Safety precautions in pathology Laboratory

August 17, 2021

There are many conditions in the laboratory have the potential for causing injury to staff and damage to the building or to the community. Patients’ specimens, needles, chemicals, electrical equipment, reagents, and glassware all are potential causes of accidents or injury. Managers and employees must be knowledgeable about safe work practices and incorporate these practices into the operation of the hematology laboratory. The key to prevention of accidents and laboratory-acquired infections is a well-defined safety program.

1. Hand-washing is one of the most important safety practices. Hands must be washed with soap and water. If water is not readily available, alcohol hand gels (minimum 62% alcohol) may be used. Hands must be thoroughly dried. The proper technique for handwashing is as follows:

a. Wet hands and wrists thoroughly under running water.

b. Apply germicidal soap and rub hands vigorously for at least 15 seconds, including between the fingers and around and over the fingernails.

Hands must be washed:

a. Whenever there is visible contamination with blood or body fluids

b. After completion of work

c. After gloves are removed and between glove changes

d. Before leaving the laboratory, Before and after eating and drinking, smoking, applying cosmetics or lip balm, changing a contact lens, and using the lavatory

f. Before and after all other activities that entail hand contact with mucous membranes, eyes, or breaks in skin

2. Eating, drinking, smoking, and applying cosmetics or lip balm must be prohibited in the laboratory work area.

3. Food and drink, including oral medications and tolerance-testing beverages, must not be kept in the same refrigerator as laboratory specimens or reagents or where potentially infectious materials are stored or tested.

4. Mouth pipetting must be prohibited.

5. Needles and other sharp objects contaminated with blood should be discarded properly.

6. Contaminated sharps (including, but not limited to, needles, blades, pipettes, syringes with needles, and glass slides) must be placed in a puncture-resistant container that is appropriately labeled with the universal biohazard symbol or a red container which must be leak-proof.

7. Procedures such as removing caps when checking for clots, filling haemocytometer chambers, making slides, discarding specimens, making dilutions, and pouring specimens or fluids must be performed carefully so that splashing, spraying, or production of droplets of the specimen is prevented. These procedures may be performed behind a barrier, such as a plastic shield, or protective eye wear should be worn.

8. Gowns, laboratory coats, and sleeve protectors, should be worn when there is a chance of splashing or spilling on work clothing. The outer covering must be made of fluid-resistant material, must be long-sleeved, and must remain buttoned at all times.

9. All protective clothing should be removed before the worker leaves the laboratory; it should not be worn into public areas.

10. Eye wear, including face shields, goggles, and masks, should be used when there is potential for aerosol, splashes, or sprays to mucous membranes (mouth, eyes, or nose). Removing caps from specimen tubes, working at the cell counter, and centrifuging specimens are examples of tasks that could result in creation of aerosol or contamination.

11.Contaminated gloves should be disposed of according to applicable state regulations.

12. Phlebotomy trays should be appropriately labeled to indicate potentially infectious materials. Specimens should be placed into a secondary container, such as a resealable biohazard-labeled bag.

13. If a pneumatic tube system is used to transport specimens, the specimens should be transported in the appropriate tube (primary containment), placed into a special self-sealing leak-proof bag, appropriately labeled with the bio-hazard symbol (secondary containment).

14. Requisition forms should be placed outside of the secondary container to prevent contamination if the specimen leaks. Foam inserts for the pneumatic tube system carrier prevent shifting of the sample during transport and also act as a shock absorber, thus decreasing the risk of breakage.

15. Routine cleaning should be performed on equipment that has the potential for receiving splashes or sprays, such as inside the lid of the micro-hematocrit centrifuge.

16. To prevent contamination, all work surfaces should be cleaned when procedures are completed and whenever the bench area or floor becomes visibly contaminated.

17. Laboratory employees should receive the HBV vaccination series at no cost before or within 10 days after beginning work in the laboratory.

18. Hematology staff should be properly educated in epidemiology and symptoms of blood-borne diseases, modes of transmission of blood-borne diseases, use of protective equipment, work practices, ways to recognize tasks and other activities that may result in an exposure.

19. Placement of adequate fire detection and suppression systems (alarms, smoke detectors) which should be tested every 3 months. Placement of manual fire alarm boxes near the exit doors.

20. Follow all handling and storage requirements for the chemical. Store alcohol and other flammable chemicals in approved safety cans or storage cabinets at least 5 feet away from a heat source.

21. Equipment that causes shock or a tingling sensation should be turned off, the instrument unplugged and identified as defective, and the problem reported.