# 10 MLT 405 PPT Facilities and Safety & Waste Mgmt.pdf

Safety in medical facilities

1. Facilities and
Safety

2. Facilities and Safety - Module 2 ٢
Learning Objectives
At the end of the lesson the students will be able to:
1.relate how facility design impacts the efficiency and safety of
laboratory workers;
2.describe practices to prevent or reduce risks;
3.list personal protective equipment (PPE) that should be used
routinely by laboratory workers;
4.explain general safety requirements for the laboratory;
5.describe steps to take in response to emergencies such as
biological or chemical spills, or laboratory fires;
6.determine the types of laboratory waste materials; and
7.discuss proper waste management of various laboratory
waste materials.

3. ٣
Scenario
Your laboratory specializes in virology. There is an epidemic of
H5N1 in your country and the Ministry of Health names your
laboratory as the reference laboratory for processing all samples.
What are the elements to consider ensuring biosafety in
your laboratory?

4. Facilities and Safety - Module 2 ٤
Laboratory Accident

5. Facilities and Safety - Module 2 ٥
Secondary effects of a laboratory
accident
loss of staff confidence
loss of reputation
loss of customers
increased costs litigation, insurance

Negligence
of laboratory safety is costly!

6. Facilities and Safety - Module 2 ٦
is responsible for quality and safety
EVERYONE

7. Facilities and Safety - Module 2 ٧
All diagnostic
and health care
laboratories
must be designed
and organized for
Biosafety level 2
or above

8. Biosafety level
Facilities and Safety - Module 2 ٨

9. Biosafety level – sign
Facilities and Safety - Module 2 ٩

10. Facilities and Safety - Module 2 ١٠
10
Laboratory design
Path followed by the sample
◻reception and registration of patients
◻sampling rooms
◻dispatch between different laboratories
◻analysis of samples
Report delivery, filing
Service rooms

11. Facilities and Safety - Module 2 ١١

12. Facilities and Safety - Module 2 ١٢
Blood clotting
Hematology
Biochemistr
y
Wash
room
Bacteriology
Gynaecological
samples
Blood
samples
Common room,
stairs to offices
Disinfection

13. Facilities and Safety - Module 2 ١٣
Registration desk

14. Facilities and Safety - Module 2 ١٤
▪no unauthorized persons
▪no friends
▪no children
▪no animals
Please
CLOSE
the DOOR
Safety during
service

15. Facilities and Safety - Module 2 ١٥
Sample collection room

16. Facilities and Safety - Module 2 ١٦
Blood

clotting
Hematology
Biochemistr
y
Wash
room
Bacteriology
Gynaecological
samples

collection
Blood
samples
collection
Common room,
stairs to offices
Disinfection
Patient
Reception

17. Facilities and Safety - Module 2 ١٧
Blood clotting
Hematology
Biochemistr
y
Wash
room
Bacteriology
Gynaecological
samples

collection
Blood
samples

collection
Common room,
stairs to offices
Disinfection
Sample
Reception

18. Facilities and Safety - Module 2 ١٨
Segregated areas

19. Facilities and Safety - Module 2 ١٩
Stock room

20. Facilities and Safety - Module 2 ٢٠
20

21. Facilities and Safety - Module 2 ٢١
Blood 

clotting
Hematology
Biochemistr
y
Wash
room
Bacteriology
Gynaecological
samples
collection
Blood
samples
collection
Common room,
stairs to offices
Disinfection
Waste
Reception

22. Facilities and Safety - Module 2 ٢٢
22
Permises Characteristic
high ceiling with good ventilation
walls and ceiling
◻use washable, glossy paint
◻easy to clean and disinfect
floor
◻easy to clean and disinfect

23. Facilities and Safety - Module 2 ٢٣
Benches and working space

24. Material
◻Resistant to bacteria and fungi
◻UV resistant (withstand significant sunlight exposure)
◻Easily disinfected and cleaned
◻Non-porous surface for outstanding chemical resistance
◻Material (Phenolic Resin, Epoxy Resin and Chemical resistance
Laminate)
Ergonomic considerations (e.g., adjustable work surface
heights, adequate knee clearances for seated work,
adequate toe clearances for standing work, shelving heights,
etc.).
Facilities and Safety - Module 2 ٢٤
Benches and working space

25. Facilities and Safety - Module 2 ٢٥
25
Scheduled Cleaning
daily
◻bench tops
◻floors
weekly
◻ceiling and walls
other
◻refrigerators
◻freezers
◻storage areas
record date and cleaning staff

26. Facilities and Safety - Module 2 ٢٦
Safety Management
Responsible: Safety Officer
Safety Manual: laboratory-specific
Standard Operating Procedures
Trained personnel
❑ potential risks
❑ safety procedures
Waste Management

27. Facilities and Safety - Module 2 ٢٧
General Safety Equipment
shower
eye washer PPE
waste disposal
fire safety

28. Facilities and Safety - Module 2 ٢٨
Standard Safety Practices
DO NOT-

29. Facilities and Safety - Module 2 ٢٩
Standard Safety Practices
DO-

30. Facilities and Safety - Module 2 ٣٠
Safety Signs

31. Facilities and Safety - Module 2 ٣١

32. Facilities and Safety - Module 2 ٣٢

33. Facilities and Safety - Module 2 ٣٣
Research Employee Injuries
(1997–1993)
Howard Hughes Medical Institute, Office of Laboratory Safety

