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Chapter 26 : Laboratory Safety

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Laboratory Safety, Page 1 of 2

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Abstract:

The key to a safe laboratory environment is the development, implementation, and enforcement of a quality safety management program that considers worker safety as a responsibility of the facility. The laboratory contains numerous hazards that fall into four general classes: biological, chemical, physical, and radiological. A risk assessment and exposure plan for the clinical laboratory should identify the appropriate safety practices for handling infectious material that may contain any of a variety of pathogenic microorganisms. Laboratory accidents should be discussed at the quality assurance or safety committee meeting and immediately with the staff in the section where the accident occurred. The chapter focuses on sterilization and decontamination, spill management, and waste management. Recently, the Department of Transportation (DOT) revised regulations for shipment of hazardous material were finalized. These regulations dictate the packaging and labeling of infectious material that is shipped via commercial carriers with the stated goal of protecting employees in the transportation industry and the general public. All personnel employed in the clinical laboratory must receive adequate safety training applicable to their position in order to perform their assigned tasks in a safe manner. The trainer must be competent in the area of laboratory safety and knowledgeable about current safety regulations, work practices, safety equipment, and hazards found in the clinical laboratory. The overall effectiveness of the laboratory safety program is assessed through safety audits, inspections by outside agencies and organizations, review of incident and accident reports, and observations and suggestions from employees.

Citation: Sewell D. 2004. Laboratory Safety, p 446-472. In Garcia L, Baselski V, Burke M, Schwab D, Sewell D, Steele J, Weissfeld A, Wilkinson D, Winn W (ed), Clinical Laboratory Management. ASM Press, Washington, DC. doi: 10.1128/9781555817695.ch26

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Severe Acute Respiratory Syndrome
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Sample Form for Declination of Hepatitis B Vaccinationa

Citation: Sewell D. 2004. Laboratory Safety, p 446-472. In Garcia L, Baselski V, Burke M, Schwab D, Sewell D, Steele J, Weissfeld A, Wilkinson D, Winn W (ed), Clinical Laboratory Management. ASM Press, Washington, DC. doi: 10.1128/9781555817695.ch26
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INFECTIOUS AGENTS

Citation: Sewell D. 2004. Laboratory Safety, p 446-472. In Garcia L, Baselski V, Burke M, Schwab D, Sewell D, Steele J, Weissfeld A, Wilkinson D, Winn W (ed), Clinical Laboratory Management. ASM Press, Washington, DC. doi: 10.1128/9781555817695.ch26
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CLINICAL SPECIMENS

Citation: Sewell D. 2004. Laboratory Safety, p 446-472. In Garcia L, Baselski V, Burke M, Schwab D, Sewell D, Steele J, Weissfeld A, Wilkinson D, Winn W (ed), Clinical Laboratory Management. ASM Press, Washington, DC. doi: 10.1128/9781555817695.ch26
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Figure A8.1

Marking: proper shipping name, technical name, UN identification number, and quantity.

Citation: Sewell D. 2004. Laboratory Safety, p 446-472. In Garcia L, Baselski V, Burke M, Schwab D, Sewell D, Steele J, Weissfeld A, Wilkinson D, Winn W (ed), Clinical Laboratory Management. ASM Press, Washington, DC. doi: 10.1128/9781555817695.ch26
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Figure A8.2

Marking: dry ice and weight

Citation: Sewell D. 2004. Laboratory Safety, p 446-472. In Garcia L, Baselski V, Burke M, Schwab D, Sewell D, Steele J, Weissfeld A, Wilkinson D, Winn W (ed), Clinical Laboratory Management. ASM Press, Washington, DC. doi: 10.1128/9781555817695.ch26
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Figure A8.3

Marking: diagnostic specimen

Citation: Sewell D. 2004. Laboratory Safety, p 446-472. In Garcia L, Baselski V, Burke M, Schwab D, Sewell D, Steele J, Weissfeld A, Wilkinson D, Winn W (ed), Clinical Laboratory Management. ASM Press, Washington, DC. doi: 10.1128/9781555817695.ch26
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Figure A8.4

Marking: inner packages comply (used only on overpacks).

Citation: Sewell D. 2004. Laboratory Safety, p 446-472. In Garcia L, Baselski V, Burke M, Schwab D, Sewell D, Steele J, Weissfeld A, Wilkinson D, Winn W (ed), Clinical Laboratory Management. ASM Press, Washington, DC. doi: 10.1128/9781555817695.ch26
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Figure A8.5

Label: infectious substance (class 6).

