CLINICAL CHEM Lesson 3: Laboratory Safety and Regulations

Lecture by Ms. Reyna May G. Cabilla, RMT

August 15, 2023

OCCUPATIONAL SAFETY AND HEALTH ACT (OSHA)

○ 10% hydrogen peroxide
● The goal of this federal regulation was to provide all ○ 10% formaldehyde
employees (clinical laboratory personnel included) with a ○ 5-25% hypochlorite
safe work environment. ○ 10% v/v (v/v:volume/volume) with tap water
● OSHA standard that regulate safety in the laboratory and common household bleach makes a very
include: effective and economical disinfectant, can
○ Bloodborne Pathogens inactivate HBV in 10 minutes and HIV in 2
○ Formaldehyde Standard minutes
○ Laboratory Standard
○ Hazard Communication Standard
○ Respiratory Protection Standard BIOLOGIC SAFETY
○ Air Contaminants Standard ● All samples and other body fluids should be collected,
○ Personal Protective Equipment Standard transported, handled and processed using strict
precautions.
● Gloves, gowns and face protection must be used if splash
BLOODBORNE PATHOGENS
or splattering is likely to occur.
● Specimens should remain capped during centrifugation
● Occupational Safety and Health Organization Administration because biologic specimens could produce finely
(OSHA) - “Blood-Borne Pathogens” standard requires dispersed aerosols that are a high-risk source of
written “Exposure Control Plan” infection.
● Any blood, body fluid or other potentially infectious material
spill must be cleaned up and the area of equipment
CATEGORIES OF EXPOSURE disinfected immediately.

● Category I - Daily exposure Recommended clean up includes the following:

