 LABORATORY SAFETY

 PSYCHOLOGY OF SAFETY
1. Laboratory safety necessitates the effective control of all hazards that exist in the clinical laboratory at any time.
2. Safety begins with the recognition of hazards and is achieved through the application of common sense, as safety-
focused attitude, good personal behavior, good housekeeping in all laboratory work and storage areas and the
continual practice of good laboratory technique.
3. Inexperience may cause some accidents; others are results of ignoring known risks, haste carelessness, fatigue or
mental preoccupation.
4. Preventive measures practiced in the laboratory to diminish unnecessary exposures to health and safety risks include:
a. Annual safety reviews
b. Safety drills
c. General consciousness
d. Appropriate orientation to safety rules
e. Safe work environment

 SAFETY AWARENESS FOR CLINICAL LABORATORY PERSONNEL

1. Health Care Organization focus their responsibility in protect their employee from infection especially against
Hepatitis B virus (HBV) and Human immunodeficiency virus (HIV).
2. The Center for Disease Control (CDC) updated its 1983 Guidelines for isolation Precautions in Hospitals with the
release of its Universal Precautions in 1987 because of the growing concern about HIV.
3. The CDC recommends that blood and body fluid precautions should be consistently used for all patients regardless of
their blood-borne infection status
4. The Universal Precautions of the CDC states that “All blood and body fluids are considered potentially infected
with blood borne pathogens.” They are meant to minimize occupational exposures of employees' skin eyes,
mucous membrane or parenteral contact with blood or other potentially infectious materials, which may have HIV,
HBV or other blood borne pathogens. Such potentially infectious materials include:
a. Body fluids (semen, vaginal secretions, pericardial fluid, peritoneal fluid, synovial fluid, pleural fluid, amniotic fluid,
saliva, tears, cerebrospinal fluid, urine and breast milk)
b. Unfixed tissues, organs, or blood slides.
5. Precautions include:
a. Appropriate barriers, such as gloves, gowns or laboratory coats masks and eyewear that must be worn to
prevent skin and mucous membrane exposure when contact with blood or other body fluids of a patient is
anticipated.
b. Appropriate engineering controls (devices or equipment that minimize or remove hazards) include shields,
sharp containers biohazard hoods, centrifuge bucket containers, mechanical pipetting devices and air respirators.
6. Universal Practices include:
a. Wearing of gloves when performing phlebotomies especially when the health care worker has cuts or other open
wounds on his or her skin end when the worker anticipates hand contamination.
b. Hand washing after removal of gloves, after any contact with blood or body fluids and between patients.
c. Washing and reusing gloves between patients is discouraged because microorganisms that adhere to gloves are
difficult to remove.
d. Laboratory coats must be removed before leaving the laboratory area and never taken home or outside the
laboratory such as during lunch or breaks.
e. Cleaning of laboratory coats must be done on site or handled professionally.
f. Eating, drinking, smoking, applying cosmetics or touching contact lenses is prohibited in laboratory work areas.
7. Ineffective agents may be inactivated by:
a. Heat sterilization (2500C for 15 minutes)
b. ethylene oxide (450 to 500 mg/L at 55 to 60°C)
c. 2% glutaraldehyde
d. 10% hydrogen peroxide
e. 10% formaldehyde
f. 5.25% hypochlorite (bleach)
g. 10% (v/v with tap water) of common household bleach makes a very effective and economical disinfectant
inactivating HBV in 10 minutes and HIV in 2 minutes.
8. Another safety precaution recommended by the CDC's advisory committee on immunization practices is vaccination
against HBV specifically tor medical technologists phlebotomists and pathologists.
9. Appropriate signs to identify hazards are critical not only to alert laboratory personnel to potential hazards, but also to
identify specific hazards that arise because of an emergency such as fire or explosion

 SAFETY EQUIPMENT
1. Safety equipment has been developed specifically for use in the clinical laboratory.
2. All laboratories are required to have a safety showers, eyewash stations and fire extinguishers and to periodically test
and inspect the equipment for proper operation. Other items that must be available for personnel include fire blankets,
spill kits and first aid supplies.
3. Mechanical pipetting devices must be used for manipulating all types of liquids in the laboratory, including water.
Mouth pipetting is strictly prohibited.

