Lab safety and regulations by dr.brahmesh, PG BIOCHEMISTRY, AMC, VIZAG, AP, INDIA

LAB SAFETY AND ITS REGULATIONS, OSHA GUIDELINES

1. LABORATORY SAFETY AND REGULATIONS BY DR. G . BRAHMESH PG-BIOCHEMISTRY

2. Discuss safety awareness for clinical laboratory personnel. List the responsibilities of employer and employee in providing a safe workplace. Identify hazards related to handling chemicals, biologic specimens, and radiologic materials. Choose appropriate personal protective equipment when working in the clinical laboratory. Identify the classes of fires and the type of fire extinguishers to use for each. Describe steps used as precautionary measures when working with electrical equipment, cryogenic materials, and compressed gases and avoiding mechanical hazards associated with laboratory equipment. Select correct means for disposal of waste generated in the clinical laboratory. Outline the steps required in documentation of an accident in the workplace . OBJECTIVES

3. Electric shock Toxic vapors & irritants Compressed gases Flammable liquids Radioactive material Corrosive substances Mechanical trauma Poisons Biologic materials Cryogenic materials POTENTIAL HAZARDS

4. LABORATORY SAFETY Safety begins with recognition of hazards and is achieved through the application of: Common sense. A safety-focused attitude. Good personal behavior/habits. Good housekeeping. Continual practice of good laboratory technique . LABORATORY SAFETY

5. In most cases, accidents can be traced directly to two primary causes : Unsafe acts (PERSONAL) Unsafe conditions (ENVIRONMENTAL) LABORATORY SAFETY LABORATORY SAFETY

6. 3 Strategies to contain hazards: Engineering Controls Personal Protective Equipment Work Practice Controls LABORATORY SAFETY LABORATORY SAFETY

7. Occupational Safety and Health Act Public Law 91-596 , enacted on 1970. Goal: to provide all employees (clinical laboratory personnel included) with a safe work environment. Under this legislation, the Occupational Safety and Health Administration (OSHA) is authorized to conduct on-site inspections to determine whether an employer is complying with the mandatory standards and assess fines if it finds noncompliance with the regulations. REGULATIONS REGULATIONS

8. Occupational Safety and Health Act The National Institute of Occupational Safety and Health (NIOSH ) serves as OSHA’s research and advisory arm. The regulations most specific to clinical laboratories : Occupational Exposure to Formaldehyde Standard Hazard Communication Standard Occupational Exposure to Blood-borne Pathogens Occupational Exposure to Hazardous Chemicals in Laboratories REGULATIONS REGULATIONS

9. Agencies other than OSHA also have regulations that affect laboratories: Research Conservation and Recovery Act (RSRA) Department of Transportation (DOT) Medical Waste Tracking Act Nuclear Regulatory Commission (NRC) REGULATIONS REGULATIONS

10. Other government and private agencies : National Fire Protection Association (NPFA) National Committee on Clinical Laboratory Standards (NCCLS) Centers for Disease Control and Prevention (CDC) National Institute of Occupational Safety and Health (NIOSH) National Institute of Health (NIH) American Conference of Governmental Industrial Hygienists (ACGIH) REGULATIONS REGULATIONS

11. Voluntary accrediting agencies : Commission on Laboratory Accreditation of the College of American Pathologists Joint Commission for Accreditation of Healthcare Organizations (JCAHO) REGULATIONS REGULATIONS

12. Safety Responsibility The employer and the employee share safety responsibility. The employer has the ultimate responsibility for safety and delegates authority for safe operations to supervisors. Safety management in the laboratory should start with a written safety policy . SAFETY AWARENESS FOR CLINICAL LABORATORY PERSONNEL SAFETY AWARENESS FOR CLINICAL LABORATORY PERSONNEL

13. EMPLOYER’S RESPONSIBILITIES Establish laboratory work methods and safety policies. Provide supervision and guidance to employees. Provide safety information, training, personal protective equipment, and medical surveillance to employees. Provide and maintain equipment and laboratory facilities that are adequate for the tasks required. SAFETY AWARENESS FOR CLINICAL LABORATORY PERSONNEL SAFETY AWARENESS FOR CLINICAL LABORATORY PERSONNEL

14. EMPLOYEE’S RESPONSIBILITIES Know and comply with the established laboratory work and safety methods. Have a positive attitude toward supervisors, co-workers, facilities, and safety training. Give prompt notification of unsafe conditions or practices to the immediate supervisor and ensure that unsafe conditions and practices are corrected. Engage in the conduct of safe work practices and use of personal protective equipment (PPE). SAFETY AWARENESS FOR CLINICAL LABORATORY PERSONNEL SAFETY AWARENESS FOR CLINICAL LABORATORY PERSONNEL

