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Good housekeeping Slide 3: * Preventive measures - essential to the well-being of employees. Annual safety reviews Disaster drills General consciousness Slide 4: Some causes of Accidents: 1. Inexperience 2. Ignoring known risks 3. Haste 4. Carelessness 5. Fatigue 6. Mental preoccupation Slide 5: Laboratory-acquired or Laboratory infections - are preventable only if: strict safety policy is enforced the laboratory is staffed with safety-minded people. written safety instructions as required by each employee are made available and understood. Slide 6: Diminish unnecessary Exposures to health and Safety risk: 1. Appropriate orientation to safety rules. 2. Frequent review to these rules. 3. Management’s insistence in providing clear guidelines and a safe work environment. * Each laboratory must assume responsibility to develop biological exposure and chemical exposure plans for the protection of employees. Slide 7: Employer’s Responsibilities: Establish laboratory work method and safety policies. Provide supervision and guidelines to the employees. Provide safety information, training, personal protective equipment, and medical surveillance to employees. Provide and maintain equipment and laboratory facilities that are adequate for the task required. Slide 8: Employee’s Responsibilities: Know and comply with the established laboratory work safety methods. Have a positive attitude toward supervisors, co-workers, facilities and safety training. Give prompt notification of unsafe conditions or practices to the immediate supervisor. Engage in the conduct of safe work practices and use of personal protective equipment. Slide 9: Universal Precautions: - Infection control guidelines designed to protect people from diseases spread by blood and certain body fluids. - The National Committee for Clinical Laboratory Standards (NCCLS) and the U.S. Department of Labor, Occupational Safety and Health Act (OSHA) Instructions have tentatively accepted with modifications the Universal precautions of the Center for Disease Control (CDC). Slide 10: “TREAT ALL LABORATORY SPECIMENS AS INFECTIOUS” Amniotic fluid Blood Semen Vaginal secretions Synovial fluid Cerebrospinal fluid Pleural fluid Peritoneal fluid Pericardial fluid Slide 11: Bodily fluids that require such precautions: Blood Semen Vaginal secretions Synovial fluid Amniotic fluid Cerebrospinal fluid Pleural fluid Peritoneal fluid Pericardial fluid Bodily fluids that do no require such precautions: Feces Nasal secretions Urine Vomitus Perspiration Sputum Saliva Slide 12: Universal Precautions: 1. TREAT ALL LABORATORY SPECIMENS AS INFECTIOUS. Slide 13: 2. Use a protective barrier. - barriers are used for protection against occupational exposure to blood and certain body fluids. - these barriers consist of: 1. Personal protective equipment (PPE) 2. Engineering controls 3. Work practice controls Slide 14: 1. Personal Protective Equipment (PPE) a. Masks b. Goggles c. Safety glasses d. Visor e. Gloves f. Rubberized sleeves g. Proper footwear h. Laboratory gowns Slide 15: 2. Engineering controls - refer to methods of isolating or removing hazards from the workplace. Examples: Sharps disposal containers Laser scalpels Biological safety cabinets Laboratory fume hoods Slide 24: Safety Equipment Safety showers - deliver 30-50 gallons/min of 20-50 psi Eyewash station Tested at least weekly by running water to clear the pipes. It is recommended to flush the eyes for 15 continuous minutes. Should be located within 10 seconds and 100 feet of each work area. Fire extinguishers Written protocol for use of respirators are required according to the respiratory protection standard. Slide 26: 3. Work practice control - refers to practical techniques to reduce the likelihood of exposure by changing the way a task is performed. - Examples: a. Hand washing b. Handling of used needles and sharps c. Collecting and transporting fluids according to the approved safe practices. Slide 27: 3. Avoid Handling of hypodermic needles. Slide 28: 4. Avoid and aerosol or droplets when opening a vacuum tube containing blood. Slide 29: 5. Use Pasteur pipets or other devices for transferring fluid samples. Slide 30: 6. Never pipet by mouth. Slide 31: 7. Minimize spills and spatters. Slide 32: Sterilization techniques: Heat sterilization (250ºc – 15 mins) Ethylene oxide (450 – 500 mg/L @ 55-60ºc) 2% glutaraldehyde 