34. Facilities and Safety - Module 2 ٣٤
Laboratory Support Injuries
(1997–1993)
Howard Hughes Medical Institute, Office of Laboratory Safety

35. Facilities and Safety - Module 2 ٣٥
Laboratory Hazards
physical
chemical
biological

36. Facilities and Safety - Module 2 ٣٦
Bites,
scratches
animal or
ectoparasites
Spills,
sprays
Aspiration
through
pipettes
broken
glass,
sharps
needles,
syringes
Accidents,
injuries

37. Physical hazards
include exposure to
slips, trips, falls,
electricity, noise,
vibration, radiation,
heat, cold and fire
Facilities and Safety - Module 2 ٣٧

38. Facilities and Safety - Module 2 ٣٨

39. Facilities and Safety - Module 2 ٣٩
Physical Hazards

40. Facilities and Safety - Module 2 ٤٠
▪ do not recap needles
▪ always use puncture-resistant, leakproof,
sharps containers
▪ always use specific waste disposal
containers
▪ never directly handle broken glass
Needles, Broken Glass, and Sharps

41. Facilities and Safety - Module 2 ٤١
Do you see anything wrong?

42. Facilities and Safety - Module 2 ٤٢
Do NOT reuse disposable injection equipment

43. Facilities and Safety - Module 2 ٤٣
Chemical
Hazards

44. Facilities and Safety - Module 2 ٤٤
Chemical Hazards
Biosafety Level 1 and 2 laboratories
Separate cabinets for storage:
▪spill containment cabinet
▪hazardous waste storage
▪flammable liquids storage

45. Facilities and Safety - Module 2 ٤٥
Material Safety Data Sheet

46. Facilities and Safety - Module 2 ٤٦
46
The risks for laboratory workers
-most frequently reported infections in US, 1979-1999
Disease or Agent No. of Cases
Mycobacterium tuberculosis 223
Q fever 176
Hantavirus 169
Hepatitis B virus 84
Brucella sp. 81
Salmonella sp. 66
Shigella sp. 56
Hepatitis non-A, non-B 28
Cryptosporidium sp. 27
Total 1074

47. Facilities and Safety - Module 2 ٤٧


Biological Hazard
MODIFIED SLIDE 41->42

48. Facilities and Safety - Module 2 ٤٨
Single-source, multiple laboratory infections
Disease Probable Source Max Distance
from Source
Number
Infected
Brucellosis Centrifugation Basement to 3
rd
floor
94
CoccidioidomycosisCulture transfer
solid media
2 building floors 13
Coxsackie
Virus infection
Spilled tube of infected
mouse tissue on floor
5 feet estimated 2
Murine Typhus Intranasal inoculation
of mice
6 feet estimated 6
Tularemia 20 Petri plates
dropped
70 feet 5
Venezuelan
encephalitis
9 lyophilized
ampoules dropped
4
th floor stairs to
3
rd or 5
th floor
24
Reitman and Wedum, 1956

49. Facilities and Safety - Module 2 ٤٩
Contamination Routes
Ocular invasion
Inhalation
Ingestion
Skin penetration =
injection

50. Facilities and Safety - Module 2 ٥٠
Personal Protective Equipment
BSL 1 and 2
▪laboratory coat
▪gloves
▪goggles or face shield
▪masks
▪hearing protection

51. Facilities and Safety - Module 2 ٥١
Minor spill
Major spill
Chemical Spills
▪ anything beyond a minor
spill and requiring help from
outside of the laboratory group
constitutes a major spill

52. Biological spillages
Biological spillages can fall within 2 types:
Infectious material which has been handled or
generated within a laboratory eg liquid. cultures of
micro-organisms which is not covered in this
safety note or. Involving human or animal bodily
fluids or materials such as blood, urine, vomit or
faeces.
Facilities and Safety - Module 2 ٥٢

53. Facilities and Safety - Module 2 ٥٣
Learn how to operate a portable
fire extinguisher
Laboratory Fire Safety

54. On Waste Management
Apply Safety Practices Throughout the
Testing Process:
Before Testing (Pre-analytical)
◻Specimen collection
◻Specimen preparation
◻Specimen transport
Testing (Analytical)
◻Testing
After Testing (Post-analytical)
◻Disposal
Facilities and Safety - Module 2 ٥٤

55. Waste management ( Con’t.)
Facilities and Safety - Module 2 ٥٥
Manage waste responsibly:
Classification/ Characterizing
hazardous waste
Proper packaging
Proper storage of waste
Effective labeling
Waste collection protocol in place

56. Types of Wastes
Normal Municipal waste (general)
◻Recyclable waste
◻Broken Glass
Biological / Medical waste
◻Chemical waste
◻Sharps, Broken Glass
Radioactive material waste
◻Electronic and computer waste
Facilities and Safety - Module 2 ٥٦