15. SAFETY PRACTICES

16. General Practices: Smoking , eating, and application of cosmetics are prohibited. Protective garment must be worn over clothing. Shoes should be made of nonporous material with closed toes and heels. Contact lenses should be discouraged. Goggles or face shields are recommended if contact lenses are worn. Dangling jewelry , long hair, and beards are not allowed. Mouth pipetting should be strictly prohibited. SAFETY PRACTICES SAFETY PRACTICES

17. Labels and Signage: All chemical containers should be clearly labelled. Appropriate signs to identify hazards are critical. Areas where flammables, hazardous or toxic chemicals, and carcinogens are stored or being used must be clearly marked. Areas where blood and body fluids are being stored or analyzed should be clearly marked with a biohazard mark . SAFETY PRACTICES SAFETY PRACTICES

18. Flammable Poison / Toxic Oxidizer Harmful / Irritant Explosion Environmental Hazard Corrosive Biohazard Radioactive SAFETY PRACTICES

19. Labels and Signage: The National Fire Protection Association (NFPA) developed a standard hazards-identification system ( diamond-shape, color-coded symbol ), which has been adopted by many clinical laboratories . SAFETY PRACTICES

20. SAFETY PRACTICES

21. SAFETY PRACTICES

22. Hoods Fume Hoods Biological Hoods Chemical storage equipment Personal protective equipment (PPE) SAFETY EQUIPMENT

23. HOODS Fume Hoods Fume hoods are used when chemical reagents may produce a hazardous fume. The sash or window should be lowered when working in the hood. Air flow should be checked to assure proper ventilation. Controls such as power, gas, and vacuum should be located externally to prevent a spark that may cause a fire when using volatiles. SAFETY EQUIPMENT

24. HOODS Biosafety / Biological Hoods Biological safety cabinets (BSCs) Biological hoods remove particles that may infect the person working with the biologically infected specimen. These hoods contain a HEPA (high-efficiency particulate air) filter and are used typically in a microbiology laboratory. SAFETY EQUIPMENT

25. BIOSAFETY LEVEL AGENTS   1 Bacillus subtilis Mycobacterium gordonae Agents include those that have no known potential for infecting healthy people . 2 HIV, HBV Bacillus anthracis Yersinia pestis Agents associated with human disease ; routes of transmission include percutaneous injury, ingestion , and mucous membrane exposure . 3 Mycobacterium tuberculosis Mold stages of systemic fungi Francisella tularensis Brucella spp. Indigenous/exotic agents that may cause serious or potentially lethal disease through the inhalation route of exposure. 4 Arbovirus Arenavirus Filovirus Smallpox virus Dangerous/exotic agents which post high individual risk of aerosol-transmitted laboratory infections that are frequently fatal, for which there are no vaccines or treatments available. CLASSIFICATION OF BIOLOGIC AGENTS BASED ON HAZARD SAFETY EQUIPMENT

26. CHEMICAL STORAGE EQUIPMENT Safety equipment is available for the storage and handling of chemicals and compressed gases. Safety carriers should always be used to transport 500-mL bottles of acids, alkalis, or other solvents, and approved safety cans should be used for storing, dispensing, or disposing of flammables in volumes greater than 1 qt. SAFETY EQUIPMENT

27. CHEMICAL STORAGE EQUIPMENT Safety cabinets are required for the storage of flammable liquids, and only specially designed, explosion-proof refrigerators should be used to store flammable materials. Only the amount of chemical needed for the day should be available at the bench. Gas cylinder supports or clamps must be used at all times, and large tanks should be transported using handcarts. SAFETY EQUIPMENT

28. PERSONAL PROTECTIVE EQUIPMENT (PPE) The parts of the body most frequently subject to injury in the clinical laboratory are the eyes, skin, and respiratory and digestive tracts . Hence, the use of personal protective equipment is very important. All contaminated PPE must be removed and properly disposed of before leaving the laboratory. SAFETY EQUIPMENT

29. BIOLOGICAL SAFETY

30. General Considerations: All blood samples and other body fluids should be collected, transported, handled, and processed using strict precautions. Gloves, gowns, and face protection must be used if splashing or splattering is likely to occur. Consistent and thorough hand washing is an essential component of infection control. Centrifugation of biologic specimens produce finely dispersed aerosols that are a high-risk source of infection. Ideally, specimens should remain capped during centrifugation. BIOLOGICAL SAFETY

31. Hand Washing: Hand washing is one of the major ways of preventing the spread of infectious agents. Even if gloves are worn, hand washing is necessary because of microscopic holes in gloves that may occur. When dealing with patients, hand washing should be done between each patient even if gloves are worn. BIOLOGICAL SAFETY

32. STERILIZATION & DISINFECTION Sterilization – is a process whereby all forms of microbial life, including bacterial spores, are killed. Sterilization may be accomplished by physical or chemical means. PHYSICAL METHODS : Incineration – most common method Moist heat – simplest and fastest method Dry heat Filtration Ionizing radiation BIOLOGICAL SAFETY