10% Hydrogen peroxide 10% formaldehyde 5.25% hypochlorite (bleach) 10% Sodium hypochlorite * HBV 10mins * HIV 2mins Slide 33: 8. Wash hands after contamination, after removing gloves, and always before eating. Slide 34: 9. Dispose of samples properly when no longer needed for possible reanalysis. Slide 35: 10. Place warning signs on all known biohazards. at points of access to the laboratory areas directing all visitors to a receptionist. at specific laboratories handling pathogenic microorganism. - only authorized visitors should enter a laboratory displaying the Universal Biohazard Symbol. - doors displaying a biohazard symbol should not be propped open, but should remain closed. Slide 36: Laboratory Hazards Biological Chemical Electrical Fire Radiation Physical Emotional Mechanical Cryogenic materials Compressed gases Ergonomic Slide 37: Biological hazards - blood and other body fluids - the greatest risk of occupational infection in these laboratories is associated with the use of pathogenic microorganisms or the handling of contaminated material. Slide 38: Preventive measures Observe Universal Precaution. All blood samples of patient with high risk should be processed with strict precaution. Specimen containers should remain “capped” during centrifugation. Any blood spills must be cleaned up & disinfected immediately. Individuals with any open wounds and abrasion should wear finger cots/ gloves when handling blood specimens. Immunization Slide 39: Chemical hazards - can cause serious injury to workers if they are not instructed and trained in how to handle them safely. - Overt exposure can result to tissue damage and acute adverse effects. - toxic and poisonous - flammable & combustible - CORROSIVE (injuries to the skin or eyes by direct contact or to the tissue of the respiratory and gastrointestinal tracts if inhaled or ingested. e.g. Acids ( acetic, nitric, sulfuric and hydrochloric) Bases (NH4OH, KOH, NaOH) - REACTIVE (can spontaneously explode or ignite or that evolve heat or flammable or explosive gases. - CARCINOGENIC ( producing or inciting cancer) - MUTAGENS ( cause changes in DNA or RNA) - TERATOGENS (cause birth defects) Slide 40: Preventive measures Know the nature of chemical used. Label chemicals properly Prohibit mouth pipetting Observe basic rule “Acid to Water” Chemical spills containment Use safety cans, fume hood and cabinets. Wear proper attire Observe proper storage and disposal. Slide 41: Shock sensitive chemicals: - may decompose violently if struck or heated. 1. Ethyl ether 2. Picric acid 3. Ammonium nitrate 4. Hydrazine Slide 42: National Fire Protection Association (NFPA) - has developed a series of symbols to warn against fire, biologic, chemical, and radiation hazards. - it defines the colloquial “fire diamond” used by emergency personnel to quickly and easily identify the risks posed by nearby hazardous materials. - this is necessary to help determine what, if any, specialty equipment should be used, procedures followed, or precautions taken during the first moments of an emergency response. Slide 43: FIRE DIAMOND - broken into four (4) sections. - numbers in the three(3) color-coded sections range from 0 (least severe hazard) to 4 (most severe hazard). - the fourth (white section) is left blank and is used only to denote special fire fighting measures/ hazards. Slide 49: Blue(1) - exposure could cause irritation but only minor residual injury even if no treatment is given. Red(3) - liquids and solids that can be ignited under almost all ambient conditions. Yellow (0) - normally stable, even under fire exposure conditions, and are not reactive with water. White - no special hazards. Slide 50: Material Safety Data Sheets (MSDS) - summary of the hazardous nature of chemical used in the workplace. - must be maintained and updated its inventory of toxic chemicals periodically. - must be provided for all products by the manufacturers. - it specifically includes: a. chemical identity as it appears on the label b. chemical name & common name c. Physical & chemical characteristics d. signs & symptoms of exposure e. Routes of entry f. exposure limits g. carcinogenic potential h. safe handling procedures i. spill cleanup procedures j. emergency first-aide - must be available to all in case of emergency. Even before a technologist goes to the ER, she/he must have the MSDS to give to the ER physician. Slide 51: Electrical hazards - some