which scenario shows poor laboratory safety?

2004;53:8424. Splash guards at workstations are recommended during work at the blood culture bench or at any station at which the potential for splashing exists. Employees are to be made aware and frequently reminded of the importance and locations of emergency equipment and facilities. Employers are to have a formal plan to address actions to be taken after an employee is exposed. The International Air Transport Association (IATA) and the US Department of Transportation (DOT) provide only minimal standards (i.e., no detailed and numbered packing instructions) for packing and shipping exempt human specimens. Javadi MA, Fayaz A, Mirdehghan SA, Ainollahi B. Application of a quality management system model for laboratory services; approved guidelinethird edition (CLSI document GP26-A3). All of these compounds contain heavy metals and are very toxic if inhaled, ingested or introduced through cuts or abrasions. 2019 Dec 23;14(12):e0226477. Do not breathe any of the evaporated metal that may flake off from the surface. There are a total of 8, Your students can memorize all of the lab, rules that you want them to, but how about switching it up? Which scenario shows poor laboratory safety? * This table can be used to estimate the time necessary to clear the air of airborne Never autoclave materials that contain toxic agents, corrosives (e.g., acids, bases, phenol), solvents or volatiles (e.g., ethanol, methanol, acetone, chloroform), or radioactive materials. Clin Lab Med. Am J Public Health. Release of chlorine gas, might occur violently. Elicit and discuss creative solutions to prevent biosafety problems. Students create their own dialogues and plan their skit. Many of these potential hazards can be minimized by adoption of safe handling practices. Example of job safety analysis for laboratorians working in diagnostic laboratories: hazards and controls, Safer sharps; retractable needles; puncture-resistant sharps container, No recapping; immediate disposal into sharps container, Face protection if not in BSC; gloves; gown or lab coat with knit cuffs, Splashdirect contact with mucous membranes, Face protection if not in BSC; gloves; gown or lab coat, BSC; removable rotors; safety cups; O-rings on buckets; plastic tubes; splash shield, Spin in BSC, or load and unload rotor in BSC; check O-rings and tubes for wear; no glass tubes; wait for centrifuge to stop before opening, Work in BSC; sputum decontaminant; slide warmer, Use slide warmer in BSC; dispose of slide in tuberculocidal disinfectant, Work in BSC or perform in disposable tube, BSL-3 laboratory optimal; BSL-2 laboratory with BSC minimal, Solid-front gown with cuffed sleeves; gloves; respirator if warranted. Vaccination records and safety training records are appropriately completed, maintained and easily recovered. 10 6 eV). Washington, DC: National Academy Press; 1993. MMWR 2005;54:10213. Do not use alcohols to clean floors; alcohols will dissolve floor wax, creating areas with different degrees of traction. Long-term budgetary planning for this event is important. Porcine parvovirus: frequency of naturally occurring transplacental infection and viral contamination of fetal porcine kidney cell cultures. National Fire Protection Association. The cloth or paper towels and the broken material should be cleared away into biohazard sharps receptacles. The creation of aerosols should be minimized to the greatest possible extent. Primary inoculation tuberculosis of the skin; prosector's paronychia. Ammonium molybdate is very dangerous in case of eye contact, ingestion, and inhalation. The primary container inside the package contains a Biological Substance, Category B infectious substance and is packed according to PI 650. Do not plug, remove, or tamper with any pressure relief device. CDC. The chemical hazards unique to the molecular virology laboratory include chloroform, ethidium bromide (Section 8.2.8) and guanidinium-based extraction reagents (Section 8.2.10). Sewell DL. Serologic testing every 6 months; booster vaccination if antibody titer is below acceptable level.