which scenario shows poor laboratory safety?which scenario shows poor laboratory safety?

Fume cupboards in our study were provided in 34.7% of laboratories. Select and use engineered sharps injury prevention devices that are acceptable for clinical care and provide optimal protection against injuries. Instruments and equipment are used appropriately to carry out laboratory functions. See Section 3.5 for discussion, including a waste management plan. No recirculation; total exhaust to the outside through a HEPA filter. The frequency and concentration of organisms routinely isolated, as determined by specimen type, patient data (of individual or the hospital population), epidemiologic data, and geographic origin of the specimen; Indicators of possible high-risk pathogens that may require continuation of work in a biological safety cabinet (BSC), such as. Mats can present a slip hazard if they are not properly anchored to the floor. Students create their own dialogues and plan their skit. CO vapor is considerably heavier than air; in confined, poorly ventilated spaces, it can displace air, causing asphyxiation. BOX 2. Argon is used in sputter coaters, and some laboratories carry out plasma ashing of biological specimens, which requires oxygen (. Autoclave or disinfect all material coming into contact with cell cultures before discarding. Always use thick, elbow-length, heat-resistant, liquid-impervious gloves to remove hot items from the autoclave. The USPS regulations for mailing hazardous materials generally adhere to DOT regulations; however, consult the USPS Domestic Mail Manual for specific needs and requirements. 1910.1048, Formaldehyde. The room might need to be renovated to accommodate a Class IIA2 BSC, directional air flow, telephone jacks, and communication devices such as intercoms. All shipped goods must be classified using a three-step process to define dangerous goods that are shipped by commercial carriers. (14) There has to be standardization across laboratories and tools of quality assurance and CQI (Continuous Quality Improvement) have to be used to improve safety in laboratories. This continued workup places the technologist and others in the laboratory at risk for infection. In some cases after formaldehyde waste treatment with crystal products, the resulting solid waste may be discarded in approved laboratory solid waste streams. The risks and causes of LAIs have been documented. Close the drain valve and pour disinfectant onto the surface and through the grille into the drain pan. Even after heat-fixing, the slide may contain viable tubercle bacilli and should be treated as contaminated. Regulatory affairs and biotechnology in Europe: III. Before histologic slide preparation, small blocks of brain tissue <5 mm thick are soaked in 95%100% formic acid for 1 hour, followed by soaking in fresh 4% formaldehyde for at least 48 hours. Effluents of clinical analyzers are to be considered contaminated, and disposal must comply with state and local regulations. Chatigny MA, Hatch MT, Wolochow H, et al. Handle all stored infectious substances using Standard Precautions and aseptic technique. Ensure label and bar code are not obscured before advancing specimen for analysis. Transplantation 2004;77. A reporting mechanism exists to enable reports to be categorized to type of error so that corrective actions can be established. Clostridium difficile, Mycobacterium tuberculosis, If infectious material flows into the grille, wipe all items in the cabinet with disinfectant and remove them. These activities can present a freezing hazard. Are you getting the free resources, updates, and special offers we send out every week in our teacher newsletter? Whether automated or manual, procedures with the potential for producing specimen aerosols and droplets (e.g., stopper removal, vortexing, opening or piercing evacuated tubes, automatic sample dispensers) require either PPE or engineering controls designed to prevent exposures to infectious agents. Documentation of training and competency assessment in phlebotomy. The risk for transmission of, Meyer J. TB Plagues Office of the LA Coroner. Source: CDC. (89) $20.00. MMWR 2005;54:10213. Storage shelves need a 1-cm (1/2-inch) lip to ensure chemicals cannot slide off a shelf. doi: 10.1097/MD.0000000000010990. Lymphocytic choriomeningitis virus infection in organ transplant recipientsMassachusetts, Rhode Island, 2005. Use of one of the current commercial substitutes for xylene will avoid the need to address the special handling required for hazardous waste management described here. Use shrink seals or tape to seal petri plates (especially if mould begins to grow) in order to prevent accidental opening and spread of hyphal segments, conidia, or spores. Federal government websites often end in .gov or .mil. Establish a process and procedure for specimen transport within and, if applicable, outside the facility (. BOX 3. 