LABORATORY SAFETY

By: Rose Marie E. Sing, RMT, AMT,

MPH
Lecturer
SAFETY
❑ The clinical laboratory contains a variety of safety
hazards, many of which are capable of producing
serious injury or life threatening disease.
❑ To work safely in the laboratory the personnel
must:
1. learn what hazards exist
2. the basic safety precautions associated with
them
3. how to apply the basic rules of common sense
required for everyday safety for patients, co-
workers, and themselves.
❑ Some hazards are unique to the health-care
environment, and others are encountered routinely
throughout life.

❑ Safety procedure manuals: readily available in the

laboratory; describe the safety policies mandated by
CDC and OSHA
❑ CDC: Center for Disease Control and Prevention

❑ OSHA: Occupational Safety and Health

Administration

❑ CLSI: Clinical and Laboratory Standards Institute

BIOLOGIC HAZARDS
❑ Chain of infection: the
process of
microorganism
transmission.
❑ Infection Control: Procedures to monitor and
control the spread of an infection.

❑ Biologic Safety: concerns with the prevention on

chain of infection completion.

❑ CONTACT WITH PATIENT SPECIMEN:

most direct contact with a source of infection in the
clinical laboratory.
 UNIVERSAL PRECAUTIONS
❑ Drafted by CDC and OSHA

❑ All patients are considered to be possible carriers

of blood borne pathogens.

❑ Recommends wearing of gloves, face shields and

disposal of sharps in appropriate container.

❑ PROBLEM: Excluded urine and body fluids that

are not visibly contaminated by blood.
 BODY SUBSTANCE
ISOLATION

❑ Not only limited to blood borne pathogens; all

body fluids.

❑ Considers all body fluids and moist body

substance to be potentially infectious.

❑ PROBLEM: does not recommend hand washing

after removal of gloves not unless with visual
contamination.
 STANDARD PRECAUTIONS

❑ “new guidelines”, a combined feature of Universal

Precautions (UP) and Body Substance Isolation
(BSI)

❑ Drafted by CDC and HICPAC (Healthcare

Infection Control Practices Advisory Committee.
Stipulates the following precautions:
❑ Hand hygiene
❑ Gloves
❑ Mouth, nose and eye protection
❑ Gown
❑ Patient care equipment
❑ Environmental control
❑ Linen
❑ Occupational health and blood borne pathogens
❑ Patient placement
❑ Respiratory hygiene and cough etiquette
 OCCUPATIONAL EXPOSURE TO BLOOD
BORNE PATHOGENS STANDARD

❑ A Law monitored and enforced by OSHA

❑ Should be provided by an employer to the
employees and includes the following:
A. Engineering Controls
1) Providing sharps disposal container and
needles with safety devices.
2) Required discarding of needles with the
safety device activated and holder attached.
3) Labeling of all biohazards.
B. Work practice controls
1) Requiring all employees to practice Standard
Precautions and documenting training on an
annual basis.
2) Prohibiting eating, drinking, smoking and
applying cosmetics in the work area.
3) Establishing a daily work surface disinfection
protocol.

C. PPE (Personal Protective Equipment)

* Provision of PPE Set
D. Medical
1) Providing immunization for Hepatitis B virus
free of charge.
2) Providing medical follow-up to employees who
have been accidentally exposed to blood
borne pathogens.

E. Documentation
1) Documenting annual training of employees in
safety standards.
2) Documenting evaluation and implementation
of safer needle devices.
 3) Involving employees in the selection and
evaluation of new devices and maintaining a
list of those employees and the evaluations.
4) Maintaining a sharps injury log including the
type and brand of safety device, location and
description of the incident and confidential
employee follow-up.
❑ Accidental exposure must be immediately reported
to the supervisor.

❑ After evaluation, PEP (post exposure prophylaxis)

must be given right away.
MAJOR IMPORTANT
PRACTICES IN THE
LABORATORY
 PROPER HAND HYGIENE
❑ Hand Contact: primary method of infection
transmission.
❑ Hand Hygiene: includes both hand washing and
use of alcohol based antiseptic cleaners.
❑ Hand Hygiene is done:
1) before and after patient contact
2) after gloves are removed
3) before leaving the work area
4) at any time when knowingly contaminated
5) before going to designated break areas
6) before and after using bathroom facilities
Hand washing procedure includes:
❑ Lathering and removal of debris (at least 20
seconds)

❑ Singing of Happy Birthday 2X

 Hand Washing Procedure
Equipment:
1) Antimicrobial soap 3) Running water
2) Paper towels 4) Waste container
Procedure:
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.
 CORRECT DISPOSAL OF
CONTAMINATED EQUIPMENT