33. STERILIZATION & DISINFECTION Sterilization – is a process whereby all forms of microbial life, including bacterial spores, are killed. Sterilization may be accomplished by physical or chemical means. CHEMICAL METHODS: Ethylene oxide gas – most common sterilant Formaldehyde vapor and vapor -phase H 2 O 2 Glutaraldehyde Peracetic acid BIOLOGICAL SAFETY

34. STERILIZATION & DISINFECTION Disinfection ­ - it is the process destroying pathogenic microorganisms EXCEPT spores . Disinfection may be accomplished by physical or chemical means. PHYSICAL METHODS: Boiling at 100 o C for 15 minutes Pasteurizing at 63 o C for 30 minutes or 72 o C for 15 seconds Non-ionizing radiation such as UV light – long wavelength and low energy BIOLOGICAL SAFETY

35. STERILIZATION & DISINFECTION Disinfection ­ - it is the process destroying pathogenic microorganisms EXCEPT spores. Disinfection may be accomplished by physical or chemical means. CHEMICAL METHODS: Alcohols – 70% ethanol Aldehydes – 2% glutaraldehyde Halogens – 10% hypochlorite(bleach) , iodophor Heavy metals – 1% silver nitrate Quaternary ammonium compounds Phenolics – carbolic acid derivatives BIOLOGICAL SAFETY

36. Spills: Any blood, body fluid, or any other potentially infectious material spill must be cleaned up and the area or equipment disinfected immediately. BIOLOGICAL SAFETY

37. Spills: Recommended clean-up includes the following: Wear appropriate protective equipment. Use mechanical devices to pick up broken glass or other sharp objects. Absorb the spill with paper towels, gauze pads, or tissue. Clean the spill using a common aqueous detergent. Disinfect the spill site using approved disinfectant or 10% bleach, using appropriate contact time. Rinse the spill site with water. Dispose of all materials in appropriate biohazard containers. BIOLOGICAL SAFETY

38. Blood-borne Pathogen Exposure Control Plan To minimize employee exposure, each employer must have a written exposure control plan. The plan must be available to all employees whose reasonable anticipated duties may result in occupational exposure to blood or other potentially infectious materials. The exposure control plan must be discussed with all employees and be available to them while they are working. The employee must be provided with adequate training of all techniques described in the exposure control plan at initial work assignment and annually thereafter. BIOLOGICAL SAFETY

39. Blood-borne Pathogen Exposure Control Plan All necessary equipment and supplies must be readily available and inspected on a regular basis. Special precautions must be taken when handling all specimens because of the continual increase of infectious samples received in the laboratory. Adopting a Standard Precautions­ policy , which considers blood and other body fluids from all patients as potentially infective, is required. BIOLOGICAL SAFETY

40. Healthcare personnel are at risk for occupational exposure to bloodborne pathogens, including hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeiciency virus (HIV). Exposures occur through needlesticks or cuts from other sharp instruments contaminated with an infected patient's blood or through contact of the eye, nose, mouth, or skin with a patient's blood. Important factors that inluence the overall risk for occupational exposures to bloodborne pathogens include the number of infected individuals in the patient population and the type and number of blood contacts. BIOLOGICAL SAFETY

41. BIOLOGICAL SAFETY Most exposures do not result in infection. Following a specific exposure, the risk of infection may vary with factors such as these:   The pathogen involved The type of exposure The amount of blood involved in the exposure . The amount of virus in the patient's blood at the time of exposure.

42. BIOLOGICAL SAFETY How can occupational exposures be prevented?   Many needlesticks and other cuts can be prevented by using safer techniques (for example, not recapping needles by hand), disposing of used needles in appropriate sharps disposal containers, and using medical devices with safety features designed to prevent injuries. Using appropriate barriers such as gloves, eye and face protection, or gowns when contact with blood is expected can prevent many exposures to the eyes, nose, mouth, or skin.

43. BIOLOGICAL SAFETY   RISK OF INFECTION AFTER EXPOSURE   What is the risk of infection after an occupational exposure?   HBV   Healthcare personnel who have received hepatitis B vaccine and developed immunity to the virus are at virtually no risk for infection. For a susceptible person, the risk from a single needlestick or cut exposure to HBV-infected blood ranges from 6-30% and depends on the hepatitis B e antigen (HBeAg) status of the source individual. Hepatitis B surface antigen (HBsAg)-positive individuals who are HBeAg positive have more virus in their blood and are more likely to transmit HBV than those who are HBeAg negative. While there is a risk for HBV infection from exposures of mucous membranes or nonintact skin, there is no known risk for HBV infection from exposure to intact skin.