Citation: Sewell D. 2004. Laboratory Safety, p 446-472. In Garcia L, Baselski V, Burke M, Schwab D, Sewell D, Steele J, Weissfeld A, Wilkinson D, Winn W (ed), Clinical Laboratory Management. ASM Press, Washington, DC. doi: 10.1128/9781555817695.ch26
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Figure A8.6

Label: miscellaneous dangerous goods (class 9).

Citation: Sewell D. 2004. Laboratory Safety, p 446-472. In Garcia L, Baselski V, Burke M, Schwab D, Sewell D, Steele J, Weissfeld A, Wilkinson D, Winn W (ed), Clinical Laboratory Management. ASM Press, Washington, DC. doi: 10.1128/9781555817695.ch26
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Figure A8.7

Label: cargo aircraft only (figure courtesy of SafTPak®).

Citation: Sewell D. 2004. Laboratory Safety, p 446-472. In Garcia L, Baselski V, Burke M, Schwab D, Sewell D, Steele J, Weissfeld A, Wilkinson D, Winn W (ed), Clinical Laboratory Management. ASM Press, Washington, DC. doi: 10.1128/9781555817695.ch26
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Figure A8.8

Label: package orientation.

Citation: Sewell D. 2004. Laboratory Safety, p 446-472. In Garcia L, Baselski V, Burke M, Schwab D, Sewell D, Steele J, Weissfeld A, Wilkinson D, Winn W (ed), Clinical Laboratory Management. ASM Press, Washington, DC. doi: 10.1128/9781555817695.ch26
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Image of Shipper's Declaration for Dangerous Goodsa
Shipper's Declaration for Dangerous Goodsa

Reprinted with permission of Larry D. Gray.

Citation: Sewell D. 2004. Laboratory Safety, p 446-472. In Garcia L, Baselski V, Burke M, Schwab D, Sewell D, Steele J, Weissfeld A, Wilkinson D, Winn W (ed), Clinical Laboratory Management. ASM Press, Washington, DC. doi: 10.1128/9781555817695.ch26
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Employee Accident/Incident Report

Citation: Sewell D. 2004. Laboratory Safety, p 446-472. In Garcia L, Baselski V, Burke M, Schwab D, Sewell D, Steele J, Weissfeld A, Wilkinson D, Winn W (ed), Clinical Laboratory Management. ASM Press, Washington, DC. doi: 10.1128/9781555817695.ch26
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References

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45. Tweedy, J. T. 1997. Healthcare Hazard Control and Safety Management. Lewis Publishers, Boca Raton, Fla.
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Tables

Generic image for table
Table 26.1

Elements of a safety management plan

Citation: Sewell D. 2004. Laboratory Safety, p 446-472. In Garcia L, Baselski V, Burke M, Schwab D, Sewell D, Steele J, Weissfeld A, Wilkinson D, Winn W (ed), Clinical Laboratory Management. ASM Press, Washington, DC. doi: 10.1128/9781555817695.ch26
Generic image for table
Table 26.2

WHO's risk groups

From reference .

Citation: Sewell D. 2004. Laboratory Safety, p 446-472. In Garcia L, Baselski V, Burke M, Schwab D, Sewell D, Steele J, Weissfeld A, Wilkinson D, Winn W (ed), Clinical Laboratory Management. ASM Press, Washington, DC. doi: 10.1128/9781555817695.ch26
Generic image for table
Table 26.3

CDC/NIH guidelines for assigning microorganisms to BSL

From reference .

Citation: Sewell D. 2004. Laboratory Safety, p 446-472. In Garcia L, Baselski V, Burke M, Schwab D, Sewell D, Steele J, Weissfeld A, Wilkinson D, Winn W (ed), Clinical Laboratory Management. ASM Press, Washington, DC. doi: 10.1128/9781555817695.ch26
Generic image for table
Table 26.4

BSLs, practices, and equipment

From reference .

Citation: Sewell D. 2004. Laboratory Safety, p 446-472. In Garcia L, Baselski V, Burke M, Schwab D, Sewell D, Steele J, Weissfeld A, Wilkinson D, Winn W (ed), Clinical Laboratory Management. ASM Press, Washington, DC. doi: 10.1128/9781555817695.ch26
Generic image for table
Table 26.5

Risk assessment and exposure control plan for clinical microbiology laboratory

Adapted from reference . Abbreviations: R, required; D, discretionary; P, prohibited; A, one of the required alternatives.

Remove PPE when leaving the laboratory. Gowns must have a solid front and be impervious to liquid.

Recapping of needles is prohibited. Carry tubes in racks or use plastic tubes. Plan each task to minimize known hazards.Wash hands before leaving the laboratory.

Sharps include needles, scalpels, pipettes, sticks, syringes, slides, plastic loops, and coverslips.

