiliar equipment
• Practice proper disposal system. until you have received instruction and
authorization.
Mechanical Hazards • Read all labels and instructions carefully.
• Use of centrifuge properly. • Use the personal safety equipment that is
• Use glass beads to help eliminate boiling-over when provided.
liquids are heated. • For the safe handling, uses, and disposal
• Use tongs to remove hot glasswares from ovens, hot chemicals, learn their properties and hazards.
plates, or water baths. • Learn emergency procedures and become
• Handle with care sharp instruments as cork-borers, familiar with the location of fire exits, fire
needles, scalpel, blades. extinguishers, blankets, and so on.
• Be careful when transferring chemicals from
Cryogenic Materials (Liquid Nitrogen) container to container, always add acid to water
• Use gloves of impermeable material when handling slowly.
this kind of material.
• Store cryogenic fluids in well-insulated but loosely LABORATORY WASTES
stopped containers. • are materials used to sustain laboratory operations
that are no longer needed and should be discarded
Compressed Gases (ex. Propane) or disposed.
• Observe proper labeling and storage conditions. • Classified into hazardous and non-hazardous wastes.
• Follow correct handling and transport of tanks.
EXPLOSIVITY AND REACTIVITY LABORATORY WASTE MANAGEMENT
• includes waste that is unstable and reacts violently
when exposed to chemical change, releases toxic • Incineration (by burning)
fumes when mixed with water and even explode This is the most acceptable means of waste disposal.
under extreme conditions Incinerators are complex devices that contain secondary
• wastes that are capable of detonation and explosive equipment such as burners, scrubbers, electrostatic
decomposition at standard temp. and pressure precipitators, and filters.
CORROSIVITY • Microwave Treatment, Autoclaving (ex. Getting rid of
• includes waste that needs to be separated from pathogens/ contaminants in test tubes/ glass pipettes),
other wastes, waste that may react with heavy Plasma-based Systems, and Irradiation
metals to produce toxic contaminates, and corrode *Can plastic pipettes be autoclaved?
steel waste containers, and aqueous substances with • Sterilization
pH less than 2 or pH greater than 12.5 • Sewer Systems
TOXICITY
• waste that is harmful to humans and also the PROPER HAZARDOUS WASTE DISPOSAL PROCEDURES
environment as it stimulates the leaching of • Hazardous wastes are to be placed in a compatible,
materials from a landfill into the surround nonleaking container, with a nonleaking sealable lid.
groundwater. • It should contain the following information:
IGNITABILITY - Laboratory name (department or division)
• includes waste that can cause a fire during routine - Labels "Caution-Toxic" and "Hazardous Wastes"
waste disposal and storage conditions, ignitable gas - Identification of components
from flammable mixture at 13% or less - hazard information, concentration and content
concentration - Quantity
• solid substances that may cause fire through friction - Check the number of containers.
or absorption of moisture • Labeling of Waste
INFECTIOUS WASTE Label all waste bottles properly as "Hazardous
• these are wastes suspected to contain pathogenic Wastes." which are the only acceptable words.
microorganisms. (ex. Cotton, bandages used to Labels of old containers should be completely
disinfect, tissues form patients who sneezed) removed or defaced.
PATHOLOGICAL WASTES • Segregation of Waste
• include human and animal tissues, organs, body - Segregate laboratory wastes chemical wastes, as
parts (excluding teeth, hair, fingernails), and body pathological wastes, biological wastes, and
fluids that are removed during autopsy, biopsy, radioactive wastes.
surgery or other medical procedure. - The wastes should be separated based on
CHEMICAL WASTES chemical compatibility in order to prevent
• include discarded solids, liquids, and gaseous violent chemical reaction.
chemicals from laboratory procedures, and include - Acids, bases, and organic wastes should not be
laboratory reagents stored in the same cabinet.
BIOMEDICAL WASTES • Storage of Wastes
• wastes generated in diagnostic laboratories, - Do not store wastes in a fume hood where
including pathology laboratories, are considered reactions take place as this may trigger a violent
biochemical wastes. reaction or might cause a fire.
- Do not use metal cans for storing wastes since
they might corrode in a short time; instead use
polyethylene containers.