44. BIOLOGICAL SAFETY HCV   The average risk for infection after a needlestick or cut exposure to HCV-infected blood is approximately 1.8%. The risk following a blood exposure to the eye, nose or mouth is unknown, but is believed to be very small; however, HCV infection from blood splash to the eye has been reported. There also has been a report of HCV transmission that may have resulted from exposure to nonintact skin, but no known risk from exposure to intact skin

45. BIOLOGICAL SAFETY HIV   The average risk of HIV infection after a needlestick or cut exposure to HlV-infected blood is 0.3% (i.e., three-tenths of one percent, or about 1 in 300). Stated another way, 99.7% of needlestick/cut exposures do not lead to infection. The risk after exposure of the eye, nose, or mouth to HIV-infected blood is estimated to be, on average, 0.1% (1 in 1,000). The risk after exposure of non-intact skin to HlV-infected blood is estimated to be less than 0.1%. A small amount of blood on intact skin probably poses no risk at all. There have been no documented cases of HIV transmission due to an exposure involving a small amount of blood on intact skin (a few drops of blood on skin for a short period of time).

46.     TREATMENT FOR THE EXPOSURE   Is vaccine or treatment available to prevent infections either blood-borne pathogens?   HBV   H epatitis B vaccine has been available since 1982 to prevent HBV infection. All healthcare personnel who have a reasonable chance of exposure to blood or body luids should receive hepatitis B vaccine. Vaccination ideally should occur during the healthcare worker’s training period. Workers should be tested 1-2 months after the vaccine series is complete to make sure that vaccination has provided immunity to HBV infection. Hepatitis B immune globulin (HBIG) alone or in combination with vaccine (if not previously vacci-nated) is effective in preventing HBV infection after an exposure. The decision to begin treatment is based on several factors, such as:   Whether the source individual is positive for hepatitis B surface antigen Whether you have been vaccinated Whether the vaccine provided you immunity

47.   HCV   There is no vaccine against hepatitis C and no treatment after an exposure that will prevent infection. Neither immune globulin nor antiviral therapy is recom-mended after exposure. For these reasons, following recommended infection control practices to prevent percutaneous injuries is imperative.

48. HIV   There is no vaccine against HIV. However, results from a small number of studies suggest that the use of some antiretroviral drugs after certain occupational exposures may reduce the chance of HIV transmission. Postexposure prophylaxis (PEP) is recommended for certain occupational exposures that pose a risk of transmission. However, for those exposures without risk of HIV infection, PEP is not recommended because the drugs used to prevent infection may have serious side effects.

49. What specific drugs are recommended for postexposure treatment?   HBV   If you have not been vaccinated, then hepatitis B vaccination is recommended for any exposure regardless of the source person’s HBV status. HBIG and/or hepatitis B vaccine may be recommended depending on the source person’s infection status, your vaccination status and, if vaccinated, your response to the vaccine. HCV   There is no postexposure treatment that will prevent HCV infection.

50. HIV   The Public Health Service recommends a 4-week course of a combination of either two antiretroviral drugs for most HIV exposures, or three antiretroviral drugs for exposures that may pose a greater risk for transmitting HIV (such as those involving a larger volume of blood with a larger amount of HIV or a concern about drug-resistant HIV). These recommendations are intended to provide guidance to clinicians and may be modified on a case-by-case basis. Determining which drugs and how many drugs to use or when to change a treatment regimen is largely a matter of judgment. Whenever possible, consulting an expert with experience in the use of antiviral drugs is advised, especially if a recommended drug is not available, if the source patient's virus is likely to be resistant to one or more recommended drugs, or if the drugs are poorly tolerated.

51. How soon after exposure to bloodborne pathogens should treatment starts? HBV   Postexposure treatment should begin as soon as possible after exposure, preferably within 24 hours, and no later than 7 days. HIV   Treatment should be started as soon as possible, preferably within hours as opposed to days, after the exposure. Although animal studies suggest that treatment is less effective when started more than 24-36 hours after exposure, the time frame after which no beneit is gained in humans is not known.

52. Airborne Pathogens A tuberculosis (TB) exposure control program must be established and risks to laboratory workers must be assessed. Those workers in high-risk areas may be required to wear a respirator for protection. All health workers considered to be at risk must be screened for TB infection. BIOLOGICAL SAFETY

53. Shipping of Specimens There are two types of specimen classifications: Known or suspect infectious specimens – are labelled “infectious substances” if the pathogen can be readily transmitted to humans or animals and there is no effective treatment available. Diagnostic specimens – are those tested as routine screening or for initial diagnosis. Each type of specimen has rules and packaging requirements. BIOLOGICAL SAFETY

54. Shipping of Specimens BIOLOGICAL SAFETY

55. Housekeeping Work surfaces should be frequently cleaned with a disinfectant and at the beginning and end of each shift . Trash, infectious waste, and dirty glassware should not be allowed to accumulate in large quantities in the laboratory. Containers of discarded specimens and causative agents should be covered when not in use. The disinfectant should be a 10% bleach solution, which is made fresh every 24 hours. BIOLOGICAL SAFETY

56. Needles and Sharps Needles, blades, broken glass, and other sharp objects pose a physical hazard and a potential infectious hazard to the laboratory and support personnel. All disposable needles and other sharps should be discarded into puncture-resistant and leak-proof containers marked with the biohazard symbol. These containers should be discarded according to institutional policy when they are one-half to three-fourths full. BIOLOGICAL SAFETY