*. Use disposable plastic bags with separate pockets for the requisition slip and specimen when possible (. Title 40 CFR 261.24(a) (. In the virology laboratory, the distinction between dirty and clean areas is a misnomer; all areas within the laboratory present increased opportunities for encountering infectious, chemical, and physical hazards. Not all protective eyewear will protect laboratory workers from deleterious UV light exposure. Laboratorians who handle specimens in which. Wayne, PA: Clinical and Laboratory Standards Institute; 2007. Great for ESL and SPED, but all students enjoy reading the stories and finding errors in both the written and comic form. Gas tanks should be individually secured (. J Clin Microbiol 1993;31:30710. Title 40 Code of Federal Regulations (, Wear appropriate protective gloves and protective clothing to prevent skin exposure. Place leaking specimen containers into a biohazard bag and decontaminate by autoclaving or another approved method. Fluids may be disinfected by treating with a 1:10 household bleach (Section 3.4.2 and 3.5) or by autoclaving. Recommendations of the Advisory Committee on Immunization Practices. * Not every possible parasite is included in the table; those mentioned represent the most likely transmission possibilities. They can also lead to skin punctures and abrasions that make laboratory workers more vulnerable to LAIs. m) that floats on air currents for extended periods and can subsequently reach the pulmonary alveoli and small-droplet particles (>5 The specimen login and processing personnel are responsible for checking the suspect agent "Do Not Process/Do Not Test" list before the specimen is sent on for testing (see 8.1.1). Microbiology specimens are to be received in uncontaminated containers that are intact and are consistent with laboratory specimen collection policy. Mycobacterium tuberculosis, a hierarchy of controls must be employed, including safe work practices, use of containment equipment, and specially designed laboratory facilities (1). parenteral inoculations with syringe needles or other contaminated sharps; spills and splashes onto skin and mucous membranes; ingestion or exposure through mouth pipetting or touching mouth or eyes with fingers or contaminated objects; animal bites and scratches (research laboratories or activities); and. Br Med J 1957;2:1014. Breathing powders can cause respiratory irritation. Although many common activities might be performed by all personnel, customize the list to reflect the actual job duties. Localities may restrict the amounts of alcohols that may be flushed down the drain. Their disposal must comply with state and local regulations. Liquid nitrogen is dangerously cold (-320F [-196C]), and skin contact with either the liquid or gas phase can immediately cause frostbite. Your students have to determine what went wrong, and what rules needed to be followed. The following guidelines for disinfection and cleaning following an autopsy or necropsy apply to both types of procedures. sanjeet brought a change of shoes into lab because he was wearing sandals. The recommendations presented in this section represent a broad view of safety throughout the laboratory. Always use thick, elbow-length, heat-resistant, liquid-impervious gloves to remove hot items from the autoclave. New Brunswick, NJ: Rutgers University Press; 2005. Minor spills in a BSC can be absorbed with absorbent paper. The attack rate in the general population aged 3059 years (the estimated age range of the average laboratorian) was 0.3 per 100,000. J Gen Virol 2000;90:64853. A table at the end of the document shows an aggregate of the scenarios by domain and their corresponding sources. Sotir M, Switzer W, Schable C, Schmitt J, Vitek C, Khabbaz RF. ", involving possible kitchen accidents. Bacteriol Rev 1968;32:185205. Vesley D, Hartmann HM. government site. Bags selected for use in autoclaving waste must be specifically manufactured for this purpose. 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. Regardless of whether gloves are worn, thorough washing of hands after completion of procedures is required. Application of sodium hypochlorite solutions to spent solutions of EtBr will deactivate the ethidium bromide, but the reaction products are mutagenic, according to the Ames test (. Good housekeeping is the most fundamental means for reducing slips, trips, and falls. Are you getting the free resources, updates, and special offers we send out every week in our teacher newsletter? NIH = National Institutes of Health; BSL = biosafety level; BSC = biological safety cabinet; PPE = personal protective equipment. In most clinical laboratories specimens are first received in the main microbiology laboratory (biosafety level [BSL]-2), where they are logged in and processed for other bacteriologic testing. Aspiration traps are used in virology to remove culture media from tubes, shell vials, and other vessels before refeeding or other cell manipulations. LAIs