May 15, 2019Mari Ishak Gabra, MS
A safe workplace is one where workers are protected from physical, chemical, and biological injuries as defined by the Occupational Safety and Health Administration (OSHA). Laboratories today can contain several threats to workers’ health and safety that vary from dangerous equipment to biological agents and blood borne pathogens. Lab managers and safety officers are fully aware that accidents happen. Therefore, training and keeping up with appropriate personal protective equipment (PPE) requirements are benchmarks for clinical laboratories.
According to OSHA’s laboratory safety guidance, PPE should be implemented after engineering controls, proper work practices, and administrative controls. Employers will often install the necessary engineering controls such as biosafety cabinets or ventilated work stations. Work practices limits duration and intensity of exposure to hazardous material and administrative controls modify workers’ schedules to minimize potential exposures through training or shift design. PPE serves as the final protective barrier between clinical laboratory workers and the hazard, and should therefore be carefully considered.
Whether working directly with patients to draw up blood or with various biological samples for analysis, it is crucial to understand the possibilities of exposure and the proper PPE to be used. Having worked as a both a research assistant and a consultant in clinical laboratory analysis, I have noticed that most safety risks involve splashes from opening tubes with patient samples and accidental spilling. Additionally, the Eye and Face Protection standard 1910.133 is among the most common citations issued by OSHA to clinical laboratories and costs several thousands of dollars in fines.
A clinical lab manager or safety officer’s first step is to identify the types of hazards and proper controls through a job hazard analysis or risk evaluation checklist. This will allow laboratories to identify potential risks associated with all techniques used by their employees in order to devise the most suitable way to reduce chances of injury. There are several templates available online, which can be adopted or modified. Some laboratories will also provide an individual assessment for workers to obtain the appropriate fitted PPE during training.
Basic PPE is required for all laboratories. This includes long pants, closed-toe shoes, lab coats, and safety glasses. There are now several lab coat options available to clinical laboratories depending on the nature of tasks being performed. For instance, staff or nurses working directly with drawing up or collecting samples should dress in fluid resistant scrubs or disposable lab coats in case of accidental spilling. A reusable fluid resistant lab coat, rather than a traditional cotton blend coat, is recommended for laboratory staff working directly with biological samples.
Gloves are also considered part of the basic PPE in a clinical laboratory as they provide protection from skin contact and contamination. A chemical compatibility chart should be consulted when deciding on the appropriate type and material to be used. Latex gloves are not always optimal for all tasks.
As the most common exposure route is through splashing, clinical lab managers should provide face masks as an additional PPE to be used during sample preparation. Finally, clinical laboratories that handle specimen processing in formaldehyde or risk exposure to infectious diseases may also require extra respiratory protection,even if proper engineering controls are implemented.
OSHA inspectors will often ask workers if they understand the purpose of their PPE and the type of hazards they are being protected against. Therefore, training should cover when PPE are required to be on and taken off, and the limitations of each type of PPE. For instance, workers should remove their PPE before entering shared areas and restrooms. It is also imperative to indicate which computers or instruments are considered clean and which ones require gloves and proper PPEs.
Monitoring and revising
It is important for laboratories to ensure proper maintenance of PPE to protect their workers. Regular monitoring of PPE condition and use is key. This can be achieved by maintaining updated information and training on PPE requirements through online platforms or an annual self-assessment form. Additionally, thorough investigation in the case of any accidents involving use of PPE should be documented and discussed to help improve the current PPE guidelines for maximized protection of all employees.