 - Containers for flammable waste should be • Improper labeling of the waste container.
stored in an explosion-resistant solvent cabinet. • Failure to close/seal the waste container.
• Capping Waste Bottles • Improper segregation of the wastes.
• Waste bottles should be capped to prevent the • Improper storage of the wastes.
release of contents. • Using an improper waste container.
• Accumulation of Excessive Wastes • Accumulation of too much waste.
• Only one waste container of each type should be
in the laboratory. If an organic waste bottle is BLOODBORNE PATHOGEN ISSUES SPECIFIC FOR
full, it should be sent to the stockroom for LABORATORY SECTIONS
disposal. A number of laboratory sections face unique bloodborne
pathogen issues, as described in the following:
Common Plastic Bags for Disposal
1. Black Bag – for dry and non-infectious wastes Phlebotomy
(ex. barrel of syringes that are unused, wrappers, • Single-use latex-free tourniquets are recommended
boxes of syringes) in order to maintain good infection control
2. Yellow Bag – for infectious wastes • Employees are required to use gloves during
3. Red Bag – for shards of broken glass and tourniquet procedures
needles/ sharp objects • Use needle holders with evacuated blood tube only
once
GUIDELINES FOR LAB WASTE SEGREGATION • Use hematocrit tubes made of plastic or Mylar
• Do not store the following wastes close to each wrapped glass
other:
- acids and bases; organic materials and acids; Hematology
cyanides, sulfides, arsenic compounds, and acids • Use sealant for hematocrit tubes only once, do not
- powdered or reactive metals and combustible reform for re-use
materials • Decontaminate sedimentation racks frequently
- mercury, silver, and ammonium compounds.
• Waste containers should be solid, with no cracks, Microbiology
rust, or deterioration; compatible with the waste • Work with Mycobacterium tuberculosis (TB) cultures
and the contents; in the laboratory and not in in a Class II Biosafety Cabinet (BSC) level 3
hallways, floor drains, or the sink. • Secure blood culture bottles in a holding device that
• Should be taken to the stockroom for disposal allows for easy entry and removal of the needle
• Should be properly labeled with its FULL • Place a gauze square on the stopper of inoculated
CHEMICAL NAME media
• Biochemical wastes should be segregated based
on their categories and their source of Chemistry
generation: patient, care activity areas, • Decontaminate equipment at the end of each shift
diagnostic services, operating rooms, delivery • Consider all waste from analyzers to be
rooms, treatment rooms, and so on. Biomedical contaminated and discard it
wastes must be collected within 24 hours and • Never re-cap or remove contaminated needles and
the biomedical waste management and handling other contaminated sharps except where no
rules should be adhered to when doing so. alternative is feasible, and the medical procedure
requires it (e.g. blood gas analysis)
ERRORS ENCOUNTERED IN HANDLING Blood Bank
HAZARDOUS LABORATORY WASTES
• Failure to label the waste container.
• When tubing is returned to the blood bank with the HOW TO USE FIRE EXTINGUISHER
needle attached, heat seal, clamp, or tie it, cut the • RESCUE, ALARM, CONFINE,
tube, and discard it in a sharps container EXTINGUISH/EVACUATE (RACE)
➢ An acronym that hospital personnel use to
Anatomic pathology remember their duties in case of fire
• Wrap known or suspected TB tissue blocks in
cellophane or plastic bags before filling
• Decontaminate the cryostat daily with at least 70%
ethanol solution
• Always consider trimmings and sections of tissue to
be infectious
• Wear stainless steel mesh or sharp impermeable
gloves when changing knife blades
• Consider all solutions used for staining frozen
sections to be contaminated
• Never store or process reusable sharps, place them • PULL, AIM, SQUEEZE, SWEEP (PASS)
in puncture-resistant label color coded, leakproof ➢ An acronym that hospital personnel use to
containers. remember their duties for discharging a fire
extinguisher.
1. Pull the pin at the top of the extinguisher that
keeps the handle from being accidentally
pressed.
2. Aim the nozzle toward the base of the fire.
3. Stand approximately 8 feet away from the fire
and squeeze the handle in short intervals to
discharge the extinguisher.
4. Sweep the nozzle back and forth at the base of
the fire. After the fire appears to be out, watch it
carefully since it may re-ignite!