2016 Aug 21;9:A1-4. Cover any subsequent jagged edges of exposed bone with towels. Instrument failures such as clogged sort nozzle or air in the fluidic system can drastically increase aerosol formation. Liquid gases, even those considered inert, can present explosion hazards. For optimal protection when there is a known risk of exposure to bloodborne pathogens and to agents transmitted by aerosols, all autopsy/necropsy facilities should be able to use BSL-3 work practices and physical containment or reference the work to a facility that does (. The material in this report originated in the National Center for Emerging and Zoonotic Infectious Diseases, Beth P. Bell, MD, MPH, Director. The principal hazards associated with handling cryogenic fluids include cold contact burns and freezing, asphyxiation, explosion, and material embrittlement. Laboratory of one private medical college was accredited with NABL and safety parameters were better in that laboratory. To extend this activity, students can create their own, Rules Poster (2 sizes) justine notices a chip at the top of the beaker, considers using it, but then asks her teacher if she should use it. The responsibility for overseeing the safety education of laboratory personnel must be clearly assigned. Tuberculosis (TB) resulting from exposure to infectious aerosols remains a major risk for laboratorians. Train laboratory workers in the use of PPE for specific tasks and to know the limitations of PPE and the appropriate procedures for maintaining and disposing of PPE. Laboratory-acquired meningococcal diseaseUnited States, 2000. Science Lab Safety Pictures Teaching Resources | TpT Gloves protect the wearer from exposure to potentially infectious material and are usually thin latex, vinyl or nitrile. Determine if laboratory staff working with human cells and tissues need to provide a baseline serum sample (if this is institutional policy based on a risk assessment), be offered hepatitis B immunization and be evaluated by a health-care professional following an exposure incident (. Other laboratory exposures and LAIs continue to occur, almost always because of a breakdown of established safety protocols. West Nile virus encephalitis in a kidney transplant recipient. a. This is a great way to get everyone involved.I r, Science Lab Safety Bundled Package in English and Spanish, Science Safety Poster and Discussion Cards Bundle, Science Lab Safety Worksheets and Beginning of the Classroom Essentials Bundle, Back To School Science Skills - Planning An Investigation - Lab Safety - CER. Keep clutter to a minimum. Hofmann and colleagues projected that only 6.3% and 14.7% of injuries in a German hospital in late 1990s were officially reported7. Although the risks associated with antibiotic preparation and use are relatively low in the virology laboratory, antibiotic preparation and handling has been associated with hypersensitivity reactions and contact dermatitus (115,116) and asthma (116120) in hospital, pharmaceutical, and animal workers. Have written procedures for nonlaboratory operations, e.g., technical instrument maintenance, in-house or contracted maintenance, emergency response, housekeeping, and construction and utility operations, to mitigate exposures associated with assigned operational tasks. Ensure that specimen placement, specimen flow, and bench operational workflow are unidirectional (i.e., from clean areas to dirty areas) and uniform for all operators to maximize effective use of engineering controls. All the specimens are treated as potentially hazardous in all the laboratories. Never put dry ice in beverages to cool them. Microbiology specimens are to be received in uncontaminated containers that are intact and are consistent with laboratory specimen collection policy. TABLE 15. When possible, use these in a fume hood. They dumped the chemical in the sink and left the water running in the sink as they left class. Telephones are a potential vehicle for transferring infectious agents to the face and mucous membranes, and they should be used with this in mind. 5.1.4. Infections acquired in clinical laboratories in Utah. Hepatitis B has been the most frequent laboratory-acquired viral infection, with a rate of 3.54.6 cases per 1000 workers, which is two to four times that of the general population. Automated hematology/hemostasis analyzers. Another option is to call a designated spill emergency response team. Infectious substances in a clinical microbiology laboratory are encountered as fresh and processed patient specimens, cultures and subcultures, stored