Requires surveillance and action plan for occasional isolation of BSL 3 organism (e.g., spp., spp., spp., and systemic fungi), especially when plates are held more than 3 days. requires the use of a safety centrifuge, a BSC, and a HEPA-filtered mask or respirator.

Use a BSC or acrylic splash shield.

Requires a contingency plan for breakage of culture containers.

Mycobacteria other than tuberculosis can be handled at BSL 2; however, use BSL 3 practices because most manipulations precede organism identification.

Special precautions for BSL 4 agents (e.g., hemorrhagic fever virus, smallpox) should be arranged through CDC's emergency number (770-488-7100).

Vortexing or other splatter-generating steps require use of a BSC or safety shield.

Requires BSL 3 practices if there is potential for aerosols

Citation: Sewell D. 2004. Laboratory Safety, p 446-472. In Garcia L, Baselski V, Burke M, Schwab D, Sewell D, Steele J, Weissfeld A, Wilkinson D, Winn W (ed), Clinical Laboratory Management. ASM Press, Washington, DC. doi: 10.1128/9781555817695.ch26
Generic image for table
Table 26.6

Select Agent list

From reference .

Citation: Sewell D. 2004. Laboratory Safety, p 446-472. In Garcia L, Baselski V, Burke M, Schwab D, Sewell D, Steele J, Weissfeld A, Wilkinson D, Winn W (ed), Clinical Laboratory Management. ASM Press, Washington, DC. doi: 10.1128/9781555817695.ch26
Generic image for table
Table 26.7

Characteristics of hand-hygiene antiseptic agents

From reference . +++, Excellent; ++, good, but does not include entire bacterial spectrum; +, fair; −, no activity or not sufficient; F, fast; I, intermediate; S, slow; GP, gram positive; GN, gram negative.

phenoxyphenol.

Citation: Sewell D. 2004. Laboratory Safety, p 446-472. In Garcia L, Baselski V, Burke M, Schwab D, Sewell D, Steele J, Weissfeld A, Wilkinson D, Winn W (ed), Clinical Laboratory Management. ASM Press, Washington, DC. doi: 10.1128/9781555817695.ch26
Generic image for table
Table 26.8a

Vaccines

From http://www.bt.cdc.gov.

Some degree of immunity is conferred following cutaneous anthrax, i.e., the lethal dose is below that required for an immune response.

LD, Amount of a toxic agent sufficient to kill 50% of a population.

Sentinel (level A) laboratories are located in hospitals and clinics and primarily function at BSL2.

Distributed by the CDC under an investigational new drug protocol and used to protect high-risk laboratorians actively working with or the toxins.

Distributed by the CDC.

Immunity to Lassa fever reinfection occurs following infection, but the length of protection is unknown.

Citation: Sewell D. 2004. Laboratory Safety, p 446-472. In Garcia L, Baselski V, Burke M, Schwab D, Sewell D, Steele J, Weissfeld A, Wilkinson D, Winn W (ed), Clinical Laboratory Management. ASM Press, Washington, DC. doi: 10.1128/9781555817695.ch26
Generic image for table
Table 26.8b

Vaccines

From http://www.bt.cdc.gov.

Some degree of immunity is conferred following cutaneous anthrax, i.e., the lethal dose is below that required for an immune response.

LD, Amount of a toxic agent sufficient to kill 50% of a population.

Sentinel (level A) laboratories are located in hospitals and clinics and primarily function at BSL2.

Distributed by the CDC under an investigational new drug protocol and used to protect high-risk laboratorians actively working with or the toxins.

Distributed by the CDC.

Immunity to Lassa fever reinfection occurs following infection, but the length of protection is unknown.

Citation: Sewell D. 2004. Laboratory Safety, p 446-472. In Garcia L, Baselski V, Burke M, Schwab D, Sewell D, Steele J, Weissfeld A, Wilkinson D, Winn W (ed), Clinical Laboratory Management. ASM Press, Washington, DC. doi: 10.1128/9781555817695.ch26
Generic image for table
Table 26.9

Activity levels and hazards of selected germicides

From references . NA, not available.

Citation: Sewell D. 2004. Laboratory Safety, p 446-472. In Garcia L, Baselski V, Burke M, Schwab D, Sewell D, Steele J, Weissfeld A, Wilkinson D, Winn W (ed), Clinical Laboratory Management. ASM Press, Washington, DC. doi: 10.1128/9781555817695.ch26
Generic image for table
Table 26.10

Laboratory safety checklist

Citation: Sewell D. 2004. Laboratory Safety, p 446-472. In Garcia L, Baselski V, Burke M, Schwab D, Sewell D, Steele J, Weissfeld A, Wilkinson D, Winn W (ed), Clinical Laboratory Management. ASM Press, Washington, DC. doi: 10.1128/9781555817695.ch26

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