 POSSIBLE HAZARDS OF A CLINICAL LABORATORY

1. BIOLOGICAL HAZARDS – factors that may affect the health-care setting of the laboratory staff, most especially
potentially harmful microorganisms present in the specimens received in the clinical laboratory
2. SHARP HAZARDS – factors that are involved in the possible dangers caused by sharp objects in the laboratory
including needles, lancets and broken glassware that must be disposed in puncture-resistant containers
3. CHEMICAL HAZARDS – factors that are involved in the possible dangers caused by chemically hazardous materials
that should be avoided in or on bodies, clothes or work area
4. ELECTRICAL HAZARDS – factors that are involved in the possible dangers caused by the electrical equipment with
which workers have frequent contact
5. FIRE AND EXPLOSIVE HAZARDS – factors that are involved in the possible dangers caused by the flammable
and/or explosive materials or reagents that should be placed in fire-proof containers
6. PHYSICAL HAZARDS – involve general precautions to consider such as to avoid running, watch for wet, slippery
floors, bend the knees when lifting heavy objects, keep long hair pulled back, avoid dangling jewelry and maintain a
clean, organized work area

FIG. 5.1. HAZARD SIGNS OR SYMBOLS

 SOURCES AND POSSIBLE INJURIES OF LABORATORY HAZARDS
Type Source Possible Injury
Biologic Infectious agents Bacterial, fungal, viral or parasitic infection
Needles, lancets, broken glass Cuts, punctures, or blood borne pathogen
Sharps
exposure
Preservatives and reagents Exposure to toxic, carcinogenic, or caustic
Chemical
agents
Radioactive Equipment and radioisotope Radiation exposure
Ungrounded or wet equipment and frayed Burns and shock
Electrical
cords
Bunsen burners, alcohol lamps, organic Burns and dismemberment
Fire/Explosive
chemicals
Physical Wet floors, heavy boxes patients, traffic Falls, sprains or strains

 BIOLOGICALSAFETY
1. All samples and other body fluids should be collected, transported, handled and processed using strict precautions.
2. Gloves, gowns and face protection must be used if splash or splattering is likely to occur.
3. Specimen should remain “capped” during centrifugation because biological specimens could produce finely dispersed
aerosols that are high-risk source of infection.
4. Any blood, body fluid or other potentially infectious material spill must be cleaned up and the area or equipment
disinfected immediately. Recommended clean up includes the following:
a. Wear appropriate protective equipment
b. Use mechanical devices to pick up broken glass or other objects.
c. Clean the spill site using a common aqueous detergent.
d. Disinfect the spill site using approved disinfectant or 10% bleach using appropriate contact time.
e. Dispose all materials in appropriate biohazard containers.
5. Occupational Safety and Health Organization Administration (OSHA) “Blood-Borne Pathogens” standard requires
written “Exposure Control Plan”.
a. Categories of exposure are the following:
i. Category I – daily exposure to blood and body fluids
ii. Category II – regular exposure to blood and body fluids
iii. Category III – no exposure to blood and body fluids
b. Employers must offer Hepatitis B vaccine at no cost to all personnel in Category I and Category II
6. Biological Safety cabinets should be installed in strategic places to facilitate manipulations of infectious material. It
reduces risk of exposure of laboratory personnel and patients.

 SAFETY AGAINST EXPOSURE TO TOXIC CHEMICALS

1. OSHA (Occupational Safety and Health Organizations) published its hazard Communication Standard in 1983 to
minimize the incidence of chemically related occupational illnesses and injuries in workplaces. OSHA requires the
following:
a. Manufacturers of chemicals should evaluate the hazards of the chemicals they produce and develop hazard
communication programs for employees exposed to the hazardous chemicals.
b. Clinical laboratories should develop and institute a chemical hygiene plan.
c. Hospitals and laboratories are obliged to maintain an inventory of all hazardous substances used in the
workplace.
2. To comply with OSHA regulations, the employer must maintain and update its inventory of toxic chemicals periodically
and communicate the hazards to employees. Communication may be achieved by:
a. Labeling the containers and posting warnings
 b. Informing employees of employer’s responsibilities and training employees regarding the nature and the safe
handling of hazardous chemicals
c. Developing and implementing a written program of hazard communication
3. OSHA requires that material safety data sheets(MSDS) be provided for each chemical by manufacturers and
suppliers and must be made available on site for laboratory personnel MSDS contains information regarding the
properties and effects of each chemical: toxic, flammable / caustic and combination of these effects.
4. The National Fire Protection Association(NFPA) has develop a labeling system in which labels are a standard format
and divided into four coded sections:
a. Red colored designated flammability
b. Blue indicates health hazards
c. Yellow indicates reactivity level
d. White indicates special considerations

