Laboratory Safety

1. Laboratory Safety A SMILE Program Presentation Patient Safety Monitoring in International Laboratories (SMILE) Program

2. Responsibility Who is responsible for safety in laboratories clinics and hospitals participating in clinical trials Patient Safety Monitoring in International Laboratories (SMILE) Program

3. Employer Establishes necessary policies Standard Operating procedures and Safety Plan Engineering and work practice controls Personal protective equipment (PPE) Safety equipment such as fire extinguishers and eye wash stations Training Responsibility Patient Safety Monitoring in International Laboratories (SMILE) Program

4. Employee Knows and understands safety policies and procedures Follows safety policies and procedures Reports unsafe conditions to the Safety Officer or Laboratory Director Responsibility Patient Safety Monitoring in International Laboratories (SMILE) Program

5. Responsibility Safety is Everyone’s Responsibility! Patient Safety Monitoring in International Laboratories (SMILE) Program

6. Components of a Safety Program • Fire safety • Chemical Safety • Bloodborne Pathogens Patient Safety Monitoring in International Laboratories (SMILE) Program

7. Fire Safety Patient Safety Monitoring in International Laboratories (SMILE) Program

8. Oxygen Chemical Reaction Heat Fuel Fire Safety • The Fire Triangle Patient Safety Monitoring in International Laboratories (SMILE) Program

9. Fire Safety What should you do in case of a fire ? Remember the acronym – RACE Rescue – any people in danger Alarm – activate the fire alarm Contain – the fire by closing doors and windows Extinguish – the fire if it is small enough Patient Safety Monitoring in International Laboratories (SMILE) Program

10. Fire Safety Types of Fire Extinguishers • A – Combustibles (paper, trash, cloth) • B – Flammable liquids • C – Electrical Equipment • D – Combustible metals (not Common) Patient Safety Monitoring in International Laboratories (SMILE) Program

11. Fire Safety How do you operate a fire extinguisher? Remember PASS • Pull - the pin • Aim – at the base of the Fire • Squeeze - the handle • Sweep - to cover the fire Patient Safety Monitoring in International Laboratories (SMILE) Program

12. Fire Safety Maintenance of Fire Extinguishers Fire extinguishers should be visually inspected on a monthly basis. The inspection should assure that Fire extinguishers are: In their assigned place Not blocked or hidden Pressure gauges show adequate pressure Pins and seals are in place No signs of damage The nozzles are free of blockages Patient Safety Monitoring in International Laboratories (SMILE) Program

13. Chemical Safety Patient Safety Monitoring in International Laboratories (SMILE) Program

14. Chemical Safety How Do Chemicals enter the body? • Inhalation – breathing in (e.g. powders, fumes) • Absorption – on skin or mucus membranes • Ingestion – entry through the mouth • Injection - through skin by foreign body Patient Safety Monitoring in International Laboratories (SMILE) Program

15. Chemical Safety Examples of Chemical Hazards • Carcinogens – cancer • Corrosives –burns • Hepatotoxins –liver damage • Mutagens-damage genetic materials in cells • Nephrotoxins – Kidney damage • Neurotoxins – damage to the nervous system • Tertatogens – birth defects Patient Safety Monitoring in International Laboratories (SMILE) Program

16. Chemical Safety How can you obtain information about the Chemicals you use? Patient Safety Monitoring in International Laboratories (SMILE) Program

17. Chemical Safety Material Safety Data Sheet (MSDS) The following Data Can be found on MSDS sheets………. • Name of Chemical • Physical Characteristics and hazards • Health information • First Aid required if there is a spill or exposure • Date of most recent update Patient Safety Monitoring in International Laboratories (SMILE) Program

18. MSDS Sheets Continued………. Need to check for updates annually Highlight the name of the chemical and the first aid section for easy access in an emergency Organize in alphabetical order Must be available to everyone all of the time The internet is also a good way to access MSDS sheets Instrument manufacturers usually have MSDS sheets available on their websites. Chemical Safety Patient Safety Monitoring in International Laboratories (SMILE) Program

19. Chemical Safety What should you do if there is a chemical spill? RAFT Rescue Avoid the Chemical Find the MSDS Telephone Patient Safety Monitoring in International Laboratories (SMILE) Program

20. Chemical Safety Chemical Exposures First AID Flush with plenty of water • For at least 15 minutes • Remove contaminated clothing Seek medical Attention Document incident Patient Safety Monitoring in International Laboratories (SMILE) Program

21. Chemical Safety Liquid Nitrogen Characteristics of Liquid Nitrogen • 78% of atmosphere • Colorless, Odorless, Tasteless, Nontoxic • Boils at -196 Degrees C • Non Flammable Patient Safety Monitoring in International Laboratories (SMILE) Program

22. Chemical Safety Liquid Nitrogen When returning to the gaseous state: • Can displace oxygen from the air • Can lead to asphyxiation Will not support Life Patient Safety Monitoring in International Laboratories (SMILE) Program

23. Chemical Safety Liquid Nitrogen – Precautions • Always wear safety equipment • Avoid use in a small enclosed area • Avoid prolonged breathing of vapors • Avoid rough handling of containers • Install O2 Monitors in LN work areas Patient Safety Monitoring in International Laboratories (SMILE) Program

24. Chemical Safety Liquid Nitrogen PPE • Full face shield with safety glasses • Cryogenic gloves • Arm protection • Lab coat • Cuff-less pants • Close toed shoes Patient Safety Monitoring in International Laboratories (SMILE) Program