and exposures have been reported since early in the 20th century, but only in the 1970s were sufficient data available to attempt quantitative assessments of risk. Special precautions for suspicious specimens. Dry ice can also cause bench tops and ceramic sinks to crack. Neutralizing reagents provide a convenient, cost-effective method for disposal of hazardous formaldehyde, glutaraldehyde, and other aldehyde solutions. General guidelines for the microbiology laboratory also apply for the parasitology section of the laboratory. West Nile virus associated encephalitis in recipients of renal and pancreas transplants: case series and literature review. Seal off the bag when it is filled. Available at, International Federation of Biosafety Associations. West Nile virus infection transmitted by blood transfusion. Guidelines for the general microbiology laboratory apply also for the mycology laboratory. Place disposable items, paper products, aprons, sponges, and similar items, into a biohazard container or bag for terminal treatment or autoclaving. When power strips are necessary, the safety office of the facility or a licensed electrician must approve their use. Wear gloves, long-sleeved laboratory coat, and a UV-resistant full-face shield when working with UV view boxes. Load and unload rotors in a BSC, particularly in virology and mycobacteriology sections. Air changes per hour (ACH) and time required for removal efficiencies of 99% and 99.9% of airborne contaminants*. Use of scalpels, saws, and needles as well as exposure to sharp objects within the body, bone fragments, fractured metal, and/or needles, can result in cuts and percutaneous injuries. Hepatitis B and transplantation. Lancet 1992;340:2713. Step 5. Care should be taken to collect all scraps of paraffin and unused sections on a disposable sheet. Step 5) should always be the first line of defense to minimize exposures. 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. The hazard to pathologists from tuberculosis specimens. This is a great way to reinforce material in your, classroom. CDC. Expert opinion: what to do when there is. We have more than 5 000 verified experienced expert. Patient specimens that meet Category A or Category B criteria must be classified as Category A or Category B substances. Clinical Laboratory Products. Safety manual is available in 56.5% of laboratories. IATA packing instructions (PI) describe the minimum standards for safe transport of infectious substances. 11.6.3. 2.1.2. Dewars must be moved carefully. Clean any spills of body fluids or tissues immediately. Clinical and Laboratory Standards Institute. Necropsy guidelines for cattle with suspected BSE are published elsewhere and focus primarily on avoiding skin puncture, reducing splashes onto mucous membranes, decontaminating facilities and equipment, and disposing of carcasses (, Cyanide, metallic phosphides and organophosphate pesticides, Diagnostic radioactive beads or therapeutic scans, Electrical and other hardware hazards (pacemakers, indwelling catheters). There are no specifically PI-numbered instructions for specimens classified as "exempt human or animal specimens"; however, IATA provides directions that must be followed (. Theres a perception that labs have become more dangerous, based on some high-profile lab disasters over the last few years, says Louis DiBerardinis, CIH, CSP, Director of Environment, Health, and Safety at Massachusetts Institute of Technology and Program Co-Director of Guidelines for Laboratory Design at the Harvard T.H. MMWR 2001;50(No. For all refrigerators and freezers in the blood bank, establish a cleaning and maintenance protocol that will minimize contamination and extend the life of the equipment and also maintain the sophisticated cooling systems blood bank refrigerators require to provide uniform and quick temperature recovery when needed. Biosafety guidelines developed for National TSE Veterinary Diagnostic Laboratory Network. Occupational asthma in workers of a pharmaceutical company processing spiramycin. Wear gloves, long-sleeved laboratory coat, and full-face shield when working with UV view boxes lacking protective filter shields. 