5. Laboratories should also be provided with fumehoods where reagent preparation is done.

 ELECTRICAL SAFETY
1. Lock-out/ tag-out malfunctioning electrical or mechanical equipment until serviced. report any small schocks, unplug
and tag equipment until serviced.
2. If a severely shocked person cannot let go of instrument, unplug it (without touching) or knock person loose with non-
conductive material such as wood.

 RADIATION SAFETY
1. A radiation-safety policy should include environmental and personnel protection.
2. All areas where radioactive materials are used or stored must be posted with caution signs and traffic in these areas
should be restricted to essential personnel only.
3. Records must be maintained as to the quantity of radioactive material on hand as well as the quantity that is disposed.
Record must be maintained for the length of employment plus 30 years.
4. Radiation monitoring utilizes film badge or survey meter. The exposure limit (maximum permissible dose equivalents
is 5000 mrem/year whole body).
5. The Wipe test (leak test) involves wiping laboratory surfaces with moistened absorbent material and the radiation
contained in each wipe is counted.

 FIRE SAFETY
1. Fire is basically a chemical reaction that involves the rapid oxidation of a combustible material or fuel, with the
subsequent liberation of heat and light and all the elements essential for fire to begin like present-fuel, heat or ignition
source and oxygen (air) are present in the clinical chemistry laboratory.
2. Fire have divided into five classes based on the nature of the combustible material and requirement for
extinguishments.
3. Fire extinguishers are also divided into classes that correspond to the type of fire to be extinguished. Laboratory
personnel should be certain to choose the right type of extinguisher.
4. Personnel should know the location and type of portable fire extinguishers near the work are and know how to use an
extinguisher before a fire occurs.

Class of Fire Type of Hazard Type of Extinguisher

Ordinary combustibles like cloth, paper, rubbish, Water, dry chemical and loaded steam
Type A
plastics and wood
Type B Flammable liquids like grease, gasoline, paint and oil Dry chemical, carbon dioxide and halon foam
Type C Electrical equipment and motor switches Carbon dioxide, dry chemical and halon
Flammable metals like mercury, magnesium, sodium Metal X (should be used by firefighters only)
Type D
and lithium
Detonation (Arsenal fire) Usually allowed to burn out and nearby materials
Type E
protected

 DISPOSAL OF HAZARDOUS MATERIALS

1. There are four basic waste disposal techniques. These include:
a. flushing down the drain to the sewer system
b. incineration
c. landfill burial
d. recycling
2. Chemical waste
a. It is permissible to flush water-soluble substances down the drain with large quantities of water.
b. Strong acids or bases should be neutralize before disposal.
c. Foul smelling chemicals should never be disposed off down the drain.
d. Other liquid wastes, including flammable solvents, must be collected in approved containers and segregated into
compatible classes.
e. Flammable material can be burned in specially designed incinerators with after burners and scrubbers to remove
toxic products of combustion.
f. Solid chemicals wastes that are unsuitable for incineration must be buried in a landfill.
3. Biohazardous Waste
a. Medical waste is defined as a special waste from health care facilities and is further defined as solid waste that, if
improperly treated or handled may transmit infectious diseases.
b. It comprises animal waste, bilk blood and blood products, microbiological waste, pathologic waste and sharps.
c. The approved methods for treatment and disposition of medical waste are steam sterilization, incineration,
thermal inactivation, burial, chemical disinfections, or encapsulation in a solid matrix.

/ Douglas Wilfred N. Rimando, RMT, MSMT ☺/