Safety

Explain terms and concepts associated with OSHA safety protocols including blood-borne pathogens and "right to know"

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Recognize and describe symbols utilized in the laboratory to identify cautions and hazards

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List the 3 classification of fires.

1. Class A 2. Class B 3. Class C 4. Class D

Materials that use the oxidizer symbol.

1. Oxidizers--gases, liquids, solids 2. peroxide formers--low-power explosives that are sensitive to shock, sparks or other accidental ignition

Outline steps required in documentation of an accident in the workplace

1. Report to supervisor immediately 2. First report of injury 3. accident investigation report 4. annual summary

What should you do if a spill occurs?

1. alert others in the area 2. wear appropriate PPE 3. use mechanical devices to pick up broken glass/sharp objects 4. absorb spill with paper towels, gauze pads, or tissue 5. clean the spill site using a common aqueous detergent 6. disinfect the spill site using approved disinfectant or 10% bleach, using appropriate contact time 7. dispose of all materials in appropriate biohazard containers

Radiation Safety: Environmental Protection

1. all areas where radioactive materials are used or stored must be posted with caution signs, and traffic in these areas should be limited to essential personnel only

What should you do if a chemical is spilled?

1. assist/evacuate personnel 2. confinement of spill 3. spill clean up 4. emergency procedures should include a reporting system

Class C fire extinguishers

1. carbon dioxide 2. halon 3. multipurpose dry-chemical

Identify hazards related to handling biological specimens.

1. centrifugation of biologic specimens produces finely dispersed aerosols that are a high-risk source of infection 2. spills 3. blood borne pathogens 4. airborne pathogens 5. shipping

The Medical Waste Tracking Act of 1988

1. charge the EPA with the responsibility to establish a program to track medical waste from generation to disposal 2. define medical waste 3. establish acceptable techniques for treatment and disposal 4. establish a dept with jurisdiction to enforce new laws 5. implementation of procedures

Discuss safety awareness for clinical laboratory personnel.

1. employer and employee share safety responsibility 2. employee has an obligation to follow safe work practices and be attentive to potential hazards 3. employer has the ultimate responsibility for safety and delegates authority for safe operations to lab managers/supervisors--should start with a written safety policy

Blood borne pathogen exposure

1. employers must have a written exposure control plan to minimize employee exposure; must be available to all employees 2. special precautions must be taken when handling all specimens because of continual increase in proportion of infectious samples received in the laboratory

OSHA

1. enacted by US Congress in 1970 2. provides all employees with a safe work environment 3. authorized to conduct on-site inspections 4. Bloodborne Pathogen Standard, Formaldehyde Standard, Laboratory Standard, Hazard Communication Standard, Respiratory Protection Standard, Air Contaminants Standard, Personal Protective Equipment Standard

Nonionizing radiation

1. equipment often emits a variety of wavelengths of electromagnetic radiation that must be protected against through engineered shielding or use of PPE 2. varying biologic effects, depending on wavelength, power intensity, and duration of exposure

List the responsibilities of the employer in providing a safe workplace.

1. establish laboratory work methods and safety policies 2. provide supervision and guidance to employees 3. provide safety information, training, PPE, and medical surveillance to employees 4. provide and maintain equipment and laboratory facilities that are free of recognized hazards and adequate for the tasks required.

What should you do in the event of a fire in the lab?

1. evacuate all personnel, patients, and visitors who are in immediate danger 2. activated the fire alarm 3. report the fire 4. if possible, attempt to extinguish the fire

List the 3 classes of materials that use the explosive symbol.

1. explosives 2. water reactive--materials that react violently with water 3. unstable reactives--chemicals that can react or can become self-reactive when subjected to shock, pressure, or temperature

Hazards of using cryogenic materials

1. fire or explosion 2. asphyxiation 3. pressure buildup 4. embrittlement of materials 5. tissue damage similar to thermal burns

List the 3 classes of materials that use the fire symbol.

1. flammables--gases/solids; flashpoint under 100F (37.8C) 2. combustibles--similar to flammables but do not ignite easily; flashpoint above 100F 3. Pyrophoric--spontaneous combustible materials; burst into flames on their own at temperatures below 130F

What are the 4 basic waste disposal techniques?

