Safety in the Clinical Laboratory

May 1, 2020Chemical pathologyLab Tests

The clinical laboratory has various types of safety hazards. Some of these may be very dangerous and life-threatening.

The people working in the laboratory must know what are various types of hazards in the laboratory, and also know what are the possible precautions to be taken to avoid those accidents.

The main type of hazards in the laboratory are:

Possible Safety hazards

Physical hazards:

1. These are quite common and these need to be avoided e.g.
   1. Running in the rooms and hallways.
   2. When the floor is wet, be careful.
   3. Take care while lifting heavy objects.
   4. Ladies should keep their long hair tight and on their backside.
   5. Avoid loose jewelry.
   6. Wear closed-toe shoes that provide maximum support.
   7. Try to keep the working area neat and clean.
   8. Also, keep the working area well-organized.

Sharp edge instruments:

1. Sharp edge instruments like a needle, broken glasses and lancets give rise to biological hazards like:
   1. Give rise to blood born pathogens diseases.
   2. These may give rise to bleeding.
   3. Dispose of all these sharp edges articles in a safe place, like metal containers.
   4. Cut the needle of the syringe by the cutter.
   5. Also, crush the plastic syringes.

If you want to close the needle in the syringe then follow the following diagrammatic method.

Syringe Needle precautions while closing the syringe

Fire and explosives:

1. In the laboratory, there are so many explosive and volatile chemicals used in the routine.
2. Flammable chemicals should be kept in the safety cabinet and explosion-proof refrigerators.
3. Compressed gas cylinders should be kept away from the heat.
4. The fire protection guidelines are given by the JCAHO.
5. Whenever fire erupts then following measures should be taken:
   1. Rescue anyone in immediate danger.
   2. Activate the institutional alarm.
   3. Close all the doors of the fire area.
   4. Try to extinguish the fire.
   5. Fire blankets should be available in the lab.
   6. Multiple purpose fire extinguishers may be used.
6. One can follow the guidelines given by the national fire protection association (NFPA).

Chemicals:

1. These should be labeled as carcinogenic, poisonous, or corrosive.
2. NFPA 704 gives the color coding for the materials. This color-coding will help the firefighter.
3. When mixing the acid and water, then first take the water and then add slowly the acid. Because by the addition of the acid there will heat production. If you add water to acid that may burst out.

Safety acid to water to avoid accidents

1. In the case of chemical spills, the best option is to flush the area with water.
2. Remove the contaminated clothes as soon as possible.
3. OSHA gives the written chemical hygiene plan (CHP).
4. It consists of:
   1. Appropriate work practice.
   2. Standard operating procedure.
   3. Personal protective equipment.
   4. Use of fume hoods and flammable safety cabinet.
   5. Employee training equipment.
   6. Medical consultation guidelines.
5. Label hazardous chemicals.

Electrical hazards:

1. There are so many equipments working on electricity.
2. Avoid wet hands to operate the equipment.
3. Look after the damaged wires and avoid overload the circuits.
4. If any equipment becomes wet, then immediately unplug the wires and let it dry before using it.
5. Try to ground all the equipment.
6. If accidents occur and someone has electric shock, immediately shut off the electricity without touching the person or equipment.
   1. Close the circuit breaker.
   2. Move the equipment by some nonconductor objects like wood or glass.

Biological factors:

1. Laboratory staff is always exposed to sources of potentially pathogenic microorganisms.
2. Most of the sample like blood, body fluids, urine, CSF, and tissues have pathogenic organisms.
3. The spread of infections may be by:
   1. By direct contact of the laboratory staff. to the patient sample.
   2. By inhalation of the infected material e.g. by droplet infection or if you are centrifuging the tube without caping it.
   3. By ingestion of contaminated foods and water.
   4. Then you may spread the infection to your colleagues.
4. Personel handwash and wearing personal protective clothes and pieces of equipment are important.
5. Special precautions are needed while handling the sample of a patient with HBV, HIV, and HCV viruses.
   1. Wear gloves while collecting the blood from the possible case of a patient with HBV, HCV, or HIV.
   2. Wear the face mask if there is any possibility of the splashing of the blood.
   3. Dispose of all the sharp needles and objects in the puncture-resistant containers.
   4. Follow the CDC universal precautions (UP).
   5. In 1996 CDC combined the UP and Body surface isolation (BSI) and gave the guidelines:
      1. Advised wash the hands after handling the blood or body fluids or secretions.
      2. Wash hands immediately after removing the gloves.
      3. Wear gloves when touching the blood, body fluids, secretions, excretions, and contaminated items.
      4. Wear gloves when touching the mucous membranes or nonintact skin.
      5. Change the gloves on the same patient if there is a possibility of a high concentration of pathogens.
      6. Immediately remove the gloves and wash your hands before going to another patient.
      7. Waer the mask, eye protection, and face shield to protect the mucous membranes of the eye, nose, and mouth during the procedure where there is any danger of the splash or spray of the blood, body fluids, excretions, and secretions.
      8. Wearing the gown protects the clothes, and skin during the procedure.
      9. If the gown is soiled, then remove it immediately and wash your hands to prevent others from the spread of infection.
      10. Clean the patient care equipment and sterilize it.
   6. Never recap the used needle, better to dispose of it. Or follow the direction given in the above diagram.
   7. Most important in the case of prick or bleeding: Don’t stop the blood immediately, best is to bleed under the tap water as much as possible, and then use disinfectants and stop the bleeding.

Radioactive materials:

1. This is needed in case using radioactive material like radioisotopes.
2. Mostly the radioactivity in the laboratory is very minimal and very little danger.
3. The best option is to wear a measuring device.
4. Exposure to pregnant ladies should be avoided because that will cause harm to the fetus.
5. The ladies should avoid such areas of radiation.