LABORATORY HEALTH AND

SAFETY
INFECTION PREVENTION; STERILIZATION & DISINFECFTION
Introduction
• SAFETY is a measure of protection.
• Is the condition of being protected from harm or other non-
desirable outcomes.
• Safety can also refer to the control of recognized hazards in
order to achieve an acceptable level of risk.
• The measure is to minimize and prevent the followings….
- Exposure to risks.
- Transmission of Diseases.
- Acquisition of Diseases.
Why Safety Cycle.

• It involves three key players and their role in the Cycle

• Key players are SELF, CO-STAFF and CLIENT/PATIENT
• Prevention of Acquisition of Infection by any of the key
players.
- also from the Environment.
• Prevention of Exposure of the key elements to infection.
• Prevention of Nosocomial infection.
• Prevention of Occupational hazards.
Safety Mechanism

• It is always the duty of the individual to ensure safety at

where the individual find himself.

• It can be the Hospital the House, etc.

• HOW ?
- Observation of the Universal Safety Precautions [USP].
Safety Sign
Barrier protection and Protective
equipment
Wearing of protective garments at all times.
• Aprons, Laboratory coats, Gowns etc.
• These prevent splashes and spillages on the body
Protective Equipment
• Gloves, Face masks, Goggles, and Boots.
• Face Mask and Goggles are for facial protection.
i.e prevention of splashes, aerosols, foul smells, etc
 Protective
Equipment/Gadgets
Safety Rules
Gloves

• Protection of the hands from contamination.

• Change gloves after contamination.
• Change gloves between patients.
Boots.
• To protect the feet from splashes
• To protect the feet from injuries
Hand Washing

• Wash hands when contaminated.

• Wash hands after usage of gloves.
• Wash hands after physical examination of patients.
• Wash hands after procedures.
• Wash hands after close of work.
Blood/Body fluid Collection and Injection

• Don’t recap needles after any of the above procedures.

• If need be use for recapping, the ONE TOUCH Technique is
used.
• Don’t recycle sharps, especially syringe and needles
• Proper disposal of needles and sharps
- use rigid needle containers for disposal.
Sharps
• Don’t mix sharps with other wastes.
• All cuts, needle pricks and abrasions should be dressed well
and covered with gauze and plaster.
• All needle pricks must be reported for treatment and
dressing
• All sharps injuries must be documented.
Aerosols

• Minimize spills and splashes.

• Avoid creation of AEROSOLS.
• Disinfect and Clean all devices and surfaces before and after
procedures.
• Decontaminate, disinfect and clean all devices and surfaces
after procedures.
Cleaning and Disinfecting
• Use the correct percentage of Disinfectant i.e. 1:5 or 1:10
dilution for disinfection.
• When cleaning, start from the less clean area to the most
dirty area.
• Provision of ASEPTIC FIELD for procedures.
• Proper disposal of Clinical Waste.
Sample/ Medical Waste Disposal

• The laboratory is responsible for ensuring that disposal of all

laboratory samples and waste are handled in a safe manner.
• The laboratory should establish and follow procedures to
decontaminate and disinfect samples prior to disposal
• A policy for disposal of samples which will take care of local
and country regulations for disposal of medical waste should
be developed.
Universal Safety Precautions
• Use of Biohazard disposal techniques.
• Use of Leak proof primary and secondary containers for
transportation of clinical samples.
- especially from one facility to the other.
• Provision of Fire Extingushers at vantage areas.
• Provision of Emergency Exit and Fire Points at strategic areas.
• Ensure control of movements to Restricted areas by
unauthorized persons.
 Fire Extinguishers Fire
Exit
 Universal Safety Precautions

Provision of Safety Signs and Warning Signs at vantage areas.

• Provision of a Conducive and Protective environment to

clients.

- especially at the Reception area, Wards and the Theatre.

• Health Education.
Universal Safety Precautions
• Remind Clients of Restricted areas.

• Safety Policy of your outfit.

• Safety and Accident Protocol.

Health and Safety Management
Systems
• Employer must put a process in place to minimize the risk of
injury and illness.
• Control measures to eliminate or reduce the risks to workers
from hazards
• This is made possible by identifying, assessing and
controlling risks to workers in all workplace operations.
• Control measures to eliminate or reduce the risks to workers
from hazards.
Effective Health & Safety Management
Systems
• Identification and analysis of health and safety hazards at the
work site
• Control measures to eliminate or reduce the risks to workers
from hazards
• Management commitment, and written company policy
• Worker competency and training
Effective Health & Safety Management
Systems
• The scope and complexity of a system will vary due to the
type of workplace, and the type of operations carried out.
• Inspection program
• Emergency response planning
• Incident reporting and investigation
• Management system administration
Occupational Health and Safety (OHS)
• Works in consultation with the system or occupation to help
prevent work-related injuries, illnesses and fatalities.
• All workers are entitled to work in environments where risks
to their health and safety are properly controlled.
• Under Health and Safety Law, the primary responsibility for
this is down to employers.
• Employers have a duty to consult with their Employees, or
their representatives, on health and safety matters
Risk Assessment
Sterilization and Disinfection
Prevention of Hospital infections depends on 3 factors.
• Availability of clean Environment.
• Availability of clean and sterile Equipment, Instruments, and
Dressings
• Isolation facilities, Safe disposal of waste and infected
materials.
Sterilization
• COMPLETE destruction or removal of all micro organisms
include cells and spore bearers from an object or article.
• Sporicidal action and can penetrate protein-rich materials
• A sterile item is absolutely free from all viable organisms.
• STERILITY is ABSOLUTE
Sterilization Equipment
Methods
• Method depends on the material to be sterilized.