1. flushing down the drain into the sewer system 2. incineration 3. landfill burying 4. recycling

Elements essential for a fire to begin

1. fuel 2. heat or ignition source 3. oxygen (air) 4. reaction chain which burning continues and even accelerates; caused by breakdown and recombination of the molecules from the material burning with oxygen in the atmosphere

Airborne pathogen exposure

1. global resurgence of TB 2. OSHA--CDC guidelines for Preventing the Transmission of TB in HCF----encourage early detection, isolation, and treatment of active cases

Toxic effects from hazardous substances.

1. have the potential of producing deleterious effects by direct chemical action or interference with the function of body systems 2. can cause acute/chronic effects related to duration of exposure 3. exposure can be through direct contact, inhalation, ingestion, or inoculation/injection 4. should be aware of toxic vapors from chemical solvents such as acetone that do not give sensory irritation warnings 5. air sampling and routine monitoring = quantify dangerous levels 6. mercury is a source of poisonous vapors; highly toxic and volatile and rapidly absorbed through the skin and respiratory tract

Approved methods for disposal of biohazardous waste

1. incineration 2. steam sterilization 3. burial 4. thermal inactivation 5. chemical disinfection 6. encapsulation in a solid matrix

Occupational Exposure to Hazardous Chemicals in Laboratories Standard

1. intended to address the shortcomings of the Hazard Communication Standard 2. requires appointment of chemical hygiene officer and development of a chemical hygiene plan

Hazard Communication Standard

1. intended to ensure that the hazards of all chemicals used in the workplace have been evaluated and that this hazard information is successfully transmitted to employees who use the substances 2. primary means of communication: safety data sheets and employee education

Accident investigation report

1. investigation into the cause of what happened 2. cause can usually be traced back to environmental or personal factors

List the employee's responsibilities in providing a safe workplace.

1. know and comply with the established laboratory safe work practices 2. have a positive attitude toward supervisors, coworkers, facilities, and safety training 3. be alert and give prompt notification 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; use of PPE

General requirements for safely handling compressed gases

1. know the gas you will use 2. store tanks in a vertical position 3. keep cylinders secured at all times 4. never store flammable liquids and compressed gases in the same area 5. use the proper regulator, tubing, and fittings, for the type of gas in use 6. do not attempt to control or shut off gas flow with the pressure relief regulator 7. keep removable protection caps in place until the cylinder is in use 8. do not force a "frozen" or stuck cylinder valve 9. use a hand truck to transport large cylinders 10. always check cylinders on receipt and then periodically for any problems such as leaks 11. make certain that the cylinder is properly labeled to identify the contents 12. empty tanks should be marked "empty"

Bloodborne Pathogens Standard

1. mandates "Universal Precautions" to prevent, evaluate, and manage exposure to bloodborne pathogens 2. presume all blood, tissue, and fluids are infected 3. requires a written "Exposure Control Plan"

Class B fire extinguishers

1. multipurpose dry-chemical 2. carbon dioxide

Chemical Waste Disposal: Flammable material

1. must be collected in approved containers and segregated into compatible classes 2. xylene and acetone may be filtered or redistilled for reuse 3. can also be burned in specially designed incinerators with afterburners and scrubbers to remove toxic products of combustion

Precautions when working with cryogenic materials

1. only containers constructed of materials designed to withstand ultralow temperatures should be used for cryogenic work 2. use eye/face protection 3. hand protection to guard against touching supercool surfaces; should fit loosely so they can be taken off quickly if liquid spills on or into them 4. specimens to be frozen should always be inserted into the coolant very slowly to minimize violent boiling/frothing and splashing 5. should be stored in well insulated but loosely stoppered containers that minimize loss of fluid resulting from evaporation by boil-off and that prevent plugging and pressure buildup

Radiation Safety: Personal Protection

1. only properly trained personnel should work with radioisotopes 2. users should be monitored to ensure that the maximal permissible dose of radiation is not exceeded 3. radiation monitors should be evaluated regularly to detect degree of exposure for the lab employee 4. records must be maintained for length of employment plus 30 years

Chemical Waste Disposal: Combustible material and carcinogens

1. peroxides--combustible 2. should be transformed whenever feasible

Class A fire extinguishers

1. pressurized water 2. foam and multipurpose dry-chemical

OSHA Laboratory Standard

1. provides labs with specific guidelines for handling hazardous chemicals 2. chemical hygiene plan

