NUS Safety & Health Manual

Title:

Procedure No: Rev No: Issue date: Page:

OSHE/SOP/BS/07 000 2-Aug-07 1 of 6

Safe handling of sharps

Khng Hwee Hoon
Prepared by

Saravanan Gunaratnam
Approved By

Review Date

1.0 OBJECTIVE The objective of this SOP is to provide guidance to all laboratory personnel on the safe handling of sharps in order to prevent the occurrence of percutaneous injury. Physical injuries and accidental injections of infectious agents / toxic or harmful materials may result from sharps injuries. 2.0 SCOPE The procedure is applicable to all National University of Singapore (NUS) laboratories where sharps are used in the course of work. All staff and students are to adopt the practices in the procedure. 3.0 RESPONSIBILITIES 3.1 Head of Department/ Principal Investigator Principal Investigators (PI) and Heads of Department (HOD) shall be responsible for ensuring that this SOP is disseminated to all laboratory personnel and that they are aware of the procedures to take for safe handling of sharps. 3.2 Laboratory personnel All lab personnel shall be responsible for proper handling and use of sharps in accordance with this procedure. All lab personnel shall report any injuries with sharps to their supervisor or the Faculty Safety and Health officer. 4.0 DEFINITION a. Sharp(s) - Any object used or encountered in a laboratory setting that can puncture or penetrate the skin or any other part of the body and result in an exposure incident. Examples of laboratory items that fall under this category include but are not limited to, needle devices (hypodermic needles, suture needles etc), scalpels, lancets, pasteur pipettes, broken glass, and broken capillary tubes and disposable syringes. b. Sharps injury - Any injury caused by a sharp, including, but not limited to, cuts, abrasions, or needle sticks. 5.0 PROCEDURE There are two aspects to dealing with sharps: using them and throwing them away. Both can be risky and require special care. Use the hierarchy of controls concept to prioritize prevention interventions-

NUS Safety & Health Manual

Title:

Procedure No: Rev No: Issue date: Page:

OSHE/SOP/BS/07 000 2-Aug-07 2 of 6

Safe handling of sharps

Khng Hwee Hoon
Prepared by

Saravanan Gunaratnam
Approved By

Review Date

The first priority is to eliminate and reduce the use of needles and other sharps where possible. Second is to substitute with safer alternatives. Next is to isolate the hazard, thereby protecting an otherwise exposed sharp, through the use of an engineering control. When these strategies are not available or do not provide total protection, consider work-practice controls and personal protective equipment. 5.1 Elimination/substitution of sharps a. The best way to avoid a sharps injury is to avoid using sharps. E.g. Needles and syringes should never be used as a substitute for pipettes! b. Avoid using needles and syringes whenever possible because the majority of laboratory biohazard injuries are due to needlestick injuries. The use of needles and syringes should be restricted to procedures for which there is no alternative. c. Where possible, find alternatives to using needles such as: Using alternate routes for inoculation, medication delivery or vaccination to animals e.g. blunt cannulae or IV delivery systems that do not require needle access. Reviewing specimen collection systems to identify opportunities to consolidate and eliminate unnecessary punctures. d. Substitute sharps with plastic where possible. For example: Disposable transfer pipettes may be a good replacement for glass pasteur pipettes. Replace lab glassware with plastic ware wherever possible. It can eliminate broken glass problems. e. Use round-tipped scalpel blades instead of sharp-tipped blades 5.2 Engineering Controls a. Use devices with engineered sharps injury prevention features e.g. safety-engineered blood collection needles. These devices have a built-in physical attribute such as blunting, needle withdrawal, automatic needle-resheathing or other physical mechanism which effectively reduces the risk of an exposure incident.

NUS Safety & Health Manual

Title:

Procedure No: Rev No: Issue date: Page:

OSHE/SOP/BS/07 000 2-Aug-07 3 of 6

Safe handling of sharps

Khng Hwee Hoon
Prepared by

Saravanan Gunaratnam
Approved By

Review Date

b. Use a sharps disposal container for the disposal of sharps and place it close to where sharps are being used. The container should be durable, closable, leak resistant and puncture resistant. It should be clearly visible, with appropriate warning signals, and be easily accessible to lab personnel who use\dispose of sharp devices. These are typically available commercially in different sizes as yellow plastic containers with a biohazard symbol. Use an appropriate sized container to minimize protruding sharps.

5.3 Work-practice Controls When sharps must be used, the following procedures are recommended: 5.3.1 General controls a. Use instruments rather than bare hands to handle sharps. For example, use forceps to load or unload needles and scalpels; use tongs to pick up broken glass. b. Give verbal announcements when passing sharps. c. Do not leave unprotected sharps (razor blades, scalpel tips, etc.) unattended on bench tops. Contain the sharp items in a tray or a suitable container. d. Be careful when cleaning up after experimental procedures that require the use of sharps as sharp items may have become hidden in the garbage. e. Lab glassware that are chipped or cracked should be discarded. 5.3.2 Syringes and Needles As the majority of laboratory biohazard injuries are due to hypodermic needles, special attention must be paid to the use and disposal of needles to minimize the possibility of exposure via accidental autoinoculation. a. To attach a needle to a syringe, insert the small end of the syringe into the hub of the capped needle.