isolates, and serum or plasma. "Infectious medical waste" is defined as waste capable of transmitting disease. Wash hands with simple soap and water or antimicrobial solution to protect against external and internal exposure to bloodborne pathogens. Harrington JM, Shannon HS. http://www.aphis.usda.gov/programs/ag_selectagent/ag_bioterr_toxinlist, Centers for Disease Control and Prevention. Accessibility This bundle includes:2 sets of 16 discussion cards with 16 numbered, in slides for Google Slides format. Murray PR, Baron EJ, Horgensen JH, Pfaller MA, Yolken RH. Cut large fixed organs in a fume hood or downdraft table. Never mix different chlorine solutions or store them with cleaning products containing ammonia, ammonium chloride, or phosphoric acid. Never leave dry ice in a parked passenger vehicle. lab! Kekarainen T, Martnez-Guin L, Segals J. Swine torque teno virus detection in pig commercial vaccines, enzymes for laboratory use and human drugs containing components of porcine origin. Those involved in the autopsy directly as well as others in the room are at risk for exposures. Available at. Establish SOPs for use and decontamination of the pneumatic tube system (PTS). What is the temperature change? Several heavy metal stains and aggressive fixatives are used in the electron microscopy laboratory. Marking and labeling outer packages. Compared with humans, bees can sense electromagnetic waves that have a lower frequency and a shorter wavelength. Encephalitozoon, Pleistophora, Trachipleistophora, Bacillus, All persons who frequently handle bats. Manufacturer instructions for use and care of centrifuges, and especially rotors, are to be strictly enforced to prevent the serious hazards and potential exposures associated with rotor failure. Use appropriate face and eye protection when cutting donor segments during either confirmatory testing or other testing. Safety is only one discipline involved in lab design; lab planners must also work with architects, engineers, and the researchers who will use the lab, says DiBerardinis. Many of the biosafety practice guidelines for human clinical microbiology laboratories are applicable in veterinary diagnostic laboratories. Collins C, Grange J. Hopps HE. Transport of infectious substances. Exhaust air passes through two HEPA filters in series and is exhausted to the outside via a hard connection. Could cause overpressure/rupture of a closed system. A Category B substance is "an infectious substance that does not meet the criteria for inclusion in Category A" (93). MMWR 2002;51:27981. 8.3.3. Centrifuges can be extremely dangerous instruments if not properly cleaned, maintained and operated. Avoid direct contact with sunlight or UV light. Sher-i-Kashmir Institute of Medical Sciences, Srinagar (India). MMWR. The vacuolating virus, SV40. Storage in a sealed container can cause the container to rupture or explode from overpressurization. Primary course. 2007 (1). Selected adventitious agents associated with cell cultures, organs and tissues that could be used to generate cell cultures, and cell culture reagents, Human kidney, pancreas, some adenovirus transformed cell lines, rhesus monkey kidney cells, Bovine serum, fetal bovine serum (substantially lower risk today due to ultrafiltration of bovine serum), Kidney, human foreskin, monkey kidney cells, Some lymphoid cell lines and EBV-transformed cell lines, human kidney, Blood cells, serum, plasma, solid organs from infected humans or monkeys, Fetal porcine kidney cells, trypsin preparations, Human cornea, kidney, liver, iliac vessel conduit, Rhesus, cynomologous, and African green monkey kidney cells, Trypsin, swine-origin biological components, Multiple cell lines, commercial interferon preparations, Human blood, heart, kidney, liver, lung, pancreas, TABLE 10. Use of sodium hypochlorite solutions in work areas of EtBr use is also not recommended. The employer must develop an accurate job description so that the employee understands the job responsibilities. Recommendations for the general microbiology laboratory are sufficient for use in the mycology laboratory; these include guidelines for disinfection of countertops and items such as telephones, computers, equipment, and hands-free telephones. Allow the dry ice to sublimate or evaporate to the atmosphere in a well-ventilated area where CO vapor cannot build up. Laboratory biosafety manual, 3rd edition. of India has authorized NABL (National Accreditation Board for Laboratories) as the sole accreditation body for testing and calibration of laboratories. Do not disable safety interlocks and/or sensors. Do not stack or store combustible materials (e.g., cardboard, plastic materials) or flammable liquids next to the autoclave. It would take 