Chemical Hygiene Plan

1. provides procedures and work practices for regulating and reducing exposure of lab personnel to hazardous chemicals (those that pose a physical/health hazard from acute/chronic exposure) 2. procedures describing how to protect employees against teratogens, carcinogens, and other toxic substances 3. training in the use of hazardous chemicals provided to all employees 4. recognition of signs/symptoms of exposure 5. location of SDS 6. location of chemical hygiene plan 7. how to protect themselves 8. chemical hygiene officer must be designated

Annual summary of workplace injuries

1. recorded on OSHA injury/illness form 2. forwarded to U.S. Dept of Labor, Bureau of Labor Statistics' OSHA injury and illness log

examples of reactive chemicals

1. some strong acids/bases react with water to generate heat (exothermic reaction) 2. hydrogen is liberated if alkali metals (sodium/potassium) are mixed with water or acids, and spontaneous combustion may also occur 3. mixing oxidizing agents, such as peroxides, and reducing agents, such as hydrogen, generates heat and may be explosive

What do the disposal of radioisotopes depend on?

1. the type of waste: insoluble or soluble 2. its level of radioactivity 3. the radiotoxicity and half-life of the isotopes involved

Shipping of biological specimens

1. there are 2 types of classification: (1) infectious substances--label for known or suspect infectious and (2) diagnostic specimens--label for specimens tested as routine screening for initial diagnosis

Precautionary measures when working with electrical equipment

1. use only explosion-rated equipment in hazardous atmospheres 2. be careful when operating high-voltage equipment such as electrophoresis apparatus 3. use only properly grounded equipment (3 prong plug) 4. check for frayed electrical cords 5. promptly report any malfunctions or equipment producing a "tingle" for repair 6. do not work on "live" electrical equipment 7. never operate electrical equipment with wet hands 8. know the exact location of the electrical control panel for the electricity to your work area 9. use only approved extension cords in temporary applications and do not overload circuits 10. have ground, polarity, and leakage checks and other periodic preventative maintenance performed on outlets and equipment

First report of injury

1. used to notify insurance company and HR that workplace injury has occurred 2. usually filled out by supervisor and employee 3. forwarded to institution's risk manager or insurance rep

Chemical Spills: C.L.E.A.N.

C--contain the spill L--leave the area E--emergency: eye wash, shower and medical attention A--access MSDS N--notify supervisor

Bloodborne Pathogens: Categories of exposure

Category 1: exposed to blood and body fluids on a daily basis Category 2: regularly exposed to blood and body fluids Category 3: never exposed to blood and body fluids Employees must offer HBV vaccine at no cost to all personnel in Category 1 and Category 2

Chemical Waste Disposal: Foul-smelling chemicals

NEVER dispose of down the drain

Fire Safety: R.A.C.E.

R--rescue injured A--alarm C--contain fire, close doors E--emergency number; extinguish if small

How to use a fire extinguisher

Remove pin from fire extinguisher Slowly squeeze the handle Aim at base of fire Walk slowly up to fire while moving extinguisher in sweeping motion

What precautions should be used when collecting, handling, transporting, and processing all blood samples and other body fluids?

Universal Precautions

Fire

a chemical reaction that involves the rapid oxidation of a combustible material or fuel, with the subsequent liberation of heat and light

sharps container

a container used for the disposal of needles and required in health care facilities to be in compliance with OSHA standards

Right-to-Know

a law developed for employees who may be exposed to hazardous chemicals in the workplace 1. employees must be informed of the health risks associated with those chemicals 2. written hazard communication program 3. obtain SDSs for each hazardous compound present in the workplace and have SDSs readily available to employees 4. educate all employees annually on how to interpret chemical labels, SDSs, and health hazards of chemicals and how to work safely with the chemicals.

decontamination

a process that removes or destroys microorganisms to render an object safe for use and eliminates infection transmission

How are flammable/combustible chemicals classified?

according to flash point = the temperature at which sufficient vapor is given off to form an ignitable mixture in the air

common flammable/combustible chemicals

acetone, benzene, ethanol, heptane, isopropanol, methanol, toluene, xylene can also be gases such as hydrogen gas and solids such as paraffin

examples of corrosive chemicals

acids (acetic, sulfuric, nitric, hydrochloric) bases (ammonium hydroxide, potassium hydroxide, sodium hydroxide)

Universal Precautions

an approach to infection control in which all human blood, tissue, and most fluids are handled as if known to be infectious

flash point of combustible liquid

at or above 37.8*C (100*F)