57. Needles and Sharps Most institutions incinerate sharp containers. Needles should not be recapped unless a recapping device is used. Needles should never be cut because cutting may splatter blood or other fluids into the environment. BIOLOGICAL SAFETY

58. Employee Training Each new laboratory employee should be instructed in safe work practices before exposure to hazardous substances or situations. Annual training in chemical safety and in exposure control is required by OSHA and must be documented. The laboratory should appoint a person to be responsible for laboratory safety training. BIOLOGICAL SAFETY

59. CHEMICAL SAFETY

60. Hazard Communication Employees must be informed of the health risks associated with those chemicals. This ensures that health hazards are evaluated for all chemicals that are produced and that this information is relayed to employees. CHEMICAL SAFETY

61. To comply with the new Hazard Communication Standard, clinical laboratories must: Plan and implement a written hazard communication program. Obtain material safety data sheets (MSDS) for each hazardous compound present in the workplace and have the MSDS readily accessible to employees. Educate all employees annually on how to interpret chemical labels, MSDS, and health hazards of the chemicals and how to work safely with the chemicals. Maintain hazard warning labels on containers received or filled on site. CHEMICAL SAFETY

62. Chemical Hygiene Plan (CHP) The written CHP must include the following : Criteria for and methods of monitoring chemical exposure Standard operating procedures for handling hazardous chemicals Criteria for implementing engineering controls (fume hoods) Use of personal protective equipment and other hygiene practices Special precautions for extremely hazardous chemicals CHEMICAL SAFETY

63. Chemical Hygiene Plan (CHP) The written CHP must include the following: Specific measures to ensure that fume hoods and other equipment are working properly Provision for employee information and training Provision for medical consultation and examination Designation of a chemical hygiene officer responsible for implementation of the CHP. CHEMICAL SAFETY

64. Material Safety Data Sheet The MSDS is a major source of safety information for employees who may use hazardous materials in their occupations. Employers are responsible for obtaining from the chemical manufacturer or developing an MSDS for each hazardous agent used in the workplace. A standardized format is not mandatory, but all requirements listed in the law must be addressed. CHEMICAL SAFETY

65. Material Safety Data Sheet Information contained on a material safety data sheet includes the following: Product name and identification Hazardous ingredients Permissible Exposure Limit (PEL) Physical and chemical data Health hazard data and carcinogenic potential Primary routes of entry Fire and exposure hazards Reactivity data Spill and disposal procedures Personal protective equipment recommendations Handling Emergency and first aid procedures Storage and transportation precautions Chemical manufacturer’s name, address, and phone number Special information section CHEMICAL SAFETY

66. Categories of Chemicals: Since the laboratory deals with a wide variety of chemicals, clinical laboratory scientists must understand the potential hazards involved in their use. Chemicals may have health hazards or physical hazards. CHEMICAL SAFETY

67. Categories of Chemicals: Corrosives – chemicals with a pH of 2 or 12.5. Toxic substances – poisons, irritants, asphyxiants Carcinogens – capable of causing cancer. Mutagens and teratogens – capable of causing chromosomal aberrations or congenital malformations. Ignitable – flammables and combustibles. Reactive – explosive and oxidizers.   CHEMICAL SAFETY

68. CORROSIVE CHEMICALS Corrosive chemicals are injurious to the skin or eyes by direct contact or to the tissue of the respiratory and gastrointestinal tracts if inhaled or ingested. Commonly used corrosives in the laboratory: Concentrated acids – such as hydrochloric, nitric, sulfuric , and acetic Concentrated alkalis – sodium hydroxide, potassium hydroxide, and ammonium hydroxide. CHEMICAL SAFETY

69. TOXIC SUBSTANCES Toxic substances include poisons , irritants , and asphyxiants . They do not act directly with human tissue but interfere with the metabolic processes of the body. They may enter the body by: Ingestion Inhalation Skin absorption CHEMICAL SAFETY

70. CARCINOGENS Carcinogens are chemicals that have been shown to cause cancer in animals or humans. Chemicals labeled or noted on the MSDS as being carcinogenic, cancer-causing, potential carcinogen, or cancer suspect should be clearly labeled . CHEMICAL SAFETY

71. CARCINOGENS OSHA regulated carcinogenic chemicals include: Chloromethyl methyl ether – vinyl chloride N- Nitrosodimethylamine N-2-Fluorenylacetamide (2-AAF) Benz[a] pyrene 4-Aminobiphenyl Benzidine 1-Naphthylamine 2-Naphthylamine 4-Nitrobiphenyl Benzene Ethylenimine p- Dimethylaminoazobenzene β- Propiolactone bis-Chloromethyl ether CHEMICAL SAFETY