23 minutes to clear the air of airborne Always use special ultralow-temperature containers to hold liquid nitrogen. Abbreviation: 0 - '` bjbjLULU 4 .? Wear gloves and use gauze pads with impermeable plastic coating on one side when using instruments for which the operator is required to wipe sample probes. Production of large volumes or concentrations of potential pathogens; Age (younger or inexperienced employees might be at higher risk); Genetic predisposition and nutritional deficiencies, immune/medical status (e.g., underlying illness, receipt of immunosuppressive drugs, chronic respiratory conditions, pregnancy, nonintact skin, allergies, receipt of medication known to reduce dexterity or reaction time); Education, training, experience, competence; Stress, fatigue, mental status, excessive workload; Perception, attitude, adherence to safety precautions; and, The most common routes of exposure or entry into the body (i.e., skin, mucous membranes, lungs, and mouth) (, Administrative and work practice controls, PPE (as a last resort in providing a barrier to the hazard). Available at, Occupational Safety and Health Administration. Antony S. Severe meningo-encephalitis and death in a renal transplant recipient resulting from West Nile virus infection. Domestic mail manual. The size of the safety training program will vary with needs but should include. Weston J, Locker G. Frequency of glove puncture in the postmortem room. Do not try to force the threads or use the wrong regulator on a tank. While the number of test errors encountered in the analytic phase represented only 14.3 percent of total errors. To be an effective disinfectant, working bleach solutions must contain >0.5% but <2% sodium hypochlorite. Never use a knife or other instrument to scrape dried blood or body fluid from surface areas because this can generate aerosols. Cytology receives large- and small-volume body fluids, bone marrow samples, or needle aspirate specimens, most of which are received in fixative but others that must be processed by aliquoting or pouring off large-volume body fluids, which can result in splashing and spills. Minor spills in a BSC can be absorbed with absorbent paper. I. Source: Adapted from Clinical and Laboratory Standards Institute. Do not store or use acetone in a refrigerator that is not rated as explosion proof. These viruses and virus genetic elements survive freezing and may be present in archived culture materials. They are toxic if ingested and may cause neurologic disturbances. Cases of rabies in Germany following organ transplantation. Volatile and flammable chemicals are sorted in designated areas in 73.95% of laboratories and these areas are suitably ventilated in 94% of laboratories. Biosafety risk assessment for veterinary diagnostic specimens is critical because the pathogenic potential for humans in veterinary diagnostic specimens is different from that in human specimens. The creation of aerosols should be minimized to the greatest possible extent. Human rabies transmitted by corneal transplant. A table at the end of the document shows an aggregate of the scenarios by domain and their corresponding sources. Primary inoculation tuberculosis of the skin; prosector's paronychia. Addendum II. The most critical risk assessments for veterinary diagnostic laboratories are consideration of host species, the known medical condition and clinical history of the patient, clinical signs of the patient, and endemic local geographic conditions. Contact the appropriate reference laboratory in advance of any forwarding. largely due to the movement to design them in ways that promote the health and safety of lab users." . Ask what theyll do, and youll get a much clearer picture of what their needs are. Recent MMWR reports (311) have indicated that bacteria account for >40% of infections, with >37 species reported as etiologic agents in LAIs; however, other microbes are often implicated. Types and classifications of IATA division 6.2 infectious substances, Abbreviation: Tuma S, Sepkowitz KA. As part of an on-site waste management plan, the responsibilities of the laboratory management or the designated safety officer or safety team are to. Biomol Detect Quantif. Only one answer below shows the total number of parts for all eight boxes. Step 3. This is normal. To reduce exposures to Do not touch the sides or back of older autoclaves; they have little or no heat shielding and may cause burns. nancy wears her safety goggles over her glasses in lab. A specific scenario could be handed to a randomly selected technologist, and some laboratories may have the technological capacity to send safety challenges to individual workers when they sign on for the day. A comprehensive approach for identifying