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. Cover bath sonicators while the device is in use. Follow accepted laboratory procedures applied to infectious materials for handling and disposing of slides. For human laboratories, the separate tuberculosis and virology laboratories that manipulate cultures for identification and characterization would ideally meet BSL-3 requirements. Certain risk group 3 agents are endemic to specific geographic regions or specific species and clinical syndromes and would warrant increasing BSL practices to appropriate levels. Any manipulation of colonies of growth is performed within the BSC (. Category A substances must be assigned UN number UN2814 or UN2900 (, Certain Category A pathogens have been designated as agents of bioterrorism and are known as select agents (. Included: Sanitatio, product, students will write their plan of action to several different, presented. Careers. 2005[b]. The clinical virology laboratory receives a wide variety of clinical specimens for virus detection. Bleach solutions (sodium hypochlorite) (38). Once the sample on which a rapid test will be performed has been inactivated or genetic material extracted, further testing can be performed in a BSL-2 laboratory setting. Virology 1995;209:37483. Hanta viral biosafety issues in the autopsy room and laboratory: concerns and recommendations. 2016 Aug 21;9:A1-4. (. Double-gloving may be prudent because the chemical will eventually penetrate latex gloves. Maintain American National Standards Institute (ANSI)specification eyewash station and drenching facilities in the work area. The room might need to be renovated to accommodate a Class IIA2 BSC, directional air flow, telephone jacks, and communication devices such as intercoms. Do not detach or resheathe needles. Clin Chem 1980;26:11078. Remove any broken glass in a spill area, and discard without contact with the hands (use [e.g.] 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. In addition, these laboratories or entities are required to report the identification of select agents and toxins from samples received for proficiency testing within 90 days after receipt of the sample. I. The risk is never zero, and potential for human error always exists. ***************************************************************************** Commercial compounds and safe aldehyde solutions should be employed. Mahy BW, Dykewicz C, Fisher-Hoch S, Ostroff S, Sanchez A. If the facility is an open design and has no drop ceiling, the microbiology laboratory can have clear glass or Plexiglas walls, which give an appearance of openness but provide a floor-to-ceiling safety barrier from possible aerosol exposures. Alcaligenes spp., Arizona spp., Campylobacter spp., Perform procedures using a plasma extractor or expressor with appropriate face and eye protection to protect from sprays and possible explosion of the blood/component bags. Am J Clin Pathol 1990;94:4225. a higher frequency and a shorter wavelength. Do not place dry ice directly on bench tops, tile, laminated countertops, or ceramic sinks. Dried medium on the lip of culture tubes could present a contamination hazard. Dedicated equipment may be required depending on local jurisdictions. Documented instruction for each centrifuge type includes proper instrument startup and shutdown, emergency procedures and shutdown, balancing of tubes, use of safety cups and covers, rotor and container selection, requirements for high-speed and ultracentrifuges, and container fill-height limitations. Examples of engineering controls include use of a BSC, having sealed safety cups or heads in centrifuges, and negative air flow into the laboratory. (1). Release of oxygen gas, generally does not occur violently. The supervisor or manager must follow up on every employee who has incurred a problem to protect the employee and to make sure these incidents are monitored and systematic risks are eliminated. The most common formalin preparation is 10% formalin. If any concern exists about external contamination, carefully disinfect the outside of the tubes or bottles before inserting them into the blood culture instruments. Biological safety cabinet versus fume hood. Examples of common zoonotic microorganisms in risk groups 2 and 3* that might be present in the veterinary diagnostic laboratory, Viruses: Influenza viruses types A, B, C; Newcastle disease virus; parapoxvirus (Orf); West Nile virus, Bacteria: Prudent practices for the handling and disposal of infectious materials. Hazardous materials (601.10.1). The following biosafety recommendations are based upon CDC biosafety guidance for handling clinical specimens or isolates containing 2009-H1N1 influenza A virus (194). Do not use alcohols in closed spaces. Post the instructions in the phlebotomy office for reference. The purpose of this paper is to identify part of the commonly encountered laboratory errors throughout