Biohazardous Waste: contaminated non-combustible waste

autoclaved

contaminated noncombustible waste

autoclaved before being discarded

flash point of flammable liquid

below 37.8*C (100*F)

example of carcinogen

benzidine

potentially hazardous material, such as blood or blood products and contaminated lab waste

cannot be directly discarded

external exposure of corrosive chemicals

cause severe burns and require immediate flushing with copious amounts of water

Bloodborne pathogens: Cleaning up spills

clean immediately with 1:10 dilution of 5% household bleach

Class D fires

combustible/reactive metals, such as magnesium, sodium, and potassium

Compressed gases present a unique combination of hazards in the laboratory

danger of fire, explosion, asphyxiation, mechanical injuries

When must gloves, gowns, and face protection be worn?

during manipulations or transfers when splashing or splattering is most likely to occur

Class C fires

energized electrical equipment

Class D fire extinguishers

extinguishment is left to firefighters using a special dry-chemical generally all that can be done in the lab is to try and isolate the burning metal from combustible surfaces with sand or a ceramic barrier material

What can indirect hazards of electrical energy result in?

fire or explosion

Class B fires

flammable liquids/gases and combustible petroleum products

What is an essential part of infection control?

hand washing

when will a fire extinguish?

if any of the 3 basic elements (heat/air/fuel) are removed

Biohazardous Waste: contaminated combustible waste

incinerated

Contaminated combustible waste

incinerated

Biohazardous Waste: Medical Waste

incineration steam sterilization burial thermal inactivation chemical disinfection encapsulation in a solid matrix

Waste Disposal: Infectious/Medical wastes

incineration or autoclaving

Corrosive chemicals

injurious to the skin or eyes by direct contact or to the tissue of the respiratory and GI tracts if inhaled/ingested

What is the most widely used cryogenic fluids in labs?

liquid nitrogen (liquified gas)

Safety Data Sheet (SDS)

major source of safety information for employees who may use hazardous materials in their occupations: 1. product name/ID 2. hazardous ingredients 3. permissible exposure limit 4. physical and chemical data 5. health hazard data and carcinogenic potential 6. primary routes of entry 7. fire and explosion hazards 8. reactivity data 9. spill and disposal procedures 10. PPE recommendations 11. handling 12. emergency and first aid procedures 13. storage and transportation precautions 14. chemical manufacturer's name, address, phone # 15. special information section

Disposal of radioactive waste

many labs transfer radioactive materials to a licensed receiver for disposal

Class A fires

ordinary combustible solid materials, such as paper, wood, plastic, and fabric

blood-borne pathogens

pathogenic microorganisms that are present in human blood and cause disease in humans if a person comes in contact with the contaminated blood; pathogenic microorganisms that are transmitted via blood to humans and cause disease; HIV, HBV, HCV, ect.

Disposal of biomedical waste

place in a bag marked with the biohazard symbol, then place in leakproof container that is puncture resistant and equipped with a solid, tight-fitting lid; all containers must be clearly marked with the biohazard word or symbol

infection control

policies and procedures used to prevent or minimize the spread of infection in a health care facility

Nuclear Regulatory Commission (NRC)

required if the amount of radioactive material exceeds a certain level

Choose appropriate PPE when working in the clinical laboratory

see book

Disposal of chemical waste

see notes

What can direct hazards of electrical energy result in?

shock, death, burns

Chemical Waste Disposal: Sodium Azide

should NEVER be disposed down the drain because it forms explosive salts with metals, such as the copper in pipes

Chemical Waste Disposal: Strong Acids and Bases

should be neutralized before disposal

Disposal of sharps

should be placed into special puncture-resistant containers before placing them inside the bag and container

Disposal of needles

should not be transported, recapped, bent, or broken by hand

Disposal of highly pathogenic waste

should undergo preliminary treatment on site

What should you do to prevent being contaminated with aerosols during centrifugation of biologic specimens?

specimens should remain capped during centrifugation, or several minutes should be allowed to elapse after centrifugation is complete before opening the lid

What are carcinogenic chemicals?

substances that have been determined to be cancer-causing agents

carcinogens

substances that have been determined to be cancer-causing agents

What are reactive chemicals?

substances that, under certain conditions, can spontaneously explode or ignite or that evolve heat or flammable or explosive gases

Electrical safety: what to do if a severely shocked person cannot let go of instrument

unplug the instrument (without touching it) or knock the person loose with nonconductive material such as wood

Bloodborne pathogens: Engineering controls

work shields, face shields, pipetting devices, ect.