❑ All waste are placed in designated containers with the

BIOHAZARD symbol.
❑ Decontamination: Incineration, Autoclaving, or
picked up by waste hazard companies.
❑ Urine Specimen: Poured on a laboratory sink and
flushed with water.
❑ Sink can be disinfected with 1:5 or 1:10 dilution of
Sodium hypochlorite. Prepared solution can last
for 1 month.
❑ Empty urine containers can be discarded as non-
biologically hazardous waste.
 WEARING OF PERSONAL
PROTECTIVE EQUIPMENT
PPE
1) Gloves (latex, nitryl or vinyl)
2) Gowns - completely buttoned, gloves be pulled
over the cuffs, fluid resistant, removed prior to
leaving the work area.
3) Eye and face shields
* masks and goggles, full-face plastic shields that
cover the front and sides of the face, mask with
attached shield, and Plexiglas countertop
shields.
SHARP HAZARDS
Includes: Needles,
lancets, broken glassware
 PRECAUTIONS
❑ All sharps must be disposed properly in a sharps
container:
1) puncture resistant
2) leak proof
3) with biohazard symbol
4) located as close as practical to where sharps
are used.

❑ The container should not reach beyond the

capacity mark before replacement.
CHEMICAL HAZARD
 PRECAUTIONS

❑ When skin contacts with a chemical, flush the area

with large amount of water for at least 15
minutes.
❑ Contaminated clothing should be removed right
away.
❑ Do not neutralize chemical spills.
❑ Cleaning up spills kit: Protective apparel, non-
reactive absorbent material, bags for
contaminated
materials.
Chemical Handling:

1) Acid should always be added to water and not

vice versa.
2) Wear goggles and mix reagents inside the
fume hood.
3) No mouth pipetting of chemicals.
Chemical Hygiene Plan

❑ Appropriate work practices

❑ Standard operating procedures

❑ PPE

❑ Engineering controls, such as fume hoods and

flammables safety cabinets.

❑ Employee training requirements

❑ Medical consultation guidelines

 Chemical Safety Aids

Emergency Shower Eye Wash Station

CHEMICAL LABELING
 MSDS (MATERIAL SAFETY DATA
SHEET)
Information contained in an MSDS includes the
following:
1. Physical and chemical characteristics
2. Fire and explosion potential
3. Reactivity potential
4. Health hazards and emergency first aid procedures
5. Methods for safe handling and disposal
6. Primary routes of entry
7. Exposure limits and carcinogenic potential
RADIOACTIVE HAZARD
❖ Can be encountered in
laboratories that make
use of radioisotopes.

❖ Radiation exposure is
related to: time, distance
and shielding.
 PRECAUTIONS

❑ Symbol must be displayed on doors with potential

hazard.
❑ Pregnant employees should avoid rooms with the
symbol.
ELECTRICAL HAZARDS
 WARNING

Electrical Hazards

Authorized
Personnel Only.
 PRECAUTIONS
❑ Equipment should not be operated with wet
hands.
❑ Do not use frayed cords and overloaded circuits; if
found must be reported to the supervisor.
❑ Wet equipment must be unplugged and dried
completely before next usage.
❑ In cleaning: equipment needs to be unplugged.
❑ All electrical equipment should be grounded with
three pronged plugs.
❑ Turn off circuit breaker, unplug instrument, or
move instrument using non-conductive material.
❑ Shock victims should immediately receive medical
assistance.
FIRE/EXPLOSIVE HAZARDS
The Joint Commission on Accreditation of Health Care
Organizations (JCAHO) requires that all health-care institutions post
evacuation routes and detailed plans to follow in the event of fire.
FIRE HAZARD EXPLOSIVE
SYMBOL HAZARD SYMBOL
In Case of Fire:
R Rescue Rescue anyone in
immediate danger.

A Alarm Activate institutional fire

alarm.

C Contain Close all doors to

potentially affected areas.

E Extinguish Attempt to extinguish the

Evacuate fire; if ppossible exit the
area.
How to Manipulate Fire Extinguisher?

❑ P - Pull the pin

❑ A - Aim at the base of the fire

❑ S - Squeeze the handle

❑ S - Sweep side to side

PHYSICAL HAZARD
 PRECAUTIONS

❑ Decorum: Uniform with laboratory gown and

closed-toed shoes.
❑ Avoid running in rooms and hallways.
❑ Watch for wet floors.
❑ Avoid dangling jewelries.
❑ No eating and applying of make up inside the
laboratory.
❑ Maintain a clean and organized working area.