electrical units can cause electric shock and fire hazards - physical harm from shock or burns - danger from fire due to heat and sparks produced. Slide 52: Preventive measures: Use only explosion proof equipment in hazardous atmospheres. Be particularly careful when operating high-voltage equipment such as electrophoresis apparatus. Use only properly earthen or grounded equipment. Check for frayed electrical cords. Report any malfunctioning or equipment producing a “tingle” promptly 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 to your work area. Use only approved extension cords and do not overload circuits. Have periodic preventive maintenance performed on equipments Slide 53: Fire hazard - basically a chemical reaction that involves a rapid oxidation of combustible material or fuel, with the subsequent liberation of heat and light. - potential hazard in almost any environment. - flammable and combustible chemicals or materials electrical hazard. Slide 55: Preventive measures: Prominent display of emergency directions. Fire drills, some of which may be without warning. Distinct marking of fire exits. Fire exits kept unblocked. Fire extinguishers: Available, functional and staff trained in their use. Installation of fire alarms. Declaration of the laboratory as a no smoking zone. Proper storage of flammables and explosives. (open ether cans must not be stored in refrigerators which are not explosion-proof ) Slide 56: Classification of Fires: Slide 58: Radiation hazard - particles emitted by radioactive substances. - The Nuclear Regulatory Commission (NRC) regulations must be followed by users of radioisotopes. - radiation monitors must be evaluated regularly to detect degree of exposure. - records must be maintained for the length of employment plus 30 years. Slide 59: Preventive measures: Radioactive materials, waste containers, storage facilities, and the door leading into the room must all be properly labeled. Disposal of radioimmunoassay waste products must be according to regulations. Under no circumstances should radioactive materials be incinerated. The radioactive material is so small that it can be harmlessly flushed down the sewer. Personnel must wear a film badge to monitor their radiation exposure. Only trained personnel are allowed in the areas. Slide 60: Preventive measures for other laboratory hazards: Physical Hazards Emotional hazards Mechanical hazards Proper use of centrifuges. Safety locks of equipments should never be inoperable. Glass pipits and sharp instruments should be handled with extra care. Use of glass beads to help eliminate boiling-over when liquids are heated. Use of tongs to remove hot glass wares from oven, hot plates or water bath. Slide 61: Cryogenic material hazards - materials having extremely low temperature. - Liquid nitrogen is one of the most widely used cryogenic fluids (liquefied gases) in the laboratory. Hazards associated with the use of any cryogenic materials: Fire or explosion Asphyxiation Pressure buildup Embrittlement of materials Tissue damage similar to thermal burns Preventive measures: Use of gloves of impermeable material. Store cryogenic fluids in well – insulated but loosely stoppered containers. Slide 62: Compressed Gases - Liquefied Petroleum Gas (LPG), Oxygen Present a unique combination of hazards in the clinical laboratory: 1. danger of fire 2. explosion 3. Asphyxiation 4. Mechanical injury -Preventive measures: Observe proper labeling & storage condition. Follow correct handling & transport of tanks. Slide 63: Ergonomic hazards for maximum comfort, ease of use, efficiency, safety in the laboratory. tedious, repetitive manual tasks obsolete. Contribute to the repetitive strain disorders such as: 1. Tenosynovitis 2. Bursitis 3. Ganglion cysts Symptoms: 1. Chronic pain 2. Numbness 3. Tingling in extremities Primary contributing factors associated with repetitive strain disorders: 1. Position/ posture 2. Applied force 3. Frequency of repetition Slide 64: Preventive measures: Observe proper position/posture. Adhere to ergonomically correct technique and equipment positioning. 1. Lift heavy objects properly. Keeping the load close to the body and using the muscles of the legs not the back. 2. Gradually increase force when pushing or pulling. 