72. MUTAGENS & TERATOGENS Teratogen – anything capable of disrupting normal fetal growth and producing malformation , e.g., drugs, poisons, radiation, physical agents such as electroconvulsive shock, infections. Mutagen – a physical or chemical agent that is capable of causing a heritable alteration in the DNA , which induces a genetic mutation , e.g., drugs, UV light, ionizing radiation. CHEMICAL SAFETY

73. REACTIVE CHEMICALS Reactive compounds have molecular structures of high reactivity. EXPLOSIVES An explosive chemical is one that rapidly decomposes and produces energy that creates an explosion. Example: picric acid , in its crystalline form, is known to be explosive upon impact. The MSDS for each chemical received by the laboratory should be consulted for potential hazards. OXIDIZERS Oxidizers are compounds which are capable of reacting with and oxidizing (i.e., giving off oxygen) other materials. The primary hazard associated with this class of compounds lies in their ability to act as an oxygen source, and thus to stimulate the combustion of organic materials . CHEMICAL SAFETY

74. COMMON OXIDIZING GROUPS CHEMICAL GROUP CHEMICAL FORMULA Peroxide O 2 -2 Nitrate NO 3 - Nitrite NO 2 - Perchlorate ClO 4 - Chlorate ClO 3 - Chlorite ClO 2 - Hypochlorite ClO - Dichromate Cr 2 O 7 -2 Permanganate MnO 4 - Persulfate S 2 O 2 -2 CHEMICAL SAFETY

75. CLASSIFICATION SYSTEM FOR OXIDIZERS CLASS RATING HAZARD DESCRIPTION 1 An oxidizing material whose primary hazard is that it may increase the burning rate of combustible material with which it comes in contact. Examples: Potassium dichromate Silver nitrate Hydrogen peroxide (8 – 27.5%) Nitric acid (<70% conc.) 2 An oxidizing material that will moderately increase the burning rate of which may cause spontaneous ignition of combustible material with which it comes in contact. Examples: Potassium permanganate Calcium hypochlorite (<50% wt.) Hydrogen peroxide (27.5 – 52% conc.) Nitric acid (>70% conc.) CHEMICAL SAFETY

76. CLASSIFICATION SYSTEM FOR OXIDIZERS CLASS RATING HAZARD DESCRIPTION 3 An oxidizing material that will cause a severe increase in the burning rate of combustible material with which it comes contact or which will undergo vigorous self-sustained decomposition when catalyzed or exposed to heat. Examples: Potassium chlorate Hydrogen peroxide (52 – 91% conc.) Calcium hypochlorite (>50% wt.) Perchloric acid (60 – 72.5% conc.) 4 An oxidizing material that can undergo an explosive reaction when catalyzed or exposed to heat, shock, or friction. Examples: Ammonium perchlorate Guanidine nitrate Hydrogen peroxide (>91% conc.) Perchloric acid (>72.5%) CHEMICAL SAFETY

77. REMEMBER these things about oxidizers: The primary hazard is the ability to act as an oxygen source, especially hazardous during fire situation. These materials present a fire and explosion hazard when in contact with organic or combustible materials. All contact with organic or combustible material must be avoided. They are generally corrosive. The hazards associated with the use of perchloric acid are particularly severe . CHEMICAL SAFETY

78. REMEMBER these things about oxidizers: Perchloric acid may NOT be used in any hood except those specially designed for perchloric acid use. Strong oxidizing agents, such as chromic acid, should be stored and used in glass or other inert, and preferably unbreakable, containers. Corks or rubber stoppers must NEVER be used. Reaction vessels containing appreciable amounts of oxidizing materials should never be heated in oil baths, but rather on a heating mantle or sand baths. CHEMICAL SAFETY

79. Other reactive chemicals Compounds with redox groups (hydrazine, hydroxylamine) Compounds that react violently with water or air (anhydrous metal oxides) Pyrophoric compounds that spontaneously react with air Compounds that form peroxides over time and become explosive – such as diethyl ether. CHEMICAL SAFETY

80. Storage of Chemicals Chemicals should be stored in an uncluttered area that is properly ventilated and away from a heat source. They should not be stored above eye level. It is not a good idea to store chemicals alphabetically. Inorganic compounds should be stored separately from organics. Inorganic acids should be stored together with the exception of nitric acid. Nitric acid should be isolated from other acids. Acetic acid can be stored with inorganic acids. CHEMICAL SAFETY

81. Storage of Chemicals Water-reactive chemicals such as sodium, potassium, and metal hydrides should be segregated from other chemicals and stored in a dry environment. These areas should NOT be equipped with sprinkler systems . W CHEMICAL SAFETY

82. CONCENTRATED ACID / BASE SPILLS: Dilute first with water before clean-up is attempted. The spill should then be covered with a neutralizer: Boric acid – for bases Sodium bicarbonate – for acids The spill should then be absorbed with an absorbent material . CHEMICAL SAFETY