• 2 main methods of sterilization

- Physical Method.

- Chemical Method.
Methods
Physical Method
3 main methods of Heat or Thermal technique.
• Heat method

• Radiation method

• Filteration method
Thermal - Heat
2 Types of Heat sterilization.
• Dry Heat: Hot Air Oven,
- Incineration and Flaming
• Moist Heat: Autoclave (Steam under Pressure)
- Boiling at 100 degrees
Dry Heat

• Sterilization is done in an Hot Air Oven.

• Temperature of 160–165 degree celcius for 2hrs.
• Temperature of 170-200 degrees celcius for 1hr.
• This technique is applicable to articles like
- Glass ware ,Oils etc.
• Also Flaming of inoculating Loops and Forceps.
 Dry Heat sterilization - Hot Air
Oven
Flaming - Bactincinerator
Moist Heat
• Boiling at 100 degrees for 1hour.

• Boiler

• This measures time and temperature

- E.g. for Hypodermic needles and Kidney dishes

Boiler
Autoclave
• Temperature greater than 100 degrees.
• Utilizes Steam under Pressure
• Most effective and efficient method of sterilization.
• Pressurized device that uses heat steam and Pressure to
achieve sterilization
• This measures Time, Temperature and Pressure
Autoclave
 Autoclave

• Articles are sterilized at 121 degrees celcius at 15Ibs or Kilo

Pascal for 15 minutes.
• However, the Temperature and the Holding period can be
varied depending on the article.

• E.g. for Culture media, Petri Dishes and Dressings.

Autoclave
Autoclave Tape Sterilization
Validation
Radiation

• Use of Energy waves of various wavelengths.

• Ionizing radiation: Electron beams
• Infra Red radiation (Longer wavelength)
• Ultra Violet radiation (Shorter wavelength).
• Gamma radiation (Electromagnetic rays).
 Radiation

• Technique use for sterilization of manufactured equipment in

industries.
- E.g. Syringe and Needles, Swab tubes and Gloves
- Also Gloves, Intravenous lines Catheters and Vaccines.

• Technique is 100% effective and efficient.

Radiation
Filteration
• Use of Filters for the removal of Particles, Pyrogens and
Pathogens from fluids.

• Principle is based on use of various PORE Sizes.

• For separation of cells and prevention of passage of

microorganisms.
Filteration
 Filters
Filters used for the Filteration process are…
• Porcelain
• Asbestos
• Cellulose membrane
• Sintered glass
Filteration
Chemical Method- High level
Disinfection
• Technique deals with CHEMICAL Agents.
• Microorganisms are Killed, Paralyed or Inhibited.
• Chemical agents used are usually Liquids and Gases.
• Gases e.g. Ethylene oxide and Formaldehyde
• Usually used for articles like Heart valves and Endoscopes.
• Liquids e.g. Glutaraldehyde
Disinfection

• PARTIAL removal of pathogens from Non Living materials.

• Disinfection is mostly done by chemical means

• Chemicals are usually used

Disinfectants
Disinfectants

• Many disinfectants are used alone or in combinations

• These include Alcohols, Chlorine, Chlorine compounds,
- Formaldehyde, and Glutaraldehyde
• In most instances, a disinfectant is designed for a specific
purpose
• It should be used in a certain manner.
Disinfectants
• It is usually done used on In-animate articles.
• Articles such as Bedside pans, Kidney dishes and Formites.
• Theatre walls, floors and rooms.
Types of Disinfectants
• Disinfectants are Microbicides.
• They are characterized with the Prefix -CIDE.
• Virucide, Fungicide, Bactericide, etc.
Mode of action of Disinfectants

• Bactericidal: Disinfectants that kill the pathogen

• The bactericidal action denatures Proteins of microbes
• Bacterostatic: Disinfectants that inhibits or immobilizes the
pathogen
• The bacteriostatic action inhibits the production of
metabolites essential for rapid cell division of microbes
Disinfectants

• Users must read labels and protocols carefully to ensure the

correct product is selected for the intended use
- and applied for efficiency
• Precautions should be observed to minimize exposure to the
disinfectant
• Precautions such as gloves use and proper ventilation.
Mechanism
Mechanism of these microbicides varies from one
disinfectant to the other.
• Disinfectant target and destroyed various parts of the
microbe.
- Cell wall and Cell membrane.
- Enzymes and Structural Proteins.
- Nucleic acids.
Factors affecting action of Disinfectants

• Concentration

• Temperature and Ph

• Holding period (Exposure period).

• Presence of Organic materials (Blood).

Examples of Disinfectants
• Alcohols: Ethyl and Isopropyl alcohol.
- 70% used for disinfecting Thermometers and Bench tops

• Phenols: Lysols, Carbolic acids and Izal.

• Aldehydes: Gluteraldehydes and Formaldehydes.

• Halogens: Chlorine, Chlorine compounds [Hypochlorites]

Examples of Disinfectants

• Heavy metals: HgCl (Mercurochrome and Merthiolate) can

be used as both Antiseptic and Disinfectant.

• Silver nitrate (Arzyrol), Copper sulphate and Zinc sulphate.

• Oxidizing Agents: Ethylene oxide (Sporocide), Potassium

permanganate and Hydrogen Peroxide