25. Chemical Safety Liquid Nitrogen Emergencies • Inhalation – Move person into the fresh air • Eyes – Flush with water for 15 minutes • Skin - soak affected area in tepid water • Seek medical attention • Document incident Patient Safety Monitoring in International Laboratories (SMILE) Program

26. Chemical Safety What’s Wrong with this picture? Patient Safety Monitoring in International Laboratories (SMILE) Program

27. Chemical Safety Carbon Dioxide – Dry Ice Characteristics of Carbon Dioxide • Colorless, odorless, tasteless nontoxic • Non flammable • Can only be solid when the temperature is < -78oC Patient Safety Monitoring in International Laboratories (SMILE) Program

28. Chemical Safety Solid Carbon Dioxide Can displace oxygen from air • Can lead to asphyxiation • Will not support life High concentrations cause rapid circulatory insufficiency • Nausea • Headache • Vomiting • Unconsciousness Patient Safety Monitoring in International Laboratories (SMILE) Program

29. Chemical Safety Solid Carbon Dioxide – Dry Ice • Always wear safety equipment • Avoid use in a small enclosed area • Avoid prolonged breathing of vapors • Vent Closed CO2 containers away from you when opening Patient Safety Monitoring in International Laboratories (SMILE) Program

30. Chemical Safety Solid Carbon Dioxide – PPE • Full face shield with safety glasses • Cryogenic gloves • Lab coat • Close toed shoes Patient Safety Monitoring in International Laboratories (SMILE) Program

31. Chemical Safety Solid Carbon Dioxide – Emergencies • Inhalation – Move person into the fresh air • Eyes – Flush with water for 15 minutes • Skin - soak affected area in tepid water • Seek medical attention • Document incident Patient Safety Monitoring in International Laboratories (SMILE) Program

32. Chemical Safety Managing Chemicals in the Laboratory • Storage • Hazard Communication • MSDS Updates • Acids and Bases in separate approved cabinets • Spill kits available Patient Safety Monitoring in International Laboratories (SMILE) Program

33. Chemical Safety What’s Wrong with this picture? Patient Safety Monitoring in International Laboratories (SMILE) Program

34. SAFETY – Waste Disposal Tips for safe disposal of laboratory waste: • Place all sharps in approved sharps containers • Use goggles or full face shields to protect mucus membranes from splashes when disposing of liquid waste or specimen tubes. • Refer to MSDS sheets for information on the safe disposal of chemicals Patient Safety Monitoring in International Laboratories (SMILE) Program

35. Bloodborne Pathogens Bloodborne Pathogens Patient Safety Monitoring in International Laboratories (SMILE) Program

36. Bloodborne Pathogens What are bloodborne pathogens? Viruses, bacteria or other micro-organisms that are carried in the bloodstream and are capable of causing disease. Other body fluids that can spread bloodborne pathogens include: • Blood products (plasma, platelets) • Abdominal fluids • Amniotic fluids • Cerebrospinal fluids • Vaginal secretions • Semen Patient Safety Monitoring in International Laboratories (SMILE) Program

37. Bloodborne Pathogens Most Common Bloodborne Pathogens Hepatitis B Hepatitis C HIV Patient Safety Monitoring in International Laboratories (SMILE) Program

38. Bloodborne Pathogens Standard Precautions Standard Precautions replaces Universal Precautions – using Standard Precautions all blood and body fluids are treated as infectious all of the time. Patient Safety Monitoring in International Laboratories (SMILE) Program

39. Bloodborne Pathogens Personal Protective Equipment (PPE) Gloves Safety glasses/Goggles Lab coats (should be fluid resistant) Face shields Patient Safety Monitoring in International Laboratories (SMILE) Program

40. Bloodborne Pathogens PPE Continued……. How much PPE should you use? Wear as much or as little as you anticipate you will need to prevent blood and other infectious materials from contact with your skin, mucus membranes and clothing. Patient Safety Monitoring in International Laboratories (SMILE) Program

41. Blood borne Pathogens General Safety Rules Handle sharps with care: • Do not recap needles or other sharps • Do not bend or break off needles • Dispose of sharps in puncture resistant containers DO Not: Eat, drink, smoke, apply cosmetics, take medication in areas where you are working with blood and other body fluids Patient Safety Monitoring in International Laboratories (SMILE) Program

42. Bloodborne Pathogens What should you do if there is a blood or body fluid exposure ? • Follow the post exposure prophylaxis (PEP) plan • Wash puncture wounds with soap and water • Flush affected mucus membranes with water • Inform Safety Officer or administrative staff member • Seek medical attention • Complete an incident report form Patient Safety Monitoring in International Laboratories (SMILE) Program

43. Bloodborne Pathogens Hand Washing A basic but very important method of reducing your risk of infection. Patient Safety Monitoring in International Laboratories (SMILE) Program

44. Bloodborne Pathogens Hand Washing What song should you sing while you are washing your hands so that you know that you have washed for enough time? Patient Safety Monitoring in International Laboratories (SMILE) Program

45. Laboratory Safety Questions and Comments Patient Safety Monitoring in International Laboratories (SMILE) Program

46. Laboratory Safety References: 1.PPD (May, 2005) – PowerPoint Presentation, Presented at the Washington DC GCLP Meeting. 2. WWW.safetylady.com Patient Safety Monitoring in International Laboratories (SMILE) Program