hazards in the laboratory will include information from a variety of sources. Minimal PPE for the general setup area is gown and gloves. Clean any item (e.g., timer, pen, telephone, thermometer) touched with used gloves. Richard M, Biacabe A, Perret-Liaudet A, McCardle L, Ironside J, Kopp N. Protection of personnel and environment against Creutzfeldt-Jakob disease in pathology laboratories. Risk mitigation of laboratory-acquired infections is discussed in Sections 2 and 3. RR-16). Biosafety in Microbiological and Biomedical Laboratories (BMBL-5) and in the World Health Organization's Keywords: Goto M, Yamashita T, Misawa S, Kowari T, Oklezumi K, Takahashi T. Current bio- given off during processing of safety in clinical laboratories in Japan: report of questionnaires, data obtained from clinical laboratory personnel in Japan. Do not use alcohols to clean floors; alcohols will dissolve floor wax, creating areas with different degrees of traction. This property has been used as a drug delivery system to allow antifungal medications to penetrate skin, toenails and fingernails. Special precautions for suspicious specimens. Ensure compliance with all government regulations. Avoid using sodium azide to prevent growth of microorganisms because it forms explosive compounds with certain metals. J Clin Pathol 1999;52:4158. In 91% of laboratories staff is using protective clothing while working in laboratories. Potential exposures to laboratory-acquired parasitic infections, Leaving a needle on the counter, point up, Breaking hematocrit tube while pressing the end into clay, Performing venipuncture on agitated patient, Sudden animal movement during an inoculation procedure, Creation of aerosols during tapeworm proglottid injection, Creation of aerosols while working with cultures (bacteria, viruses, fungi, blood parasites, free-living amebae), Bitten by an infected animal (e.g., mouse or hamster), Bitten by infected mosquito or tick (e.g., mosquito colony), Failure to wear laboratory coat (closed sleeves, closed front over clothes), Accidentally touching face or eyes during handling of infectious materials, Exposure of eyes, nose, or mouth to potential aerosols, Sprayed with inoculum droplets from coughing or regurgitating animal, Working in disorganized laboratory bench setting, Assumption that agent is not infectious to humans, Assumption that agent(s) are no longer viable, TABLE 8. Guidelines for the general microbiology laboratory apply also for the mycology laboratory. Shred autoclave red-bag waste if appropriate. If the gauze pad dries during work processes, rewet it. The plan is to incorporate at least the elements presented here (or the equivalent) and be easily accessible to employees. Notify nearby workers and the supervisor if a splash or spill occurs, regardless of how small. Some alcohols will cloud plastics; care must be taken when wiping down plastic instrument faces with alcohols. Documented training and assessment of competency will include knowledge of the risks associated with using a PTS and the precautions to be taken to control those risks. Report known bloodborne pathogens or other suspected aerosolization danger to the mortician and others potentially handling the body to limit subsequent transmissions that may occur during transport or embalming (69). Biological samples, reagents and other items shipped to reference laboratories ("customers") are clearly labeled for biosafety hazards. It is imperative to understand and minimize the risk of exposure to patient specimens through surface contact, aerosolization, or penetrating injury. Discarded cultures and stocks of organisms handled under BLS-3 physical containment (e.g.. Decontaminate discarded cultures and stocks of organisms handled at BSL-2. Bite, nonbite, or aerosol exposure. MMWR 2005;54:5379. Rabies research laboratory workers; rabies biologics production workers. Application of a quality management system model for laboratory services; approved guidelinethird edition (CLSI document GP26-A3) 2004 (222). The answer key will match up exactly to the answer document to allow for quick and easy grading! Provide material safety data sheets (MSDS) for each component in the laboratory. Consult product labels, product manufacturers, sodium hypochlorite suppliers, or the Chlorine Institute for information. This means that the lab is designed in a way that provides everyone ample space to work and allows researchers to carry out their work efficiently and in the correct order. the contents by NLM or the National Institutes of Health. Transplant Proc 2003;35:29356. Clinical and Laboratory Standards Institute. Wearing a respirator, such as N95, is highly recommended for protecting the laboratorian when processing and manipulating