83. CONCENTRATED ACID / BASE SPILLS : Dispose according to the institutional policy on chemical waste disposal. The surface should then be cleansed with soap and water after the chemical is cleaned up. CHEMICAL SAFETY

84. SOLVENT SPILLS: If a solvent is spilled, no water or diluent should be added and the solvent should not be allowed to flow down a drain. Since solvents may present a fume problem, respiratory protective equipment needs to be available. After absorption with absorbent material, the material should be placed in a closed container to prevent fumes from escaping. All containers should be labeled with the chemical name and any hazard and disposed as chemical waste. CHEMICAL SAFETY

85. FIRE SAFETY

86. FLAMMABLE & COMBUSTIBLE CHEMICALS Flammable and combustible liquids, which are used in numerous routine procedures, are among the most hazardous materials in the clinical chemistry laboratory because of possible fire or explosion. They are classified according to flashpoint Flammable liquids have a flashpoint below 100 or 140 o F. Combustible liquids have a flashpoint at or above 100 or 140 o F. FIRE SAFETY

87. HEAT FUEL OXYGEN FIRE TRIANGLE FLAMMABLE & COMBUSTIBLE CHEMICALS FIRE SAFETY

88. Uninhibited reaction Fuel Oxygen Heat FLAMMABLE & COMBUSTIBLE CHEMICALS FIRE SAFETY

89. FIRE CLASS GEOMETRIC SYMBOL PICTOGRAM / PICTURE SYMBOL INTEDED USE A Garbage can and wood pile burning Ordinary solid combustibles B Fuel container and burning puddle Flammable liquids and gases C Electric plug and burning outlet Energized electrical equipment D ­ Combustible metals K Pan burning Cooking oils and fats FIRE SAFETY

90. TYPE SUITABLE FOR USE ON FIRE CLASSES WATER FOAM DRY CHEMICAL (POWDER) CARBON DIOXIDE CLASS D POWDER FIRE SAFETY

91. P A S S ULL IM QUEEZE WEEP To operate a fire extinguisher: FIRE SAFETY

92. ELECTRICAL SAFETY

93. Laboratories have a great deal of electrical equipment in proximity to sinks, liquids or other grounded surfaces. HAZARDS: Burns Shock Electrocution Ignition Explosion Fire and explosion hazards are avoided by preventing the occurrence of high temperatures. Circuit breakers, fuses, and ground fault interrupters (GFI) are designed to detect overloaded circuits that could cause ignition and explosion. ELECTRICAL SAFETY

94. Precautionary Measures Use only explosion-proof equipment in hazardous atmospheres. Be particularly careful when operating high-voltage equipment, such as electrophoresis apparatus. Use only properly grounded equipment (three-prong plug). Check for frayed electrical cords. Promptly report any malfunctions or equipment producing a “tingle” for repair. ELECTRICAL SAFETY

95. Precautionary Measures Do not work on “live” electrical equipment. Never operate electrical equipment with wet hands. Know the exact location of electrical control panel for the electricity to your work area. The use of extension cords is NOT ALLOWED. In emergency situations, use only approved extension cords (properly grounded, heavy-duty) and do not overload circuits. Have ground checks and periodic preventive maintenance performed on equipment . ELECTRICAL SAFETY

96. COMPRESSED GASES

97. Compressed gas cylinders of varying sizes can be found in laboratories and especially in research laboratories. Since the cylinders are pressurized , they can become “torpedoes” that can even penetrate block walls if the main valve stem is sheared by falling over. A good working practice when using a flammable gas is to allow only one cylinder of gas to be in use at a time and to use the smallest size possible. COMPRESSED GASES

98. Gas cylinders, both flammable and non-flammable, should never be stored in fire safety cabinets with flammable and combustible liquids. They should be grouped by type and stored in a ventilated room reserved exclusively for cylinder storage. The room should have a fire resistance rating of at least 2 hours. COMPRESSED GASES

99. Cylinders should always be secured by a chain or other device to prevent them from falling over and shearing the valve stem. When cylinders are transported, valve protective caps should be used. When cylinders are not in use, the valves should be tightly closed. COMPRESSED GASES

100. Precautionary Measures Know the gas that you will use. Store tanks in a vertical position. Keep cylinders secured at all times. Never store flammable liquids and compressed gases in the same area. Use the proper regulator for the type of gas in use. Do not attempt to control or shut off gas flow with the pressure relief regulator. Keep removable protection caps in place until the cylinder is in use. COMPRESSED GASES

101. Precautionary Measures Make certain that acetylene tanks are properly piped (the gas is incompatible with copper tubing). Do not force a “frozen” or stuck cylinder valve. Use a hand truck to transport large tanks. Always check tanks on receipt and then periodically for any problems such as leaks. COMPRESSED GASES

102. Precautionary Measures Make certain that the cylinder is properly labeled to identify the contents. Empty tanks should be marked “EMPTY”. COMPRESSED GASES

