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MLAB 2401: Clinical Chemistry

Chapter 1: Laboratory Safety and Regulations

Introduction

The chemical reagents that are used can be dangerous if not used properly Caustic / corrosive

Patient specimens must be handled with caution due to the possibility of infectious agents HIV, Hep B, meningitis, antibiotic resistant

pathogens, etc

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Minimize Risks by:

Everything must be labeled and stored appropriately

It’s essential to know the location and proper use of all safety equipment

It’s essential to know and have access to all printed information about safety policies and reagents

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LABORATORY SAFETY AND REGULATIONS

Lab risks

Electrical: fire and shock Toxic vapors Compressed gasses Flammable liquids Radioactive materials ( not too common these days ) Corrosives Mechanical: moving machinery Poisons Biological: microbes, animals, plants and genetically modified agents Ergonomic: standing, repetitive motion

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Safety is…… A combination of common sense , good behavior and

housekeeping

Good personal behavior & habits such as professional conduct and appearance, frequent hand washing, no eating, smoking, drinking, or application of makeup, etc. in lab. Should also make yourself aware of emergency procedures / location and proper use of emergency equipment and fire escape route.

Good housekeeping - Laboratory cleanliness, properly labeled containers, immediate appropriate cleanup of any spills, warning signs of potential danger posted, etc.

Good laboratory technique - carefully read all instructions and labels, do not operate equipment until you are instructed and authorized to do so, always respect the power of acids, bases and corrosive chemicals. Protect yourself with PPDs and use proper eyewear protection devices.

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Precautions

No eating, drinking, application of personal products, such as make-up or contact lenses in lab area

Frequent handwashing Follow Standard precautions at all times,

treat all specimens as if infectious Never pipet by mouth Properly dispose of wastes

SAFETY AWARENESS

Safety responsibility – shared responsibility

Employer Provide and supervise safety methods, equipment and policies

Employee Understand and practice established safety procedures Notify supervisors of unsafe conditions

Bottom line … Safety is everyone’s responsibility !!!

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OSHA ( Occupational Safety and Health Act )

Federal law that mandates safe working conditions for workers

OSHA may inspect work places for compliance with safety rules

OSHA compliance is the law, not just a nice idea

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Other Regulations and Guidelines

Clean Water Act – federal

Toxic Substances Control Act – federal

JACHO (Joint Commission on Accreditation of Health Care Organizations ) – non governmental ** outlines requirements of participating healthcare agencies for accreditation.

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CHEMICAL SAFETY

Hazard Communication Standard (Right to Know Law) The lab, by law, must provide written policies for the safe use of hazardous

chemicals ( OSHA regulation ) Intent to ensure all chemical health hazards are evaluated and information

presented to employees.

Material Safety Data Sheet ( MSDS ) A list of all safety information created by the manufacturer for each laboratory

reagent (biological or chemical) The lab is responsible to collect and make available MSDS information for all

reagents and chemicals An MSDS lists general information, precautionary measures, and emergency

information. Employees must have ready access to MSDS information

Lab must have written Chemical Hygiene Plan that provides specific work practices for hazardous chemicals

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Storage and Handling of Chemicals

Different storage/handling requirements chemicals based on their differing characteristics: Flammable/Combustible - classified according to flashpoint,

among the most dangerous in the lab. Corrosives – cause injury to eyes/skin, respiratory tract if contact

is made Reactives – under certain circumstances may react violently -

require special knowledge to prevent their contact with reaction causing substances.

Carcinogenic chemicals- been determined to cause cancer. Benzidine is often used as example of lab chemical now classified as carcinogen.

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Signage and Labeling of Chemicals

Everything must be labeled !!!

Hazardous material must include all necessary safety information

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Chemical Safety

NFPA labeling system for hazardous chemicals

• The system uses a diamond-shaped symbol, four colored quadrants, and a hazard rating scale of 0 to 4.

• The health hazard is shown in the blue quadrant.

• The flammability hazard is shown in the red quadrant.

• The instability hazard is indicated in the yellow quadrant.

• The specific hazard is shown in the white quadrant.

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SAFETY EQUIPTMENT

Safety showers Eyewash stations Fire blankets Fire extinguishers Spill kits First aid kits Fume hoods Biosafety hoods Chemical storage cabinets PPEs ( Personal Protective Equipment )

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BIOLOGICAL SAFETY

Standard Precautions ( Universal Precautions ) All biological specimens must be considered potentially infectious

Always use required PPEs when handling biohazardous material

Cap specimens that are being centrifuged

Mouth pipeting is NEVER permitted under any circumstances

Spills must be cleaned using proper technique

OSHA mandates that labs provide written bloodborne and airborne ( TB ) safety policies.

Annual TB screening ( PPD test ) for hospital employee’s is mandatory

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Laboratory Safety

Cleaning Specimen Collection Areas and Biological Spills

• Wear gloves.• Use 1:10 bleach solution or commercially prepared

solution.• First clean area with visible blood and then disinfect

the entire area.• Keep the bleach in contact with contaminated area

for at least 20 minutes. • Use colored biohazard labels. • Provide accident follow-up.

Radioactivity Safety

Gamma ray - most penetrating; must store behind lead

Beta ray - less penetrating; normal storage

Must wear badge Work area monitored frequently

The Three Cardinal Principles of Self-protection

1. Time2. Shielding 3. Distance

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FIRE SAFETY

Classification of Fires Class A: Paper, wood, plastic, fabrics Class B: Flammable liquids – gasses Class C: Electrical Class D: Combustible metals

Fire extinguishers are labeled to indicate which type of fire they combat

Most extinguishers utilize a dry chemical that combats A, B and C fires

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FIRE SAFETY

Know the location of Fire alarm pull stations Extinguishers Fire blankets

Know the telephone number to report fires

RACE Rescue - Remove patients from immediate harm Alarm -Pull fire alarm Contain - Close doors and windows Extinguish - Extinguish fire

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DISPOSAL OF HAZARDOUS MATERIALS

Chemical Waste Know the SOP for the disposal of every substance You can’t assume that everything goes down the drain !

Biohazardous Waste Disposal of biohazardous waste is regulated by law Waste containers must be clearly labeled Sharps ( needles, blades, glass ) must be placed in hard containers Infectious wastes should be autoclaved before disposal General rules

Tubes and other containers of blood, papers or other materials that contain significant amounts( > 1 inch diameter on paper or ½ mL total) of blood, used culture plates should go into bio-waste

Paper towels, used gloves, KimWipes should go in regular trash

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ACCIDENT DOCUMENTATION AND INVESTIGATION

All accidents must be immediately reported to a supervisor (AFTER first aid )

Accident Investigation forms must be completed by the employee and employer

OSHA regulations require accident records to be kept 30 years

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