specimens or TB cultures. * The proper shipping name for Category B substances is Biological Substance, Category B. Engineering controls (2.1.5. educating clinicians and nurses about safe specimen procurement and transport to ensure their safety and that of the laboratory personnel who receive the clinical samples. Students will be presented with 16, that could potentially happen in any classroom, each with a disaster. Double-door autoclaves can be installed so that one side opens into the mycobacteriology laboratory and the other side opens into a disposal area used by the laboratory for disposing of other waste. Standard no.1910.1030. An N95 respirator is usually not required for biocontainment levels up through BSL-2, although it provides a higher degree of protection than a surgical mask. The preferred disposal method is incineration in an approved facility. The slides are labeled as infectious CJD and stored/filed in an appropriately labeled container. Ensure instrument safety shields and containment devices are in place at time of use. FAU Theatre: Safety in the theatre Care must be taken to prevent damage to bell jars and suction flasks caused by excessive wear or impact with hard objects. This is a versatile activity that can be used with a variety of grade and ability levels and can easily be modified to be used as, stations or a homework activity. Organisms in cracks, shadows, and on the underside of equipment are not affected by UV light treatment. Therefore, even a small heat input can create large pressure increases within the vessel. If the tissue has not been pretreated with formic acid before embedding, double gloves and eye protection are to be worn at all times, including during sectioning. Title 40 Code of Federal Regulations (, Wear appropriate protective gloves and protective clothing to prevent skin exposure. Available at, Code of Federal Regulations. However, routine clinical laboratory testing may provide the first evidence of an unexpected bioterrorism event. The UV lamp must never be on while an operator is working in the cabinet. Virus zoonoses and their potential for contamination of cell cultures. Vocabulary Terms Include: (See Section 3.5, Waste Management.). 2.1.3. Personnel who operate the autoclave must be trained to package, load, and label materials to be autoclaved in accordance with the procedures used to validate the sterilization cycle of the unit. Safety equipment. In: OIE manual for diagnostic tests and vaccines for terrestrial animals, 6th Edition. Am J Public Health 1988;78:121315. These cells may produce infectious virus or they may have viral genomic material within the cells. Transplantation 1987;1:214. Type 508 Accommodation and the title of the report in the subject line of e-mail. The assessment will determine whether these wastes can be safely managed off-site or should be managed on-site. Virus present continuously, often in high concentrations. Six-foot-wide BSCs may accommodate additional testing equipment or materials. Paraffin from tissue mounting and cutting can accumulate in tissue processing areas and can make the floor slick despite regular cleaning unless special floor care measures are taken. Clinical Microbiology Newsletter 1990;12:857. This bundle includes 4 different interactive and student-led, Method S.C.I.E.N.C.E. In Taiwan, the incidence rate of needle stick injuries is 0.11 per person-month among healthcare workers including laboratory technicians. Each particular centrifuge type must have an operation manual. 8.7.1. All clinical samples submitted specifically for TB testing must be handled by persons using PPE consisting of a laboratory coat and gloves, and the work must be conducted in a BSC (. Martn-Dvila P, Fortn J, Lpez-Vlez R, et al. When transporting dry ice, place the container in the trunk of the car or truck bed, and leave the car windows open for fresh air circulation. Austin, TX: Science Stuff, Inc.; 2006. Ejilemele AA, Ojule AC. A common feature in newer systems is closed system sampling. See Section 5 for detailed biosafety guidelines applicable to necropsy, surgical pathology, and histology working areas in a veterinary diagnostic laboratory. All BSCs must be certified by trained professionals in accordance with Annex F of ANSI/NSF Standard No. She decides to test several products to see which clears her face up fastest: washing with soap and water, washing with an acne face wash from the pharmacy, and washing her face with organic oils. Work in a diagnostic laboratory entails safety considerations beyond the biological component; therefore, these guidelines also address a few of the more important day-to-day safety issues that affect laboratorians in settings where biological safety is a major focus.