● Category II - Regular exposure ● Wear appropriate protective equipment
● Category III - No exposure ● Use mechanical devices to pick up broken glass or other
sharp objects
Employers must offer Hepatitis B vaccine at no cost to all ● Absorb the spill with paper towels, gauze pads, or tissue,
personnel in Category I and II etc.
● Biological safety cabinets should be installed in strategic ● Clean the spill site using common aqueous detergent
places to facilitate manipulations of infectious material. It (10% bleach)
reduces risk of exposure of laboratory personnel & patients. ● The spill site using approved disinfectant or 10% bleach
using appropriate contact time.
SAFETY AWARENESS FOR LABORATORY PERSONNEL ● Rinse the spill site with water
● Dispose all materials in appropriate biohazard
containers.
● Health Care Organizations focus their responsibility in
protecting their employees form infections especially
against hepatitis B virus and human immunodeficiency virus HAZARD COMMUNICATION STANDARD
● The Centers for Disease Control (CDC) updated the 1983
Guidelines for isolation precaution in hospitals with the ● OSHA requires that Material Safety Data Sheet (MSDS)
release of its universal precaution in 1987 because of the be provided for each chemical by manufacturers and
growing concern about HIV suppliers and must be made available on site for laboratory
● The CDC recommends that blood and body fluid personnel.
precautions should be consistently used for all patients ● MSDS will specifically include:
regardless of their blood-borne infection status. ○ The chemical identity
● Potentially infectious materials include: ○ Chemical and common name
○ Body fluids (semen, vaginal secretions, pericardial ○ Physical and chemical characteristics
fluid, peritoneal, synovial, pleural, amniotic, saliva, ○ Signs and symptoms of exposure
tears, CSF, urine and breast milk) ○ Routes of entry
○ Unfixed tissues, organs or blood slides ○ Exposure limits
● Infective agents may be inactivated by: ○ Carcinogenic potential
○ heat sterilization (250ºC for 15 mins) ○ Safe handling procedures
○ ethylene oxide (450-500 mg/L at 55-60 °C) ○ Spill cleanup procedures
○ 2% glutaraldehyde ○ Emergency first aid
Abelgas, Labra, Machate, Rebusit notes 1
● MSDS contain information on the nature of the chemical,
precautions if spilled and disposal recommendations.
OSHA published its hazard communication standard in 1983 to
minimize the incidence of chemically related occupational
illnesses and injuries in the workplace. OSHA requires the
following:
● MANUFACTURERS OF CHEMICALS should evaluate
the hazards of the chemicals they produce and develop
hazard communication programs for employees exposed
to hazardous chemicals.
● CLINICAL LABORATORIES should develop and institute
a chemical hygiene plan.
● HOSPITALS and LABORATORIES are obliged to
maintain an inventory of all hazardous substances used
in the workplace.
INTERNATIONAL CHEMICAL LABELING SYSTEM
● The National Fire Protection Association (NFPA) has
developed the Hazards Identification System to provide
common, recognizable warning signs for chemical hazards.
The system consists of four color-coded, diamond-shaped
symbols arranged to form a larger diamond shape.
○ RED - Designates Flammability
○ BLUE - Health hazard
○ YELLOW - Reactivity-stability
○ WHITE - Special considerations
● Contained within each color-coded diamond is a number
ranging from 0 to 4, indicating the severity of the respective
hazard (0 = none, 4 = extreme)
GLOBALLY HARMONIZED SYSTEM OF CLASSIFICATION AND
LABELING OF CHEMICALS (GHS)
● Is an internationally-agreed chemical hazard identification
system managed by the United Nations.
● Core elements of the GHS system include:
○ Standardized hazard
○ Testing criteria
○ Universal warning pictograms
○ Harmonized safety data sheets
● Universal Warning Pictograms - to visually alert those
who come in contact with hazardous chemicals of the risk
they may be exposed to and their need to take
precautionary steps to protect themselves from harm.
ELECTRICAL HAZARD
1. All laboratory equipment shall be properly grounded at
all times and use three-pronged electrical plugs.
2. Never operate or service any electrical equipment with
wet hands.
3. Never use extension cords.
4. Never overload electrical circuits.
5. Inspect all electrical cords and plugs periodically.
6. Unplug electrical equipment before servicing or repairing
even if the servicing only involves replacing a worn-out
light bulb.
7. Use laboratory electrical equipment in accordance with
the manufacturer’s specifications and instructions.
8. Use signs and labels to indicate the presence of
high-voltage equipment or other instrumentation with risk
of electric shock.
9. Equipment used in areas where volatile materials are
located must have explosion-proof monitors.
10. if electrical equipment gets wet, unplug it immediately
and be allowed to dry completely before cleaning or
servicing and reusing.
11. When a situation involving an electric shock occurs, it is
important to remove the electrical source immediately
and must be done without direct contact or touching the
patient or equipment.
RADIATION SAFETY
● A radiation-safety policy should include environmental
and personnel protection.
● 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.
● Records must be maintained as to the quantity of
radioactive material on hand as well as the quantity that
is disposed. Records must be maintained for the length
of employment plus 30 years.
● Radiation monitoring utilizes film badge or survey meter.
The exposure limit (maximum permissible dose
equivalents is 5000 mrem/year whole body)
● The WIPE TEST (Leak Test) involves wiping laboratory
surfaces with moistened absorbent material and the
radiation contained in each wipe is counted.
FIRE OR EXPLOSIVE HAZARDS
Bureau of Fire Protection (BFP)
● Responsible with the enforcement of Presidential
Decree No. 1185 or the "Fire Code of the
Philippines".
● BFP requires everyone including healthcare institutions
to be familiar with the safety procedures and basic steps
when a fire or explosion is discovered. to know chuchu
Initial steps when a fire is discovered:
● R-escue
● A-larm/Access; activate the institutional fire system, call
the fire station and ensure access to emergency exit
● C-ontain the fire by closing all windows and doors in
potentially affected area
● E-xtinguish/Evacuate
US NFPA classifies fires with regard to the type of burning
material and also classifies the type of fire extinguisher that is
used to control them.
Steps to follow when operating a fire extinguisher:
● P - Pull the pin with gentle twisting,
● A- Aim nozzle at the base of fire,
● S- Squeeze the handle,
● S- Sweep side to side.
Fires have been divided into four classes on the nature of the
combustible material and requirements for extinguishments.
● Class A - Ordinary combustible solid materials such as
paper, wood, plastic and rubber
● Class B - Flammable liquid/gasses and combustible
petroleum products
● Class C - Energized electrical equipment
Abelgas, Labra, Machate, Rebusit notes 2
 ● Class D - Reactive/combustible metals such as Mg, Na
and K
TYPES OF FIRES AND FIRE EXTINGUISHERS
● Type A - Pressurized water extinguishers (foam and
multipurpose dry-chemical types) are for Class A fire
● Type ABC - Multipurpose dry chemical and carbon
dioxide extinguisher are used for Classes B and C
● Type C - Halogenated hydrocarbon extinguishers are
recommended particularly for use with computer
equipment
● Type D - Class D fires present special problems and
extinguishments is left to trained firefighters using
special dry-chemical extinguishers
● Personnel should know the location and type of portable
fire extinguisher near the work area and know how to
use an extinguisher before a fire occurs.
BIOHAZARDOUS WASTE
● 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.
● It comprises of animal waste, bulk blood and blood
products. microbiological waste, pathologic wastes, and
sharps.
● The approved methods for treatment and disposition of
medical waste are incineration, steam sterilization,
burial, thermal inactivation, chemical disinfection, or
encapsulation in a solid matrix.

COMPRESSED GASSES

Safety procedures when handling compressed gasses:

● Always move gas cylinders using an approved carrier or
hand truck.
● Always check the cylinder’s label before connecting to a
system.
● Do not force fittings; they should connect or screw on
easily.
● Be sure that cylinders are secured to the wall or other
support structure.
● When the gas in the cylinder is depleted, label it “empty”.
● Inspect all gas cylinders and pipes periodically.

DISPOSAL OF HAZARDOUS MATERIALS

These are Four Basic Waste Disposal Techniques. These

include:
○ Flushing down the drain to the sewer system
○ Incineration
○ Landfill Burial
○ Recycling

Disposal of Hazardous Materials

● It is permissible to flush water-soluble substances
down the drain with large quantities of water.
● Strong acids and bases should be neutralized before
disposal.
● Foul smelling chemicals should NEVER be disposed
of down the drain.
● Other liquid wastes, including flammable solvents, must
be collected in approved containers and segregated into
compatible classes.
● Flammable material can be burned in specially designed
incinerators with after burners and scrubbers to remove
toxic products of combustion.
● Solid chemical wastes that are unsuitable for
incineration must be buried in a landfill.

Abelgas, Labra, Machate, Rebusit notes 3