NUS Safety & Health Manual

Title:

Procedure No: Rev No: Issue date: Page:

OSHE/SOP/BS/07 000 2-Aug-07 4 of 6

Safe handling of sharps

Khng Hwee Hoon
Prepared by

Saravanan Gunaratnam
Approved By

Review Date

b. To remove a needle cap, hold the syringe with one hand and use the other hand to grasp and push the needle cap toward the syringe while rotating the cap just slightly (about 1/4 turn) to break the seal. Do not try to pull the cap off the needle as you may inadvertently stick yourself when the cap comes off suddenly. c. Never leave an uncovered needle on the counter. Always rest the needle in its cap while waiting to use the assembled needle and syringe or in between steps of a procedure. It is not necessary to place the cap securely onto the needle at this point. d. Do not walk around the lab with an uncapped needle or syringe and needle e. Do not bend, break, or otherwise manipulate needles BY HAND. f. Never recap needles as an accidental puncture may occur. If it is absolutely necessary, recap use a cap-holding device or a pair of forceps or a one-handed technique to scoop the cap up. g. Use disposable needle locking syringe units whenever possible. Do not remove needles from syringes. Throw away the entire syringe-needle combination. h. When using syringes and needles with biohazardous or potentially infectious agents, Work in a biosafety cabinet and avoid quick and unnecessary movements of the hand holding the syringe. Wear surgical or other type of rubber gloves Use needle-locking (Luer-Lok type) syringes. Fill the syringe carefully to minimize air bubbles and frothing of the inoculum. Expel air, liquid and bubbles from the syringe vertically into a cotton/gauze pad moistened with disinfectant. Do not use a syringe to mix infectious fluid forcefully so as to prevent aerosol formation. Do not contaminate the needle hub when filling the syringe in order to avoid transfer of infectious material to fingers. Wrap the needle and stopper in a cotton pad moistened with disinfectant when removing a needle from a rubber-stoppered bottle. Use a separate pan of disinfectant for reusable syringes and needles. Do not place them in pans containing pipettes or other glassware in order to eliminate sorting later.

5.4 Sharps Disposal Proper disposal of sharps is essential for protecting cleaners/ waste disposal workers; and the general public from being injured by discarded sharps. a. Never discard sharps into regular trash bins or biological waste. b. Dispose of all sharps into puncture resistant containers that do not allow the whole hand to go in.

NUS Safety & Health Manual

Title:

Procedure No: Rev No: Issue date: Page:

OSHE/SOP/BS/07 000 2-Aug-07 5 of 6

Safe handling of sharps

Khng Hwee Hoon
Prepared by

Saravanan Gunaratnam
Approved By

Review Date

c. Never try to recover sharp material after it has been disposed off into the sharp container. d. When disposing needles and syringes, do not recap the needle nor remove the needle from the disposable syringe. Place the entire needle-syringe unit directly into the sharps disposal container. e. All contaminated sharps are to be treated as infectious and disposed of only through licensed biohazardous waste collectors. f. Contaminated broken test tubes or other small items of broken glassware should be placed directly into Sharps containers. Larger pieces of clean broken glassware (e.g. beakers, flasks, test tubes, etc free from biohazardous, radioactive or chemical contamination) can be discarded into the standard broken glassware boxes. If the glassware is contaminated disinfect it before disposal. g. Do not place sharps containers on the floor of the lab at all times h. Keep sharps containers covered at all times except when sharps are being deposited into the container. i. Do not overfill sharp containers beyond the recommended fill line or beyond 3/4 full. j. Filled sharps containers should be sealed, labeled as SHARPS and the biohazard symbol before disposal by licensed biohazardous waste collectors for incineration. k. Refer to Office of Safety Health and Environment (OSHE) SOP on Biological Waste Disposal (OSHE/SOP/BS/01) for more details of the waste disposal procedure. 5.5 Sharps/ Needlestick injury a. In the event of a sharps or needlestick injury, encourage bleeding, wash the punctured wound with soap and water and apply an appropriate skin disinfectant. b. Inform the principal investigator or laboratory supervisor about the cause of the wound and organisms involved if any.

NUS Safety & Health Manual

Title:

Procedure No: Rev No: Issue date: Page:

OSHE/SOP/BS/07 000 2-Aug-07 6 of 6

Safe handling of sharps

Khng Hwee Hoon
Prepared by

Saravanan Gunaratnam
Approved By

Review Date

c. In the event of exposure to biological materials/infectious agents resulting in possible infection, disease or illness, please call at the University Health and Wellness Center (UHWC) for a medical assessment or proceed to the Accident & Emergency Units of Hospitals after office hours.

1. YIH Main Clinic Level 4, Yusof Ishak House Kent Ridge Crescent x2880 (65162880) Consultation Hours: Monday - Thursday 8.30am to 6.00pm (Closed 12.30pm to 1.30pm) Last registration at 5.40pm Friday 8.30am to 5.30pm (Closed 12.30pm to 1.30pm) Last registration at 5.10pm

2. Bukit Timah Campus (BTC) Block B, MPA-02-01 (Level 2 MPA block). Consultation Hours Mondays, Wednesdays & Fridays 8.30am to 10.30am

d. Submit a report to OSHE via the online NUS Accident and Incident Reporting System (AIRS). 6 RECORDS a. Records for the disposal of the wastes must be kept for verification by authorities or for inspection. b. All sharps injuries have to be reported via OSHEs Accident and Incident Reporting System (AIRS). 7 REFERENCES a. National Environmental Agency (NEA) guidelines on bio-Hazardous substances control (http://app.nea.gov.sg/) b. OSHE/SOP/BS/01 on SOP on Biological Waste Disposal c. CDC Workbook for Designing, Implementing, and Evaluating a Sharps Injury Prevention Program (http://www.cdc.gov/sharpssafety/) d. U.S. Department of Labor Occupational Safety and Health Administration (OSHA) Safety and Health Topic: Blood borne pathogen and needlestick prevention (www.osha.gov) e. U.S. Department of Labor Occupational Safety and Health Administration (OSHA) standards - 29 CFR Part 1910.1030: Occupational Exposure to Blood borne Pathogens Standard (Bloodborne Pathogens Standard) 8 APPENDICES Nil