103. CRYOGENIC MATERIALS

104. Liquid nitrogen – probably one of the most widely used cryogenic fluids (liquefied gases) in the laboratory. Hazards of cryogenic material: Fire or explosion Asphyxiation Pressure build-up Embrittlement of materials Tissue damage (similar to that of thermal burns) CRYOGENIC MATERIALS

105. Precautionary Measures Only containers constructed of materials designed to withstand ultralow temperatures should be used for cryogenic work. The use of eye/face protection , hand protection to guard against the hazards of touching super-cooled surfaces is recommended. The gloves, of impermeable material , should fit loosely so that they can be taken off quickly if liquid spills on or into them. CRYOGENIC MATERIALS

106. Precautionary Measures To minimize violent boiling/frothing and splashing, specimens to be frozen should always be inserted into the coolant very slowly. Cryogenic fluids should be stored in well-insulated but loosely stoppered containers that minimize loss of fluid resulting from evaporation by boil-off and that prevent plugging and pressure build-up. CRYOGENIC MATERIALS

107. RADIATION SAFETY

108. There are four types of ionizing radiation hazards: Alpha particles – plutonium Beta particles – 3 H, 14 C, 32 P Electromagnetic radiation – not composed of atomic particles Gamma rays – 125 I and 131 I X-rays Neutrons – arise from spontaneous fission of some isotopes and are produced by atomic reactors and accelerators. RADIATION HAZARDS

109. MECHANICAL AND ERGONOMIC HAZARDS

110. Centrifuges – must be balanced to distribute the load equally Autoclaves – steam under pressure Homogenizers Laboratory glassware – be careful in handling breakable and sharp objects Sharp instruments – dispose in puncture-resistant containers MECHANICAL HAZARDS

111. Repetitive strain disorders: Tenosynovitis Bursitis Ganglion cysts Acute musculoskeletal injury Primary contributing factors associated with repetitive strain disorders: Position / posture Applied force Frequency of repetition ERGONOMIC HAZARDS

112. DISPOSAL OF HAZARDOUS MATERIALS

113. In some cases, it is permissible to flush water-soluble substances down the drain with copious quantities of water. Strong acids and bases should be neutralized before disposal. Foul-smelling chemicals should never be flushed down the drain. Other liquid wastes, including flammable solvents, must be collected in approved containers and segregated into compatible classes. CHEMICAL WASTES

114. Flammable material can also be burned in specially designed incinerators with afterburners and scrubbers to remove toxic products of combustion. Before disposal, hazardous substances that are explosive, such as carcinogens and peroxides, should be transformed into less hazardous forms whenever feasible. Solid chemical wastes that are unsuitable for incineration must be buried in a landfill. This practice, however, has created an environmental problem, and there is now a shortage of safe sites. CHEMICAL WASTES

115. A general license by the Nuclear Regulatory Commission is required for use of radioimmunoassay (RIA) kits in the clinical laboratory even when exempt material is used. Under these guidelines, effluents from RIA in-vitro tests may be flushed into the sanitary sewer and diluted with large amounts of water. When disposing of radioisotopes into the sanitary sewer, designate one sink for this purpose. This sink should be clearly labeled and routinely monitored with a wipe test for residual radioactivity. RADIOACTIVE WASTES

116. Other material such as disposable tubes and pipets that have been in contact with the radioisotopes may be safely discarded in the routine trash after all the radioactive labels are removed. If the waste also contains biohazardous material, it may be autoclaved before disposal into routine trash. The radiation safety officer should always be consulted about policies dealing with radioactive waste disposal. RADIOACTIVE WASTES

117. All biomedical waste should be placed into a leak-proof container that is puncture-resistant and equipped with a solid, tight-fitting lid. All containers must be clearly marked with the word “biohazard” or its symbol. All sharp instruments, such as needles, blades, and glass objects, should be placed into puncture-resistant containers before placing them inside the bag and container. Needles should not be transported, recapped, bent, or broken by hand. BIOHAZARDOUS WASTES

118. Potentially biohazardous material, such as blood or blood products and contaminated laboratory waste, cannot be directly discarded. Contaminated combustible waste can be incinerated. Contaminated non-combustible waste, such as glassware, should be autoclaved before being discarded . Special attention should be given to the discarding of syringes, needles, and broken glass that could also inflict accidental cuts or punctures. BIOHAZARDOUS WASTES

119. ACCIDENT DOCUMENTATION AND INVESTIGATION

120. Any accidents involving personal injuries, even minor ones, should be reported immediately to a supervisor. It is particularly important that the appropriate authority be notified immediately if any individual sustains a needle puncture during blood collection or a cut during subsequent specimen processing and handling. ACCIDENT DOCUMENTATION AND INVESTIGATION

121. The investigation report should include: Information on the injured person Description of what happened C ause of the accident (environmental or personal); O ther contributing factors Witnesses N ature of the injury A ctions to be taken to prevent recurrence. ACCIDENT DOCUMENTATION AND INVESTIGATION

122. THANK YOU