57. Hazardous Wastes
Any waste that directly or indirectly represents a
threat to human health or to the environment by
introducing one or more of the following risks:
•Explosion or fire
•Infections, pathogens, parasites or their vectors
•Chemical instability, reactions or corrosion
•Acute or chronic toxicity
•Cancer, mutations or birth defects
•Toxicity or damage to the ecosystems or natural
resources
•Accumulation in the biological food chain, persistence in
the environment or multiple effects
Facilities and Safety - Module 2 ٥٧

58. Chemical Wastes
Segregate Chemical Wastes
Proper segregation =good chemical hygiene + safe
workplace environment
Only put compatible chemicals in a container;
Also do not store the following near each other
◻Acids and bases
◻Organics and acids
◻Powdered or reactive metals and combustible materials
◻Cyanide, sulfide or arsenic compounds and acids
◻Mercury or silver and ammonium containing compounds
Do not mix solids and liquids
Halogenated with non-halogenated chemicals
Facilities and Safety - Module 2 ٥٨

59. Chemical Wastes segregation
Facilities and Safety - Module 2 ٥٩

60. Labeling
•Must be labeled as HAZARDOUS WASTE
•Should be accurate, legible and fully explained
•Contain name of the department, lab group name,
contact person details, content and concentration,
hazard class, date
•Use Enviroserv /Sanumed self adhesive labels or
your own.
•Waste vs. used
•No old labels
Facilities and Safety - Module 2 ٦٠

61. Storage
•Select the correct container (glass / polyethylene) for
storage
•Use original containers if possible
•Use appropriate sized container
•Do not make containers too heavy to lift by the
contractors
•Containers must be tightly sealed and not leak
•Containers correctly labeled
•Container compatible with chemical being stored
-separate containers for each type of waste
•Do not store longer than 90 days
Facilities and Safety - Module 2 ٦١

62. Collection Procedure
•Pack all waste in drums provided by
contractors
•Ensure glass bottles are prevented from
breaking by adding vermiculite
•All drums must be properly classified and
labelled as HAZARDOUS WASTE
•Follow protocols adapted by your unit or
department for picking the drums/waste
containers at your department.
Facilities and Safety - Module 2 ٦٢

63. Biological Waste
Definition: Waste generated from biologically-
cultured stocks and plates, molecular material,
blood, animal and plant tissues etc.
All sharps e.g. glass implements, needles,
syringes, blades, glass Pasteur pipettes
Separate biological waste from chemical
hazardous waste
Treat to eliminate biohazard by sterilization or
incineration
Label correct, use biohazard tape
Facilities and Safety - Module 2 ٦٣

64. Biological Waste ( Continuation)
Biohazard/medical waste
boxes
◻Disposal of non-sharp
bio hazardous waste
◻Cardboard box lined
with a red 45 micron
plastic bag
◻Two sizes 50 and 142
litre-max 15kg
◻Seal bag with cable tie,
seal box with
biohaz .tape
Container 1
Facilities and Safety - Module 2 ٦٤

65. Biological Waste ( Continuation)
Biohazard Sharp
containers
◻Disposal sharp bio-
hazardous waste
◻100% puncture proof
◻Available in 4, 7.6, 10,
15 and 25 l
◻Destruction by high
temp
Container 2
Facilities and Safety - Module 2 ٦٥

66. Biological Waste ( Continuation)
Specimen bins
◻For safe human and
animal tissue disposal.
◻Ideal for wet waste
◻Available in 2.5, 5 and
10 l bin
◻Destruction by high
temp
Container 3
Facilities and Safety - Module 2 ٦٦

67. POINTS to remember:
No bio-hazardous waste shall be stored for
longer than 24 hours without being
decontaminated
Decontaminated bio-hazardous waste stored up
to 30 days
No storage public areas
Store under refrigeration if necessary to prevent
odors
Sharps containers treated as regular bio-
hazardous waste
Facilities and Safety - Module 2 ٦٧

68. Bio-hazardous waste Pick-up
Procedures
Sample protocol:
Seal red bags when ¾ full with cable ties provided
by contractor
Seal Biohazard/Medical waste boxes with
biohazard tape
Complete chemical/biological waste pick-up
request form
Forward electronically to USBD
contractor to pick up waste and replace containers
as needed
Facilities and Safety - Module 2 ٦٨

69. WAYS to minimize waste
Good housekeeping
Document Procedures
Maintain Chemical inventory
Centralize purchasing
Spill Preparedness
Neutralize corrosives
Minimize use of solvents
Use alternative products
Facilities and Safety - Module 2 ٦٩

70. Facilities and Safety - Module 2 ٧٠
Summary
When designing a laboratory or
organizing workflow, ensure that
patients and patient samples do not
have common pathways

71. Facilities and Safety - Module 2 ٧١
Summary
Safety is dependent on:
▪a responsible supervisor
▪a safety and waste management
manual and SOPs
▪trained personnel
▪assessment of risks
▪laboratory design & workflow

72. Facilities and Safety - Module 2 ٧٢
Key Message
Neglecting laboratory safety is costly.

It jeopardizes the lives and health of
employees and patients, and
jeopardizes laboratory reputation,
equipment, and facilities.