3. Avoid pounding actions with the extremities. Slide 65: Hospital Policy & Waste Management Republic Act No. 9003 An act providing an ecological solid waste management program, creating the necessary institutional mechanisms, & incentives, declaring certain acts prohibited & providing penalties, appropriating funds therefore, & for other purposes. Republic Act No. 6969 An act to control toxic substance & hazardous & nuclear wastes providing penalties & violations. (Guideline for the control of chemical & chemical substance) Republic Act No. 3931 An Act on National water & air pollution control commission. Republic Act No. 825 An act providing penalty for improper disposal of Garbage, & other forms of un-sanitation. All garbage, filth & other waste matters, shall be placed in proper receptacles for the disposition thereof by garbage collectors. Slide 66: Laboratory waste management: 1.Treatment 2. Segregation 3. Storage 4. Disposal Slide 67: 1. Methods of waste TREATMENT 1a. Flushing down the drain to the sewer system. 1b. Incineration 1c. Landfill burial 1d. Recycling Slide 68: 1a. Flushing down the drain to the sewer - chemical wastes - flush water-soluble substances down the drain with copious quantities of water. - strong acids and bases should be neutralized first before disposal. - Foul smelling chemicals should never be disposed of down the drain. Slide 69: 1b. Incineration - preferred method for the waste treatment of hazardous chemical waste. - flammable materials also can be burned in especially designed incinerators with afterburners and scrubbers to remove toxic products of combustions. Slide 70: 1c. Landfill burial - the landfill sites have to licensed to accept hazardous waste. - has caused environmental problem, shortage of safe sites) - for solid chemical waste that are unsuitable for incineration. Slide 71: 1d. Recycling - for solvents such as xylene and acetone may be filtered or redistilled for reuse. (chemicals) - Papers: one-side = scratch Two-side = disposal or scrap Separate box = white and colored papers Empty boxes = flattened an disposed as scrap sold to scrap buyer Slide 72: 2. Segregation - not to mix hazardous from non-hazardous waste. - so that it can be sent to appropriate route for disposal. - colour coding for waste containers for different categories of healthcare waste. Slide 73: 3. Storage Waste that has to be stored before collection and final disposal should not accumulate in corridors, wards, or places that are accessible to the general public. The location and size of any storage area depends upon the quantity, quality and type of waste produced and how frequent collections are made. The storage area should allow for any spillage of contents to be contained safely and should be cleaned regularly. Characteristics of an appropriate area for the storage of clinical waste: a. identified only for specific waste. b. well lit and ventilated area. c. not near food preparation or storage areas and vermin free. d. away from routes used by general public. e. totally enclosed and secure space with only authorized access. f. clearly marked with warning signs. g. there is access to first aide and washing facilities. Slide 74: Containers for storage of chemical waste: be UN approved conform with NHS performance specification be compatible with the chosen container or fittings in use be identified with the source where the waste is generated (written label or bar coded) Slide 75: 4. Disposal/ Handling precautions: Check that storage bags are effectively sealed before and after handling. Handle bags by the neck and never throw or drop them. Know what to do if there is an accidental spillage. Report accidents and incidents Make sure that the source and origin of the waste is clearly marked on the bag. Understand the risk of sharps disposal. Slide 76: Accident Documentation and Investigation - any accidents involving personal injuries, even minor ones, should be reported immediately to a supervisor. - (OSHA), employers are required to maintain records of occupational injuries and illnesses for length of employment plus 30 years. Record-keeping requirements include: First report of injury Information of the employer and the injured person. Time and place Cause Nature of the injury Accident investigation report Information of the injured person Description of what happened Cause of the accident Annual summary that is recorded in the OSHA injury log (Form 300) You do not have the permission to view this presentation. In order to view it, please contact the author of the presentation.