1. Chapter1: Laboratory Safety Precautions Biochemistry Clinical practice CLS 432 Dr. Samah Kotb Lecturer of Biochemistry 2015

2. Lab Safety Precautions Bio-safety guidelines: 1. Treat all specimens (blood, urine, sputum, etc) as potentially infection source. 2. Wear protective gloves and a lab gown while drawing blood and handling specimens. 3. Do not, eat, drink, or smoke in the lab. 4. Do not keep food in the lab refrigerator.

3. Lab Safety Precautions 5.Do not wear open toe footwear in the lab. 6. Clean up spills with an appropriate disinfectant. 7. Decontaminate all instruments and materials with an appropriate disinfectant. 8. Dispose of all waste, including test kits, in a biohazard container. open toe footwear

4. Safety management plan Development, implementation and enforcement of a quality safety management program → WORKER SAFETY. Occupational Safety and Health Administration (OSHA) – risk assessment of each lab task.

5. Safety management plan Well written ‘Safety manual’ – defines the program and identifies responsible people. World Health Organization (WHO) has published laboratory safety guidelines and ACDP ( Advisory Committee on Dangerous pathogens) has formulated biosafety levels for all microbes.

6. Phlebotomy safety Injuries may occur when drawing blood or using a finger stick or heel stick to obtain a blood specimen, or testing with sharps (blood collection needles, lancets, cutting blades, glass pipettes or slides, broken plastic or glass, etc.). When possible, use single-use vacuum blood collection tubes with safety needles rather than a syringe and needle.

7. Sharps disposal manner 1)If possible, only use vacuum tubes and a needle to draw blood (instead of syringe and needle). 2) DO NOT recap, bend, break, or manipulate needles by hand.

8. Sharps disposal manner 3) After you use sharps, put them in a puncture- resistant, leak-proof trash container right away. DO NOT place sharps in regular trash containers. 4) Report all injuries involving sharps to the (person in charge of safety) at your centre or at the district level.

9. Post-exposure prophylaxis (PEP) PEP is the use of antiretroviral Drugs (ARV) to reduce the risk of HIV infection following accidental exposure. PEP should be available for all staff members following exposure of non-intact skin (through percutaneous sharps injury or skin abrasion) or mucous membranes (through splashes to the eyes, nose or oral cavity) to a potentially infected body fluid from a source that is HIV-positive or has unknown HIV status.

10. Post-exposure prophylaxis (PEP) PEP includes: 1)a staff person trained to provide prompt clinical advice; and 2) access to antiretroviral (drugs to prevent HIV infection) as soon as possible after exposure and within 72 hours.

11. Safety Resources http://www.who.int/csr/resources/ publications/biosafety/en/Biosafet y7.pdf

12. Hazards in the lab Biological : exposure to blood and body fluids and specimens that harbour HIV, HBV, HCV etc, bioterrorism). Chemical : acids, alkalines, toxic chemicals. Radiological : ineffective radioactive waste disposal. Fire. Electrical accidents.

13. 1. Biological hazards Infectious agents transmitted through body secretions or tissue. HIV, Hepatitis B and C, Mycobacterium tuberculosis etc.

14. 2. Chemical hazards Label lab chemicals with their hazard classification – irritant, corrosive, flammable, carcinogen etc. Store reactive chemicals separately ( acids x bases, oxidizers x reducing agents). Flammables are stored in flammable safe cabinets.

15. 2. Chemical hazards Use of carcinogens / toxic chemicals to be used only by trained personnel and in designated area. Chemical hygiene plan, engineering and work practice controls, exposure monitoring and waste management.

16. 3.Physical hazards Fire. Electrical accidents – shock, short circuit. UV light exposure. Compressed gases.

17. 4.Radiation hazards Type of radiation – α, β or ϒ, quantity and source of exposure (internal /external). Time, distance, shielding – engineering and work practice controls (designated areas, lead aprons, monitoring badges). Shielding Distance Time

18. Factors determining the impact of hazards 1. Exposure levels. 2. Duration of exposure. 3. Toxicity or pathogenecity of the hazardous material. 4. Safety controls. 5. Number and types of contact with the hazard. 6. Host factors – age, health etc.

19. Routine safety precautions 1) Centrifugation – Check tubes/vials for cracks. – Properly balanced. – Wait for a complete stop. – In case of breakage, clean the buckets with disinfectant. – For infectious agents, seal the tubes.

20. Routine safety precautions 2) Electrical safety – Must know master switches and circuit breaker boards. – All electrical equipment must be grounded. – All shocks to be investigated.

21. Routine safety precautions 3) Corridor cautions – Swinging doors ; should open into corridors. – Use only one side of corridor for storage of equipments. – Look for spills, glass etc on the floors. – Always walk, never run.