our practice in laboratory work, their hazards on patient health care and some measures and recommendations to minimize or to eliminate these errors. A visual reminder on small objects such as workbooks, tissue boxes, and pens can easily identify items located to a clean area. Wear latex, vinyl, or nitrile gloves when handling alcohols to minimize skin exposure. There is no safe level of exposure since exposure to as few as 110 organisms can cause disease. All cell cultures, whether inoculated with clinical specimens or not, are potentially infectious. Only those activities that are solely observational and do not risk creation of aerosols can be performed at the open bench. In microbiology, a surgical-type mask is recommended, but optional if the BSC is used. compare the momentum of a 6,300 kg elephant walking 0.11 m/s and a 50-kg dolphins swimming 10.m/s. Visually inspect all specimen containers for leakage. Do not use alcohols or alcohol-based solutions to disinfect surface areas because they evaporate readily, which significantly decreases efficacy. When manufacturer instructions do not include spill containment and cleanup instructions, collaborate with the manufacturer to develop a standard operating procedure that will effectively protect the operator and maintain and extend the instrument's operational life. 10.6.3. Such specimens received for testing need to be promptly and properly packaged and shipped to an appropriate reference laboratory. Visually examine containers for leaks upon arrival and before placing on rockers, in centrifuges, in racks, in closed-tube sampling (cap-piercing probe) systems, in automated aliquot stations or automated slide preparation systems, or on conveyor belts. De Carli G, Puro V, Scognamiglio P, Ippolito G. Infection with hepatitis C virus transmitted by accidental needlesticks. They convert glutaraldehyde and other more hazardous aldehydes into a nonhazardous, noncorrosive, nontoxic polymer and water. A BSC is not required for processing fecal specimens in the parasitology laboratory; however, some laboratories use Class I (open-face) or in many cases, a Class II-A2 (laminar-flow) BSC for processing all unpreserved specimens. Raal SS. Davies RJ, Hendrick DJ, Pepys J. Protection of laboratorians, coworkers, patients, families, and the environment is the greatest safety concern. A Category A substance is "an infectious substance which is transported in a form that, when exposure to it occurs, is capable of causing permanent disability, or life-threatening or fatal disease to otherwise healthy humans or animals" (93). Accidental inoculation could transmit any of the five species (P. vivax, P. ovale, P. falciparum, P. malariae, P. knowlesi). BSL-3 is appropriate for work with indigenous or exotic agents that have a known potential for aerosol transmission and for agents that can cause serious and potentially fatal infections (e.g., tuberculosis laboratories). Display on your projector to help students identify what hazards are considered dangerous in a kitchen. Copper-based fixatives (containing no formalin), 6.4.1. Decontaminate specimens, reagents, cultures and equipment that come into contact with specimens from patients with suspected Creutzfeldt-Jakob or other prion-associated disease according to local protocols, usually by autoclaving for 1 hour in the presence of 20,000 ppm hypochlorite solutions or 1 N NaOH (. Use disposable loops and needles or use electric incinerators for metal wire devices. (See Section 3.1). Emergency response telephone number. If a specimen tube breaks within the plastic screw-capped canister in a centrifuge: The Advisory Committee on Immunization Practices, in addition to recommending immunization of health-care personnel with vaccines recommended for all adults (influenza, measles/mumps/rubella, varicella, and tetanus/diphtheria/pertussis), recommends meningococcal or hepatitis B vaccination for those at risk for occupational exposure (. Blastomyces dermatitidis (tissues), Coccidioides immitis (tissues), Employees must receive initial training and refresher training at least annually, and this training is to be documented. According to the U.S. Bureau of Labor Statistics, in 2008, approximately 328,000 medical laboratory technicians and technologists worked in human diagnostic laboratories in the United States. 2004 Dec;24(4):1023-35. doi: 10.1016/j.cll.2004.05.017. The answer key will match up exactly to the answer document to allow for quick and easy grading!

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